JNMA; journal of the Nepal Medical Association
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JNMA J Nepal Med Assoc · Apr 2017
ReviewNeed of The Ministry of Health in Federal Democratic Republic of Nepal.
The constitution of Nepal provides appointing a council of ministers both at federal and provincial levels without defining portfolios. There is a political agreement that MOH will be retained at the federal level. ⋯ Retaining ministry of health at federal level without creating devolved structure at province and local levels in health sector will create difficulty in translating the spirit of the constitution and may not be effective in addressing health issues nationally and meeting global achievements like SDGs. It is suggested to establish an elaborate health system accordingly in Nepal to ensure constitutional mandate of health as a basic human right.
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In routine practice, regional anaesthesia is less commonly used for clavicular fracture compared to general anaesthesia. We report two cases of clavicle fracture for which operative treatment was done under combined superficial cervical plexus and interscalene brachial plexus block. ⋯ Both the patients exhibited comfort and there was no additional analgesic demand in both the cases. Thus combination of interscalene and superficial cervical plexus block can prove to be useful in patients with clavicle fracture where administration of general anaesthesia and its adverse effects could be avoided.
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JNMA J Nepal Med Assoc · Jan 2017
Risk Factors for Complications in Acute Appendicitis among Paediatric Population.
Appendicitis is one of the most common causes of acute abdomen in children. Patients who are diagnosed early and undergo an appendectomy before perforation have a good outcome. However, it is difficult to diagnose in young children because its clinical manifestations may be atypical. The aim of this study was to determine the risk factors for complications in acute appendicitis in paediatric population. ⋯ Increase in total leucocyte count and duration of the presentation can be a good marker of complicated appendicitis.
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JNMA J Nepal Med Assoc · Oct 2016
Titanium Elastic Nailing System (TENS) for Tibia Fractures in Children: Functional Outcomes and Complications.
Closed reduction and cast application is still regarded as first line treatment for pediatric tibial fractures. Over the past few decades, management of pediatric tibial fractures has shifted more towards operative intervention because of quicker recovery, shorter rehabilitation period, less immobilization, lack of stiffness of adjoining joints, and less psychological impact to the children. Flexible intramedullary nails not only fulfill the above advantage but also maintain alignment and rotation. ⋯ Titanium elastic nail fixation is a simple, easy, rapid, reliable and effective method for management of pediatric tibial fractures in patients with operative indications. There may be the chances of complication following the TENS in tibia but these are avoidable as well as manageable with careful precautions.
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JNMA J Nepal Med Assoc · Jul 2016
Comparative StudyHysteroscopy in Abnormal Uterine Bleeding vs Ultrasonography and Histopathology Report in Perimenopausal and Postmenopausal Women.
Abnormal uterine bleeding is one of the most common morbidity landing women to attend medical attention in gynecology outpatient department. This study aims to evaluate the hysteroscopy finding in diagnosis of AUB and its correlation with ultrasonography finding and histopathological reports. ⋯ Hysteroscopy is reliable method for evaluating cases of AUB and it can be used as first line diagnostic method for benign lesions. Hysteroscopy guided biopsy has most accurate in diagnosing pathology.