JNMA; journal of the Nepal Medical Association
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JNMA J Nepal Med Assoc · Apr 2020
Critical Incidents during Anesthesia and Early Post-Anesthetic Period: A Descriptive Cross-sectional Study.
Critical incidents related to peri-operative anesthesia carry a risk of unwanted patient outcomes. Studying those helps detect problems, which is crucial in minimizing their recurrence. We aimed to identify the frequency of peri-anesthetic critical incidents. ⋯ Critical incidents occur even in low-risk patients during anesthesia delivery. Patient factors and emergency surgery contribute to the most serious incidents.
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JNMA J Nepal Med Assoc · Apr 2020
Case ReportsSevere Cardiac Dysautonomia and Sudden Death in a Patient Presenting with Anginal Symptoms in Absence of Cardiovascular and Other Diseases: A Case Report.
Angina is a type of chest pain, experienced by patients with ischemic heart diseases. Cardiac autonomic modulation as assessed by heart rate variability and baroreflex sensitivity is found reduced in ischemic heart disease patients. Marked reduction in heart rate variability and baroreflex sensitivity in ischemic heart disease patients is found associated with sudden cardiac death. ⋯ The patient had sudden death within 6 months of follow-up. Reportedly, no other specific abnormalities were found before death. This case report suggests that patients presenting with typical chest pain as angina may have severe dysautonomia and risk of sudden death even in the absence of cardiovascular or any other known end-organ diseases.
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Many of us may be unknowingly suffering from information disorder syndrome. It is more prevalent due to the digitized world where the information flows to every individual's phone, tablet and computer in no time. Information disorder syndrome is the sharing or developing of false information with or without the intent of harming and they are categorized as misinformation, disinformation and malinformation. ⋯ The management of this disorder requires the management of false information, which is rumor surveillance, targeted messaging and community engagement. Repeated sufferers at the Grade 1 level, all sufferers from grade 2 and 3 levels need psycho-social counseling and sometimes require strong regulations and enforcement to control such information disorder. The most critical intervention is to be mindful of the fact that not all posts in social media and news are real, and need to be interpreted carefully.
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JNMA J Nepal Med Assoc · Apr 2020
Case ReportsRare Cause of Tension Pneumothorax: Hydatid Disease of Lung: A Case Report.
Lung is the second most common site of hydatid disease, after liver. Pleural involvement of hydatid disease can occur, and usually follows the rupture of a pulmonary or hepatic hydatid cyst into the pleural space. When a patient presents with tension pneumothorax, zoonotic infections, especially hydatid disease of the lung, also has to be considered especially in areas with high burden of the disease. We report a 31 years male patient presenting with tension pneumothorax due to rupture of hydatid cyst of lung.
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JNMA J Nepal Med Assoc · Apr 2020
Comparative StudySensitivity of Sinus Radiography Compared to Computed Tomogram: A Descriptive Cross-sectional Study from Western Region of Nepal.
Radiography of the paranasal sinuses is commonly used diagnostic modality. However, the trustworthiness of plain radiographic findings of paranasal sinuses is debatable. The intention of this study was to weigh the diagnostic soundness of plain radiograph of the paranasal sinuses to that of computed tomogram scan. ⋯ Sinus radiography is more sensitive for detecting pathologies in maxillary sinuses, while it is moderate for frontal, ethmoid sinuses and least for sphenoid sinuses. Diagnostic accuracy of computed tomogram scan is more, hence should be recommended to characterize the complex pathology and anatomy of the osteomeatal complex.