ABSTRACT
Background:Acute kidney injury (AKI) is a frequent complication in critically sick patients admitted to the intensive care unit (ICU). The objective of this study was to assess the risk factors and clinical outcomes of AKI in patients admitted to a teaching hospital's intensive care unit.Methods:This prospective observational study was conducted in the department of internal medicine, Janaki Medical College, Janakpur, Nepal from June 2018 till May 2019. Adults (aged 18 years or more) diagnosed with AKI using RIFLE criteria and were either admitted in ICU with diagnosis of AKI or developed AKI after admission to ICU. AKI patients were classified as those who satisfied any of the RIFLE categorization criteria.Results:The most common presenting complaint was fever (77%). The most common etiology of AKI was sepsis (71%). Other causes of AKI were post-operative cases (16%) and alcoholic liver disease (13%). When classified as per RIFLE criteria, we classified 38 cases (31.9%) as ‘risk’, 53 (44.54%) as ‘injury’ and28 (23.53%) as ‘failure’. The etiological classification of our patients to be significantly associated with RIFLE classification (p<0.01). However, we found the mortality not to be significantly associated with RIFLE classification (p=0.74). Conclusions:AKI classification should be used as a risk assessment tool towards the AKI's influence on the prognosis of ICU patients. Further study should investigate determining the death rate according to the RIFLE criteria in this region of Nepal.
ABSTRACT
The medical laboratories are increasing significantly with striking challenges in ensuring praiseworthy public health service in Nepal. Quality medical laboratory service provision is important in order to enhance diagnostic value and save lives. Poverty, poor infrastructure, unskilled manpower and incompetency are major contributing factors leading to inefficient provision of health services in developing countries. Nepal has been increasing its network of clinical health laboratories in the Government and private sectors that are scattered in various geographical regions. The quality of service remains a growing concern even as medical diagnostic laboratories are undergoing the process of accreditation for quality services in line with WHO standards. But, still the status of clinical laboratory practice regarding quality assurance, skilled manpower, standard labs and cost effective quality service remains challenging due to different loopholes in policy making. The regulatory bodies and legal provisions seem to be in non-functional state. The malpractices in clinical laboratory medicine service are increasing exponentially. Therefore, this review draws attention towards unhealthy practices in clinical laboratory services and critically examines different factors affecting the healthy practice in medical laboratory science.
ABSTRACT
Background and Objectives: The accountability of nurses for nutritional care and best nutritional practices in nutritional management has been shown to improve patient outcomes at hospitals. Several studies had been conducted before to explore the level of nutritional knowledge among nurses in different countries but there is paucity of data among nursing students. Therefore, the present study was designed to focus on bachelor level nursing students about the therapeutic nutritional towards CVDsMaterial and Methods: A cross sectional descriptive study was conducted among 97 nursing students studying in B.Sc. nursing and PBBN programme. Random sampling technique was used. Structured questionnaire was distributed to each participant to choose the most correct answer. The collected data was entered in Microsoft Excel for analysis. The level of knowledge was assessed on the basis of percentage score.Results: Out of total students, 42% were less than or equal to 20 years and 58% were greater than 20 years. Most of the students were from Dhanusha district. Almost all respondents had heard about the different types of diet, CVD (98.96%) but 1.03% respondent was not familiar with CVD. 93.81% respondents knew high blood cholesterol increases the incidence of heart disease and 85.56% responded that caffeinated beverage is harmful for myocardial infarction. The poor knowledge was found about good fats and bad fats among respondents.Conclusion: The basic information regarding CVDs was significant but the therapeutic nutritional knowledge among the nursing students was found to be satisfactory. Therefore, the improvement in the curriculum of undergraduate nursing courses is necessary regarding the proper therapeutic nutritional knowledge for its integration into health services effectively at hospitals.