Kathmandu University medical journal (KUMJ)
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Kathmandu Univ Med J (KUMJ) · Apr 2015
Analgesia before Performing Subarachnoid Block in the Sitting Position in Patients with Proximal Femoral Fracture: A Comparison between Fascia Iliaca Block and Femoral Nerve Block.
Positioning for subarachnoid block (SAB) in patients with femoral fracture is painful and may remain suboptimal requiring use of large doses of opioids. These patients generally being elderly with multiple comorbidities and frailty are likely to have many undesirable effects of opioids including respiratory depression and confusion. ⋯ Fascia iliaca compartment block provides better analgesia than femoral nerve block in terms of facilitating optimal positioning for subarachnoid block in patients undergoing proximal femoral fracture fixation procedure.
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Kathmandu Univ Med J (KUMJ) · Jan 2015
Undertreated Hypertension and its Implications for Public Health in Nepal: Nationwide Population-Based Survey.
Hypertension (HTN), a major risk factor for cardiovascular diseases (CVDs), is a substantial global public health problem. Occasional studies indicate a high prevalence of HTN in the Nepalese population, but no nationwide population-based data exist so far. We opportunistically used a survey of major disorders of the brain in Nepal to measure blood pressure (BP) in participants selected randomly from the adult general population. ⋯ In the context of the survey we could not collect data on antihypertensive therapy being taken but, clearly, whatever this might have been, it was failing to meet treatment needs. Almost one in six adults met criteria for hypertension, carrying risk implications for CVDs and their substantial public-health consequences. Two remediable associated factors were identified, although in a cross-sectional survey we could not prove causation.
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Kathmandu Univ Med J (KUMJ) · Jan 2015
ReviewPoint-of-care Ultrasonography in Critically Ill Patients.
Point-of-care ultrasonography has been used frequently by the physicians involved in managing critically ill patients. It allows direct visualization of pathology or abnormal physiological state at the bed side. ⋯ It is helpful to guide the therapy in patients with undifferentiated shock and for bedside diagnosis of common pathological conditions in acute care setting. It can facilitate common bedside procedures and interventions.
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Kathmandu Univ Med J (KUMJ) · Jan 2015
Case ReportsAnesthetic Management of a Patient with Myasthenia Gravis for Meningioma Surgery - A Case Report.
Myasthenia gravis is a disease of great challenge to the anesthesiologist, because it affects the neuromuscular junction. Anesthetic management involves either muscle relaxant or non-muscle relaxant techniques. This case report documents the safe use of fentanyl, propofol and sevoflurane combination guided by bispectral index, without the use of muscle relaxants in a patient with myasthenia gravis who presented for meningioma surgery.
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Kathmandu Univ Med J (KUMJ) · Jan 2015
Case ReportsCommunity-Acquired Methicillin Resistant Staphylococcus aureus Bacteremia: Case Series.
Community-acquired methicillin resistant Staphylococcus aureus (MRSA) usually causes skin and soft tissue infections. However, community-acquired methicillin resistant S.aureus has been identified as a causative agent of many invasive infections like necrotizing fasciitis, pneumonia and bacteremia. Risk factors such as immunodeficiency and skin and soft tissue infections have been identified for acquiring bacteremia. We present four cases of bacteremia caused by community-acquired methicillin resistant S.aureus, risk factors and outcome.