Journal Issue: Volume: 15, No 1, Issue 57, JAN.-MARCH, 2017
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Volume
Number
Issue Date
2017
Journal Title
Journal ISSN
1812-2027
Journal Volume
Articles
Dermoscopy – Not just for diagnosis and not just for Dermatologists !
(Kathmandu University, 2017) Sonthalia, S; Errichetti, E
NA
Incidence and Associated Risk Factors of Postoperative Sore Throat in Tertiary Care Hospital
(Kathmandu University, 2017) Shrestha, S; Maharjan, B; Karmacharya, RM
ABSTRACT
Background
Postoperative sore throat is a relatively minor complaint but a frequent postoperative
complication of anesthesia. The incidence of postoperative sore throat varies from
0-50% in most research studies, but some report the incidence is as high as 51-100%
following general anesthesia.
Objective
The aim of this study was to obtain the incidence and determine the associated risk
factors of postoperative sore throat in tertiary care hospital.
Method
Three hundred and seventy six patients who underwent various surgeries under
general anesthesia in Dhulikhel Hospital during a four month period were included.
Using a predesigned questionnaire with follow up after 24-30 hours after extubation,
data was collected. Sore throat was identified using a four point scale (0-3).
Result
Overall incidence of postoperative sore throat was 50.8%. Patient with airway device
endotracheal tubes had the highest incidence (52.2%, 176 of 337), and patient with
i-gel had a lower incidence of sore throat (33.3%, 7 of 21). Female patients reported
more sore throat than male, more common with older age group and duration of
anesthesia more than two hours. Increased incidence of postoperative sore throat
was not associated with the type of surgery, number of intubation attempts, category
of personnel performing airway managementr and use of oropharyngeal airway.
Conclusion
Postoperative sore throat is a common complication of airway instrumentation in
general anesthesia that can lead to discomfort. The overall incidence of postoperative
sore throat in this study was 50.8%. Endotracheal tube, female patients and increased
duration of anesthesia were associated with increased postoperative sore throat
rates.
KEY WORDS
Airway device, anesthesia, complication, postoperative, sore throat
Pattern of Self-medication in Undergraduate Students at BP Koirala Institute of Health Sciences
(Kathmandu University, 2017) Sarraf, DP; Karna, G; Dhungana, P; Lammichhane, S; Rauniar, GP
ABSTRACT
Background
Self-medication is a growing health problem. It may lead to wastage of resources,
emergence of antimicrobial resistance, adverse drug reactions and prolonged
suffering. Little has been reported on the extent of self-medication practiced in
medical students in Nepal.
Objective
To study the pattern, reason and perception of self-medication among undergraduate
students.
Method
A cross-sectional study was conducted among all undergraduate students at BP
Koirala Institute of Health Sciences, Dharan, Nepal between April and May, 2015.
After obtaining ethical clearance, pre-validated questionnaire was used to collect
data. The date were analyzed and presented as frequency and percentage using SPSS
version 11.5.
Result
Total of 520 students participated in the study with a mean age of 21.2±1.7 years.
Prevalence of self-medication was found to be 48.3%. Most common cause for
self-medication was common cold (53.3%). Nonsteroidal anti-inflammatory drugs
(78.9%) were the most commonly used medicine for self-medication. The students
commonly approached their seniors (50.2%) for the drug information. The most
common adverse drug reaction experienced by the students was drowsiness (50.9%).
Approximately one third of the students (33.2%) used to prescribe medicines to
others. More than half of the students (53.8%) opined that self-medication is a part
of self-care. Around one-fifth of the students (21.5%) students opined that self-
medication is recommended by WHO.
Conclusion
Self-medication is commonly practiced by undergraduate students. Nearly one third
of the students also prescribe medicines to others. Nonsteroidal anti-inflammatory
drugs are the most commonly used medicine as self-medication. The students need
to be educated regarding appropriate safe-medication.
