Browsing by Author "Acharya, Santosh"
Now showing 1 - 2 of 2
Results Per Page
Sort Options
Publication Loss of Consciousness and Cardiac Arrest as an Atypical Presentation of Tubercular Meningitis: A Case Report(Nepal Medical Association, 2022) Yadav, Saroj; Acharya, Santosh; Thapa, Astha; Hirday, Aditya; Dahal, AgnimshworAbstract Tubercular meningitis is a devastating presentation of extra pulmonary tuberculosis, with fatality in each case without treatment. A 39 years male, a regular consumer of alcohol and a known case of major depressive disorder, presented with the alleged history of using an electric heater in a closed room, and presented to emergency with unconsciousness and cardiac arrest. As his neurological status didn’t improve over 72 hrs, a magnetic resonance imaging brain was done which was non-conclusive. Electroencephalogram revealed diffuse right fronto-parietal seizure activity ceasing with midazolam injection, hence levetiracetam was started. Lumbar puncture revealed increased adenosine deaminase and nil white blood cells. Repeat lumbar puncture showed lymphocytic–predominant pleocytosis, elevated protein and low glucose. The patient was started on anti-tubercular therapy and an injection of dexamethasone was added. Repeat electroencephalogram didn’t show any seizure-like activity. It is important to be aware of variety of presentations of tubercular meningitis. Delay in treatment leads to irreversible neurological damage and even death.Publication Preoperative Anxiety Assessment in Adult Patients Undergoing Elective Surgeries: A Cross-Sectional Observational Study(Institute of Medicine, 2020) Acharya, Santosh; Gurung, Renu; Parajuli, BasudevABSTRACT Introduction: Anxiety is the subjective unpleasant feeling of dread over something unlikely to happen. The incidence of preoperative anxiety ranges from 32% to 76.7%. We aimed to measure the preoperative anxiety level using Amsterdam Preoperative Anxiety and Information Scale questionnaire and clinical rating scale given by attending anesthesiologist / anesthesia residents. Methods: It was cross-sectional observational study conducted in wards. We enrolled 110 adult patients planned for elective gynecological and gastrointestinal surgeries. After taking informed written consent, principal investigator interviewed the patient, one day prior to surgery in wards using a structured questionnaire of Amsterdam Preoperative Anxiety and Information Scale. Demographics characters were recorded. The attending anesthesia residents (blinded to patient response) performed preanesthetic assessment, provided their subjective rating about patient anxiety and need for information using Clinical Rating Scale. Results: Out of 110 patient, 57(51.81%) were found to have higher anxiety level. Comparing the APAIS score with various factors, we found younger age, female gender, unemployed status, higher level of education, adverse events in previous surgery and higher grade of surgery was associated with higher anxiety score. Comparing APAIS with Clinical Rating Score, there was poor correlation. Conclusion: The incidence of preoperative anxiety is high (51.81%) in adult patients undergoing elective surgery. During the preoperative anesthetic checkup, APAIS can be used as a screening tool. It provides relevant information on the presence of preoperative anxiety and need for information, which helps to achieve patient satisfaction and better outcome. Keywords: Amsterdam preoperative anxiety and information scale (APAIS), anxiety, clinical rating score, need for information, preoperative anxiety