Browsing by Author "Paudyal, N"
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Publication Clinico-demographic Profile of Poisoning Cases Admitted in Intensive Care Unit of Bharatpur Hospital, A Tertiary Referral Center in Nepal(Kathmandu University, 2020) Paudyal, N; Sapkota, KABSTRACT Background Poisoning is a major cause of death in young adults. The epidemiological factors such as geography, occupation, literacy rate can influence the clinical presentation and outcome of the poisoning patients. Poisoning has a significant impact on the economic and social life of individuals. Objective The main objective of this study is an effort to evaluate the characteristic of poisoning cases and identify the reasons for Intensive Care Unit (ICU) admission. Method This was a prospective observational study at Bharatpur Hospital ICU over a period of one year. Demographic profiles, poison characteristics, types and reasons for poisoning, duration of hospital stay, and outcome of the patients were studied. Result A total of 156 patients were admitted with poisoning. Females were affected more than males with a ratio of F:M= 1.6:1. The age group that consumed poison the most was 16-25 years, and the mean age group of males was 35±14 years and 29±11 years respectively. The main cause of poisoning was conflicts/quarrel. Organophosphorus compound was the most common poisoning with 53% of total cases due to it. There were 07 cases of accidental poisoning secondary to mushroom poisoning. The mean duration of stay in ICU of these patients was 04 days. The total fatality rate due to poisoning was 07%. Conclusion The significant proportion of Intensive Care Unit admission was due to organophosphorus compounds. It was more common among females and young age groups. This calls for special health education on chemical safety among vulnerable people along with efficient supervision in regulatory controls on chemicals and its use. KEY WORDS Conflicts, Intensive care unit, Organophosphorus, Poisoning, Young agePublication Comparison of Two Entry Methods for Laparoscopic Port Entry(Kathmandu University, 2021) Yadav, RP; Paudyal, N; Bhattarai, A; Adhikari, DABSTRACT Background The first step in laparoscopic surgery is to establish the pneumoperitoneum for which many approaches have been introduced to minimize the complications. Although controversies exist regarding the most efficient technique, till now the best entry technique is still unsettled. Objective To compare the safety, operating time and outcome of Direct Trocar Insertion with a well-established and widely practised Open Access Technique. Method This is a prospective study at Nobel Medical College Teaching Hospital from November 2019 to February 2021. Patients were grouped into either of the two groups, Group 1 for Direct Trocar Insertion and Group 2 for Open Access Technique. They were later analysed for major and minor complications of the technique and a comparison of either method was done at the end of the study period. Result A total of 823 patients were enrolled in the study. Among the study population, 411 patients had Direct Trocar Insertion while 412 patients had Open Access Technique. The majority of the operation that was done during the study period was laparoscopic cholecystectomy. Patients in the Open Access Technique group experienced more complications compared to Direct Trocar Insertion group. Conclusion Despite the fear of adopting the Direct Trocar Insertion, this is a safe, better and quick technique for laparoscopic port entry. However, any surgeon practising laparoscopic surgery should be competent to adopt either technique to overcome failure in either process during port entry. KEY WORDS Cholecystectomy, Laparoscopic surgery, Pneumoperitoneum