Journal Issue: Volume: 33, No. 3, December, 2011
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Volume
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Issue Date
2011
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Journal ISSN
ISSN (Print) : 1993-2979 | ISSN (Online) : 1993-2987
Journal Volume
Articles
Wound – biological basis of surgical treatment
(Institute of Medicine, 2011) Bishwas, NC
Abstract
Introduction: After having a through study along with available methods and medicines to treat external wounds, I came to conclusion that existing antiseptic solutions or antibiotic ointment to treat wounds is not sufficient and also costly. Biological basis of healing should be most crucial for wound healing. Central mechanism that control normal wounds healing is very important. Local wound’s environment like moistures, temperature, and tension is also very important. So it was very important to get such a ointment which meets all these demands and should be easily available and can work without sterilization or without antibiotic.
Method: A long and difficult work was started. At last a ointment was created which was cheap and met the conditions which was put in research work. This ointment contains coconut oil, water, bhangra sindoor, ghee, carbolic acid, Aloe Vera, Placentrex, coral, Evion, Xantinol Nioctinate ( Complamina). Complamina and trental was given orally also as it is a new combination of medicine, so any reference.
Results: Two groups were studied with different type of treatment. The first group containing 60 patients received routine treatment of wound with sterility maintained as well as antibiotic used. The other group consisting 150 patents wastreated with the new ointment. To treat with the new ointment sterilized material was not needed as well as without giving any antibiotic.
Conclusion:Ointment givesthe patientsthe feeling of calmness and removesstress, can work without antibiotic and sterilization. The whole treatment is cheaper with this ointment. This ointment will be useful for the people of the whole world.
Keywords: Wound, Biological Basis, mental stress, unsterility, Antibiotic
Management of Pseudoaneurysms in IV Drug Users
(Institute of Medicine, 2011) Sapkota, R; Sapkota, S; Thapa, B; Shrestha, KR; Rajbhandari, N; Shrestha, UK
Abstract
Introduction: Pseudoaneurysms are major vascular complications in intravenous drug abusers. They are potentially fatal, often infected and require urgent management.
Method: This is a retrospective study of the prevalent practice of their management in our center. The inpatient medical charts of the patients spanning 5 years (Sep 2006 to Aug 2011) were reviewed. Data were obtained on their demographic, clinical, management and outcome parameters.
Result: Among the thirty intravenous drug users presenting with pseudoaneurysms (excluding one who bled to death before surgery), 28 had their femoral artery involved. Most of them (90%) were infected. Nearly half of the patients (45%) were seropositive for HIV and/or HCV. All were operated, with no mortality. Ligation and debridement was the technique used almost exclusively (83%). One brachial artery wasrepaired primarily, whereas 3 femoral and 1 brachial pseudoaneurysms were managed with autologous saphenous vein bypass. Five patients had neurological complications, and 5 others had non-limb threatening claudication which got better with medical management. Mean follow up period was 11 months.
Conclusion: Ligation and debridement appears to be a simple, safe and effective procedure in infected pseudoaneurysms in IV drug users.
Keywords: Claudication, IV Drug Users, Infected Pseudoaneurysms, Ligation
Vault prolapse after vaginal hysterectomy with pelvic floor repair for uterovaginal prolapse
(Institute of Medicine, 2011) Pant, PR
Abstract
Introduction: Utero-vaginal prolapse is the most common gynaecological pathology among the Neplease women. Many women in Nepal are the unable to get the treatment of this pathology due to their poor economical conditions (1,2). However since last few years many governmental and nongovernmental organizations are organizing hysterectomy camps in rural areas of Nepal to help these poor people.
Objective: To compare the incidence of vault prolapse among the women underwent vaginal hysterectomy with pelvic floor repair for different degree of utero-vaginal prolapse in hysterectomy camps.
Methods: It was Prospective comparative study, done on 1646 women in different nine districts of Nepal from June 1999 to May 2009.All the Patientssubjected to the vaginal hysterectomy for different degree of utero-vaginal prolapse were grouped in to two groups selecting the patients alternatively. In first group of the patients during anterior colporraphy bladder wassupported by interrupted bladder buttressing stitches and in second group this repair was done by applying single purse string stitch including the apex of the vagina and incidence of vault prolapse was compared in two groups after two years of the surgery in follow up camps.
Results: Out of 1646 operated patients 891 came for follow up. Among these women 567 were from group A (interrupted suture group) and325 patients were from the Group B (single purse string) group. From group A there were 22 cases and from group B 4cases of vault prolapse. In both the groups majority of the women were chronic smoker. And majority of them started heavy work after one month of prolapse surgery in both the groups.
Conclusion: Single purse string suture seems better technique for the support of the bladder or as a whole vault during the anterior colporraphy while doing the pelvic floor repair in cases of uterovaginal prolapse, especially in the camp set up.
Keywords: vault prolapse, bladder buttressing, utero-vaginal prolapse, pelvic floor repair
Prevalence and types of cutaneous drug reactions intwo institutes
(Institute of Medicine, 2011) Shrestha, A; Regmi, B M; Pokhrel, D B; Jha, A K; Jha, N; Bharati, L
Abstract
Introduction: Adverse drug reaction is one of the growing concerns of today!s health practice. Thepurpose of the study was to find out the prevalence and types of cutaneous drug reactions at TribhuvanUniversity Teaching Hospital (TUTH) and DI Skin Hospital and Research Centre.
Methods: It was a prospective, cross sectional study conducted at Department of Dermatology of TUTHand DI Skin Hospital and Research Centre from 14th April 2010 to 14th October 2010. All the suspectedcases of cutaneous drug reaction above 14 years were included. Naranjo Algorithm was used to establishthe causality and Modified Hartwig and Siegel Scale was used to access the severity of the cutaneousdrug reaction. Clear purpose of the study was described and a patient consent form was produced beforethem while collecting the data and ethically approved from Institutional Review Board, Institute ofMedicine.
Results: Prevalence of cutaneous drug reaction was found to be 0.258%. The male: female ratio was2.1:1. The highest percentage of CDR was seen in 15-34 years age group. Antibiotics were the group ofdrug involved in most CDR followed by anticonvulsant. Phenytoin, ibuprofen+paracetamol combinationand betamethasone were mostly associated with CDR. 51.61% of the cases were of moderate III rdlevel which was followed by moderate IV (b) level. 51.62% were assessed to be probable and 48.38%were possible. Out of 13 admitted cases, 6 cases were admitted for 7-9 days. Maculopapular rash wasthe most common clinical presentation observed followed by Steven!s Johnson Syndrome.
Conclusion: The study estimated the average rate of cutaneous drug reaction in two major hospitals ofNepal. It also determined the most common type of manifestation of the cutaneous drug reaction.
Key words: Cutaneous drug reaction, DI Skin Hospital, prevalence, Tribhuvan University TeachingHospital