JNMA; journal of the Nepal Medical Association
-
JNMA J Nepal Med Assoc · Nov 2018
ReviewEarly Undifferentiated Arthritis: A Developing Country Perspective from Nepal.
Early undifferentiated arthritis is a group of inflammatory joint disease of less than 3 months duration that do not classify under any of the specific rheumatic or connective tissue disorder. Previously, inflammatory arthritis used to be treated only when there was a clear evidence of damage or deformity occurring with it. Use of disease modifying anti-rheumatic drugs were considered potentially harmful early in the course of arthritis which could be self-limiting. ⋯ It is now imperative that the risk be assessed early in the course of disease and early DMARDs be instituted for better outcome in these cases. This review analyses the historical evolution of evidence in the management of early undifferentiated arthritis and summarises the treatment approach, monitoring and disease outcomes till date. Keywords: arthritides; Nepal; power doppler; rheumatoid; ultrasonography.
-
JNMA J Nepal Med Assoc · Oct 2017
ReviewVentilator-Associated Pneumonia and Role of Nurses in Its Prevention.
Ventilator-associated pneumonia (VAP) is one of the most frequent nosocomial infections among ventilated patients in ICUs, associated with an increase in days of ICU stay, morbidity, and mortality. Its prevention is a significant concern in every hospital. Most of the interventions and prevention strategies are part of routine nursing care. ⋯ This study will help nurses to know about VAP and its prevention in detail so that they can apply the knowledge in clinical practice. Understanding pathophysiology of VAP, its risk factors, and care bundle is vital for the proper prevention and treatment of VAP. There must be specific protocols, strategies and active surveillance in every ICU regarding the care bundle.
-
JNMA J Nepal Med Assoc · Apr 2017
ReviewNeed of The Ministry of Health in Federal Democratic Republic of Nepal.
The constitution of Nepal provides appointing a council of ministers both at federal and provincial levels without defining portfolios. There is a political agreement that MOH will be retained at the federal level. ⋯ Retaining ministry of health at federal level without creating devolved structure at province and local levels in health sector will create difficulty in translating the spirit of the constitution and may not be effective in addressing health issues nationally and meeting global achievements like SDGs. It is suggested to establish an elaborate health system accordingly in Nepal to ensure constitutional mandate of health as a basic human right.
-
JNMA J Nepal Med Assoc · Apr 2015
Review Case ReportsComplete Bilateral Calcified Psoas Abscess- Rare Sequelae of Untreated Pott's Spine.
Although rare in the western world; psoas abscess is a frequent finding in Indian sub continent associated with Pott's spine. Untreated Pott's spine may lead to various sequelae like destruction of vertebra, kyphosis, paraplageia etc which in modern world is amenable to anti-tubercular drugs and surgical management. ⋯ To the best of our knowledge no such case of complete bilateral calcified psoas abscesses has been reported earlier. We want to discuss this case with relevant literature review and its influence on treatment plan.
-
Contrast-enhanced ultrasound (CEUS) is a simple, safe and reliable technique for the clinical management of patients with various liver diseases. Although the major target of the technique may be focal hepatic lesions, it is also effective for the diagnosis of non-tumor liver diseases, such as grading hepatic fibrosis, characterization of chronic liver diseases and diagnosis of portal vein thrombosis. This review article aimed to overview the recent application of CEUS in the assessment of non-tumor liver diseases.