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NepMed is a Nepal MEDLINE(Medical Literature Analysis and Retrieval System Online) by Nepal Health Research Council(NHRC). It includes bibliographic information for articles from academic biomedical journals covering medicine, dentistry, nursing, pharmacy, dentistry veterinary medicine, and allied health sciences.

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Article

Unilateral vocal cord paralysis post Covid-19 infection: a case report

(Nepal Medical College Pvt. Ltd., 2023) Paudyal, Anish; Karki, Sphurna; Bhatta, Sachin; Lamichhane, Sashwat Raj; Dhungana, Anup

Abstract: Late-onset neurological complication post-SARS-COV-2 infection is an atypical feature of COVID-19 infection. Vocal cord paralysis is one such complication that can cause symptoms ranging from mild hoarseness of voice to severe dyspnoea requiring mechanical ventilation. In this case report, we describe a 51 years old male with sudden onset of hoarseness of voice six months after recovery from COVID-19 pneumonia without endotracheal intubation and no history of respiratory or any other new illness in between. Nasopharyngolaryngoscopy revealed the left vocal cord paralysis, and a CT scan showed fibrosis, an air cyst in the upper lobe of the left lung, and bilateral lung diffuse ground glass opacity. There was no significant improvement in voice on treatment with prednisolone for nine days and speech therapy. Thus, unilateral vocal cord palsy can present as sequelae of COVID-19 pneumonia.

Article

A case of retinal artery macroaneurysm: a ticking time bomb of the eye

(Nepal Medical College Pvt. Ltd., 2023) Parajuli,Sanket; Sharma, Sadhana; Sharma, Ruchi

Abstract: Retinal arterial macroaneurysms are acquired, focal dilation of a retinal artery. Patients with retinal arterial macroaneurysms can present with an acute or gradual loss of vision as a result of vitreous hemorrhage, preretinal hemorrhage or macular edema. An 81 year old female, a known hypertensive since 12 years under regular follow-up visits, presented to us with vitreous hemorrhage secondary to ruptured retinal artery macroaneurysm in the right eye. She was managed with indirect argon laser treatment. Accurate diagnosis and co-management are crucial to save vision and help prevent life altering complications. This case report emphasizes the need of ocular examination in systemic diseases and further establishes ‘eye as the window of the body’.

Article

Knowledge, attitude, and practice regarding cervical cancer screening among female health professionals of a Tertiary Care Hospital in Kathmandu district

(Nepal Medical College Pvt. Ltd., 2023) Mahaseth, Rita Kumari; Pun, Rashmey; Baral, Prakiti

Abstract: Cervical cancer is the cancer that forms in the tissue of cervix. It is usually slow growing cancer that may not have symptoms but can be found with regular Pap tests and proper screening. Hence it is absolutely necessary for the health workers especially female workers to have proper knowledge about cervical cancer and have a positive attitude to getting screening tests done as per the Cervical Cancer Screening guidelines so that early detection and diagnosis can be done leading to decrease in the incidence of the disease. We have conducted this study to see the knowledge, attitude and practice regarding cervical cancer screening among female health professionals of a tertiary care hospital in Kathmandu District. Overall score for adequate knowledge about cervical cancer among different health professionals was not significantly different (χ2 = 1.118, p-value = 0.572). However, there was a significant association between knowledge and those who underwent screening (χ2 = 8.481, p-value = 0.004). There was no association between Knowledge and attitude towards cervical cancer (χ2 = 3.144, p-value = 0.076). However, there was significant association between attitude and profession (χ2 = 4.568, p-value = 0.033).

Article

Use of oral tramadol to prevent post-anaesthetic shivering in patients undergoing surgery under spinal anaesthesia

(Nepal Medical College Pvt. Ltd., 2023) Acharya, Sulav; Dangol, Sanam

Abstract: Shivering is a common and distressing problem after spinal anaesthesia which occurs due to heat loss and core to peripheral redistribution of body heat, resulting in reduction of core body temperature. Post anaesthetic shivering has deleterious metabolic and cardiovascular effect which should ideally be prevented by pharmacological methods that are economically and practically feasible in all settings compared to many physical methods. Therefore, this study was conducted using a centrally acting analgesic, oral Tramadol hydrochloride prophylactically for the prevention of perianaesthetic shivering after spinal anaesthesia. This prospective observational study was carried out in 106 patients of ASA I or II, aged 15 to 70 yrs of age undergoing lower limb or lower abdominal surgery under spinal anaesthesia. Postanaesthetic shivering was evaluated during the surgery. Shivering was observed in 11 (10.4%) patients and among them 2 (1.9%) patients had grade 1, 6 (5.7%) patients had grade 2, 2 (1.9%) patients had grade 3 and 1 (0.9%) patients had grade 4 type of shivering. Sedation was observed in 19 (17.9%) patients. The result of this study concluded that oral tramadol is very safe and superior to various drugs studied till date and can be used prophylactically as a part of premedication for the prevention of postanaesthetic shivering in patients undergoing surgery under spinal anaesthesia.

Article

Serum aminotransferases in chronic kidney disease patients: a hospital based comparative study

(Nepal Medical College Pvt. Ltd., 2023) Pokhrel, Asmita; Pokhrel, Buddhi Raj; Pandey, Rachana; Malla, Pragya; Sah, Bishesh; Shrestha, Jharana; Khanal, Madhav Prasad

Abstract: Estimation of serum aminotransferase levels play important role in the diagnosis and monitoring of hepatic diseases. Studies suggest that in patients with chronic kidney disease, especially in those under hemodialysis, the reference ranges of the serum aminotransferases might not be reflective of hepatic function. Due to this, diagnosis and management of liver diseases in such patients becomes quite challenging. This study aims to estimate and compare serum aminotransferases levels of hemodialysis patients and healthy controls. Seventy-five patients undergoing hemodialysis in Nepal Medical College Teaching Hospital for at least three months were included in the study as cases and apparently healthy individuals with no active illness and regular medication use for the past three months and were recruited as controls. Predialysis blood samples were drawn and were analyzed for serum aminotransferases and other blood parameters. The median serum AST and ALT values for hemodialysis patients were 15 U/L and 21 U/L, while for the healthy controls, it was 30 U/L and 36 U/L and the differences were statistically significant (p < 0.001). Among the hemodialysis patients, serum AST was positively correlated with eGFR (ρ = 0.247, p = 0.033) and negatively correlated with serum creatinine levels (ρ = -0.307, p = 0.007). Hence, serum aminotransferases levels were found to be low in patients with impaired kidney function compared to those with normal kidney function.

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