Journal Issue: Volume: 1, No. 2 (2022)
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Volume
Number
Issue Date
2022
Journal Title
Journal ISSN
ISSN 2822-1893 eISSN 2822-2016
Journal Volume
Articles
Catching up with WHO guidelines of DRTB; shorter, easier, better”
(Nepalese Respiratory Society, 2022) Mishra, Deebya Raj
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Knowledge of Inhaler Therapy among Undergraduates and Resident Doctors in Tertiary Care Hospital, Nepal
(Nepalese Respiratory Society, 2022) Shrestha, Bhakta Dev; Dhungana, Ashesh; Shrestha, Prajwol; Thapa, Kamal Raj; Sahani, Bikash; Dhodary, Shyam
Abstract:
Introduction: Inhalation therapy is the administration of the aerosolized medication directly into the lungs and it is the most effective form of management of the obstructive airway disease including chronic obstructive airway disease, asthma and overlap syndrome. There is less data on the knowledge of inhaler therapy among the junior doctors who are managing obstructive airway disease at the first contact point. This study was done to assess the knowledge of undergraduate doctors and resident doctors who are treating the patients before the consultation with senior consultants working in one of the tertiary care hospital . The findings of the study will help find the strategies of filling the gaps of the knowledge of inhalation therapy among junior doctors while managing obstructive airway disease
Objective: The primary objective of the study was to find the Knowledge of Inhaler Therapy among Undergraduates and Resident doctors in Bir Hospital.
Methods: The study was a cross sectional questionnaire based descriptive study conducted in Bir Hospital, National Academy of medical Sciences. The study included purposeful sampling of the medical officers and residents working in medical ward and emergency.
Results: Out of 70 respondents, 79% and 82% percent responded the correct method of the administration of the DPIs and MDIs respectively. Forty percent of the respondents had heard of the breath actuated devices and 88% of the respondents had heard of the spacer device. Forty one percent of the respondents said they teach the patients about the method of inhalation technique while prescribing the inhalation therapy. Seventy three percent of the respondents thought inhaler therapy as the first line therapy for managing COPD and Asthma.
Conclusion: Prescription of inhalers, knowledge among junior MBBS undergraduate doctors regarding inhalation therapy, and correct use of inhalers varied, and was generally inadequate. More effort, academic training and exposure is needed to change the attitude of medical officers and residents regarding the concept of inhalation therapy.
Diagnostic Yield of Bronchoalveolar Lavage in Nepalese Patients Presenting with Chronic Cough with Normal Radiological Imaging in Tertiary Care Hospital
(Nepalese Respiratory Society, 2022) Shahi, Rejina; Bhatta, Narendra; Mishra, Deebya Raj; Verma, Avatar; Upreti, Augraj; Aryal, Prakash; Yadav, Devesh Kumar; Regmi, Gunjan
Abstract:
Background: Cough is one of the most common symptoms that lead patients to seek medical attention. The diagnosis of chronic cough is complex and challenging. In our setting, a large proportion of patients with cough are treated empirically without a definite diagnosis. Despite investigation and treatment, fiberoptic bronchoscope with bronchoalveolar lavage (BAL) has been shown to be a useful technique in a selected group of patients with unexplained chronic persistent cough. The aim of the study was to determine the diagnostic yield of bronchoalveolar lavage in Nepalese patients presenting with chronic cough with normal radiological imaging.
Methods: This was a hospital based cross sectional study. The patients presenting with chronic cough (>8 weeks) with normal radiological imaging were enrolled in the study.
Results: 1 patient (2.6%) sputum sample for AFB was negative however BAL sample of the same patient sent for Gene xpert came positive for Mycobacterium Tuberculosis, 5 patients (12.8%) had positive BAL culture, 29 patients (74.4%) had normal cellular pattern in BAL Cytology.
Conclusion: Diagnostic yield of BAL was very low for chronic cough in our study. Patient presenting with eosinophilic pattern in BAL had cough variant asthma suffer from non-productive cough in the absence of other asthma symptoms such as dyspnea and wheezing. Thus, though fiberoptic bronchoscope with BAL is indicated in chronic cough of unknown etiology, its diagnostic yield is low
Study of Point of Care Lung Ultrasound in Patients with Acute Respiratory Failure Authors
(Nepalese Respiratory Society, 2022) Puri, Niraj; Adhikari, Shital; Bhattarai, Madhur Dev; Gauli, Basanta; Gurung, Sailesh; Patel, Sunil; Wagley, Pratik
Abstract:
Introduction: An acute dyspnea has been a common cause of hospital admission throughout history. When formulating a treatment plan based on limited clinical information, a rapid diagnosis is important. Bedside maneuvers and tests that deliver rapid and reliable results represent a cornerstone of diagnostics medicine.
Methods: This was a one-year cross-sectional research conducted at Chitwan Medical College Teaching Hospital. Consecutive patients with acute dyspnea whom were admitted for ≤ 6 hours were included in the study. A 5MHz micro-convex probe was used as the optimal single probe. Data entry and descriptive analysis were done in IBM SPSS version 20.0. Point estimate at 95% confidence interval was calculated along with frequency and descriptive statics.
Results: Pneumonia was the most common overall ultrasound diagnosis with combined frequency of 47%. With a Positive Predictive Value of 94.11% and Negative Predictive Value of 97.01%, anterior pneumonia exhibited a sensitivity of 94.11% and specificity of 97.11%. Similarly, Posterior Lateral Alveolar Points (PLAPS) pneumonia had a sensitivity of 94.11% and specificity of 98.08%, with a PPV of 94.11% and NPV of 98.80% respectively. The clinical accuracy for pulmonary edema was the greatest with 96.77%. while COPD/asthma had least accuracy with 81.25%.
Conclusions: POCUS of the lung, has a high sensitivity and specificity, especially for evaluation of acute causes of dyspnea such pulmonary edema and pneumonia. It is more sensitive than Chest X ray alone and should be integrated while making clinical diagnosis.
The Clinical Utility of Lung Function Testing in Respiratory Medicine: A Review
(Nepalese Respiratory Society, 2022) Cooper, Brendan G.
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