Pub Date : 2019-10-25DOI: 10.3126/mjpahs.v2i3.26112
M. Baral
Background: Violent asphyxial deaths chiefly include death due to hanging, strangulation, suffocation and drowning. Deaths resulting from hanging and ligature strangulation both show similar type of findings in which the ligature marks at the neck is very important characteristic finding. That’s why it is a challenge for forensic experts and needs thorough knowledge and experience to differentiate between them. Some of the typical autopsy findings help autopsy surgeon in such dilemma. Objective of Present study is about the external and internal autopsy findings in fatal neck compression cases specially focusing on hanging and ligature strangulation cases to differentiate and clear the dilemma in such cases. Materials and Methods: Current study was conducted among 103 corpses with compression of neck by ligature materials brought for autopsy examination at Mortuary of Forensic Medicine Department of Western Regional Hospital Pokhara from February2017 to January 2018. Conclusion: In fatal neck compression cases external autopsy findings like dribbling of saliva from angle of mouth, facial pallor, urine and fecal material discharge were common finding in 99 cases of hanging where as it was variable in ligature strangulation cases. Similarly fracture of hyoid bone and thyroid cartilage was found in hanging cases with age greater than 38 years but not in any ligature strangulation cases as an internal autopsy finding.
{"title":"Autopsy findings in Fatal neck Compression cases at Western Regional Hospital, Pokhara, Nepal","authors":"M. Baral","doi":"10.3126/mjpahs.v2i3.26112","DOIUrl":"https://doi.org/10.3126/mjpahs.v2i3.26112","url":null,"abstract":"Background: Violent asphyxial deaths chiefly include death due to hanging, strangulation, suffocation and drowning. Deaths resulting from hanging and ligature strangulation both show similar type of findings in which the ligature marks at the neck is very important characteristic finding. That’s why it is a challenge for forensic experts and needs thorough knowledge and experience to differentiate between them. Some of the typical autopsy findings help autopsy surgeon in such dilemma. Objective of Present study is about the external and internal autopsy findings in fatal neck compression cases specially focusing on hanging and ligature strangulation cases to differentiate and clear the dilemma in such cases. \u0000Materials and Methods: Current study was conducted among 103 corpses with compression of neck by ligature materials brought for autopsy examination at Mortuary of Forensic Medicine Department of Western Regional Hospital Pokhara from February2017 to January 2018. \u0000Conclusion: In fatal neck compression cases external autopsy findings like dribbling of saliva from angle of mouth, facial pallor, urine and fecal material discharge were common finding in 99 cases of hanging where as it was variable in ligature strangulation cases. Similarly fracture of hyoid bone and thyroid cartilage was found in hanging cases with age greater than 38 years but not in any ligature strangulation cases as an internal autopsy finding. ","PeriodicalId":256896,"journal":{"name":"Medical Journal of Pokhara Academy of Health Sciences","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121074812","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-09-05DOI: 10.3126/mjpahs.v2i3.26104
Bishow Raj Baral, M. Koirala, B. Lamichhane, S. Paudel, L. Banstola, A. Nepal, Swasti Sharma
Background: Obesity, a chronic disease that is increasing in prevalence in adults, adolescents and children, is now considered a global epidemic. Thyroid dysfunction contributes to the pathogenesis of obesity. Many clinical studies raise the questions of whether thyroid-stimulating hormone (TSH) changes in physiological limits is associated with obesity and whether there is a link between adipose tissue and hypothalamo-thyroidal axis. Materials and Method: This was a cross-sectional study. All clinically euthyroid patients and healthy volunteer adults of age 18 to 60 years of either gender were included in the study. Fasting blood sample was taken for thyroid function evaluation, which included Free T3, Free T4 and thyroid stimulating hormone. Height, weight, waist circumference and hip circumference were measured. The results were compared with calculated Body Mass Index (BMI). Results: 61 patients who met the inclusion criteria were studied. Among 61 patients 16 had subclinical hypothyroidism, 2 patients had hypothyroidism and 43 were euthyroid. Similarly, 2 underweight patients were observed, 7 had normal weight, 13 were over weight and 39 were obese. The mean TSH according to BMI were 3.8, 4.04, 3.88 and 6.19 respectively. Conclusion: The result in this study showed that the mean TSH increased as BMI increased with significant relationship between serum TSH and BMI (p <0.001). Thus thyroid dysfunction mainly subclinical hypothyroidism and hypothyroidism could be found in association with increased body weight.
