JNMA; journal of the Nepal Medical Association
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JNMA J Nepal Med Assoc · Oct 2017
Prehospital Events in ST- Elevation Myocardial Infarction Undergoing Primary Angioplasty.
Pre-hospital delay includes time from onset of symptoms of myocardial infarction till arrival to emergency room of the hospital. This defines time from symptom onset to first medical contact and first medical contact to emergency room. This study aims to study the prehospital events and determining factors in patients undergoing primary angioplasty. ⋯ Chest pain was common in morning and the prehospital delay can be minimized by improving time from symptom to first medical contact and first medical contact to Emergency room.
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JNMA J Nepal Med Assoc · Oct 2017
Randomized Controlled TrialEffects of Intrathecal Dexmedetomidine as an Adjuvant to Hyperbaric Bupivacaine for Spinal Anaesthesia in Adults Undergoing Elective Infra-umbilical Surgery.
Various adjuvants to local anaesthetic are used to improve quality and duration of spinal anaesthesia. Dexmedetomidine, a novel alpha-2 adrenergic agonist, has been proposed to augment local anaesthetic effects. This study aims to investigate effects of intrathecal Dexmedetomidine on duration of analgesia and duration of sensory block during spinal anaesthesia. ⋯ Dexmedetomidine as an intrathecal adjuvant to hyperbaric Bupivacaine in spinal anaesthesia prolongs duration of analgesia and sensory block with minimal adverse effects.
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JNMA J Nepal Med Assoc · Oct 2017
ReviewVentilator-Associated Pneumonia and Role of Nurses in Its Prevention.
Ventilator-associated pneumonia (VAP) is one of the most frequent nosocomial infections among ventilated patients in ICUs, associated with an increase in days of ICU stay, morbidity, and mortality. Its prevention is a significant concern in every hospital. Most of the interventions and prevention strategies are part of routine nursing care. ⋯ This study will help nurses to know about VAP and its prevention in detail so that they can apply the knowledge in clinical practice. Understanding pathophysiology of VAP, its risk factors, and care bundle is vital for the proper prevention and treatment of VAP. There must be specific protocols, strategies and active surveillance in every ICU regarding the care bundle.
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JNMA J Nepal Med Assoc · Oct 2017
Significance of Non-Invasive Markers as Predictor of Esophageal Varices in Liver Cirrhosis.
Upper gastro-intestinal endoscopy remains the gold standard for screening for esophageal varices but it has its own limitations. It is an invasive, expensive and uncomfortable procedure and needs clinical expertise. Accordingly, this study was conducted to establish the role of non-invasive markers for prediction of esophageal varices in liver cirrhosis. ⋯ Platelet count, spleen size and Child-Turcotte-Pugh class are good predictors of presence of esophageal varices in patients with liver cirrhosis. AST/ALT ratio and APRI score are not good substitutes for upper gastro-intestinal endoscopy.
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JNMA J Nepal Med Assoc · Jul 2017
Observational StudyPrediction of Difficult Airway Among Patients Requiring Endotracheal Intubation in a Tertiary Care Hospital in Eastern Nepal.
Various screening tests are done for predicting difficult laryngoscopy with variable diagnostic accuracy. Difficult laryngoscopy is being considered a surrogate indicator of difficult intubation, though it is not the exact measure of intubation difficulty. Our objectives were to find out the better predictor of difficult laryngoscopy amongst the routinely used tests and also to find the ability of difficult laryngoscopy to predict difficult intubation. ⋯ Modified Mallampati test was better for predicting difficult laryngoscopy compared to other bedside screening tests. Difficult laryngoscop could significantly predict difficult intubation in our patients.