Kathmandu University medical journal (KUMJ)
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Penetrating neck wounds are potentially dangerous and require emergency management because of the presence of vital structures in the neck. Organic foreign bodies further carries a risk of wound infection. We present a case of penetrating broken branch of a tree traversing from zone II to zone III without any neurovascular injury. Neck exploration was done with midline mandibulotomy approach and foreign body was removed without any complication.
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Kathmandu Univ Med J (KUMJ) · Apr 2007
Case ReportsTopiramate induced bilateral angle-closure glaucoma.
Topiramate is a sulfamate-substituted monosaccharide and is used as an antiepileptic medication. It can also be used as a prophylactic agent for headache from migraine. ⋯ This is the first reported case of topiramate induced bilateral angle-closure glaucoma in Nepal. This case was managed successfully by discontinuing topiramate and by starting anti-glaucoma medication along with atropine eye drops which were tapered and eventually discontinued.
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Kathmandu Univ Med J (KUMJ) · Apr 2007
Case ReportsSitus inversus with dextrocardia with multiple cardiac lesions in adult.
Situs inversus with dextrocardia is the malposition most likely to occur with structurally normal heart; generally discovered on routine chest x-ray or physical examination performed for other reasons. These persons experience normal longevity of life and have similar risk of getting acquired disease as that of other person of same age and sex group. ⋯ Incidence of congenital cardiac anomalies in dextrocardia with situs inversus is very low globally but its figure in Nepal is not known. We report an adult of 43 years age having situs inversus with dextrocardia associated with multiple cardiac lesions i.e. ventricular septal defect, aortic regurgitation, mitral regurgitation and tricuspid regurgitation.
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Kathmandu Univ Med J (KUMJ) · Apr 2007
Comparative StudyComparative study between bupivacaine heavy vs pethidine intrathecally to study early haemodynamic changes and postoperative analgesia in patients undergoing caesarean section.
To study early hemodynamic changes and duration of postoperative analgesia between two study groups of intrathecal pethidine and bupivacaine heavy in patients undergoing caesarean section. ⋯ The hemodynamic parameters (HR & BP) were compared in different time intervals. The difference in heart rate and blood pressure at different time intervals in the two study groups were statistically insignificant as (p > 0.05). The total duration of postoperative analgesia in patients receiving sole intrathecal pethidine was 8 hours and 30 minutes. Where as, in Bupivacaine group the duration was 2 hrs and 36 minutes. This has been found statistically significant (p<0.05).
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The present study was undertaken to study the frequency of electrolyte imbalance in children with diarrhoea and the relationship between electrolyte abnormalities and mortality. ⋯ Hyponatremia, hypokalemia and metabolic acidosis are common electrolyte and acid-base abnormalities in children with diarrhoea and dehydration and often responsible for mortality.