JNMA; journal of the Nepal Medical Association
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Male breast carcinoma is a rare malignancy (<1% of all breast carcinomas, 0.2% of all male malignancies). Its common histopathological type is infiltrating carcinoma, not otherwise specified. Three male patients aged 56 (stage -IIIB), 64 (T4bN0M0) and 78 (T2N0MO) years presented with a breast lump within a year. ⋯ Male breast carcinoma differs from female breast carcinoma on clinical presentation, biological behaviour and prognosis. Male breast carcinoma as a separate clinical entity with its own biological behaviour is manageable by surgery and chemotherapy. Keywords: female breast carcinoma; infiltrating carcinoma; male breast carcinoma.
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JNMA J Nepal Med Assoc · Jul 2018
Perception of District Judges and Lawyers Towards Medico-legal Reports, Medical Certificates and Medical Expert Opinion.
The medico legal reports and certificates prepared by doctors can be used as valuable documentary evidence in the court of law. The study was designed with objectives to explore the perception of judges and lawyers about the quality of medico legal reports prepared by the doctors and their competence in providing the expert evidence in the court. ⋯ The medical reports prepared by the Nepalese doctors were just average as perceived by judges and lawyers and the competency in presenting the evidence in courts was moderate as rated by them.
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JNMA J Nepal Med Assoc · Jul 2018
Case ReportsAbdominal Cocoon Syndrome following Primary Subfertility Management with IVF-ET.
Abdominal cocoon syndrome is a rarely encountered surgical emergency first described by Foo et al. in 1978. This condition is characterised by a thick fibrous membrane which encases the small bowel partially or completely. Diagnosis of this condition is usually made per operatively and the treatment of choice is surgical release of entrapped bowel. ⋯ Thorough screening for medical and surgical illness is very important before proceeding to any kind of assisted reproductive technologies. A multidisciplinary approach is very important to manage such cases. Keywords: abdominal cocoon syndrome; embryo transfer; In Vitro fertilization; ovarian Hyper stimulation syndrome; sub fertility.
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JNMA J Nepal Med Assoc · Jul 2018
Ultrasonographic Elasticity Contrast Index of Palpable Breast Lumps.
Elastrography used in addition to grey scale sonography increases its specificity. Elasticity contrast index (ECI) is based on strain elastrography and being a quantitative parameter, maybe more easy to obtain and reproducible while researches has been done in ECI in thyroid lesions, this is the first study, to the best of our knowledge to evaluate in breast lesions. This study was done to evaluate the diagnostic accuracy of Elasticity Contrast Index (ECI) in differentiating benign from malignant lesions of breast and to determine its cutoff value. ⋯ ECI is a quantitative elastography technique which can be easily used as an adjunct during breast sonography and can increase its specificity for diagnosing a lesion as malignant. This could reduce the number of false positive biopsies.
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JNMA J Nepal Med Assoc · Jul 2018
Case ReportsAtypical Kawasaki Disease in a 4 Years Old Child with Mumps.
Kawasaki disease is an acute febrile condition seen in children. However, it is also well recognized that some patients do not fulfill the classic diagnostic criteria for the diagnosis of Kawasaki disease. The incomplete form of Kawasaki disease is termed as 'Incomplete KD' or 'Atypical KD'. ⋯ Atypical cases might be missed if there is concomitant viral illness. Hence the identification and management of Kawasaki disease is paramount to decrease the mortality related to the cardiac disease. Keywords: bilateral cervical adenitis; fever and mumps; failed to respond IV antibiotics; incomplete kawasaki disease.