{"title":"Correlation of serum thyroid stimulating hormone with body mass index in healthy adults","authors":"Bishow Raj Baral, M. Koirala, B. Lamichhane, S. Paudel, L. Banstola, A. Nepal, Swasti Sharma","doi":"10.3126/mjpahs.v2i3.26104","DOIUrl":"https://doi.org/10.3126/mjpahs.v2i3.26104","url":null,"abstract":"Background: Obesity, a chronic disease that is increasing in prevalence in adults, adolescents and children, is now considered a global epidemic. Thyroid dysfunction contributes to the pathogenesis of obesity. Many clinical studies raise the questions of whether thyroid-stimulating hormone (TSH) changes in physiological limits is associated with obesity and whether there is a link between adipose tissue and hypothalamo-thyroidal axis. \u0000Materials and Method: This was a cross-sectional study. All clinically euthyroid patients and healthy volunteer adults of age 18 to 60 years of either gender were included in the study. Fasting blood sample was taken for thyroid function evaluation, which included Free T3, Free T4 and thyroid stimulating hormone. Height, weight, waist circumference and hip circumference were measured. The results were compared with calculated Body Mass Index (BMI). \u0000Results: 61 patients who met the inclusion criteria were studied. Among 61 patients 16 had subclinical hypothyroidism, 2 patients had hypothyroidism and 43 were euthyroid. Similarly, 2 underweight patients were observed, 7 had normal weight, 13 were over weight and 39 were obese. The mean TSH according to BMI were 3.8, 4.04, 3.88 and 6.19 respectively. \u0000Conclusion: The result in this study showed that the mean TSH increased as BMI increased with significant relationship between serum TSH and BMI (p <0.001). Thus thyroid dysfunction mainly subclinical hypothyroidism and hypothyroidism could be found in association with increased body weight.","PeriodicalId":256896,"journal":{"name":"Medical Journal of Pokhara Academy of Health Sciences","volume":"16 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125332403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-09-05DOI: 10.3126/mjpahs.v2i3.26108
P. Dhungana, R. Adhikari, Prem Raj Pageni, A. Koirala, A. Nepal
Background: Labor is a naturally occurring physiological process associated with uterine contractions, effacement, dilatation of cervix and descent of presenting part. Drotaverine hydrochloride is a non-anticholinergic isoquinoline derivative which acts by elevating intracellular cyclic Adenosine Mono Phosphate (cAMP) and cyclic Guanosine Mono Phosphate (cGMP) promoting smooth muscle relaxation. Materials and Method: This was a hospital based prospective study on effectiveness of Drotaverine Hydrochloride on enhancing dilatation of cervix and acceleration of active phase of labor. The sample size was 100. Fifty cases of women in active phase of labor received injection drotaverine hydrochloride 40 mg (group i) and fifty cases of women did not receive any drug (group ii) among those at term with singleton pregnancy and vertex presentation. Variables like maternal age, interval between administration of drug and delivery, mode of delivery, apgar score at 5 minutes, NCU (Neonatal Care Unit) admission and neonatal outcomes were recorded. Data analysis was done with the help of SPSS program. Results: The mean interval between drug administration to delivery in primipara and multipara in group i was 3.05 hours and 2.31 hours while in group ii was 4.5 hours and 3.75 hours respectively. The mean interval between drug administration and delivery was shorter in both groups of multipara. In group i, 96% had normal delivery and 4 % had vacuum delivery and in group ii 90% and 10% had normal delivery and vacuum delivery respectively. None of the participants had caeserian section. There were no perinatal mortalities. Conclusion: The administration of drug Drotaverine Hydrochloride is effective in shortening duration of labor with favorable feto-maternal outcome.
