Journal of Nepal Health Research Council
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J Nepal Health Res Counc · Jan 2012
External validation of prognostic model of one-year mortality in patients requiring prolonged mechanical ventilation.
External validation of prognostic model for one-year mortality in patients ventilated for 21 days or more. A measure that identifies patients who are at high risk of mortality after prolonged ventilation will help physicians communicate prognoses to patients or surrogate decision makers. Our objective was to validate a prognostic model developed by Carson et al in a different setting. ⋯ Simple clinical variables measured on day 21 of mechanical ventilation can identify patients at highest and lowest risk of death from prolonged mechanical ventilation.
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J Nepal Health Res Counc · Jan 2012
Percutaneous K wire fixation of fifth metacarpal neck fracture--new and simple technique.
Isolated fractures of metacarpals and phalanges are the commonest injuries affected upper extremity, which constitute about 10% of skeletal fractures in general. Fifth metacarpal (boxer's fractures) being the most common. The objective of this study was to investigate the outcome of treatment of the displaced neck and sub-capital fractures of the fifth metacarpal by percutaneous K wire fixation. ⋯ This method under consideration does not disturb the fracture site itself, the Kirschner wire being introduced in retrograde fashion makes it easier to correctly place the wire, which gives reasonably stable fixation, gives excellent results in a high proportion of selected cases. Local anesthesia is an added advantage.
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J Nepal Health Res Counc · Oct 2011
Randomized Controlled TrialNerve stimulation under ultrasound guidance expedites onset of axillary brachial plexus block.
Axillary block is popular technique in upper extremity surgery. Nerve stimulation is used for location of nerves to provide effective blockade. The advent of ultrasound imaging technique in regional anaesthesia has increased the accuracy of needle placement and local anaesthetic deposition around the nerve. The aim of this study is to find out if the nerve stimulation technique with ultrasound guidance has advantages over sole nerve stimulation technique. The outcome measures studied were onset of sensory and motor block, procedure time, number of skin puncture, vascular puncture and paresthesia during nerve stimulation. ⋯ This study showed that the onset of sensory and motor block was faster with ultrasound assistance nerve stimulation. Complications can be decreased with the use of ultrasound in axillary block.
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J Nepal Health Res Counc · Oct 2011
Molecular screening of major bacterial enteropathogens in human stool samples from diarrhoeal outbreak sites.
V. cholera types have been implicated often in a number of occasions in diarrhoeal outbreaks in Nepal. The recent outbreak in Far Western Nepal, 2009, was also attributed primarily to V. cholera. Molecular tools were used for the first time on some of the samples from the outbreak to screen for major pathogens present in those samples. ⋯ This first ever molecular screening study shows that bacterial screening is indeed possible in diarrhoeal samples. The results obtained from this study will enable monitoring of future such outbreaks using similar techniques.
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J Nepal Health Res Counc · Oct 2011
Developing community-based intervention strategies and package to save newborns in Nepal.
In Nepal, the proportion of under 5 deaths that are neonatal (0-28 days) has been increasing in the last decade, due to faster declines in infant and child mortality than in neonatal mortality. This trend is likely due to a focus on maternal and child survival programs that did not adequately address newborn health needs. Policy and actions to save newborn lives resulted from increased attention to newborn deaths in 2001, culminating in the endorsement of the National Neonatal Health Strategy in 2004, a milestone that established newborn health and survival as a national priority. ⋯ Not only was Nepal one of the first countries in south-east Asia where government adopted a national strategy to reduce neonatal deaths, but it was also one of the first to endorse a package of neonatal interventions for pilot testing and scaling up through existing community-based health systems that provide basic health services throughout the country. CB-NCP was designed to be gradually scaled up throughout the country by integration with Safe Motherhood and Child survival programs that are currently operating at scale. Under Ministry of health and Population leadership, a network of academia, professional bodies and partners developed a common vision for improving newborn health and survival, and launched district-level pilot programs to demonstrate and learn how newborn health interventions could be effectively and efficiently delivered and scaled up in Nepal.