Indian Journal of Surgical Nursing

Budd-Chiari syndrome is a rare but life-threatening condition that requires rapid diagnosis and appropriate treatment. It is an uncommon condition induced by thrombotic or non thrombotic obstruction to hepatic venous outflow. It occurs in 1 out of 100,000 individuals and is more common in females. Some 10–20% also has obstruction of the portal vein. Budd-Chiari syndrome is a potentially fatal disorder, if untreated. The syndrome occurs in persons of all races. I present a rare case of Budd-Chiari syndrome in a male with mild abdominal pain since one year. Early recognition of Budd-Chiari syndrome is important in preventing possible morbidity and mortality for this patient.

Keywords: Budd-Chiari syndrome; Hepatomegaly; Ascites; Endophlebitis.

In last few years a unique clinical phenomenon of “ICU psychosis” or “Sun downing” in Intensive Care Unit (ICU) has been discussed. More recently, Eisendrath defined "ICU Syndrome" as an acute organic brain syndrome involving impaired intellectual functioning and occurring in patients treated within a critical care unit. "ICU psychosis" was present when the impairment prevented the patient from accurately judging reality.5 The aims of study understand about meaning of ICU psychosis, causes, signs and symptoms and management. ICU psychosis is dangerous because it impedes the delirium if not treated on time. So it is very necessary to understand about the topic and must be involved all medical and nursing professional in care to prevent it. This study will help to prevention and management of ICU psychosis.

Keywords: Intensive care unit: Psychosis; Sun downing.

Nipah virus infection is highly fetal zoonotic, communicable and viral infection. The causative agent of Nipah virus infection is Nipah Virus which causes severe respiratory and Neurological disorders in humans. Flying foxes are natural reservoir of Nipah virus infection. The Transmission of Nipah virus occurs via direct contact with Human to Human or Animals to Human from infected person or animals (pigs and Fruits bats). Nipah virus spread through respiratory droplets and Nasal secretion of infected person or animals and through eating contaminated fruits and juices with secretion of infected animals. Confirmation of Nipah virus infection can be done with the help of clinical diagnosis on the basis of clinical signs and symptoms and through lab investigations through Virus culture, Urine, Spinal Fluid, Nasal & respiratory secretion & contaminated fruits. Nipah virus is global threat for health security and Alarming for health care sector with 40–75% of fatality rate on human beings which become public health concern and WHO listed Nipah virus infection in Blueprint priority disease category. At present there is no specific and effective vaccine and treatment available for Nipah virus infection. Preventive measures such as isolation, public education Campaigns and increase Awareness regarding Nipah virus infection can reduce the morbidity and mortality rate of Nipah infection.

Keywords: Nipah Virus; Infection; Fruit bat; Human; Awareness.

Neurological assessment includes a general physical examination pertaining to nervous system and a detailed neurological examination. The purpose of neurological assessment in medical surgical nursing perspective is to establish a nursing diagnosis to guide the nurse in planning and implementing nursing measures to help the patient cope effectively with daily living activities, and monitor progression of the condition and gauge the patient’s response to intervention. The frequency of neurological assessments depends on the patients’ admitting diagnosis, the presence of any chronic neurological disorders and the current functioning of the patient’s neurologic functions. However the information gathered in each assessment must be consistently communicated to all staff involved in the patient care. The content of the neurological assessment will guide nursing teachers and students to proceed the examination stepwise without any confusions and will assist in guiding the pathway to reach the goal.

Keywords: Neurological assessment; Nursing; Neurological conditions.

Introduction: Positioning the client in good body alignment and change the position regularly and systematically is used as therapeutic significant in nursing practice. Trendelenburg position is for treating intradialytic hypotension. With so much blood out of the patient’s body and with ultrafiltration over 3–4 hours, it is common for hemodialysis patients to become hypotensive. The study conducted with the aim and objectives of observing the effect of modified trendelenburg positioning against existing hospital practice on selected post dialytic complications such as hypotension, muscle cramps, nausea, vomiting, dyspnea & perspiration. Materials and methods: Quasi experimental two group pre and post-test interventional design was selected for the study with a sample size 50 of both groups. Non probability purposive sampling technique used, patient selected for both groups with sealed envelope methods. Inclusion criteria were patient who is undergoing hemodialysis, conscious and oriented to time, place and person. Exclusion criteria were patient undergoing first hemodialysis, neurological disorder, esophageal surgery, distended abdomen and lower limb ischemia. Patient developed with severe complication during hemodialysis. Modified observational check list was used to assess the selected post dialytic complication. Baseline data was collected from patient records. Unpaired t test was used to compare the effectiveness between the group, chi-square test and fisher exact test was used for association. Result: In experimental group the mean score of post-test (9.16) and in control group mean score of post-test was (15). Unpaired “t” test value for this present study was 4.45 with 48 degrees of freedom. Tabulated t value 2.0106 with 48 degrees of freedom. So, the null hypothesis was rejected at 0.05 level of significant and alternative hypothesis was accepted at 0.05 level of significant. Conclusion: The study finding revealed that the use of modified trendelenburg position for patient undergoing hemodialysis is more effective than the exsiting hospital practice positions. Unpaired t test value 4.45 with 48 degrees of freedom. Tabulated t value 2.0106 with 48 degree of freedom.

Keywords: Hemodialysis; Intradialytic hypotension; Trendelenburg position.

Pregnancy is a wonderful creation with life’s greatest blessings, dreams and expectation in women’s lives. Pregnancy is a time where a mother is going through a lot of changes both physically and psychologically. During childbirth episiotomy is one of the most widely performed surgical procedure. Due to episiotomy perineal pain is a stressful factor in mothers which interferes the daily activitiesperformed across the world. Infrared lamp therapy (IFR) is one of the best therapy which enhance episiotomy wound healing and pain reduction. The study was carried out with the aim to assess the effectiveness of IFR therapy on episiotomy pain and wound healing among postnatal mothers. In this study quasi-experimental non-equivalent post-test design was applied. Purposive sampling technique was used to assign 60 postnatal mothers (30 in each study & control group) who met the inclusion criteria. The IFR therapy for 10 minutes was applied on episiotomy wound for 3 consecutive days twice a day for the study group whereas hospital routine care was given to control group. Episiotomy wound was assessed by using observational check list REEDA scale and pain level assessed by modified numeric pain rating scale once in a day for 3 consecutive days. The result shown that there was significant difference found in episiotomy pain on 2nd day (p < 0.001) and in 3rd day (p < 0.001), and on episiotomy wound healing on 2nd day (p = 0.05) and on 3rd day (p = 0.001) in between study and control group. The study concluded that, IFR therapy is an appropriate method of care which can be included in hospital routine care for better episiotomy wound healing and managing episiotomy pain level among women at puerperium period.

Keywords: Infrared Lamp Therapy; Episiotomy Wound; Episiotomy pain.