Browsing by Author "Thapa, Rashmi"
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Publication Acid Peptic Disease among Patients with Acute Abdomen Visiting the Department of Emergency Medicine in a Tertiary Care Centre(Nepal Medical Association, 2023) Thapa, Rashmi; Pokharel, Mohir; Paudel, Saroj; Khadka, Tunam; Sapkota, Priyanka; Rana, Rohit; Pokharel, Moneec; Chhetri, DineshAbstract Introduction: Acid peptic disease is caused by excessive acid secretion or weakened mucosal defense. Symptoms include epigastric pain, bloating, and nausea. Factors like gastric acid, Helicobacter pylori infection, alcohol consumption, smoking, and stress contribute to peptic ulcers. Imbalances between offensive and defensive factors can lead to ulcers. Acid-related disorders impact the quality of life and mortality. Accurate diagnosis and prompt treatment are vital. This study aimed to find out the prevalence of acid peptic disease among patients with acute abdomen in the Department of Emergency Medicine in a tertiary care centre. Methods: A descriptive cross-sectional study was conducted from 2 April 2022 and 2 April 2023 among the patients presented in the Department of Emergency Medicine in a tertiary care centre. Ethical approval was obtained from the Institutional Review Committee. All patients presenting with acute abdominal pain in the Emergency Department were included in the study. Patients not giving consent were excluded from the study. Convenience sampling method was used. The point estimate was calculated at a 95% Confidence Interval. Results: Out of the 400 patients with acute abdomen, the prevalence of acid peptic disease was found to be 87 (21.75%) (17.71-25.79, 95% Confidence Interval). Conclusions: The prevalence of acid peptic disease among patients with acute abdomen was found to be lower than in other studies performed in similar settings.Publication Comparison Between Hyperbaric Bupivacaine with and Without Fentanyl in Reducing Visceral Pain During Cesarean Delivery Under Spinal Anaesthesia(Nepal Health Research Council, 2025) Thapa, Rashmi; Paudyal, Pooja Pooja; Pradhan, Bishwas; Koirala, Megha; Parajuli, Bashu DevAbstract Background: Visceral pain occurred during cesarean delivery during spinal anesthesia can be decreased with a higher dose of bupivacaine. However, larger doses of bupivacaine increases the risk of high sensory block. We hypothesized that addition of fentanyl to bupivacaine intrathecally could intensifies the sensory block and improves the quality of intraoperative analgesia. The aim of this study is to compare incidence of visceral pain between hyperbaric bupivacaine with or without fentanyl during cesarean delivery under spinal anesthesia. Methods: In this prospective randomized controlled trial, 72 term parturient with ASA PS II undergoing cesarean delivery under spinal anesthesia were randomly distributed into two groups. Group B received 2.2ml (11mg) of 0.5% hyperbaric bupivacaine while Group BF received 2 ml (10mg) of 0.5% hyperbaric bupivacaine and 0.2ml (10µg) of fentanyl intrathecally. Incidence of intraoperative visceral pain, maternal hemodynamics, side effects and APGAR score were compared. Results: During exteriorization of uterus, 11% of parturient in Group BF and 44% parturient in Group B complained of intraoperative visceral pain with significant difference between two group (p=0.002). The intraoperative rescue analgesia was given in 22 % parturient in Group BF and 33% parturient in Group B (p= 0.29). Maternal vital parameters like blood pressure, heart rate, oxygen saturation and respiratory rate were comparable between two groups. APGAR score was similar in both groups. Conclusion: Addition of intrathecal fentanyl to hyperbaric bupivacaine was effective in reducing intraoperative visceral pain during cesarean delivery with stable maternal hemodynamics and without neonatal side effects. Keywords: Bupivacaine; cesarean delivery; fentanyl; spinal anesthesia; visceral pain