Kathmandu University medical journal (KUMJ)
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Kathmandu Univ Med J (KUMJ) · Jan 2017
Incidence and Associated Risk Factors of Postoperative Sore Throat in Tertiary Care Hospital.
Background Postoperative sore throat is a relatively minor complaint but a frequent postoperative complication of anesthesia. The incidence of postoperative sore throat varies from 0-50% in most research studies, but some report the incidence is as high as 51-100% following general anesthesia. Objective The aim of this study was to obtain the incidence and determine the associated risk factors of postoperative sore throat in tertiary care hospital. ⋯ Conclusion Postoperative sore throat is a common complication of airway instrumentation in general anesthesia that can lead to discomfort. The overall incidence of postoperative sore throat in this study was 50.8%. Endotracheal tube, female patients and increased duration of anesthesia were associated with increased postoperative sore throat rates.
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Kathmandu Univ Med J (KUMJ) · Jul 2016
Comparative StudyLaparoscopic Appendectomy Versus Open Appendectomy for Acute Appendicitis: A Prospective Comparative Study.
Background Appendicitis is the most common cause for acute abdominal pain. Laparoscopic appendectomy is an effective alternative to open appendectomy. It is a minimally invasive results in less postoperative pain, less wound infection, early return to normal work and less morbidity compared to open appendectomy. ⋯ Surgical site infection in laparoscopic appendectomy and open appendectomy group were 3.8% and 14 % respectively (p< 0.05). Conclusion In laparoscopic appendectomy group, there is lower incidence of wound infection, lesser postoperative analgesic requirement and shorter hospital stay in comparison to open appendectomy. Though, the operative time is more with laparoscopic appendectomy, it can be considered as the gold standard for surgical treatment of acute appendicitis.
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Kathmandu Univ Med J (KUMJ) · Apr 2016
Randomized Controlled TrialUltrasound Guided Femoral Nerve Block to Provide Analgesia for Positioning Patients with Femur Fracture Before Subarachnoid Block: Comparison with Intravenous Fentanyl.
Background Positioning patients with fractured femur for subarachnoid block is painful. Intravenous analgesics or peripheral nerve block like femoral nerve block or fascia iliaca compartment block are some of the available techniques to reduce pain. We compared the efficacy of femoral nerve block and intravenous fentanyl in providing effective analgesia before positioning for subarachnoid block. ⋯ Level of significance was set at 0.05. Result FNB group had significantly less VAS scores (median) than IVF group :2 vs 3; p=0.037) during positioning for spinal anaesthesia. Procedure time (median) for spinal anaesthesia was also significantly less in FNB than in IVA group (10 vs 12 min; p=0.033) Conclusion Ultrasound guided femoral nerve block was more effective than intravenous fentanyl for reducing pain in patients with proximal femur fracture before spinal anaesthesia.
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Kathmandu Univ Med J (KUMJ) · Apr 2016
Bedside Ultrasound in the Emergency Department to Detect Hydronephrosis for the Evaluation of Suspected Ureteric Colic.
Background Renal colic is a common emergency department presentation. Hydronephrosis is indirect sign of urinary obstruction which may be due to obstructing ureteric calculus and can be detected easily by bedside ultrasound with minimal training. Objective To compare the accuracy of detection of hydronephrosis performed by the emergency physician with that of radiologist's in suspected renal colic cases. ⋯ Bedside ultrasound and formal ultrasound both detected hydronephrosis more often in patients with larger stones and the difference was statistically significant (p=.000). Conclusion Bedside ultrasound can be potentially used as an important tool in detecting clinically significant hydronephrosis in emergency to evaluate suspected ureteric colic. Focused training in ultrasound could greatly improve the emergency management of these patients.
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Kathmandu Univ Med J (KUMJ) · Jan 2016
Comparative Study Clinical Trial Observational StudyComparison of Initial Response of Nebulized Salbutamol and Adrenaline in Infants and young Children Admitted with Acute Bronchiolitis.
Background Acute bronchiolitis is common cause of hospitalization in infants and young children. There are widespread variations in the diagnosis and management. Despite the use of bronchodilators for decades, there is lack of consensus for the benefit of one above another. ⋯ Intravenous fluid duration was also less in adrenaline group compared to salbutamol group (33.15 vs 37.80 hours). Conclusion Patients of acute bronchiolitis nebulized with either salbutamol or adrenaline experienced similar decline in RDAI scores in the first 48 hours. Duration of supplementary oxygen and intravenous fluid was less in adrenaline group compared with salbutamol group.