KEY WORDS
Antibiotics, medical students, non-steroidal anti-inflammatory drugs, self-medication
To Access the Role of Serum Procalcitonin in Predicting the Severity of Acute Pancreatitis
(Kathmandu University, 2017) Kumar, S; Jalan, A; Patowary, BN; Bhandari, U
ABSTRACT
Background
Acute Pancreatitis remains a common disorder with devastating consequences
in severe form of disease. In this study we assessed serum procalcitonin for early
prediction of severity of acute pancreatitis and compared it with multiple scoring
systems and biomarkers.
Objective
This is a prospective comparative study in which 125 patients with diagnosis of acute
pancreatitis were enrolled. All blood samples and imaging studies were obtained
within 24-72 hours of admission and the severity was predicted.
Method
This is a prospective comparative study in which 125 patients with diagnosis of acute
pancreatitis were enrolled. All blood samples and imaging studies were obtained
within 24-72 hours of admission and the severity was predicted.
Result
Acute pancreatitis was graded severe in 54 patients and mild in 71 patients as per
the Atlanta criteria. Receiver operating characteristic curve showed the area under
curve of serum procalcitonin was higher (area under curve: 0.887, Confidence
interval: 0.825-0.948) compared to computed tomography severity index scoring
system (Area under curve: 0.841, Confidence interval: 0.771-0.911), Ranson’s score
(Area under curve: 0.796, Confidence interval: 0.715-0.876) and C-reactive protein
(Area under curve: 0.717, Confidence interval: 0.628-0.8.7) in predicting the severity
of acute pancreatitis. The best cut-off value of serum procalcitonin to predict severe
acute pancreatitis was 0.9 ng/ml with 92.6% sensitivity, 80.3% specificity. The
accuracy of serum procalcitonin (85.6%) was better than computed tomography
severity index score (73.6 %), Ranson’s score (76.8%) and C-reactive protein (64.8%).
Conclusion
Multifactorial scoring systems are complex and hard to use in clinical basis. Serum
procalcitonin can be used as a promising single biomarker, easily done in all setup
with better accuracy. And it is comparable to computed tomography severity index
and Ranson’s scores in earlier prediction of severity of acute pancreatitis.
KEY WORDS
Acute pancreatitis, serum procalcitonin, pancreatic necrosis
Clinical Profile of Diabetic Ketoacidosis in Adults in Dhulikhel Hospital
(Kathmandu University, 2017) Prajapati, BK
ABSTRACT
Background
Diabetic ketoacidosis is one of the life-threatening acute complications of diabetes
mellitus. Despite the improvements in diabetic care, it remains a major clinical
problem in clinical practice.
Objective
To assess the clinical and laboratory profile of adults with diabetic ketoacidosis in
Dhulikhel hospital.
Method
This is a descriptive cross-sectional study including adult patients admitted in
Dhulikhel hospital from July 2014 to July 2016 with the diagnosis of diabetic
ketoacidosis according to the guidelines of American diabetes association. The
hospital records of these patients were reviewed for their clinical and biochemical
profiles.
Result
Forty eight patients fulfilled the criteria of diabetic ketoacidosis and were included
in the study. Seventy three percent of patients had type 2 diabetes mellitus. Twenty
three percent of the patients were cases of newly diagnosed diabetes mellitus.
Polyuria and polydipsia as presenting complaint was more common in patients
with type 1 diabetes mellitus (p=0.002) whereas fever was more common in type
2 diabetes mellitus patients (p=0.03). Majority of patients had normal serum
sodium and potassium level. Forty two percent of the patients have high serum urea
level and just over one third had high serum creatinine level. The most common
precipitating factor of diabetic ketoacidosis for patients with type 1 diabetes mellitus
was omission of insulin whereas in type 2 diabetic patients was infection.
Conclusion
Diabetic ketoacidosis is complication of both type 1 and type 2 diabetes mellitus. High
degree of suspicion is needed for early detection of this life threatening condition
especially in patients without history of diabetes mellitus.
KEY WORDS
Diabetic ketoacidosis, Type 1 diabetes mellitus, Type 2 diabetes mellitus