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Papers by Manish Nath Pant
Journal of Karnali Academy of Health Sciences, Dec 30, 2020
Background: Emergency visits during pandemic also comprise the patients with various complains ot... more Background: Emergency visits during pandemic also comprise the patients with various complains other than symptoms of COVID. It is prudent to identify the variation of non-COVID-19 cases (cases that do not have fever or cough or travel history or contact history or health professional) that visit emergency department during pandemic and their outcome for proper division of resources including human resources during pandemic. Methods: This is a cross sectional study done in emergency department of Kathmandu Medical College Teaching Hospital (KMCTH) Data were collected from the record book from 24 th March 2020 to 21 st July 2020 (lockdown period) and four months prior to 24 th March. The variation in emergency admissions, demographic profile, outcome of the patients, departments admitting the patients and place of admission was evaluated using SPSS. Results: Total of 6944 cases were seen during the pre-lockdown period and 2503 cases during the lockdown period, which is 63.95% less than the pre-lockdown era. Males (53.14% and 53.40% during pre-lockdown and lockdown respectively) visited emergency more frequently than females during both the periods. The number of cases that were admitted from the ER during the lockdown had fallen by 67.5% from the prelockdown era. Likewise, the patients admitted in ward, high care, ICU had decreased by 76%, 49%, 64% respectively compared to pre-lockdown period. However, the rate of admissions in intensive care unit had risen from 32.58% to 35.73% during lockdown. (There was decrease in injury, poisoning or certain consequences of external causes and external causes of morbidity and mortality by 57.5% and 52% respectively. Conclusion: The overall rate of admissions was low both for the COVID. However, the admission in intensive care units increased during the lockdown period which gives the idea that people were only visiting hospital when their symptoms were worse.
Journal of General Practice and Emergency Medicine of Nepal, Dec 31, 2020
Journal of Nepal Medical Association, 2020
Introduction: Left against medical advice is a worldwide phenomenon. Patients leaving against Lef... more Introduction: Left against medical advice is a worldwide phenomenon. Patients leaving against Left against medical advice do not provide the health professionals with legal impunity. A well-informed consent should be present with surety that they are well understood by the patient before they leave. The study was undertaken to study the prevalence of patients that leave against medical advice. Methods: This is a descriptive cross-sectional study done in the emergency department of a tertiary care hospital from 1st February 2020 to 31 July 2020. Ethical approval was taken from the Institutional Review Committee (ref. no. 130120205). The sample size was calculated and the convenient sampling method was used. Data were analyzed in the Statistical Package of the Social Sciences version 22. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Results: Out of 5834 visits, 332 (5.96%) (4.70-7.22 at 95% Confidence Interval) patients l...
Nepal Medical Journal, 2020
Anaphylaxis is a potentially life-threatening allergic reaction. Virtually all vaccines have the ... more Anaphylaxis is a potentially life-threatening allergic reaction. Virtually all vaccines have the potential to trigger anaphylaxis. There are cases reported with mild systemic reaction but anaphylactic shock after anti-rabies vaccination is rare. Side effects due to allergic reaction to vaccine antigen or the additives have been known for some time. Most of the cases are acute and only few with delayed hypersensitivity are shown to have cell mediated immune response. Once adverse effects occur immediate medical treatment and appropriate change of vaccine and vaccination schedule are of significance.
Metoclopramide is one of the frequently used antiemetic and prokinetic. The aim of this case repo... more Metoclopramide is one of the frequently used antiemetic and prokinetic. The aim of this case report is to emphasize the occurrence of metoclopramide induced acute dystonic reaction. Its prevalence is increasing and can be life threatening. We present a case of 18 years old female, who presented to the emergency of Kathmandu Medical College with the complaints of pain and stiffness of the neck and inability to keep her tongue in her mouth. She developed acute dystonic reactions after her fourth dose of Metoclopramide; which was prescribed for her vomiting associated with dysmenorrhea. The drug was discontinued and 25 mg of intravenous Chlorpheniramine was administered. The symptom subsided in two hours and was discharged with oral Chlorpheniramine. Metoclopramide can cause severe adverse reaction such as acute dystonic reaction, which is of unpredictable nature, physicians should be aware of this bizarre effect and the treatment.
