JNMA; journal of the Nepal Medical Association
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JNMA J Nepal Med Assoc · Apr 2020
Critical Incidents during Anesthesia and Early Post-Anesthetic Period: A Descriptive Cross-sectional Study.
Critical incidents related to peri-operative anesthesia carry a risk of unwanted patient outcomes. Studying those helps detect problems, which is crucial in minimizing their recurrence. We aimed to identify the frequency of peri-anesthetic critical incidents. ⋯ Critical incidents occur even in low-risk patients during anesthesia delivery. Patient factors and emergency surgery contribute to the most serious incidents.
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JNMA J Nepal Med Assoc · Apr 2020
Case ReportsIsolated Lower Motor Neuron Facial Nerve Palsy in a Patient of Varicella: A Case Report.
Varicella or chickenpox is usually regarded as a self-limiting disease, but occasionally it may lead to irreversible neurological complications. Isolated lower motor neuron facial nerve palsy is a rare complication of varicella, with very few cases reported from the Indian subcontinent. We report one such case, where the patient developed facial palsy after healing of cutaneous lesions and recovered completely with oral corticosteroids.
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JNMA J Nepal Med Assoc · Apr 2020
Triage, Surge Capacity, and Epidemic Emergency Unit: An experience from the 2019 dengue outbreak at a Tertiary Care Centre.
In September 2019, a dengue outbreak was observed in many non-endemic areas of Nepal. The emergency department of Patan Academy of Health Sciences also received febrile patients exceeding usual daily numbers. This surge of the patient was managed by epidemic triage and activation of surge capacity. ⋯ An observation ward adjacent to the emergency was used for the epidemic emergency unit. The febrile patients who were triaged yellow and green were treated in this unit. The patients who were triaged as Red were treated in the emergency department.
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JNMA J Nepal Med Assoc · Apr 2020
Case ReportsSevere Cardiac Dysautonomia and Sudden Death in a Patient Presenting with Anginal Symptoms in Absence of Cardiovascular and Other Diseases: A Case Report.
Angina is a type of chest pain, experienced by patients with ischemic heart diseases. Cardiac autonomic modulation as assessed by heart rate variability and baroreflex sensitivity is found reduced in ischemic heart disease patients. Marked reduction in heart rate variability and baroreflex sensitivity in ischemic heart disease patients is found associated with sudden cardiac death. ⋯ The patient had sudden death within 6 months of follow-up. Reportedly, no other specific abnormalities were found before death. This case report suggests that patients presenting with typical chest pain as angina may have severe dysautonomia and risk of sudden death even in the absence of cardiovascular or any other known end-organ diseases.
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JNMA J Nepal Med Assoc · Apr 2020
Case ReportsAppendicular and Caecal Fecalith causing Perforation: A Case Report.
Fecalith is a concretion of dry compact feces or hard stony mass of faeces in the intestinal tract. Though appendicular fecoliths are commonly encountered, caecal fecoliths are rare entities. Fecoliths are amenable to conservative management with laxatives and enemas but surgical management prevents recurrence. ⋯ He was intraoperatively diagnosed as gangrenous and perforated retrocaecal appendix with multiple small fecaliths and a large fecalith on cecum with perforation. Appendectomy and primary repair of caecal perforation done. Histological examination of perforated margin confirmed as an inflammatory lesion.