The novel corona virus pneumonia epidemic poses a serious challenge to the medical and health systems of all nations in the world, especially discovering the severe shortage of intensive care medical professionals. Although our country’s intensive care medicine physicians have played a primary part in the combat against the epidemic, some problems have been debunked in the training of intensive care medicine personnel; equally there is inadequacy of standardized intensive care medicine training platform, and the lack of integrated training content and training format. Relatively single, insufficient preparations for responding to public health emergencies etc, Based on the actual experience of epidemic prevention and control and the treatment of critically ill patients, this article recommend that standardized training of resident physicians for critical care medicine should be carried out, the training content should be standardized, the combination of theory and clinical practice should be enhanced, the comprehensive quality of resident physicians should be improved, and the training methods should be expanded and strengthened. "Construction of a demand and capacity model for intensive care and hospital". These measures can make the critical care team become a professional team with a feel of social importance, which is of great acceptation for the long-term progress of critical care medicine, for the Nepalese medical system to easily respond to public health emergencies, and improve the comprehensive diagnosis and treatment capabilities of emergency and critical diseases. Excess deaths associated with COVID-19 are a direct result of the inadequate capacity of intensive care units and hospital beds.
Background Cardiovascular risk factors are associated with venous thromboembolism (VTE) has received increased attention in the past few years. At present, it is not clear whether the each cardiovascular risk factor is risk factor for venous thromboembolism. Features of cardiovascular risk factor have shown to be been individually associated with VTE. However, whether each of the factors additively increases the risk of VTE is uncertain. We performed a meta-analysis to assess the association between some major cardiovascular risk components and VTE. Methods Online Pub Med and Embase database were searched for case-control studies evaluating cardiovascular risk factors and incident Venous Thromboembolism in adults. Independent observers extracted data regarding annualized VTE incidence from studies meeting predetermined criteria, (Blood pressure: ≥ 140/90 mmHg. Dyslipidemia: triglycerides (TG): ≥ 1.695 mmol/L and high-density lipoprotein cholesterol (HDL-C) ≤ 0.9 mmol/L in male, ≤ 1.0 mmol/L in female, waist circumference ≥90cm for men, ≥80cm for women or body mass index > 30 kg/m2. Data were analyzed weighted, random-effects meta-analysis. Results Thirty two case-control studies with a total of 30929 patients met the inclusion criteria. Odds ratios or weighted means and 95% confidence intervals (CIs) were then calculated and pooled using a random-effects model. Statistical heterogeneity was evaluated through the use of X2 and I2 statistics. Compared with controls, the OR for VTE was 2.24 for obesity (95% CI, 1.83 to 2.75), 1.56 for hypertension (95% CI, 1.26 to 1.92) and 1.55 for diabetes mellitus (95% CI, 1.25 to 1.92). Weighted mean high-density lipoprotein cholesterol (HDL) levels were significantly lower in VTE patients with cardiovascular risk factor compared to controls with inverse correlation with risk of VTE, whereas no difference was observed for total cholesterol levels. Conclusion Cardiovascular risk factors are significantly associated with higher risk of VTE, which may imply that it may contribute to the multi factorial pathogenesis of VTE. Nevertheless, this report could not determine whether the combination of all three components is associated with a higher risk than each of the components in isolation.
Obesity is a complex condition with global prevalence reaching almost one-third of the world's population. It affects all ages, genders, and backgrounds, although older individuals and women tend to be more affected. In this case, a 36-year-old male business person leading a sedentary lifestyle presented with severe obesity (Class-3), hypertension, low back pain, fatigue and umbilical hernia for the past few years. The individual received 30-days of naturopathy treatments and diet intervention program. The treatment was provided through a personalized and customized protocol at Ipcowala naturopathy and yoga center (INYC) a residential naturopathy facility located in Vadodara, Gujarat. The findings indicated a significant reduction in body weight (from 130.74 kg to 116.60 kg), Body Mass Index (BMI) (from 41.76 to 37.25), Blood Pressure (from 140/100 to 130/86), as well as a notable decrease in back pain related disability and fatigue levels on scale. The patient experienced an overall improvement in functional health and reported an enhanced sense of well-being. Notably, the individual exhibited improvements across all domains of the WHO Quality of Life Bref scale. This case study strongly suggests that the naturopathy treatment, a tailored diet plan and fasting can serve as a beneficial intervention for reducing obesity and associated comorbidities. Further large scale studies are needed for observing effect of individual naturopathy therapies.
TTK Chitra heart valve prosthesis (chvp), a tilting disc mechanical heart valve of low cost and proven efficacy, has been in use for the last 15 years in India. Although various studies substantiating its long-term safety and efficacy are available but is less commonly used in Nepal. The TTK Chitra heart valve has been developed and widely used in India.
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