Aim: Clinical use of Recombinant Human Erythropoietin (rHuEPO) effectively increases the level of Hemoglobin in blood and improve quality of life of patients. Methods: Blood cancer patients is divided into two groups namely Treatment group and Control group. There is altogether 24 patients in treatment gp to whom both chemotherapy and rHuEPO is given for 4 weeks. rHuEPO is given as 150u/kg,subcutaneously, three times a week. Blood routine check up is done in every week and iron is prescribed after 2 weeks. Result: After 4 weeks of treatment, patients were evaluated for drugs effectiveness in both groups; total effectiveness were 58.34% and 20% respectively, P >0.05; after 4 weeks of treatment, there was distinct statistical significance. Comparing with pretreatment level, Treatment group has remarkable rise in Hb after 4 weeks (81.29±9.85)对(65.75±12.37),(P<0.01, whereas control group has not distinct change in Hb level(86.95±11.61)对(84.30±16.25),(P>0.05. Conclusion: Hb is significantly increased after the use of rHuEPO and side effects were less with well tolerances.
Objective: Aim of study is to describe the clinical consequences of hypotension in patient with organophosphate poisoning. Method: In the retrospective cohort study, we analyzed data of 66 patients with organophosphate poisoning who were treated at Bir Hospital, Nams Kathmandu. Data from those with hypotension and normal blood pressure were compared to identify significant clinical consequences. Results: All together 66 patients were enrolled in this study out of which 44(66.7%) were female and 22(33.3%) were male. After analyzing data, we found 18.2% of case with severe poisoning (ACHE < 700 U/L). Among all, 41(62%) were found to have normal blood pressure and 25(37.9%) were found to have low blood pressure. Among those with hypotension, around 56% were found to have prolonged QTc interval, p < 0.003 and there was statistically significant association between QTc prolongation and vasopressor requirement, X2(1) = 22.98, P < 0.001. Patients requiring higher dose to reach atropinization had statistically significant hypotension, P < 0.001. Those with low blood pressure were found to require more days of hospital admission, P < 0.001. Patients with hypotension were found to have severe poisoning both on the basis of POP Score severity grading, 16(64%) P <0.002 and ACHE Severity scale, 7(28%) P < 0.05. In comparison with normal blood pressure group, low blood pressure group had significantly more chance of developing complications like septic shock (2), aspiration pneumonia (5), ARDS (1) and bed sore, P = 0.002. Vasopressor requirement was significantly more among those with low blood pressure, P < 0.001. Most of hypotensive patients were needing ICU care, found to have higher WBC count P = 0.002 and lower GCS Score at admission P < 0.001. There was positive correlation between hypotension and POP Score at admission P < 0.001. Conclusion: Hypotension is a common complication in patient with organophosphate poisoning and is associated with higher POP Score, lower ACHE level, lower GCS Score, increased vasopressor requirement, more hospital stays, increasing ICU admission, more chance of developing septic shock and aspiration pneumonia.
Background The long QT syndrome (LQTS) is a disorder of myocardial repolarization characterized by a prolonged QT interval on the electrocardiogram (ECG). This syndrome is associated with an increased risk of polymorphic ventricular tachycardia, a characteristic life-threatening cardiac arrhythmia also known as torsades de pointes. A rate related corrected QT interval (QTc) can be calculated as QT/√RR and normally is ≤0.44s. Some references given QTc upper normal limits as 0.43s in men and 0.45s in female. OP compound supposed to block K+ channel and Na+/Ca++ channel and hence causing prolongation of QT interval. As we know that prolongation of QT interval may precipitate polymorphic ventricular tachycardia and sudden cardiac death, so it become important in case of OP poisoning and related mortality. In this study, I calculated corrected QT interval in diagnosed cases of OP poisoning admitted at Bir Hospital and compared QTc among those with complications and without complication. I also tried to evaluate QTc as a predictor for duration of hospital stays, ICU admission, vasopressor and mechanical ventilation requirement, higher POP score and low GCS.
Background: Urinary tract infections are most common bacterial infection in routine clinical practice. It is also most common nosocomial infection in many hospitals. Antibiotics are usually given empirically before urine culture reports available and treatment failure rate used to be significantly high. Study of causative agents and their antimicrobial sensitivity pattern are important factors helping formulating antibiotic policy. Generally, most common uropathogene is Escherichia Coli. Tertiary care hospitals, catering of already partially treated or mal treated patients as major chunk, may have varying etiologies and different sensitivity patterns. Objective: To study the culture and sensitivity patterns of urinary tract infections in patients presenting with urinary symptoms in local hospitals. Study design: A cross sectional study Materials and methods: Study was conducted at Madanta Research Clinic Private Limited from 12th march 021 to 12th September 021. Urine from cases suspected to have symptoms suggestive of UTI were send for bacteriological culture and sensitivity. Demographic profiles of each participant along with pathogen isolated, culture sensitivity pattern was documented. Data analysis was done in IBM spss 25. Results: A total 200 samples were selected for bacteriological culture and sensitivity out of which 32% were male and 68% were female. Around 50% of participants were in age group 20-40. There was no growth in 64% sample. Among positive samples (36%), E. coli (most common) was detected in 91.66%, Klebsiella was detected in 6.94%. Gentamicin, Amikacin and Nitrofurantoin were most common antibiotics sensitive to organisms in culture and Cephalosporins group of antibiotics are commonly resistant. Conclusions: coli is the most common organism isolated in urine culture in our region Janakpur. Cephalosporins are resistant in majority of cases where as Aminoglycosides like Amikacin, Gentamicin and Nitrofurantoin are found to be highly sensitive in most of positive cases.
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