JNMA; journal of the Nepal Medical Association
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JNMA J Nepal Med Assoc · Apr 2008
Correlation of serum cholinesterase level, clinical score at presentation and severity of organophosphorous poisoning.
The aim of the study was to correlate between the clinical score described by Peradenya Organophosphorus Poisoning (POP) scale, serum cholinesterase level at presentation and severity of poisoning. Consecutive patients of organophosphorous poisoning attending Bir Hospital from August 2004 to September 2005 were studied. Patients were grouped into mild, moderate and severe poisoning groups according to the POP scale. ⋯ The POP scale and serum cholinesterase at presentation appeared useful to assess the severity of poisoning, particularly in terms of higher amount of atropine and prolonged duration of hospital stay. The patients with evidence of moderate and severe degrees of poisoning need close monitoring. Further studies to evaluate the factors likely to cause deaths, particularly by closely monitoring of moderate and severe organophosphorous poisoning in intensive care units, are required to clarify the correlation with mortality.
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People with psychiatric problems often visit a general hospital. Many of them require emergency service. B P Koirala Institute of Health Sciences (BPKIHS) is one of the few health institutes in Nepal providing comprehensive 24-hour psychiatric emergency service. ⋯ About 20% had attempted suicide using different means, poisoning being the most common. Emergency psychiatric consultation for mental problems is sought by almost all departments of a general hospital. These consultations are most commonly sought for substance use, mood or anxiety disorders.
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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
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
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.