{"title":"A prospective study on effectiveness of drotaverine in acceleration of labor","authors":"P. Dhungana, R. Adhikari, Prem Raj Pageni, A. Koirala, A. Nepal","doi":"10.3126/mjpahs.v2i3.26108","DOIUrl":"https://doi.org/10.3126/mjpahs.v2i3.26108","url":null,"abstract":"Background: Labor is a naturally occurring physiological process associated with uterine contractions, effacement, dilatation of cervix and descent of presenting part. Drotaverine hydrochloride is a non-anticholinergic isoquinoline derivative which acts by elevating intracellular cyclic Adenosine Mono Phosphate (cAMP) and cyclic Guanosine Mono Phosphate (cGMP) promoting smooth muscle relaxation. \u0000Materials and Method: This was a hospital based prospective study on effectiveness of Drotaverine Hydrochloride on enhancing dilatation of cervix and acceleration of active phase of labor. The sample size was 100. Fifty cases of women in active phase of labor received injection drotaverine hydrochloride 40 mg (group i) and fifty cases of women did not receive any drug (group ii) among those at term with singleton pregnancy and vertex presentation. Variables like maternal age, interval between administration of drug and delivery, mode of delivery, apgar score at 5 minutes, NCU (Neonatal Care Unit) admission and neonatal outcomes were recorded. Data analysis was done with the help of SPSS program. \u0000Results: The mean interval between drug administration to delivery in primipara and multipara in group i was 3.05 hours and 2.31 hours while in group ii was 4.5 hours and 3.75 hours respectively. The mean interval between drug administration and delivery was shorter in both groups of multipara. In group i, 96% had normal delivery and 4 % had vacuum delivery and in group ii 90% and 10% had normal delivery and vacuum delivery respectively. None of the participants had caeserian section. There were no perinatal mortalities. \u0000Conclusion: The administration of drug Drotaverine Hydrochloride is effective in shortening duration of labor with favorable feto-maternal outcome. ","PeriodicalId":256896,"journal":{"name":"Medical Journal of Pokhara Academy of Health Sciences","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130728923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-09-05DOI: 10.3126/mjpahs.v2i3.26105
M. Koirala, Bishow Raj Baral, B. Lamichanne
Background: Organophosphorous (OP) poisoning is a common problem in country like Nepal where agriculture is the backbone of the economy. The primary mechanism of action is inhibition of acetylcholinesterase (ACHE). Organophosphorus poisoning is a possible cause of acute pancreatitis along with alternation of glucose metabolism. Materials and Method: This was a hospital based cross-sectional comparative study. The level of serum amylase and glucose were measured in thirty-eight OP poisoned patients at the time of admission, before discharge and were compared. Results: Amongst 38 patients, Majority had mild OP poisoning 27(71.1%) as per Peradeniya Organophosphorus Poisoning (POP) score whereas 9(23.7%) had moderate and 2(5.2%) had severe poisoning. The mean initial serum amylase level in patients with mild poisoning was 152±73.92 (IU/L)(p=0.000), in moderate poisoning was 213.38±69.39 (IU/L) (p=0.223) and in severe poisoning was 171.33±107.22(IU/L) (p=0.259). There was increase in serum amylase level in all patients with poisoning but level did not increase in proportion to increase with severity of POP score. The mean initial serum glucose level in mild poisoning was 132.48±37.73 (Mg/dl) (p=0.024), in moderate poisoning was 139±44.59 (Mg/dl) (p=0.033) and in severe poisoning was 174±23.38 (Mg/dl) (p=0.22). The serum glucose level increased as the severity of POP score increased. The serum amylase and glucose levels in recovering patients showed a tendency to decrease to their normal values. No patient had developed acute symptomatic pancreatitis. Conclusion: Serum amylase and glucose level were increased in all patients with OP poisoning but didn’t correlate with the clinical severity. Routine measurement of serum amylase in patients of OP poisoning has little value in the absence of clinical acute pancreatitis.
