Journal Issue: Volume: 20, No 4, Issue 80, OCT. - DEC, 2022
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Volume
Number
Issue Date
2022
Journal Title
Journal ISSN
1812-2027
Journal Volume
Articles
Understanding the Implementation of Evidence Based Medicine in Training and Practice
(Kathmandu University, 2022) Nepal, O
NA
Clinical Characteristics of Cataract Patients and Outcome of Cataract Surgery in Tertiary Care Hospital in Central Nepal
(Kathmandu University, 2022) Shrestha, A; Shrestha, P; Shrestha, T; Makaju Shrestha, R; Shrestha, B; Poudel, L; Shrestha, JK
ABSTRACT
Background
Cataract remains the leading cause of avoidable blindness in low-income countries
such as Nepal. Despite the availability of surgical interventions for cataract in leading
institutions, still a large number of patients from remote areas delay or have difficulty
in getting treatment, present late or with complications.
Objective
To determine the clinical characteristics and visual outcome of patients undergoing
cataract surgery in Tertiary Care Hospital in Central Nepal.
Method
We retrospectively reviewed the medical records of 138 patients who underwent
cataract surgery at a tertiary care hospital from January 2018 to September 2022. R
version 4.0.3 was used for the data analysis. Categorical variables are presented as
frequency (percentages) and the numerical ones are presented as mean (standard
deviation).
Result
During follow-up visits between one to three weeks, 91.9% out of 135 patients had
normal/near normal presenting visual acuity and with best correction it was 96.9%
out of 131 patients. About 1.6% out of 124 operated eyes still had moderate visual
impairment after best correction when they visited for follow-up at 12 weeks.
Conclusion
The study findings underline the ongoing gap in increasing access to cataract
treatment, given the large proportion of individuals who still presented extremely
late.
KEY WORDS
Cataract, Complication, Characteristics, Outcome, Surgery
Study of Two Different Volumes of 0.75% Ropivacaine for Ultrasound Guided Supraclavicular Brachial Plexus Block on Successful Blockade and Diaphragmatic Motility
(Kathmandu University, 2022) Prasad, JN; Adhikari, S; Singh, SN; Subedi, A; Thapa, P; Guddy, KM; Sarraf, DP
ABSTRACT
Background
Use of ultrasound guidance during supraclavicular brachial plexus block allows the
usage of a lower anesthetics dose and minimizing unwanted effects of the anesthesia.
Objective
To compare the success of sensory blockade and the incidence of hemidiaphragmatic
dysfunction in patients receiving two different volume of 0.75% Ropivacaine for
ultrasound guided supraclavicular brachial plexus block.
Method
A prospective randomized double-blinded comparative study was conducted.
Group A patients (n=30) received 20 ml and Group B (n=30) received 25 ml of
0.75% Ropivacaine for ultrasound guided supraclavicular brachial plexus block.
Hemodynamic parameters, oxygen saturation, diaphragmatic excursion, onset of
sensory blockade and time for completion of blockade were measured. Independent
t-test, Chi-square test and Mann-Whitney U test were used to analyze the data at
p value of less than 0.05 using Statistical Package for Social sciences (version 11.5).
Result
At 30 minutes, 29 (96.67%) patients in group B and 27 (90.0%) patients in group A
had no sensation in median, radial, ulnar, musculocutaneous and medial cutaneous
nerves teritories; however, it was not significant statistically (p value > 0.05). At 30
minutes in Group A, 25 (83.33%) patients had no diaphragmatic hemiparesis and
five (16.67%) patients had partial diaphragmatic hemiparesis. However, three (10%)
patients had no diaphragmatic hemiparesis in Group B, 25 (83.33%) patients had
partial and two (6.67%) patients had complete diaphragmatic hemiparesis and it
was statistically significant (p < 0.05). Age and sex had no effect on diaphragmatic
hemiparesis in both groups (p value > 0.05).
Conclusion
The patients receiving lower volume of Ropivacaine had less incidence of
hemidiaphragmatic dysfunction with similar sensory blockade as compared to the
patients receiving higher volume of Ropivacaine.
