Introduction: Effective nursing care by well-trained hands and affectionate heart constitute the backbone of medical intervention in HIV/AIDS. The apprehension often articulated by health professionals while dealing with people living with HIV/AIDS hampers in health care. The purpose of the present study was to assess the extent of knowledge and attitude towards HIV/AIDS amongst nursing students.Methodology: The present cross-sectional study was conducted among 113 selected proficiency certificate level nursing students of Parsa district of Nepal. Pre-tested anonymous questionnaire was administered to collect the responses necessary to infer the extent of knowledge on HIV/AIDS and nature of attitude towards PLWHA. The extent of knowledge was measured through an overall knowledge index constructed based on the responses to 10 objective questions. To ascertain the respondent’s overall attitude, responses to various opinions were scored and summed upto form an attitude index.Results: Almost half of the nursing students had good knowledge while almost a quintile numbers had incomplete knowledge about HIV/AIDS. Majority of them had negative attitude towards the care of PLWHA.Conclusions: In aggregate, nearly half of the respondents had good knowledge about the various aspects of HIV/AIDS; however, majority of them had negative attitude towards the care of PLWHA. The overall knowledge and attitude of senior class was better than their junior counterparts. The training programmes for nurses should aim at confidence and skill building to deal with HIV issues.SAARC J TUBER LUNG DIS HIV/AIDS, 2015; 12(1), Page: 8-13
Introduction: Patan Hospital (PH), Patan Academy of Health Sciences (PAHS) has separated non COVID and COVID emergencies for the safety of health care workers (HCWs). This study was conducted to assess the safety perception of healthcare workers working in emergency departments during the outbreak of COVID-19. Method: A cross sectional descriptive study was conducted among HCWs in non COVID and COVID emergency departments at PH, PAHS, Nepal, in April 2020 during COVID-19 outbreak. Questionnaires containing open and closed questions were used. Ethical approval was obtained. Result: Out of 72 HCWs, 58 (80.5%) responded, 47 (81%) felt need to have separate non COVID and COVID emergencies, 27 (46.6%) answered they were not comfortable working with the partial PPE (masks, gloves), 29 (50%) felt the need of having primary and secondary triaging. Conclusion: Emergency staff expressed need of having separate non COVID and COVID emergencies, and importance of primary and secondary triage.
Introduction: Healthcare workers (HCWs) awareness of disease outbreak, and working efficiently in a changed environment is vital to fight pandemic. How an institution responds to the crisis depends on HCWs response. This study aims to find out awareness of COVID-19 and work satisfaction of HCWs at Patan Hospital (PH), Nepal. Method: A cross-sectional questionnaires base descriptive study was conducted at PH, Patan Academy of Health Sciences, Nepal, in April 2020. The HCWs were grouped in to technical staff, doctors, and support staff. There were 20 questions each in the awareness of COVID-19 and work satisfaction domain. Ethical approval was obtained. Result: Of all the staff, 223 various level staffs responded to the questionnaire. There were 80 (35.9%) technical staff, 77 (34.5%) doctors and 66 (29.6%) support staff in the study. In the technical staff group 1106 (69.2%) responses were in favour of having good awareness and 1337 (83.5%) responses were in favour of satisfaction. In the doctors’ group 1233 (80.1%) responses were in favour of having good awareness and 1000 (65%) responses were in favour of satisfaction. In the support staff group 236 (17.7%) responses were in favour of having good awareness and 347 (26.2%) responses were in favour of satisfaction. Conclusion: Our study showed that technical staff and doctors had higher levels of perception of work satisfaction and awareness for COVID-19.
Resumo Objetivo Analisar os resultados clínicos, radiológicos e funcionais da fratura do planalto tibial (Schatzker Tipo V, VI) tratada com fixador externo do anel Illizarov com ou sem abertura mínima. Métodos Um total de 52 fraturas do planalto tibial dos tipos V e VI foram tratadas com fixador externo do anel Ilizarov com ou sem fixação interna mínima. A avaliação do desfecho funcional foi feita utilizando-se o escore da American Knee Society (AKS, na sigla em inglês) com consolidação clínica, radiológica e complicações encontradas. Resultados Foram 37 (71,15%) pacientes do sexo masculino e 15 (28,84%) do sexo feminino, com idade média de 39,07 ± 12,58 anos. Acidentes de trânsito (ATs) foram a principal causa das fraturas, contabilizando 32 casos (61,53%), seguidos por lesão por queda, com 16 casos (30,76%), e impacto direto, com 4 casos (7,69%). Foram 21 (40,38%) casos de fraturas tipo V, 31 (59,61%) casos do tipo VI e 24 (46,15%) casos de fratura exposta. Os escores médios da AKS para as fraturas tipo V e VI foram de 82,8 e 80,70, respectivamente, mas não foi estatisticamente significativo em p <0,05. O escore médio da AKS para fraturas fechadas e abertas também não foi estatisticamente significativo em p <0,05. Conclusões Para a fratura do planalto tibial complexa dos tipos V e VI de Schatzker, a fixação externa de Ilizarov é um método de tratamento seguro, econômico e eficiente que resulta em resultados satisfatórios.
