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Intravesical Colistin bladder irrigation for multidrug-resistant urinary tract infection in critically ill patients with renal compromised: Single-center case series from Nepal.Authors: Saroj Poudel1, Bikash Khadka1, Kishor Khanal1, Anup Ghimire1, Ashim Regmi2, Shirish KC3, Rohini Nepal3 on behalf of Doctors on Wheels^1 Department of Critical Care Medicine, Nepal Mediciti Hospital, Lalitpur, Nepal2 Department of Critical Care Medicine, Al Zahra Hospital, Dubai, UAE3 Department of Clinical Research, Doctors on Wheels, Kathmandu, Nepalthe article

INTRODUCTIONAn unpleasant experience for both the patient and the anesthetist, post-dural puncture headache (PDPH) is a complication of spinal anesthesia or lumbar puncture. It is believed to be caused by cerebral vasodilation, which is an indirect consequence of low cerebrospinal fluid (CSF) pressure, or meningeal traction linked to low CSF pressure.1 PDPH incidence varies, although it is generally thought to be 36% or more after lumbar puncture, 0%-10% after spinal anesthesia, and 81% after an unintentional dural puncture during epidural insertion.2, 3 Although PDPH typically resolves on its own, it can make it difficult for mothers to care for their infants and lengthen hospital stays. Serious side effects such as subdural hematoma, convulsions, sagittal sinus thrombosis, and cranial nerve palsies are more infrequently linked to PDPH.

AUTHORSDr. Saroj Poudel Clinical Pharmacist Critical Care Medicine, Nepal Mediciti Email: itsmesarozz@gmail.comDr. Rupak Chalise Anesthesiologist Critical Care Medicine, Nepal Mediciti Email: rupak.chalise1990@gmail.comDr. Manoj Bist Medical Officer Critical Care Medicine, Nepal Mediciti Email: manojbistamanisha18@gmail.comDr. Ashim Regmi Junior Consultant Critical Care Medicine, Nepal Mediciti Email: a20regmi@gmail.comDr. Anup Ghimire Junior Consultant Critical Care Medicine, Nepal Mediciti Email: anup.login@gmail.comDr. Kishor Khanal Intensivist and ICU Coordinator Critical Care Medicine, Nepal Mediciti Email: kishorkhanal01@gmail.com