Browsing by Author "Paudel, Rabi"
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Publication Anxiety among COVID-19 Patients during Their Stay in Isolation Ward in a Tertiary Care Center: A Descriptive Cross-sectional Study(Nepal Medical Association, 2021) Rawal, Prabhat; Neupane, Rasik; Singh, Aastha; Basnet, Prabina; Chapagain, Sudeep; Chapagain, Sunder; Paudel, Rabi; Thapa, Sangharsha; Pokhrel, Rojan; Pokhrel, NirdeshAbstract: Introduction: Once a patient is diagnosed with COVID-19 infection, they are required to stay in isolation for some period of time without any social interaction whether be at home or in a hospital setting. The fear of contagion, stigmatization of COVID-19, the social isolation and fear of disease complication has undeniably brought lots of stress and other mental health problems among the infected patients. The main aim of this study is to find the prevalence of anxiety among patients staying in the isolation ward of a tertiary care center. Methods: This was a descriptive cross-sectional study conducted among 147 COVID-19 patients admitted in the isolation ward of a tertiary care center in Nepal from 20 June to 25 July 2021. Ethical approval was taken from Nepal Health Research Council (Reference number 3546). Convenient sampling method was used. Analysis of the data was done using Microsoft Excel and Software Statistical Package for Social Sciences version 26.0. Point estimate at 95% Confidence Interval was done and frequency and percentage were calculated. Results: Out of 147 participants, 29 (19.74.%) (95% Confidence Interval= 13.31-26.17) experienced some form of anxiety symptoms during their stay in isolation. Conclusions: Anxiety among COVID-19 patients in this study is similar to other studies done in similar settings. Anxiety among COVID-19 patients is quite high as compared to non COVID-19 patients, therefore assessment of mental health conditions like anxiety, insomnia, depression in patients admitted with COVID-19 should be performed along with the management of physical symptoms.Publication Rocuronium-Induced Anaphylactic Shock during Elective Septoplasty: A Case Report Authors(Nepal APF Hospital, 2025) Bajracharya, Nitendra Raj; Shrestha, Saurav; Dangol, Shova; Paudel, Rabi; Bishwokarma, Pushkar; Shrestha, Surendra ManAbstract: Introduction : Perioperative anaphylaxis is a rare but potentially fatal complication during anesthesia. Among muscle relaxants, rocuronium is a leading cause of intraoperative anaphylaxis. Early recognition and prompt management are crucial to reduce morbidity and mortality. Case presentation: We report a 14-year-old female with a medical history of Hashimoto’s thyroiditis and dissociative disorder scheduled for elective septoplasty. Following induction with midazolam, fentanyl, propofol, rocuronium, and tracheal intubation, the patient developed severe hypotension, tachycardia, generalized rash, lip swelling, and increased airway pressure, suggestive of Grade III anaphylaxis suspected to be secondary to rocuronium. Immediate management with intravenous epinephrine boluses (300 mcg ×2), fluid resuscitation (2 Litres Normal Saline), hydrocortisone, ketamine, and initiation of an epinephrine infusion (0.1 mcg/kg/min) was done and surgery was postponed. The patient was transferred to the ICU for close monitoring. Epinephrine infusion was tapered off and trachea was extubated the next day, and discharged to the ward on the third day without neurological or respiratory sequelae. Conclusion: This case emphasizes on the importance of early recognition of rocuronium-induced anaphylaxis, rapid administration of epinephrine and aggressive supportive care. The incidence of such reactions remains low, but the high fatality rate necessitates preparedness during anesthesia.