States around the world has imposed lockdown to mitigate with COVID-19. This has caused unavailability of commodities including liquor. After lockdown, we observed increase in the number alcohol withdrawal cases in Emergency department of Patan hospital, Nepal. In contrast, during post-earthquake period in 2015 there was increase in number of alcohol intoxication cases. During pandemic time, along with managing COVID-19 cases, other alarming public health concerns should be noticed and necessary health support needs to be planned.
Introduction: Accurate assessment of fluid status in hemodialysis patients presents a significant challenge. Nephrologists have long relied on dry weight estimation based solely on clinical parameters to decide the ultrafiltration volume for patients with end-stage kidney disease on dialysis. However, this method is far from accurate and many patients recurrently suffer from signs and symptoms of fluid overload or circulatory collapse from overaggressive ultrafiltration. Invasive methods such as measurement of central venous pressure cannot be used routinely. We evaluated the usefulness of inferior vena cava (IVC) diameter measured by handheld ultrasound in the estimation of fluid status in patients before and after hemodialysis. Materials and Methods: Clinical assessment included patients’ symptoms, weight, blood pressure, heart rate, and presence of edema before and after dialysis session. Dry weight was assessed based on the above parameters. Each patient underwent measurement of inferior vena cava before and after hemodialysis. The anteroposterior IVC diameter (IVCD) was measured 1.5 cm below the diaphragm in the hepatic segment in supine position during normal inspiration and expiration.Results: Thirty hemodialysis patients (mean age 51.6±18.03 years) were evaluated in outpatient dialysis unit. Following hemodialysis mean IVCe (IVC diameter in expiration) decreased from 1.40±0.38 to 0.91±0.30 cm (p<0.001). Similarly, mean IVCi (IVC diameter in inspiration) decreased from 0.67±0.34 to 0.35±0.19 cm (p<0.001). Changes in IVCD were significantly correlated with alterations in body weight following dialysis (p<0.0001). The IVC collapsibility index (IVC-CI, per cent of change in IVC diameter in expiration vs. inspiration) increased significantly from 0.53±0.18 to 0.68±0.18 after dialysis (p=0.002). IVC diameter and IVC-CI clearly reflected alterations in fluid status. Regarding the clinical parameters of fluid status, following hemodialysis, mean heart rate increased from 81.17±5.21 beats per minute to 86.50±7.99, (p=0.003), systolic blood pressure increased from 148.67±26.36 mmHg to 155.00±28.50, (p=0.05), and diastolic blood pressure increased from 78.62±12.74 mmHg to 84.83±14.55, (p<0.001).Conclusions: Our findings support the applicability of IVCD measurement and IVC-CI in the estimation of fluid status in end stage kidney disease patients on hemodialysis. The clinical parameters of fluid status including heart rate, systolic blood pressure, and diastolic blood pressure suggest that significant numbers of patients underwent excess ultrafiltration based on their traditional dry weight calculation. Thus, using IVC parameters before and during hemodialysis might give a better estimation of fluid status of the patient and guide the amount of ultrafiltration to be done.
Porencephalic cyst is a fluid filled intracranial lesion, which is usually congenital, but may develop following trauma. CSF rhinorrhoea occurs mostly following trauma and some can present years later, with resulting morbidity and the need for further management . We report an unusual case of post traumatic CSF rhinorrhoea four years after history of trauma. Initial CT scan following trauma was normal and was managed conservatively. Subsequently, patient presented with CSF rhinorrhoea after four years. CT scan showed porencephalic cyst of frontal lobe. CSF leak was managed conservatively and was advised for further neurosurgical intervention. Late onset CSF leak seems to be rare, but important complication of traumatic brain injury.
Idiopathic Intracranial Hypertension (IIH) is a rare occurrence in young, physically fit male and a diagnosis of exclusion among most patients presenting with signs and symptoms of raised intracranial pressure. Here we describe a case of a young male in the ideal weight range with no previous exposure to offending chemicals presented with a history of headache, obscuration of vision, and photopsia. On examination, there were no positive neurological findings. Increased opening pressure was found on the lumbar puncture. Ophthalmological examination revealed bilateral papilledema. Humphrey’s Visual field test showed peripheral field loss. MRI scan of the brain and orbits were normal. The patient was diagnosed and managed in primary care setting after neurosurgical consultation. Though rare, we should suspect IIH in ideal body weighted male if the headache is persistent after other causes of headache have been ruled out.
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