College Before and After the National Level Lockdown for Pandemic Manish Nath Pant1, Neeti Ranjit... more College Before and After the National Level Lockdown for Pandemic Manish Nath Pant1, Neeti Ranjitkar2, Tulsi Raj Khanal3, Bishnu Singh4 Lecturer, Department of General practice and Emergency Medicine, Kathmandu Medical College and Teaching Hospital, Sinamangal, Kathmandu, Nepal Medical Officer, Department of General practice and Emergency Medicine, Kathmandu Medical College and Teaching Hospital, Sinamangal, Kathmandu, Nepal Medical Officer, Himal Hospital Private Limited, Thirbom Sadak, Kathmandu, Nepal Corresponding Author: Dr. Manish Nath Pant; Email/Contact: life.live004@gmail.com , 9851243722 ABSTRACT Background: Emergency visits during pandemic also comprise the patients with various complains other than symptoms of COVID. It is prudent to identify the variation of nonCOVID-19 cases (cases that do not have fever or cough or travel history or contact history or health professional) that visit emergency department during pandemic and their outcome for proper division of resource...
Nepal Medical Journal
Introduction: Sepsis and its consequences, severe sepsis and septic shock is at menace in country... more Introduction: Sepsis and its consequences, severe sepsis and septic shock is at menace in country like ours where infectious disease are at toll. Early diagnosis and treatment is very important to decrease the morbidity and mortality. Shock index is one of such tool that is very handy in these situations as this is just a mathematical calculation using heart rate(HR) and systolic blood pressure(SBP). The main aim of this study was to find the effectiveness of using SI as an adjunct to blood lactate in diagnosing patients in sepsis. Methods: This was an observational hospital-based study conducted at Emergency Department of TUTH, Maharajgunj on 104 patients, obtained by purposive sampling method, who had presented to the “Red Area”, aged between 18 to 65 years. These patients were screened for severe sepsis using triage vital signs, basic laboratory tests and an initial serum lactate level. Test characteristics were calculated for hyperlactatemia. I considered the following covariate...
Journal of Karnali Academy of Health Sciences, Dec 30, 2020
Background: Emergency visits during pandemic also comprise the patients with various complains ot... more Background: Emergency visits during pandemic also comprise the patients with various complains other than symptoms of COVID. It is prudent to identify the variation of non-COVID-19 cases (cases that do not have fever or cough or travel history or contact history or health professional) that visit emergency department during pandemic and their outcome for proper division of resources including human resources during pandemic. Methods: This is a cross sectional study done in emergency department of Kathmandu Medical College Teaching Hospital (KMCTH) Data were collected from the record book from 24 th March 2020 to 21 st July 2020 (lockdown period) and four months prior to 24 th March. The variation in emergency admissions, demographic profile, outcome of the patients, departments admitting the patients and place of admission was evaluated using SPSS. Results: Total of 6944 cases were seen during the pre-lockdown period and 2503 cases during the lockdown period, which is 63.95% less than the pre-lockdown era. Males (53.14% and 53.40% during pre-lockdown and lockdown respectively) visited emergency more frequently than females during both the periods. The number of cases that were admitted from the ER during the lockdown had fallen by 67.5% from the prelockdown era. Likewise, the patients admitted in ward, high care, ICU had decreased by 76%, 49%, 64% respectively compared to pre-lockdown period. However, the rate of admissions in intensive care unit had risen from 32.58% to 35.73% during lockdown. (There was decrease in injury, poisoning or certain consequences of external causes and external causes of morbidity and mortality by 57.5% and 52% respectively. Conclusion: The overall rate of admissions was low both for the COVID. However, the admission in intensive care units increased during the lockdown period which gives the idea that people were only visiting hospital when their symptoms were worse.