KEY WORDS
Brachial plexus block, Diaphragmatic motility, Ropivacaine
Evaluation of Antinociceptive Activity of Ficus Religiosa Root Extract in Swiss Albino Mice
(Kathmandu University, 2022) Singh, S; Sangraula, H; Singh, PK; Sarraf, DP
ABSTRACT
Background
Ficus religiosa, commonly known as peepal, is widely distributed in Indian
subcontinent. It has been used as an antiepileptic, aphrodisiac, analgesic, anti-
inflammatory and laxative in traditional medicine.
Objective
To explore the analgesic effect of aqueous root extract of Ficus religiosa using
thermal and chemical models of pain in swiss albino mice.
Method
The aqueous aerial root extract of Ficus religiosa was prepared using soxhlet
apparatus. The anti-nociceptive effect of the extract at doses of 50 and 100 mg/kg
was evaluated using peripheral (acetic acid-induced abdominal writhing), spinal (tail
flick) and supra-spinal (hot plate) behavioral models of pain. All data were presented
as Mean ± SEM. Statistical differences between Ficus religiosa (50 and 100 mg/kg)
and standard control groups were evaluated using Mann-Whitney U test.
Result
There was significant dose dependent increase in the mean reaction time compared
to the vehicle control in hot plate and tail- flick test. In acetic acid induced writhing
test, mice treated with Ficus religiosa (50 and 100 mg/kg) exhibited significant
dose-dependent decrease in the mean number of writhes (57.45% and 79.20%
respectively) compared to the vehicle control. The activity of Ficus religiosa extract
at doses of 50 and 100 mg/kg was equipotent to Standard control (Morphine and
Indomethacin) used in different test models.
Conclusion
The extract of Ficus religiosa possesses both central and peripheral analgesic activity
thus validating the traditional use of this plant in the management of pain.
KEY WORDS
Antinociceptive, Acetic acid induced writhing, Ficus religiosa, Hot plate method,
Tail-flick method
Prevalence of Microalbuminuria in Patients of Essential Hypertension and its Correlation with Left Ventricular Hypertrophy and Carotid Artery Intima‑media Thickness
(Kathmandu University, 2022) Pathak, SR; Bhattarai, N; Baskota, D; Koju, RP; Humagain, S
ABSTRACT
Background
Urinary albumin excretion has been associated to cardiovascular events and
increased mortality in hypertensive patients. There is limited information among
Nepalese patients about the implications of microalbuminuria (MA) in the setting of
hypertension and potential cardiovascular morbidity.
Objective
To investigate the prevalence of microalbuminuria in patients with essential
hypertension and its connection with left ventricular hypertrophy (LVH) and carotid
artery intima-media thickness (cIMT).
Method
The study involved 80 hypertension individuals in total. All patients in the study
had basic biochemical tests, routine urine evaluations, echocardiography, and
carotid artery intima-media thickness measurements performed, and the data were
analyzed.
Result
The prevalence of microalbuminuria was present in 37.5% cases of essential
hypertension. The mean left ventricular mass index (LVMI) was significantly
higher in patients with increased microalbuminuria as compared to patient with
normal microalbuminuria. In addition, a significant positive correlation between
microalbuminuria and left ventricular hypertrophy was also observed. Furthermore,
mean carotid artery intima-media thickness was found to be higher in patients with
microalbuminuria (p < 0.001), with 76.7% of the patients with microalbuminuria
having elevated mean carotid artery intima-media thickness. The carotid artery
intima-media thickness had a positive correlation with both microalbuminuria and
left ventricular hypertrophy.
Conclusion
Microalbuminuria assessment in hypertensive patients is an important test for
the evaluation of target organ damage. This study shows that microalbuminuria is
common in hypertension patients, particularly those with left ventricular hypertrophy.
Microalbuminuria was found to be associated with left ventricular hypertrophy and
carotid artery intima-media thickness.
KEY WORDS
Carotid artery intima‑media thickness, Essential hypertension, Left ventricular
hypertrophy, Microalbuminuria