Both inhalational and intravenous anaesthetic agents are being used for neuroanaesthesia. Clinical trials comparing "propofol sevoflurane" "desflurane have been published. However, the comparison of all three anaesthetics in neurosurgical patients has not done. A randomised clinical study was carried out propofol, sevoflurane desflurane to find ideal neuroanaesthetic agent.A total 75 adult undergoing elective craniotomy supratentorial tumours were included study. The induced with morphine...

Abstract Background and aims Medical education requires regular reforms to include emerging best practices technologies, while also critically evaluating effectiveness of traditional didactic teaching methods. This manuscript examines the challenges opportunities associated with modernizing anesthesiology curriculum. Methods Narrative review literature on innovations in medical education, a specific emphasis training. Results Educators face difficulties implementing new approaches their...

Introduction: Gloves provide a physical barrier preventing cross-infection between the operating team members and patient. However, there is always chance of gloves perforating breaching this barrier. This study attempts to understand prevalence perforation surgical in orthopedic surgery at Tribhuvan University Teaching Hospital. Methods: was an observational cross-sectional carried out over three months. from chief first assistant surgeons were checked for visible occult by water leak test....

This collaborative paper explores the practice and culture of transformative learning theory (TLT) within teaching processes. Authored by four contributors, offers a multi-dimensional narrative exploration individual experiences struggles with transformation. It delves into stages transformation based on Mezirow's ten-step process, ranging from disorienting dilemmas to reintegration society. Authors as scholars MPhil in STEAM education tried emphasize value valuing individuals' lived using...

Airway foreign bodies are common in children, and usually present as emergencies. However, they may sometimes late, due to a number of reasons. Chronic lodgement trachea is rarer than that bronchial tree. Flexible rigid bronchoscopies have revolutionized the management at large. Here, we report successful bronchoscopic an unusual body residing patient for 15 years.

Background and Goal of Study: One the major concerns in neurosurgical patients is emergence. The idea to allow early neurological examination reintervention if necessary. More than two decades quest for an ideal anaesthetic agents fast track recovery has not yielded conclusive results. Long acting opoids like morphine are popular use acceptability short opioids. However there paucity data which compares opioids with regards their emergence profile patients. This study was done evaluate...

Abstract Background: The emergence from anaesthesia is a very crucial aspect in neurosurgical patients due to the need for evaluation of neurological status immediate post-operative period. present study evaluates characteristics following administration morphine as compared shorter-acting opioid, fentanyl undergoing supratentorial craniotomy. Methods: A total 84 were included study. either received 0.1 mg/kg before induction or 2 mcg/kg body weight at induction, 1 skin incision and...

Introduction: Myocardial protection during Coronary Artery Bypass Graft (CABG) has always been an area of concern so we aimed to evaluate the level release Creatine Phosphokinase (CPK-MB) and Troponin I (cTnI) at various time intervals in first 24 hours after on pump CABG patients receiving either Sevoflurane or Isoflurane. Furthermore clinically relevant patient outcomes were also evaluated undergoing coronaryartery bypass grafting.
 Methods: This was a prospective randomized trial...

Pseudoaneurysm (PA) of the brachial artery in pediatric supracondylar humerus fracture who have undergone closed reduction and percutaneous pinning is a rare complication. A few cases been reported medical literature. This case report sheds some insight into early identification management outcome such Rapidly progressive swelling antecubital fossa should arouse suspicion vascular lesion. It be timely intervened. Surgical intervention pseudoaneurysm with reversed saphenous venous graft has...

Introduction European System for Cardiac Operative Risk Evaluation (EuroSCORE) is the standard tool risk stratification of patients undergoing cardiac surgery. Its relevance has been validated in European, Asian countries and also Nepal. limitations led to development EuroSCORE II. This study was carried out compare II with Nepalese surgical patients.
 MethodsA retrospective analytical cohort 3 years duration 972 adult surgeries conducted. Scores obtained from (Logistic Additive)...