Journal of General Practice and Emergency Medicine of Nepal, Dec 31, 2020
Journal of Nepal Medical Association, 2020
Introduction: Left against medical advice is a worldwide phenomenon. Patients leaving against Lef... more Introduction: Left against medical advice is a worldwide phenomenon. Patients leaving against Left against medical advice do not provide the health professionals with legal impunity. A well-informed consent should be present with surety that they are well understood by the patient before they leave. The study was undertaken to study the prevalence of patients that leave against medical advice. Methods: This is a descriptive cross-sectional study done in the emergency department of a tertiary care hospital from 1st February 2020 to 31 July 2020. Ethical approval was taken from the Institutional Review Committee (ref. no. 130120205). The sample size was calculated and the convenient sampling method was used. Data were analyzed in the Statistical Package of the Social Sciences version 22. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Results: Out of 5834 visits, 332 (5.96%) (4.70-7.22 at 95% Confidence Interval) patients l...
Nepal Medical Journal, 2020
Anaphylaxis is a potentially life-threatening allergic reaction. Virtually all vaccines have the ... more Anaphylaxis is a potentially life-threatening allergic reaction. Virtually all vaccines have the potential to trigger anaphylaxis. There are cases reported with mild systemic reaction but anaphylactic shock after anti-rabies vaccination is rare. Side effects due to allergic reaction to vaccine antigen or the additives have been known for some time. Most of the cases are acute and only few with delayed hypersensitivity are shown to have cell mediated immune response. Once adverse effects occur immediate medical treatment and appropriate change of vaccine and vaccination schedule are of significance.
Metoclopramide is one of the frequently used antiemetic and prokinetic. The aim of this case repo... more Metoclopramide is one of the frequently used antiemetic and prokinetic. The aim of this case report is to emphasize the occurrence of metoclopramide induced acute dystonic reaction. Its prevalence is increasing and can be life threatening. We present a case of 18 years old female, who presented to the emergency of Kathmandu Medical College with the complaints of pain and stiffness of the neck and inability to keep her tongue in her mouth. She developed acute dystonic reactions after her fourth dose of Metoclopramide; which was prescribed for her vomiting associated with dysmenorrhea. The drug was discontinued and 25 mg of intravenous Chlorpheniramine was administered. The symptom subsided in two hours and was discharged with oral Chlorpheniramine. Metoclopramide can cause severe adverse reaction such as acute dystonic reaction, which is of unpredictable nature, physicians should be aware of this bizarre effect and the treatment.
College Before and After the National Level Lockdown for Pandemic Manish Nath Pant1, Neeti Ranjit... more College Before and After the National Level Lockdown for Pandemic Manish Nath Pant1, Neeti Ranjitkar2, Tulsi Raj Khanal3, Bishnu Singh4 Lecturer, Department of General practice and Emergency Medicine, Kathmandu Medical College and Teaching Hospital, Sinamangal, Kathmandu, Nepal Medical Officer, Department of General practice and Emergency Medicine, Kathmandu Medical College and Teaching Hospital, Sinamangal, Kathmandu, Nepal Medical Officer, Himal Hospital Private Limited, Thirbom Sadak, Kathmandu, Nepal Corresponding Author: Dr. Manish Nath Pant; Email/Contact: life.live004@gmail.com , 9851243722 ABSTRACT Background: Emergency visits during pandemic also comprise the patients with various complains other than symptoms of COVID. It is prudent to identify the variation of nonCOVID-19 cases (cases that do not have fever or cough or travel history or contact history or health professional) that visit emergency department during pandemic and their outcome for proper division of resource...
Nepal Medical Journal
Introduction: Sepsis and its consequences, severe sepsis and septic shock is at menace in country... more Introduction: Sepsis and its consequences, severe sepsis and septic shock is at menace in country like ours where infectious disease are at toll. Early diagnosis and treatment is very important to decrease the morbidity and mortality. Shock index is one of such tool that is very handy in these situations as this is just a mathematical calculation using heart rate(HR) and systolic blood pressure(SBP). The main aim of this study was to find the effectiveness of using SI as an adjunct to blood lactate in diagnosing patients in sepsis. Methods: This was an observational hospital-based study conducted at Emergency Department of TUTH, Maharajgunj on 104 patients, obtained by purposive sampling method, who had presented to the “Red Area”, aged between 18 to 65 years. These patients were screened for severe sepsis using triage vital signs, basic laboratory tests and an initial serum lactate level. Test characteristics were calculated for hyperlactatemia. I considered the following covariate...