JNMA; journal of the Nepal Medical Association
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JNMA J Nepal Med Assoc · Oct 2022
ReviewPrehabilitation in Patients before Major Surgery: A Review Article.
The overall outcome of the patient after any surgery is determined not only by the fineness of the surgical procedure but also by preoperative conditioning and postoperative care. Prehabilitation decreases the surgical stress response and increases the preparedness of the patient to undergo planned surgical insult. Preoperatively structured inspiratory muscle exercises, cardiopulmonary fitness program, and planned exercise program for muscles of limbs, back, abdomen, head, and neck allow an overall upliftment of the physiological capacity of the patient to better cope with the surgical stress. Optimization of dietary status by macronutrients, micronutrients, and the nutrients has an impact on augmenting postoperative recovery and shortening the overall hospital stay. Preparing patients for the scheduled surgery and initiating alcohol and smoking cessation programs overhaul the patient's mental health and boost the healing process. This concept of prehabilitation a few weeks before surgery is equally beneficial compared to enhancing operative procedures and postsurgical care. ⋯ length of stay; mental health; nutrients; preoperative exercise; smoking cessation.
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JNMA J Nepal Med Assoc · Oct 2022
Case ReportsMultiple Wasp Stings Leading to Rhabdomyolysis Induced Acute Kidney Injury with Incidental Ectopic Kidney: A Case Report.
Rhabdomyolysis refers to skeletal muscle breakdown causing a release of different intracellular proteins including myoglobin and several electrolytes in the bloodstream. Elevations diagnose rhabdomyolysis in serum creatine kinase. Mass envenomation by multiple wasp stings can cause rhabdomyolysis followed by acute kidney injury, although it is scarce. A 24-year-old male presented to our tertiary centre in an anaphylaxis-like state after multiple wasps sting, rapidly developing rhabdomyolysis followed by acute kidney injury. Despite having an ectopic kidney with a pre-existing renal parenchymal disease, he recovered and was discharged, which in itself is a rare entity of low clinical incidence. Wasp stings can potentially result in serious clinical manifestations, which need to be watched over, assessed and promptly treated. ⋯ acute kidney injury; case reports; creatine kinase; hymenoptera; rhabdomyolysis.
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Penile fracture is a rare condition with an incidence of 1 case per 175000 United States male population. It can be caused by vigorous sexual intercourse and masturbation. Patients usually present with pain and swelling of the penis and can be diagnosed clinically. It mostly occur as a result of rupture of tunica albuginea of corpora cavernosa. Ultrasound is the most reliable investigation to detect penile fractures. Patients need prompt treatment with exploration and repair of defects to prevent long-term sequelae. Here we present a case of 44 years male who developed a penile fracture following sexual intercourse and underwent surgical exploration and repair. ⋯ masturbation; penis; sexual intercourse.
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JNMA J Nepal Med Assoc · Oct 2022
Radial Head Arthroplasty among Patients with Radial Head Fracture in a Tertiary Care Centre: A Descriptive Cross-sectional Study.
Proximal radial fractures are a common type of fracture around the elbow joint. Among these comminuted radial head fractures are commonly associated with secondary injuries and instability of the elbow joint. Management of the radial head in such cases is very important in restoring the stability of the elbow joint and starting early mobilization. The aim of this study was to find out the prevalence of radial head arthroplasty among patients with radial head fracture in a tertiary care centre. ⋯ arthroplasty; elbow prosthesis; radius fractures.
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JNMA J Nepal Med Assoc · Oct 2022
Amblyopia among Patients Attending the Outpatient Department of Ophthalmology of a Tertiary Care Centre: A Descriptive Cross-sectional Study.
Amblyopia is defined as a reduction in visual acuity unilaterally or bilaterally without any detectable cause. It is a major public health issue in developing and underdeveloped countries. Its prevalence is usually underestimated because of proper study and lack of awareness. The aim of the study was to find out the prevalence of amblyopia among patients attending the Outpatient Department of Ophthalmology of a tertiary care centre. ⋯ amblyopia; anisometropia; astigmatism; refractive errors.