{"title":"Clinical significance of serum amylase and glucose level in organophosphorus poisoning","authors":"M. Koirala, Bishow Raj Baral, B. Lamichanne","doi":"10.3126/mjpahs.v2i3.26105","DOIUrl":"https://doi.org/10.3126/mjpahs.v2i3.26105","url":null,"abstract":"Background: Organophosphorous (OP) poisoning is a common problem in country like Nepal where agriculture is the backbone of the economy. The primary mechanism of action is inhibition of acetylcholinesterase (ACHE). Organophosphorus poisoning is a possible cause of acute pancreatitis along with alternation of glucose metabolism. \u0000Materials and Method: This was a hospital based cross-sectional comparative study. The level of serum amylase and glucose were measured in thirty-eight OP poisoned patients at the time of admission, before discharge and were compared. \u0000Results: Amongst 38 patients, Majority had mild OP poisoning 27(71.1%) as per Peradeniya Organophosphorus Poisoning (POP) score whereas 9(23.7%) had moderate and 2(5.2%) had severe poisoning. The mean initial serum amylase level in patients with mild poisoning was 152±73.92 (IU/L)(p=0.000), in moderate poisoning was 213.38±69.39 (IU/L) (p=0.223) and in severe poisoning was 171.33±107.22(IU/L) (p=0.259). There was increase in serum amylase level in all patients with poisoning but level did not increase in proportion to increase with severity of POP score. The mean initial serum glucose level in mild poisoning was 132.48±37.73 (Mg/dl) (p=0.024), in moderate poisoning was 139±44.59 (Mg/dl) (p=0.033) and in severe poisoning was 174±23.38 (Mg/dl) (p=0.22). The serum glucose level increased as the severity of POP score increased. The serum amylase and glucose levels in recovering patients showed a tendency to decrease to their normal values. No patient had developed acute symptomatic pancreatitis. \u0000Conclusion: Serum amylase and glucose level were increased in all patients with OP poisoning but didn’t correlate with the clinical severity. Routine measurement of serum amylase in patients of OP poisoning has little value in the absence of clinical acute pancreatitis.","PeriodicalId":256896,"journal":{"name":"Medical Journal of Pokhara Academy of Health Sciences","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124008184","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-09-05DOI: 10.3126/mjpahs.v2i3.26114
I. Limbu, B. Basnet, Sandhya Paudel
Eye is a vital organ not only for vision but it is also important component of facial expression. The disfigurement associated with loss of eye can cause significant physical and emotional problem. There are several techniques documented in the literature for fabricating the artificial eye. This is a case report of fabricating ocular prosthesis with stock iris and custom made sclera to provide aesthetically satisfactory result and better fit.
{"title":"Prosthetic rehabilitation of enucleated eye with semi-customized ocular prosthesis: A case report","authors":"I. Limbu, B. Basnet, Sandhya Paudel","doi":"10.3126/mjpahs.v2i3.26114","DOIUrl":"https://doi.org/10.3126/mjpahs.v2i3.26114","url":null,"abstract":"Eye is a vital organ not only for vision but it is also important component of facial expression. The disfigurement associated with loss of eye can cause significant physical and emotional problem. There are several techniques documented in the literature for fabricating the artificial eye. This is a case report of fabricating ocular prosthesis with stock iris and custom made sclera to provide aesthetically satisfactory result and better fit. ","PeriodicalId":256896,"journal":{"name":"Medical Journal of Pokhara Academy of Health Sciences","volume":"43 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127526553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-09-05DOI: 10.3126/mjpahs.v2i3.26110
S. Bastakoti, R. Bhatta, N. Jha, S. Shrestha, A. Paudel
Background: Penile cancer is an aggressive and mutilating disease which deeply affects self-esteem and daily life of the patient. Penile cancer mostly affects the elderly, seen in people in their sixties and seventies. Occurrence in younger age is a need of research of penile neoplasia in young non-circumcised patients. Materials and Method: This is a three-year retrospective study. Data was extracted from the Department of Pathology and Medical Record section of B.P. Koirala Memorial Cancer Hospital. All histologically proven cases were included. The objective of this study was to assess clinical histopathological profile of penile carcinoma. Results. A total of 114 malignant cases were included out of which most common age group involved was 50-60 years with mean age of presentation being 51.6 years. Glans was the commonest site of involvement in 59 cases (51.7%). Well-differentiated squamous cell carcinoma was the most common type (71%). Forty nine patients (43%) presented when the mass size was 4-6 cm and 44 (39%) came with 2-4cm and rest less than 2 cm. Lymphvascular invasion was seen in 15 (13%) out of 114 cases and perineural invasion was seen only in 5 (4.3%) cases. 20 cases (17.5%) had lymphnodes positive which are less than 5 lymphnode positive and five (4.3%) had more than 5 lymphnodes positive. Conclusion. Early diagnosis and intervention of the patient ensure high probability of getting cured because the stage at presentation appears to be the most vital prognostic indicator for survival.
