Mean Cholinesterase Level among Organophosphorus Poisoning Patients Visiting the Emergency Department in a Tertiary Care Centre: A Descriptive Cross-sectional Study.

Introduction: Acute organophosphorus pesticide poisoning is widespread and the most common in many developing countries, including Nepal. Through the inhibition of acetylcholinesterase, organophosphorus poisoning is characterised by the clinical picture of acute cholinergic crisis. Many researchers have shown increased levels of liver enzymes and decreased levels of serum cholinesterase in organophosphorus poisoning, however, very little work has been done in Nepal that studies the correlation between serum cholinesterase and liver enzymes in organophosphorus poisoning. The aim of the study is to find out the mean cholinesterase level among organophosphorus poisoning patients visiting the Emergency Department in a tertiary care centre. Methods: This was a descriptive cross-sectional study done among 94 organophosphate poisoning cases visiting the emergency department of a tertiary care centre from August 2021 to August 2022 after obtaining approval from the Institutional Review Committee (Reference number: 04102021/06). Convenience sampling was done. Blood workups were done for cholinesterase and liver function tests. Point estimate and 90% Confidence Interval were calculated. Results: The mean cholinesterase level among organophosphorus poisoning patients was 1978.82±1878.22 (1660.17-2297.47, 90% Confidence Interval). Conclusions: The mean cholinesterase level among organophosphorus poisoning patients was similar when compared to other studies done in similar settings. Keywords: cholinesterases; liver function tests; organophosphorus poisoning.

Mean Serum Lactate Levels in Patients with Sepsis Presenting to the Department of Emergency Medicine of a Tertiary Care Center: A Descriptive Cross-sectional Study.

Introduction: Sepsis is a life-threatening organ dysfunction caused by a dysregulated host response to infection. Serum lactate is useful in predicting the prognosis of critically ill patients. Elevated blood lactate levels as well as delayed clearance have been linked to higher mortality in sepsis. Shock index is a simple and effective bedside assessment means of gauging the degree of shock and is an important predictor of identifying high-risk patients. Monitoring lactate levels may aid clinicians in understanding tissue perfusion and detecting unrecognized shock and making prompt therapy adjustments. This study aimed to find out the mean serum lactate levels in patients with sepsis presenting to the Department of Emergency Medicine of a tertiary care centre. Methods: A descriptive cross-sectional study was conducted at a tertiary care centre among the patient with sepsis presenting to the emergency department from 1 September 2022 to 30 November 2022. Ethical approval was obtained from the Institutional Review Committee of a tertiary care centre (Reference number: 26082022/02). History taking and detailed examination were done. Blood was sent for serum lactate and other parameters as proforma was sent. The shock index was calculated. Convenience sampling was done. Point estimate and 95% confidence interval were calculated. Results: Among 53 sepsis patients, the mean serum lactate level in sepsis patients was 2.84+2.02 (male: 2.83+1.70 and female: 2.85+2.42). Conclusions: The mean serum lactate level in patients with sepsis is similar as compared the studies done in similar settings. Keywords: emergencies; lactate; sepsis.

Effects of short-term two weeks low intensity plyometrics combined with dynamic stretching training in improving vertical jump height and agility on trained basketball players.

Sport specific training in basketball players should focus on vertical jump height and agility in consistent with demands of the sport. Since plyometrics training improves vertical jump height and agility, it can be useful training strategy to improve the performance of basketball players. A convenience sample of thirty professional basketball players were recruited. Following pre-intervention assessment, interventions using plyometrics training and dynamic stretching protocol was administered on the basketball players. The outcome measures were assessed before the intervention and at the end of first and second week. Statistically significant improvements in vertical jump height (31.68 ± 11.64 to 37.57 ± 16.74; P < 0.012) and agility (16.75 ± 2.49 to 16.51 ± 2.80; P <0.00) were observed between pretest--posttest measures and no changes in muscle girth and isometric muscle strength. The study concludes that short term two weeks plyometrics training combined with dynamic stretching as a useful sport specific training strategy to improve vertical jump height and agility on trained basketball players.

PBL implementation of Kathmandu University Curriculum - Is It Quo Vadis?

The history of the implementation of PBL which started in 1978 is long and there have been many ups and downs in the process of getting it to work. Of course there are many reasons for this, starting with the fact that basically it is a method of learning of medicine that is being tried out in various parts of the world. What is envisaged by KU is a hybrid form of the process to be implemented for the MBBS course that KUSMS conducts at its campus at Chaukot, Kavre and at its seven affiliated medical colleges. Various points regarding this are discussed in this article. The information provided in the MBBS curriculum of KU was analysed and comments made there on. The syllabi of IoM, BPKIHS and PAHS were also referred to, to note the existing differences.