Kathmandu University medical journal (KUMJ)
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Kathmandu Univ Med J (KUMJ) · Apr 2013
Post-operative drop in hemoglobin and need of blood transfusion in cesarean section at Dhulikhel Hospital, Kathmandu University Hospital.
Cesarean section has been identified as one of the commonest indication for blood transfusion in obstetric practice because it involves risk of major intra-operative blood loss. Different figures varying from less than 500 ml to more than 1000 ml have been quoted as estimated blood loss associated with caesarean section. There is also a wide variation in blood ordering practices for this surgery. ⋯ There is no need of routine cross-matching of blood for cesarean section. Only grouping with confirmation of availability should be done for emergency situation.
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Kathmandu Univ Med J (KUMJ) · Apr 2013
Epidemiological and outcome analysis of orthopedic implants removal in Kathmandu University Hospital.
Orthopedic Implant removal is one of the commonly performed elective orthopedic surgeries. Implants are generally removed after the purpose of keeping implant is solved by healing of the fracture, but there is no consensus whether routine implant removal should be a policy for all fractures that were fixed. ⋯ Implant removal procedures are one of the most commonly performed elective orthopedic surgeries. Though, after orthopedic implants removal, pain relief can be expected but it is not so predictive and hence patient should be well counseled before and the indications for implant removal has to be evaluated for better patient satisfaction and safety.
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Kathmandu Univ Med J (KUMJ) · Jan 2013
Case ReportsA case of synchronous malignancy of stomach and kidney.
The synchronous occurrence of primary renal cell carcinoma with gastric cancer is very rare. We report a case of 41 year old male who presented on 05/07/2011 to M S Ramaiah hospital, Bangalore with history of fever, pain abdomen and malena. Ultrasound abdomen and pelvis showed large heterogenous mass arising from the upper pole of left kidney. ⋯ Oesophagogastroduodenoscopy revealed gastric polypoidal growth. Gastric biopsy from the growth revealed poorly differentiated adenocarcinoma of stomach. We report this case to highlight a rare occurrence of synchronous malignancy of stomach and kidney.
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Kathmandu Univ Med J (KUMJ) · Jan 2013
Effect of sub-maximal exercise stress on cold pressor pain: a gender based study.
Analgesic effect of exercise is a well established fact; however available reports are contradictory on gender differences in pain perception following exercise stress test. ⋯ The result suggests that pain sensation decreases immediately after a brief period of exercise challenge irrespective of gender, and the analgesic effect of the acute bout of exercise in terms of pain tolerant time is more enhanced in females than males.
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Kathmandu Univ Med J (KUMJ) · Oct 2012
Randomized Controlled TrialPreemptive use of small dose fentanyl suppresses fentanyl induced cough.
Fentanyl, a synthetic opioid, is a popular choice amongst anaesthesiologists in the operating room. Pre induction intravenous fentanyl bolus is associated with coughing in 28-65% of patients. Fentanyl induced cough is not always benign and can be remarkably troublesome at the most critical moment of anaesthesia when airway reflex is lost. ⋯ Pre-emptive use of minimal dose fentanyl 25 μg administered one minute before a larger bolus dose of fentanyl (125 or 150 μg) can effectively suppress cough.