{"title":"Penile squamous cell carcinoma :a three-year study at BP Koirala Memorial Cancer Hospital","authors":"S. Bastakoti, R. Bhatta, N. Jha, S. Shrestha, A. Paudel","doi":"10.3126/mjpahs.v2i3.26110","DOIUrl":"https://doi.org/10.3126/mjpahs.v2i3.26110","url":null,"abstract":"Background: Penile cancer is an aggressive and mutilating disease which deeply affects self-esteem and daily life of the patient. Penile cancer mostly affects the elderly, seen in people in their sixties and seventies. Occurrence in younger age is a need of research of penile neoplasia in young non-circumcised patients. \u0000Materials and Method: This is a three-year retrospective study. Data was extracted from the Department of Pathology and Medical Record section of B.P. Koirala Memorial Cancer Hospital. All histologically proven cases were included. The objective of this study was to assess clinical histopathological profile of penile carcinoma. \u0000Results. A total of 114 malignant cases were included out of which most common age group involved was 50-60 years with mean age of presentation being 51.6 years. Glans was the commonest site of involvement in 59 cases (51.7%). Well-differentiated squamous cell carcinoma was the most common type (71%). Forty nine patients (43%) presented when the mass size was 4-6 cm and 44 (39%) came with 2-4cm and rest less than 2 cm. Lymphvascular invasion was seen in 15 (13%) out of 114 cases and perineural invasion was seen only in 5 (4.3%) cases. 20 cases (17.5%) had lymphnodes positive which are less than 5 lymphnode positive and five (4.3%) had more than 5 lymphnodes positive. \u0000Conclusion. Early diagnosis and intervention of the patient ensure high probability of getting cured because the stage at presentation appears to be the most vital prognostic indicator for survival. ","PeriodicalId":256896,"journal":{"name":"Medical Journal of Pokhara Academy of Health Sciences","volume":"113 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115700429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-03-31DOI: 10.3126/MJPAHS.V1I2.23391
M. Lama, Rohini Sigdel, Sanish Gurung, Krishna Bogati, Bibek Ranjit
Background: Monitored anaesthesia care is a specific anaesthesia service for diagnostic or therapeutic procedures performed under local anaesthesia along with sedation and analgesia titrated to a level with the provision to convert into general anaesthesia when required. We conducted a retrospective study to determine patient satisfaction in middle ear surgery under monitored anaesthesia care. Materials and Methods: The number of patients undergoing middle ear surgery under monitored anaesthesia care, over a period of one year were included. They received sedation with midazolam 0.02 mg/kg and fentanyl 1 mcg/kg along with local anaesthetic infiltration. Patient’s satisfaction was measured using a five point Likert scale. Intraoperative pain, nausea, vomiting and other discomforts were inquired. Results: The total number of patients was 64. Fifty-one patients (79.7%) were satisfied, 10 were neutral (15.6%) and 3 patients (4.7%) were dissatisfied with the technique. Earache (4.7%), followed by dizziness (3.1%) and bodyache (3.1%) were the most common cause of discomfort. Nausea occurred in 6 patients (9.4%) and vomiting in 5 patients (7.8%). Conclusion: Middle ear surgeries can be performed under monitored anaesthesia care with good patient satisfaction.
