JNMA; journal of the Nepal Medical Association
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JNMA J Nepal Med Assoc · Apr 2014
Randomized Controlled TrialLignocaine and Esmolol on Stress Response to Laryngoscopy and Intubation.
Laryngoscopy and tracheal intubation causes significant sympathetic response resulting in hypertension and tachycardia. In individuals with systemic hypertension, coronary artery disease, cerebrovascular disease and intracranial aneurysm, the effect of this transient sympathetic response can evoke life threatening conditions like pulmonary oedema, cardiac failure and cerebrovascular haemorrhage. ⋯ Both esmolol and lignocaine were not effective in attenuating hemodynamic stress response to laryngoscopy and tracheal intubation; however esmolol was superior to lignocaine in blunting the stress response.
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JNMA J Nepal Med Assoc · Apr 2014
Developing an Index to Measure Health System Performance: Measurement for Districts of Nepal.
Various frameworks for measuring health system performance have been proposed and discussed. The scope of using performance indicators are broad, ranging from examining national health system to individual patients at various levels of health system. Development of innovative and easy index is essential to measure multidimensionality of health systems. ⋯ Categories of low and high performing districts on health system performance are also having low and high human development, socio-economic, and infrastructure indices respectively. This methodology of computing index from various indicators could assist policy makers and program managers to prioritize activities based on their performance. Validation of the findings with that of other development indicators show that this can be one of the tools, which can assist on assessing health system performance for policy makers, program managers and others.
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JNMA J Nepal Med Assoc · Jan 2014
Randomized Controlled TrialOndansetron and Granisetron for prevention of postoperative nausea and vomiting following laparoscopic cholecystectomy.
Laparoscopic surgeries are known to be associated with a higher incidence of postoperative nausea and vomiting (PONV). Prophylaxis of PONV is usually achieved with a single-dose antiemetic drug administered during the surgical procedure. The aim of this study was to compare the antiemetic efficacy of two different 5-hydroxytryptamine-3 (5HT3) receptor antagonists, ondansetron and granisetron when given prophylactically to patients undergoing laparoscopic cholecystectomy. ⋯ Granisetron, when given prophylactically, resulted in a significantly lower incidence of PONV than ondansetron in the first 24 hours.
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JNMA J Nepal Med Assoc · Jan 2014
Frequency of Blood Culture Isolates and their Antibiogram in a Teaching hospital.
Bloodstream infections are associated with significant patient morbidity and mortality. Antimicrobial susceptibility patterns should guide the choice of empiric antimicrobial regimens for patients with bacteremia. ⋯ Ongoing surveillance for antimicrobial susceptibility remains essential, and will enhance efforts to identify resistance and attempt to limit its spread.
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JNMA J Nepal Med Assoc · Jan 2014
Psychiatric Comorbidities in Patients with Deliberate Self-Harm in a Tertiary Care Center.
Deliberate self-harm (DSH) is one of the common psychiatric emergencies in medical practice. It has become a global health problem with rates increasing over time. Very few studies have been conducted on this important health issue in Nepal. We conducted a hospital based study to evaluate the cause, mode and psychiatric comorbidities present in patients of DSH. ⋯ Majority of DSH cases were of younger generation. Psychiatric disorders and comorbid personality problems were commonly seen in DSH patients. This has significance for proper evaluation and management.