Browsing by Author "Shakya, Yagya L"
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Publication Airway Management Skills in Emergency Services(Institute of Medicine, 2021) Shrestha, Jukel; Shakya, Yogendra M; Maharjan, Ramesh K; Neupane, Ram P; Shakya, Yagya L; Prasad, Pratap NABSTRACT Introduction: Endotracheal intubation in critically ill and injured patients is a high-risk procedure in an Emergency Room (ER). The risk of complications increases with repeated or prolonged attempts, making first attempt success primary goal for airway management in these patients. The primary objectives were to compare first pass success during intubation among various specialties with different level of airway management training and education. Methods: This was a quantitative, observational, cross-sectional study conducted at Tribhuvan University Teaching Hospital for one year. The intubators completed an intubation data collecting form post intubation. After a failed first attempt, alternative methods such as using experienced intubators for subsequent intubation attempts were performed. Results: In the emergency room, 265 attempts of endotracheal intubation were made on total 224 patients. Most common causes for intubation were stroke (49 [21.8 %]), sepsis (39 [17.20 %]), COPD (28 [12.20 %]), and head traumas (24 [10.90 %]). During endotracheal intubation, 185 (82.58%) patients had a successful first-attempt success, and 39 (17.41 %) patients required ≥2 attempts. First pass success was least among medical officers (13/20 (65%)), compared to other senior specialties (p=0.01). Conclusion: With more training and education on the airway, first-pass success during endotracheal intubation increased. All front-line workers should consider it an ethical commitment to stay updated through lifelong learning, an obligation that should be made easier by governing bodies enforcing a thorough airway management training programs. Keywords: Airway, complications, emergency physicians, emergency intubation, first attempt success, techniquePublication Prevalence of Metabolic Syndrome among Subjects attending General Health Checkup of a Tertiary Center of Kathmandu, Nepal(Institute of Medicine, 2021) Shakya, Yagya L; Raut, Shankar; Shrestha, Tirtha M; Neupane, Ram PABSTRACT Introduction: Metabolic syndrome is one of the major concerns of modern health causing morbidity and mortality. The metabolic syndrome is the constellation of metabolic disorders - insulin resistance; obesity, dyslipidemia and hypertension that are interrelated which lead to higher risk of cardiovascular disease, diabetes, stroke, atherosclerosis and serious health condition. The study focused on the prevalence of all the metabolic syndrome cases that came to general health checkup (GHC) of Tribhuvan University Teaching Hospital. Methods: The study was a cross-sectional retrospective study of all cases that came to GHC from July 2019 to October 2019. GHC records files of all patients that came for their general health check-up were used to obtain data that included demographic details and the criteria for metabolic syndrome. Waist circumference, weight, height and blood investigations were sent as a routine examination of the general health checkup. Data analysis was done in Microsoft Excel 2019 and SPSS 20. Results: Among 311 cases enrolled in our study, 99 (31.8%) met the revised National Cholesterol Education Program, Adult Treatment Panel III (NCEP ATP III) criteria for metabolic syndrome. Among those with metabolic syndrome, males were 52 (52.53%) and females were 47 (47.47%). Also, 81 (81.81%) out of 99 cases had decreased HDL (<1.03 mmol/L for males and <1.30 mmol/L for females), which was the most common component of metabolic syndrome in the study. Conclusion: Metabolic syndrome is present in almost one third of the studied apparently healthy patients coming for general health checkup and it emphasizes on awareness regarding screening for metabolic syndrome. Keywords: General health checkup, metabolic syndrome