Sigdel, Shailendra; Dhakal, Sujan; Bastola, Priska; Ozaki, Akihiko; Pradhan, BishwasAuthor Information

Background: Rheumatic Valvular Heart disease (RVHD) is common in developing countries often associated with anemia; however its burden overlooked. Anemic patients undergoing surgery are likely to receive blood transfusion, increasing morbidity and mortality. Prevalence of anemia cardiac surgical studied extensively, RVHD lacking. This study attempted investigate the prevalence preoperative effect on mortality valve surgery. Methods: a retrospective observational conducted at tertiary care...

Background: Sepsis has been one of the most important conditions for morbidity and mortality Intensive care unit (ICU) patients. Antibiotics remain major combating factors it. Indiscriminate antimicrobial usage poor prescription practices have contributed to development multidrug resistant (MDR) organisms. Therefore, current study was designed evaluate spectrum, susceptibility patterns pathogens isolated from patients admitted our Cardiothoracic Vascular unit. Materials Methods: The...

Abstract Background: There is continued research to find new faster, highly accurate, easily accessible, and portable methods of confirming endotracheal tube position during intubation. A newer modality for visualizing location transtracheal or transcricothyroid ultrasonography. The aim this study was see if ultrasound machine can also be routinely used the confirmation in operating theaters along with capnograph. Methods: observational prospective, conducted from January 2017 July 2017....

Background and Goal of Study: The quest for ideal anesthetic agent which subserves the neuroanesthetic goals has now ushered us into an era whereby propofol, sevoflurane desflurane have gained popularity. Nevertheless literature is still conflicting over their equivalence or superiority in neurosurgical patients. We compared three agents- as regards to clinical effects patients undergoing elective supratentorial craniotomy. primary outcome was emergence while hemodynamics, slackness brain...

Background: The emergence from anaesthesia is a very crucial aspect in neurosurgical patients due to the need for evaluation of neurological status immediate post-operative period. present study evaluates characteristics following administration morphine as compared shorter-acting opioid, fentanyl undergoing supratentorial craniotomy. Methods: A total 84 were included study. either received 0.1 mg/kg before induction or 2 mcg/kg body weight at induction, 1 skin incision and beginning dural...

Introduction: Myocardial protection during Coronary Artery Bypass Graft (CABG) has always been an area of concern so we aimed to evaluate the level release Creatine Phosphokinase (CPK-MB) and Troponin I (cTnI) at various time intervals in first 24 hours after on pump CABG patients receiving either Sevoflurane or Isoflurane. Furthermore clinically relevant patient outcomes were also evaluated undergoing coronary artery bypass grafting. Methods: This was a prospective randomized trial graft...

Pseudoaneurysm (PA) of the brachial artery in pediatric supracondylar humerus fracture who have undergone closed reduction and percutaneous pinning is a rare complication. A few cases been reported medical literature. This case report sheds some insight into early identification management outcome such Rapidly progressive swelling antecubital fossa should arouse suspicion vascular lesion. It be timely intervened. Surgical intervention pseudoaneurysm with reversed saphenous venous graft has...

Introduction: European System for Cardiac Operative Risk Evaluation (EuroSCORE) is the standard tool risk stratification of patients undergoing cardiac surgery. Its relevance has been validated in European, Asian countries and also Nepal. limitations led to development EuroSCORE II. This study was carried out compare II with Nepalese surgical patients. Methods: A retrospective analytical cohort 3 years duration 972 adult surgeries conducted. Scores obtained from (Logistic Additive) compared...

Background: Extubation is associated with various circulatory and airway responses. Various pharmacological measures including fentanyl dexmedetomidine have been used to blunt the reflex without compromising spontaneous respiration. In this study we wanted compare on response, smoothness of extubation hemodynamic changes.
 Methodology: A total 68 patients undergoing surgery under general anesthesia endotracheal intubation, were randomized into two groups. Group received 0.5 mcg/kg B 1...