{"title":"Patient satisfaction in middle ear surgery under monitored anaesthesia care","authors":"M. Lama, Rohini Sigdel, Sanish Gurung, Krishna Bogati, Bibek Ranjit","doi":"10.3126/MJPAHS.V1I2.23391","DOIUrl":"https://doi.org/10.3126/MJPAHS.V1I2.23391","url":null,"abstract":"Background: Monitored anaesthesia care is a specific anaesthesia service for diagnostic or therapeutic procedures performed under local anaesthesia along with sedation and analgesia titrated to a level with the provision to convert into general anaesthesia when required. We conducted a retrospective study to determine patient satisfaction in middle ear surgery under monitored anaesthesia care. \u0000Materials and Methods: The number of patients undergoing middle ear surgery under monitored anaesthesia care, over a period of one year were included. They received sedation with midazolam 0.02 mg/kg and fentanyl 1 mcg/kg along with local anaesthetic infiltration. Patient’s satisfaction was measured using a five point Likert scale. Intraoperative pain, nausea, vomiting and other discomforts were inquired. \u0000Results: The total number of patients was 64. Fifty-one patients (79.7%) were satisfied, 10 were neutral (15.6%) and 3 patients (4.7%) were dissatisfied with the technique. Earache (4.7%), followed by dizziness (3.1%) and bodyache (3.1%) were the most common cause of discomfort. Nausea occurred in 6 patients (9.4%) and vomiting in 5 patients (7.8%). \u0000Conclusion: Middle ear surgeries can be performed under monitored anaesthesia care with good patient satisfaction.","PeriodicalId":256896,"journal":{"name":"Medical Journal of Pokhara Academy of Health Sciences","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130025407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-12-31DOI: 10.3126/MJPAHS.V1I2.23394
Rohini Sigdel, M. Lama, Sanish Gurung, B. Gurung, A. Neupane, A. Pun, Saindra Shrestha
Background: Several methods have been used to prevent post spinal hypotension including preloading, co-loading, use of vasopressors, placement of pelvic wedge, lumbar wedge and tilting of operating table in parturients undergoing cesarean section. We conducted a randomized controlled study to determine the hemodynamic effects of a standard pelvic wedge placed below the right hip immediately after the spinal block till the delivery of baby. Methods: One hundred consenting women undergoing elective cesarean section under spinal anesthesia were randomly allocated to wedge group (N=50) and control group (N=50). A standard wedge was placed under the right pelvis soon after spinal anesthesia till the delivery of baby in wedge group whereas the control group remained supine. Hemodynamic parameters including blood pressure, heart rate, vasopressor consumption, other side effects like nausea, vomiting and neonatal outcome were also recorded. Results: The incidence of hypotension and bradycardia was similar between groups (Wedge group 60% vs Control group 75.51%, p=0.125) before the birth of baby. The use of vasopressors (p=0.212), incidence of nausea (p=0.346) and Apgar score at 1 and 5 minutes (p=0.629, p=0.442) were also not statistically significant. None of the patients had vomiting. Conclusion: In our study, the use of right pelvic wedge immediately after spinal anesthesia was not effective in preventing post spinal hypotension in elective cesarean section.
{"title":"Hemodynamic effects of right pelvic wedge in patients undergoing elective cesarean section under spinal anesthesia","authors":"Rohini Sigdel, M. Lama, Sanish Gurung, B. Gurung, A. Neupane, A. Pun, Saindra Shrestha","doi":"10.3126/MJPAHS.V1I2.23394","DOIUrl":"https://doi.org/10.3126/MJPAHS.V1I2.23394","url":null,"abstract":"Background: Several methods have been used to prevent post spinal hypotension including preloading, co-loading, use of vasopressors, placement of pelvic wedge, lumbar wedge and tilting of operating table in parturients undergoing cesarean section. We conducted a randomized controlled study to determine the hemodynamic effects of a standard pelvic wedge placed below the right hip immediately after the spinal block till the delivery of baby. \u0000Methods: One hundred consenting women undergoing elective cesarean section under spinal anesthesia were randomly allocated to wedge group (N=50) and control group (N=50). A standard wedge was placed under the right pelvis soon after spinal anesthesia till the delivery of baby in wedge group whereas the control group remained supine. Hemodynamic parameters including blood pressure, heart rate, vasopressor consumption, other side effects like nausea, vomiting and neonatal outcome were also recorded. \u0000Results: The incidence of hypotension and bradycardia was similar between groups (Wedge group 60% vs Control group 75.51%, p=0.125) before the birth of baby. The use of vasopressors (p=0.212), incidence of nausea (p=0.346) and Apgar score at 1 and 5 minutes (p=0.629, p=0.442) were also not statistically significant. None of the patients had vomiting. \u0000Conclusion: In our study, the use of right pelvic wedge immediately after spinal anesthesia was not effective in preventing post spinal hypotension in elective cesarean section.","PeriodicalId":256896,"journal":{"name":"Medical Journal of Pokhara Academy of Health Sciences","volume":"26 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115733252","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-12-31DOI: 10.3126/mjpahs.v1i2.23407
G. Sharma, R. Adhikari, Shyam Sundar Parajuly, K. Adhikari
Introduction: The incidence of infertility is about 10 to 15 % among reproductive age group. The cause of infertility may be either due to male factor or female factor or both. The main aim of this study was to evaluate the success rate of intrauterine insemination (IUI) in a private centre of Pokhara. Materials and Methods: This was a centre based retrospective study done in private fertility centre. Sub-fertile couples who were treated from January 1st 2015 to December 31st 2016 were enrolled for the study. Couples with unexplained male factor, ovulatory dysfunction, unilateral tubal occlusion and ejaculatory dysfunction were included in this study. Three hundred and eighty IUI cases were retrospectively reviewed. Clinical pregnancy rate was the primary outcome. Result: The success rate of IUI was 15.7%. It was higher among unexplained infertility cases. Clinical pregnancy rate was directly associated with the age of the patients, indications of infertility and number of cycles. Conclusion: Success rate of IUI in infertile couples who had unexplained infertility, tubal factor, ovulatory dysfunction was higher than male factor infertility and ejaculatory dysfunction.
