JNMA; journal of the Nepal Medical Association
-
JNMA J Nepal Med Assoc · May 2019
Outcome of Ligation without Revascularization in Pseudoaneurysms of Peripheral Arteries in Intravenous Drug Users.
Management of pseudoaneurysms in intravenous drug users is complex and challenging due to an associated infection and unavailability of autologous vein grafts. Here we observe the outcomes of ligation and local debridement as a primary modality of treatment in this subset of patients with pseudoaneurysms. ⋯ With the use of ligation without revascularization technique, there was no mortality or major bleeding requiring re-exploration. None of the patients developed limb ischemia necessitating amputation so this treatment modality seems promising in treatment of pseudoaneurysms in intravenous drug users.
-
JNMA J Nepal Med Assoc · May 2019
Case ReportsCalvarial Tuberculosis: A Diagnostic Quandary: A Case Report.
Primary Calvarial Tuberculosis, a rare entity of skull is even rarer after second decade of life in a healthy person without evidence of tuberculosis elsewhere in the body. Most of the cases are often misdiagnosed as osteomyelitis/syphilis/bony metastasis. We report a case of primary skull tuberculosis in 26-year-old male with complains of headache and swelling in the right frontal region with no history of previous tuberculosis. ⋯ Being a rare disease, tubercular osteomyelitis of skull bones is often missed and misdiagnosed due to lack of clinical suspicion and slow growth of mycobacterium cultures. Histopathological examination of biopsy material and demonstration of acid-fast bacilli in the pus are helpful for diagnosis and early management of the disease. Keywords: calvaria; Mycobacterium; osteomyelitis; tuberculosis.
-
JNMA J Nepal Med Assoc · May 2019
Case ReportsCongenital Microphthalmia with Orbital Cyst: A Case Series.
Microphthalmos results from incomplete invagination of the optic vesicle or closure of the embryonic fissure. We present three patients with unilateral congenital microphthalmia with cyst. None of them had vision in the affected eye since birth. ⋯ Antenatal check up with ultrasound at 14 to16 weeks of pregnancy is important for genetic counselling. Targeted abdominal ultrasound examination of pregnant women focused on the orbital region of foetus is recommended, in mothers who have children with congenital eye anomalies. Keywords: congenital anomaly; cyst; eye; microphthalmos.
-
JNMA J Nepal Med Assoc · May 2019
Case ReportsLeiomyosarcoma of the Inferior Venacava: A Case Report.
Leiomyosarcoma of inferior venacava is a rare tumor. Female are most commonly affected and middle segment of inferior vena cava is the commonest site. The diagnosis can sometimes be challenging as patients present with non-specific symptoms. ⋯ Histopathological examination revealed a capsulated, multilobated tumor arising from muscle layer of inferior venacava with extraluminal growth pattern and tumor cells showing cytoplasmic positivity for immuno-histochemical stain smooth muscle actin. With the diagnosis of leiomyosarcoma of inferior venacava, excision of tumor was done with tangential excision of 4 cm length of inferior venacava with primary repair. Keywords: inferior venacava; leiomyosarcoma; smooth muscle actin.
-
JNMA J Nepal Med Assoc · May 2019
Prevalence of Ruptured Intracranial Aneurysms in a Tertiary Care Hospital of Nepal.
Intracranial aneurysms affect 3-8 percent of the world's population, with ruptured aneurysms being the most common cause of subarachnoid hemorrhage. The sensitivity of Computed Tomography Angiogram in diagnosing intracranial aneurysm is 97%. The aim of our study is to find out the prevalence of ruptured intracranial aneurysms among all the admitted cases encountered in our hospital. ⋯ The prevalence of ruptured intracranial aneursyms were found to be higher as compared to the other international studies.