IntroductionThe emergency department (ED) deals with serious diseases, trauma, and terminal stage cases. The mortality pattern of cases in the ED must be assessed for future planning and development.ObjectivesThe aim of this study is to evaluate the pattern of the mortality cases in ED.MethodsRetrospective mortality data were collected and analyzed during April to September 2010 from the Tribhuvan University Teaching Hospital.ResultsThere were 81 mortality records found during the study period. The mortality rate among the ED cases was 36 per 10,000 (0.36%). Sixteen (19.75%) were dead upon arrival to the ED. Among the remaining 65 mortality cases, 30 (46.2%) were male and 35 (53.8%) female. The ages ranged from 1 to 80 years; the mean age for males was 43.8 years and 55.0 years for females. The mean time duration from when the patient was bought to the ED to death was 6.7 hours. The primary causes of mortality were hypovolumic with hemorrhagic shock (10, 15.5%), aspiration pneumonitis (9, 13.8%), cardiopulmonary arrest (8, 12.4%), sepsis and septic shock (7, 10.8%), severe head injury (6, 9.3%), acute exacerbations of chronic obstructive pulmonary disease (6, 9.3%), hemorrhagic cerebrovascular accident (3, 4.7%), hepatic encephalopathy (3, 4.7%), cardiogenic shock (2, 3%), chronic renal failure (2, 3%), dyselectrolytemia (2, 3%), anaphylaxis (1, 1.5%), acute respiratory distress syndrome (1, 1.5%), meningoencepahalitis (1, 1.5%), acute myocardial infarction (1, 1.5%), OP poisoning (1, 1.5%), pulmonary edema (1, 1.5%), and severe pneumonia (1, 1.5%).ConclusionsThe mortality in the ED is due to the high rate of severe and serious cases that arrive at late stages of disease. It also is accounted with severe trauma cases despite vigorous treatment at the ED. The rate also is increased by “Brought Dead” cases which could be reduced with proper emergency medical services.
Introduction: It is known that a pregnant person’s body is undergoing immune system changes and is not operating the same way as a non-pregnant person’s body, which threatens the emotional states of women trying to cope with the COVID-19 pandemic situation. The present study aimed to identify the psychological distress during COVID-19 among pregnant women. Method: A cross-sectional analytical study was conducted at the antenatal outpatient department of Patan Hospital, Nepal. The non-probability purposive sampling technique was used to select 457 samples. Ethical approval was obtained. Data were collected through a face-to-face interview using the Coronavirus Anxiety Scale (5 items) and the Edinburgh Postnatal Depression Scale (10 items). Descriptive and inferential statistics were used for analyzing the data. Result: The average age of the respondents was 27 years. Results revealed that only 5(1.1%) pregnant women had anxiety, while 23(5.0%) had possible depression due to COVID-19. None of the sociodemographic variables were significantly associated with psychological distress (anxiety and depression) among pregnant women. Conclusion: Psychological distress was found to be minimal among pregnant women attending antenatal OPD in Patan Hospital.
Introductions: It is helpful for women to learn what to expect and what options are available in transition to menopause. The objective of this study was to find out the changes in the level of awareness among premenopausal women after educational intervention.Methods: Study was carried out at mothers’ group of Pinchhen Tole Lalitpur district, Kathmandu, Nepal. One hundred and four respondents were selected using non probability convenience purposive sampling technique. Data were collected before and after educational intervention.Results: The findings reveal that the total awareness score was 26.81 in pre-test and 31.97 in post test. The grand mean score of awareness was 24.81 in pre-test and 29.85 in post test. Standard deviation was 3.47 and 0.50 in pre-test and post-test respectively. The overall difference in knowledge between pre-test and post-test was highly significant.Conclusions: Educational intervention among premenopausal women is highly significant in establishing and strengthening awareness about menopausal symptoms and its reduction measures.Journal of Patan Academy of Health Sciences. 2014 Dec;1(2):55-57
Introductions: Presence of family during cardiopulmonary resuscitation is debatable. Doctors and nurses locally believe that family should be kept out of resuscitation. This study explores the attitude of doctors and nurses towards presence of family during resuscitation. Methods: This was a cross-sectional descriptive study conducted at Patan Hospital emergency in January 2017. Medical personnel working in emergency were given a set of questionnaires. The result was descriptively analyzed. Results: Sixty-four doctors and nursing staffs participated in the survey. Fifteen (23%) said that they would never allow presence of family during resuscitation, 37 (58%) said sometimes and 13 (20%) said always. Perception of health workers were, 32 (50%) thought it interferes with work; 25 (39%) legal problem; 33 (51%) bad reaction to the team; 35 (54%) psychological trauma to family; 23 (36%) difficult to stop resuscitation; 23 (36%) offence to family; 17 (26%) increase staff stress; 8 (12%) not culturally acceptable and 6 (9%) had no such practice observed. Conclusions: Family presence during resuscitation was not desirable for majority of medical person working at emergency department of Patan Hospital.
Nepal, a landlocked country between China and India, is developing disaster and emergency medicine. In 2007, the Nepal Disaster and Emergency Medicine (NADEM) Center was formed with the aim of developing this specialty in Nepal. The first hospital was built in July 1889. It wasn't until 1988 that a Disaster Response Team was organized following a stampede incident in the national stadium in Kathmandu. The country often experiences disaster and emergency situations due to geographic and natural hazards and political tensions.In 1984, the Institute of Medicine, Tribhuvan University Teaching Hospital created emergency services with general practitioners (GPs) directing and providing services. Since then, almost all emergency services of different hospitals are run by GPs with house officers, nurses, and paramedics. There still is a lack of training and proper management, and limited equipment and infrastructure to provide needed disaster and emergency services to the people. The NADEM Center is developing coordination objectives between different emergency service providers to organize ways of service providing. This will be done through NADEM's continuing medical education and publication of Journal of Nepal Disaster and Emergency Medicine (J-NADEM) and NewsHealth; coordination among emergency medical services (prehospital), in-hospital services, and disaster and critical care medicine; and planning and implementation of different research, training, workshops, seminars, and conferences in disaster and emergency medicine with cooperation from the world. The NADEM Center will develop International Institute of Disaster and Emergency Medicine.
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