JNMA; journal of the Nepal Medical Association
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JNMA J Nepal Med Assoc · Mar 2018
Perceptions of Medical Students About Bedside Teaching in a Medical School.
Bedside teaching is an important and established learning tool in medical education. However there is a decline in bedside teachings over the years throughout the world including Nepal, due to advancement in medical technology, clinical skills labs and simulation techniques. This study aimed to find out the perception of Nepalese medical students towards different domains of bedside teaching. ⋯ The study concluded that medical students have positive response and learning attitudes towards different aspects of bedside teaching.
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JNMA J Nepal Med Assoc · Mar 2018
Case ReportsSpinal Anaesthesia for Laparoscopic Cholecystectomy in Parkinson's Disease.
Parkinson's disease, a neurodegenerative disorder, presents with resting tremor, muscle rigidity and bradykinesia. Affecting multiple organ-systems, it's an important cause of peri-operative morbidity. General anaesthesia may deteriorate cardio-pulmonary and neuro-cognitive functions; moreover, medications used may interact with anti-parkinsonian agents. ⋯ Without deterioration, patient was discharged from hospital on third day. Spinal anaesthesia is a valid technique for laparoscopic cholecystectomy in needy patients with multiple peri-operative risks. Keywords: Laparoscopic cholecystectomy; Parkinson's disease; spinal anaesthesia.
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JNMA J Nepal Med Assoc · Mar 2018
Innovative Method of Using Endoscope in Postoperative Canal Wall Down Mastoid Cavity.
Poor access to the difficult areas in the middle ear and mastoid cavity is considered as the major reason for failure in mastoid surgery. Wide field visibility, visualization of nooks and corners by an endoscope could contribute to better clinical control of the disease in these patients that cannot be accessed by the operating microscope. The study was done to assess and clean postoperative canal wall down mastoidectomy cavities with endoscope and compare with oto-microscopy. ⋯ Outcome will make the ENT surgeons aware of use of endoscopy in post mastoid follow up cases to give better results and make the surgeon much more successful in his/her endeavor to eradicate the disease.
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JNMA J Nepal Med Assoc · Mar 2018
Periodontal Health Status and Pregnancy Outcomes: A Survey in Medical Doctors.
Periodontal disease and caries are the most common causes of tooth loss worldwide. Studies have demonstrated strong association between periodontitis and adverse pregnancy outcomes. Medical doctors, who are the primary healthcare providers, seldom advise women to seek dental care during pregnancy. This study was undertaken to explore the knowledge, attitudes and behaviours of medical doctors towards oral health and to identify the barriers of prenatal periodontal healthcare in their practices and its possible implications on pregnancy outcomes. ⋯ There is need for training on 'oral healthcare during pregnancy' for medical doctors. Developing universal guidelines for oral healthcare in pregnant women for all health professionals would be another important step. An adequate referral system to oral healthcare providers and biannual check-ups is recommended for both general patient as well as pregnant women for preventing adverse situations related to oral and specifically periodontal diseases.
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JNMA J Nepal Med Assoc · Mar 2018
Case ReportsMedication Error- A Case Report of Misadventure with Methotrexate.
Methotrexate is an antimetabolite drug with antineoplastic and immunomodulatory properties, useful as an antineoplastic agent in various haematological and solid tumours. MTX toxicity can occur because of accidental ingestion/overdose by the patient or because of prescription error. The toxic effects manifest as severe mucositis or as organ damage (bone marrow depression, renal/hepatic injury). ⋯ We present a case of MTX toxicity occurring as a result of prescription error resulting in repeat daily dosing of the drug, and the challenges associated with the management of the same, in a patient with multiple comorbidities. The present case emphasizes on a note of caution on the part of the prescriber and the suggestions regarding the measures which can be taken to avoid MTX toxicity. Keywords: drug overdose; Methotrexate; mucositis; pancytopenia.