{"title":"Outcome of Intra Uterine Insemination in Sahara International Fertility Centre Pokhara, Nepal","authors":"G. Sharma, R. Adhikari, Shyam Sundar Parajuly, K. Adhikari","doi":"10.3126/mjpahs.v1i2.23407","DOIUrl":"https://doi.org/10.3126/mjpahs.v1i2.23407","url":null,"abstract":"Introduction: The incidence of infertility is about 10 to 15 % among reproductive age group. The cause of infertility may be either due to male factor or female factor or both. The main aim of this study was to evaluate the success rate of intrauterine insemination (IUI) in a private centre of Pokhara. \u0000Materials and Methods: This was a centre based retrospective study done in private fertility centre. Sub-fertile couples who were treated from January 1st 2015 to December 31st 2016 were enrolled for the study. Couples with unexplained male factor, ovulatory dysfunction, unilateral tubal occlusion and ejaculatory dysfunction were included in this study. Three hundred and eighty IUI cases were retrospectively reviewed. Clinical pregnancy rate was the primary outcome. \u0000Result: The success rate of IUI was 15.7%. It was higher among unexplained infertility cases. Clinical pregnancy rate was directly associated with the age of the patients, indications of infertility and number of cycles. \u0000Conclusion: Success rate of IUI in infertile couples who had unexplained infertility, tubal factor, ovulatory dysfunction was higher than male factor infertility and ejaculatory dysfunction.","PeriodicalId":256896,"journal":{"name":"Medical Journal of Pokhara Academy of Health Sciences","volume":"38 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115772999","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-12-31DOI: 10.3126/MJPAHS.V1I2.23393
Lakshmi Sunar, Zhu Yan
Objectives: To evaluate the pregnancy outcomes in the patients diagnosed with Gestational Diabetes Mellitus. Materials and Methods: A retrospective study conducted on ninety-two patients, delivered in the First Affiliated Hospital of Liaoning Medical University, China from February 2014 to June 2015. Results: The rate of Cesarean section was 36.95%, polyhydramnios 27.17%, macrosomia 21.73% and preterm delivery was14.13% respectively. Conclusion: Gestational Diabetes Mellitus is recognized to be associated with increased rate of adverse pregnancy outcomes. This study demonstrated that the GDM has higher risk for polyhydramnios and macrosomia.
{"title":"Evaluation of Pregnancy Outcomes in Gestational Diabetes Mellitus","authors":"Lakshmi Sunar, Zhu Yan","doi":"10.3126/MJPAHS.V1I2.23393","DOIUrl":"https://doi.org/10.3126/MJPAHS.V1I2.23393","url":null,"abstract":"Objectives: To evaluate the pregnancy outcomes in the patients diagnosed with Gestational Diabetes Mellitus. \u0000Materials and Methods: A retrospective study conducted on ninety-two patients, delivered in the First Affiliated Hospital of Liaoning Medical University, China from February 2014 to June 2015. \u0000Results: The rate of Cesarean section was 36.95%, polyhydramnios 27.17%, macrosomia 21.73% and preterm delivery was14.13% respectively. \u0000Conclusion: Gestational Diabetes Mellitus is recognized to be associated with increased rate of adverse pregnancy outcomes. This study demonstrated that the GDM has higher risk for polyhydramnios and macrosomia.","PeriodicalId":256896,"journal":{"name":"Medical Journal of Pokhara Academy of Health Sciences","volume":"29 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132187079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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