Browsing by Author "Yadav, RK"
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Publication Effectiveness of addition of neostigmine or dexamethasone to local anaesthetic in providing perioperative analgesia for brachial plexus block: A prospective, randomized, double blinded, controlled study(Kathmandu University, 2008) Yadav, RK; Sah, BP; Kumar, P; Singh, SNAbstract Background: Various local anaesthetic agents are used for brachial plexus block.We compared effectiveness of addition of Dexamethasone versus Neostigmine to Lignocaine, adrenaline admixtures for Brachial plexus block in providing perioperative analgesia. Methods: Ninety patients were randomized in three groups and were received 24ml of study drugs. The groupA [Lignocaine with adrenaline (1.5%)], groupB [Lignocaine with adrenaline (1.5%)] +500μg Neostigmine, and group C (Lignocaine with adrenaline (1.5%) +4mg Dexamethasone) for brachial plexus block through supraclavicular approach. The observed parameters were onset of analgesia, completion of sensory and motor blockade, Duration of analgesia, Surgeon’s score, side effects, number of supplemental analgesics doses and Visual analogue scale (VAS) score for pain in 12 hour of post-operative period. Results: Mean onset of analgesia 4.6±1.1 , 4.4 ±0.8 , 3.8±1.8 mins in group A,B and C respectively and the Mean onset of motor blockade were 7.7± 2.0, 7.0±1.8, 6.0 ± 2.1mins in group A,B and C respectively. Similarly Mean Complete sensory block in 10.6 ±3, 10.4±2.5, and 8.9±2.2mins and Mean complete motor block in 17.3±4.3, 17.2 ±4.0 and 14.7±3.5 mins in group A, B and C respectively were achieved. Duration of analgesia was 176.5±53.5, 225.7±53.3 and 454.2±110.7 mins in group A, B and C respectively. Duration of analgesia in group C was statistically signi cant in comparison with other groups. The number of mean analgesic requirement by group C (0.9±0.4) was signi cantly (p- 0.005) lower. The mean VAS was signi cantly lower in groupC in 12 hours post-operatively. Conclusion: The onsets of action, duration of analgesia were better in dexamethasone group and also need less number of rescue analgesics requirement.Publication Study on Status of Serum Biochemical and Hematological Parameters in COVID-19 Positive Patients Attending a Tertiary Care Hospital(Kathmandu University, 2022) Shreewastav, RK; Singh, GK; Jha, KK; Yadav, RK; Gharti, SBABSTRACT Background Coronavirus disease 2019 (COVID-19) presents clinically a variety of pathological and clinical organ dysfunctions, ranging in severity from asymptomatic to fatal. The care and monitoring of COVID-19 patients may benefit from the use of biochemical and hematological markers. Objective To observe the alteration of serum biochemical and hematological parameters in COVID-19 positive patients, attending a Tertiary Care Hospital. Method A descriptive cross-sectional study was conducted on all COVID-19 positive patients attending Nobel Medical College Teaching Hospital, Biratnagar, Nepal from 15th December 2021 to 15th February 2022. The test results of different serum biochemical and hematological parameters done for these patients were recorded in clinical laboratory services and obtained retrospectively for the analysis. The data were entered in MS excel and analyzed by SPSS version 20. Result Out of 1537 COVID-11699 declared positive patients, 712 (46.32%) were male and 825 (53.68%) female. Mean age of COVID positive patients was 40.03±20.08 years. The level of serum SGOT, SGPT, ALP and GGT was significantly elevated in 39.9%, 42.8%, 32.3% and 47.2% of COVID positive patients respectively. Blood Urea, creatinine, uric acid and sugar level were significantly elevated in 63%, 56.1%, 33.1% and 47.6% patients respectively. The serum level of LDH, D-dimer, CRP and procalcitonin (PCT) were significantly increased in 52.1%, 75.9%, 71.6% and 61.2% of patients respectively. The serum value of total cholesterol, triglyceride, HDL and LDL were significantly lowered in 52.2%, 43.8%, 70.1% and 60.3% of patients respectively. RBC concentration and level of hemoglobin was reduced in 56.6% and 53.6% of COVID positive patients respectively whereas total leukocyte count was elevated in 80.7% with increase in neutrophil in 87.9% and decrease in lymphocyte in 79.4%. Conclusion A portion of COVID-19 positive patients showed drastically altered test results for various serum biochemical and hematological markers, although many of them had normal findings. KEY WORDS Biochemical markers, COVID-19, Tertiary hospital