Browsing by Author "Yadav, Rakesh"
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Publication Conservative management of a severe extravasation injury: A therapeutic nightmare(Madhesh Institute of Health Sciences (MIHS), 2025) Sah, Love Kumar; Jha, Ashish; Jayswal, Jitendra Prasad; Sah, Shiv Kumar; Yadav, Rakesh; Jha, SwetaABSTRACT: Intravenous calcium gluconate is commonly used in neonatal intensive care units (NICU) to treat hypocalcemia in preterm infants, who are especially prone to metabolic disturbances. Although effective, it carries the risk of extravasation injury, which can lead to local tissue necrosis and, rarely, systemic complications such as septic shock. We report a male preterm neonate (gestational age 31+4 weeks; birth weight 1750 g) who developed a significant extravasation injury following intravenous infusion of 10% calcium gluconate on day 1 of life for symptomatic hypocalcemia. Within 24 hours, progressive swelling and superficial skin and subcutaneous tissue necrosis extended from the dorsum of the right ankle to the knee. At presentation to our center on day 16 of life, the neonate was in septic shock, necessitating fluid resuscitation, inotropic support, and mechanical ventilation for 72 hours. Conservative wound management with daily dressing using normal saline and Vaseline gauze was undertaken. The patient’s sepsis resolved with antibiotics, and gradual wound healing occurred without the need for surgical intervention. Extravasation injuries from calcium gluconate are uncommon but can be severe, especially in preterm neonates with fragile skin and immature vasculature. Septic shock as a complication is rarely reported but highlights the critical need for vigilant monitoring. Management typically varies; however, this case demonstrates that timely conservative wound care, combined with supportive therapy, may result in favorable outcomes. This report underscores the importance of prevention, early recognition, and multidisciplinary management to reduce morbidity in this vulnerable population.Publication Non-compliance to the Tobacco Control and Regulatory Act among Vendors in the Vicinities of Schools of a Metropolitan City: A Descriptive Cross-sectional Study(Nepal Medical Association, 2022) Gupta, Ankush Kumar; Thakur, Dip Narayan; Sah, Mukesh Kumar; Yadav, Rakesh; Basel, Prem LalAbstract Introduction: Tobacco use is the underlying cause of ill health, preventable deaths, and disabilities worldwide. The Tobacco Product Control and Regulation Act 2011 prohibits the sale of tobacco in public places including educational institutions but non-compliance to the law had not been assessed. This study aimed to find out the prevalence of non-compliance to the Tobacco Product Control and Regulation Act among vendors in the vicinities of schools in a metropolitan city. Methods: This descriptive cross-sectional study was conducted in a metropolitan city in August 2018. Ethical approval was taken from Institutional Review Committee [Reference number: 23(6-11-E)2/075/076]. A convenience sampling method was used to recruit vendors within 100 meters radius of secondary schools. The data were collected through face-to-face interviews using a semi-structured questionnaire. Point estimate and 95% Confidence Interval were calculated. Results: Out of total 217 vendors, non-compliance to the section 3 of section 11 of Tobacco Product Control and Regulation Act was found in 195 (89.86%) (85.84-93.88 at 95% Confidence Interval). Among the non-compliers, 110 (56.41%) were selling both smoked and smokeless tobacco products, 78 (40%) were selling smoked and 7 (3.59%) were selling smokeless tobacco products. Conclusions: The non-compliance with Tobacco Product Control and Regulation Act's prohibition of tobacco sales within 100 m of schools in Kathmandu Metropolitan was similar with other studies conducted in similar settings.