Background: Stroke is one of the most common cause of morbidity and mortality worldwide. Approximately 50-85 percent of strokes are due to ischemic cerebral infarction and 7-27 percent to intracerebral hemorrhage. Since the incidence of stroke is increasing in our country, the study aims to identify various factors associated with stroke. Materials and Methods: This is a retrospective study of 86 patients admitted in A & B International Hospital, which is a private hospital located in Pokhara ,Nepal from 1st January 2018 to 31st December 2019.The case notes were taken from hospital record section and relevant data extracted and analyzed. Approval from the hospital management was taken prior to collecting the case notes. Patients below 18 years of age, stroke due to trauma were excluded. The data were collected, and were analyzed using SPSS version 20.0 software Results: Of the total 86 patients studied, the age range was from 36 years to 94 years with mean age of 64.3 years. Mean age in ischemic stroke was 66.7 years and in hemorrhagic stroke was 54.8 years. Stroke is more common in men than female (2.3:1 ratio) .Ischemic stroke accounted for 80.2 percent of cases and hemorrhagic stroke for 19.2 percent. Most common presentation included limb weakness, facial deviation and speech abnormality. Most common vascular territory involved was MCA territory infarction and small vessel strokes. Conclusion: Stroke is prevalent in our country and the incidence rises with age. Ischemic stroke is more prevalent than hemorrhagic stroke. Mean age of hemorrhagic stroke is lower than that of ischemic stroke and hypertension is most commonly associated risk factor for both types of stroke.
Introduction: Chronic kidney disease (CKD) patients are at increased risk of morbidity and mortality because of their native disease progression. Accumulation of other atherosclerotic risk factors associated with CKD multiplies their risks. This study aimed to evaluate cardiac structural and functional abnormalities in CKD patients undergoing Maintenance Hemodialysis (MHD) using Electrocardiography (ECG) and Echocardiography (Echo). Method: It was a prospective cross-sectional study containing all CKD patients undergoing MHD at Pokhara Academy of Health Sciences, Pokhara, Nepal was conducted between August 2020 to December 2020. All the relevant data were entered in Statistical Package for Social Science (SPSS) for analysis. Results: There was a total of 115 patients with a male: female ratio of 1.8:1and a mean age of 47.25 ± 15.20years. The mean duration of dialysis was 36months and hypertension was the prime risk factor. Common ECG abnormalities were left ventricular hypertrophy, left ventricular strain pattern and poor R wave progression. Common Echo abnormalities were left ventricular diastolic dysfunction, left ventricular hypertrophy and regurgitation. Left ventricular systolic dysfunction was present in 20% of the patients. Conclusion: A spectrum of structural and functional cardiac abnormalities is common in CKD patients undergoing MHD. Early measures should be adopted to mitigate the risk.
Introduction: Acute poisoning, irrespective of the etiology, is a medical emergency which requires prompt diagnosis and treatment. Such cases require ICU set up for better management. Central level hospitals in Nepal have ICU facilities to manage such cases. Materials and Methods: Current study is a retrospective type hospital based study conducted in Western Regional Hospital, Pokhara. Data collected from ICU department of Hospital in a period of one year from 2073 Ashad 16 to 2074 Ashad 16. It was analyzed and presented. Results: In this study it is observed that total 90 cases admitted in ICU department of WRH in a period of one year. Female patients outnumbered the male patients. Age group of 10-20 years is predominance in present study. Most of the patients were from Kaski district as the hospital belongs to Kaski district and one of the renowned tertiary care centers in the Gandaki province. Maximum number of patients consumed the OP compound. Outcome was better as out of 90 cases 80 were discharged and only 10 were died during the course of treatment. Conclusion: Early identification of the cause and type of poisoning, close monitoring and standard management, preferably in the ICU for at least a first few days, reduces the complication and improves the survival. The commonly available insecticides and rodenticides are the most common cause of acute poisoning.
Background: Following the outbreak of Coronavirus disease in 2019, the year 2020/21 has been an incredibly challenging one for all global health-care systems. Methods: A cross sectional descriptive research design was used to conduct the study. The study was carried out in all general private and public hospitals of Kaski district of Nepal. Data were collected from 25th October to 5th December, 2020 from the Hospital administrators using a semi structured interview schedule. Descriptive statistics were used for data analysis. Results: Most (96.3%) of the hospitals reported that increased cost or expenses of the hospitals creating financial threat is the most challenging situation that hospitals are facing in this pandemic. In addition shortages of ventilators creating ethical dilemma for patient allocation and changing guidelines from authorities have been reported as a challenge by 88.9 percent of the hospitals respectively. All of the surveyed hospitals had developed the use of thermometers for screening at the hospital entrances to minimize the risk. Conclusion: Hospitals in this pandemic are facing a lot of challenges with regard to staff management, PPE management and so on. Hence they need to adopt best strategies in responding to the corona virus.
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