Kathmandu University medical journal (KUMJ)
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Kathmandu Univ Med J (KUMJ) · Jan 2015
Percutaneous Ilio-Sacral Screw Fixation in Supine Position under Fluoroscopy Guidance.
Pelvic ring disruption when treated conservatively can be associated with prolonged hospital stay and immobilization, mal-union, chronic pain, limb length discrepancy if they are treated conservatively. Open reduction and fixation in an already compromised soft tissue and hemodynamically unstable patient causes more soft tissue injury, heamatoma, infection and neurovascular injury. Percutaneous iliosacral joint fixation can be an alternative technique for sacro-iliac joint injury and sacral fracture. ⋯ Percutaneous ilio-sacral screw fixation for sacro-iliac joint injury and sacral fracture with C arm guidance is safe and minimally invasive technique. Clear images and accurate interpretation of X-rays, CT scans and per operative C arm images are important to avoid malpositioning of screws and iatrogenic neurovascular injuries.
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Kathmandu Univ Med J (KUMJ) · Jul 2014
Case ReportsGingival calcifying epithelial tumor - a rare case report.
Calcifying epithelial odontogenic tumors are rare odontogenic neoplasms that account for approximately one percent of all odontogenic tumors. Extra osseous variant is very rare with very few cases being reported in literature Peripheral Calcifying epithelial odontogenic tumor (CEOT) commonly resemble oral hyperplastic or reactive lesions and are histologically similar to their intraosseous counterparts. Here we report a rare case of gingival calcifying epithelial odontogenic tumor in the mandibular posterior region in a 31 year old female patient. Interestingly on literature review in on PubMed search only 22 case reports were available in, English literature, added to that this report will be the 23rd case.
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Kathmandu Univ Med J (KUMJ) · Apr 2014
Observational StudySafety profile and patient satisfaction of the routine use of propofol in gastrointestinal endoscopy.
Routine use of sedation in upper gastrointestinal endoscopy is uncommon in Nepal. There is no study on use of propofol sedation in routine endoscopy examination in Nepal. This study was conducted in order to assess the patient satisfaction and safety profile in patient undergoing routine upper GI endoscopic examination on outpatients. ⋯ Upper GI endoscopy can safely be performed under propofol sedation administered by registered trained nurse under the supervision of endoscopist.
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Kathmandu Univ Med J (KUMJ) · Apr 2014
Delirium in critically ill patients in a tertiary care centre in western region of Nepal.
Delirium affects a significant proportion of critically ill patients admitted in hospital. It is associated with various adverse outcomes. Despite its enormous prognostic significance it tends to be underdiagnosed. There is a dearth of studies on risk factors of delirium in our setting. ⋯ About 16% of critically ill patients were found to be delirious. In about one third of the cases delirium was not recognized. Both patient related and iatrogenic factors may increase the risk of delirium in hospitalized critically ill patients.
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Kathmandu Univ Med J (KUMJ) · Apr 2014
Comparison of ultrasound guided transversus abdominis plane block versus local wound infiltration for post operative analgesia in patients undergoing gynaecological surgery under general anaesthesia.
Transversus abdominis plane block has been recently developed as a part of multimodal post operative analgesic techniques. We compared the analgesic efficacy of this technique with local bupivacaine infiltration in patients undergoing gynaecological surgeries with pfannenstiel incision and lower midline incision under general anaesthesia. ⋯ Bilateral Transversus abdominis plane block was effective in reducing postoperative pain scores for 8 to 12 hours postoperatively. This block was also successful in reducing postoperative opioid requirement.