JNMA; journal of the Nepal Medical Association
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JNMA J Nepal Med Assoc · Oct 2007
Randomized Controlled Trial Comparative StudyComparative study between tramadol and dexamethasone as an admixture to bupivacaine in supraclavicular brachial plexus block.
This is a prospective, randomized, double blind study to evaluate the postoperative analgesia following supraclavicular brachial plexus block with Tramadol or Dexamethasone as an admixture to bupivacaine in upper extremity surgery. Total 60 patients of ASA I and II undergoing upper extremity surgery under brachial plexus block with Bupivacaine were randomly divided in to two groups; one group received Tramadol (2 mg/kg) and the other group received Dexamethasone (8 mg) as an admixture to Bupivacaine. The duration of postoperative analgesia was recorded in both groups using pain VAS score which was determined by maximum VAS score of 8-10 and when patient demands for additional analgesics. The mean duration of postoperative analgesia in the Dexamethasone group was 1028.00 minutes while in the tramadol group it was 453.17 minutes We concluded that Dexamethasone with local anaesthetic prolongs postoperative analgesia significantly than Tramadol (P<0.05) when used as admixture to local anaesthetic in brachial plexus block in upper extremity surgery.
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JNMA J Nepal Med Assoc · Oct 2007
Multicenter Study Comparative StudyTreatment of recurrent anterior dislocations of shoulder by Laterjet-Bristow operation: an experience.
Shoulder dislocation is common problem in orthopaedics. Management of recurrent shoulder dislocation is painstaking with different surgical procedures having varying outcomes. Laterjet-Bristow procedure provides stability and good functional outcome in Rowe scale and long term patient satisfaction. ⋯ There was no restriction of external rotation in three patients at both yearly follow-ups while 18 patients had restriction in the range 10-30 degrees. Laterjet-Bristow can be the procedure of choice for surgical treatment of recurrent traumatic anterior dislocation and also as a salvage surgery for failed cases from other types of procedures. The only shortcoming of this procedure was some limitation in external rotation and minor loss in muscle power of that shoulder.
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JNMA J Nepal Med Assoc · Oct 2007
Comparative StudyAbnormal hepatic function and splenomegaly on the newly diagnosed acute leukemia patients.
To evaluate the liver function, splenomegaly and related factors in the newly diagnosed acute leukemia patients. One hundred of fifty eight acute leukemia patients admitted in our hospital from March 2003 to April 2006 were studied. The related factors such as peripheral WBC count, bone marrow blasts, peripheral blasts, sex, age, AML, ALL affecting the liver function and splenomegaly were evaluated. ⋯ PT was prolonged in 62 (39.24%) patients. Statistical study shows that there is a relation between high WBC counts and elevated serum ALT (P<0.05) and high WBC counts and splenomegaly (P<0.05). Acute leukemia patients with leukocytosis are more prone to develop abnormal liver function and splenomegaly.
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JNMA J Nepal Med Assoc · Jul 2007
Cervical spine injuries in a teaching hospital of eastern region of Nepal: a clinico-epidemiological study.
Cervical spine injuries with neural deficits carry significant impact economically, socially and psychologically to the individual and to the society. Risk factors involved, mode of injuries, constraints of management and rehabilitation are different in developing countries. Total 149 patients of cervical spine injuries presented in B. ⋯ C5 vertebra was the most commonly injured vertebra. Cervical spine injuries, which has major impact over patient and society is still not adequately addressed by medical and public health system of developing countries like Nepal. Incidence of spinal injuries and its devastating consequences can be reduced by appropriate preventive measures and management along with rehabilitation.
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JNMA J Nepal Med Assoc · Jul 2007
In hospital complications and mortality of patients of inferior wall myocardial infarction with right ventricular infarction.
This is a cross-sectional study of patients with inferior wall Myocardial Infarction (MI), who attended emergency and got admitted in ICU/CCU of TU Teaching Hospital, Maharajgunj and Bir Hospital, Kathmandu, Nepal during November 1999 to October 2000. This study was undertaken to compare the in-hospital complications and mortality of patients of inferior wall myocardial infarction with or without associated right ventricular infarction. Total 53 consecutive patients with acute inferior wall myocardial infarction were enrolled in the study. ⋯ Mortality was found higher in patients of group A, but it was not statistically significant. Two patients of group A expired on first day whereas only one patient of group B expired on the eighth day of admission. In hospital complications especially cardiogenic shock, complete A-V block and junctional rhythm are significantly higher in inferior wall MI when associated with RV infarction.