JNMA; journal of the Nepal Medical Association
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JNMA J Nepal Med Assoc · Sep 2019
Attitude of Interns towards Family Medicine as a Career in a Tertiary Care Hospital.
Family medicine is a relatively overlooked specialty in Nepalese medical education. It is unclear how many interns are actually interested in Family medicine as a career and how many non-medical individuals are aware of its existence. The aim of this study is to assess information, expectation and perception among interns regarding family medicine and its choice as a career. ⋯ Despite being the career of choice of only a few, majority considered family medicine as a potential career for them. And the knowledge about existence of family medicine was high among families of interns.
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JNMA J Nepal Med Assoc · Sep 2019
Case ReportsAn Unwanted Guest in the Biliary Tract: A Case Report.
Ascariasis is a frequent human gastrointestinal tract helminthic disease caused by Ascaris lumbricoide. It usually stays in the intestinal lumen and occasionally migrates into the biliary tract through ampulla of Vater. Biliary ascariasis is a critical complication of intestinal ascariasis with life-threatening manifestations. ⋯ Biliary ascariasis was noted on Endoscopic Retrograde CholangioPancreaticography following which extraction was done. Our report highlights the varied clinical features of biliary ascariasis. Keywords: ascariasis; ascaris lumbricoides; cholangiopancreatography endoscopic retrograde; common bile duct.
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JNMA J Nepal Med Assoc · Sep 2019
Case ReportsAlpha-gal Allergy in a 6-Year-Old Male: A Case Report.
Alpha-gal allergy is a reaction where the immunoglobulin E antibody elicits a response to galactosealpha-1,3-galactose (alpha-gal) which is a mammalian oligosaccharide epitope found in nonprimate mammalian. After being exposed to a tick bite, particularly the Lone Star tick (Amblyomma americanum), an individual has been known to develop an alpha-gal allergy. Our patient presented with symptoms of delayed-onset allergy 3-8 hours after consuming mammalian meat products including beef and pork. ⋯ Our patient highlights one of the few reported childhood cases with an alpha-gal allergy. We recommend a careful history, in particular, asking if the patient has a past history of tick bites and the appearance of allergy symptoms following beef or pork consumption. Keywords: allergy; food hypersensitivity; immunoglobulin E; meat products; tick bites.
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JNMA J Nepal Med Assoc · Sep 2019
Prevalence of Dissociative Convulsions in Patients with Dissociative Disorder in a Tertiary Care Hospital: A Descriptive Cross-sectional Study.
Dissociative disorder is one of the common psychiatric problems encountered very frequently in the hospital setting. The aim of the study is to find out the prevalence of dissociative convulsions type in patients suffering from dissociative disorder attending Psychiatry outpatient department of a tertiary care hospital. ⋯ The prevalence of dissociative convulsion type is high in patients suffering from dissociative disorder in the Nepalese context. Future studies should be conducted to understand this disorder and to propose therapeutic guidelines.
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JNMA J Nepal Med Assoc · Sep 2019
Case ReportsToxic Epidermal Necrolysis A Diagnostic Dilemma in Puerperium: A Case Report.
Toxic epidermal necrolysis is a potentially life threatening dermatologic disorder characterized by widespread erythema, necrosis and bullas, detachment of epidermis and mucous membrane resulting in exfoliation, possible sepsis and even death. This is the first case report in Nepal of toxic epidermal necrolysis in puerperium. We present a case of a 28-years-old, P1L1 on fourth postoperative day following emergency lower segment caesarean section for cephalopelvic disproportion in latent phase of labour with uneventful antenatal period. ⋯ She was managed with broad spectrum antibiotics and inotropes. Later on, it was found to be the case of Toxic epidermal necrolysis and managed with vancomycin and corticosteroids under the supervision of gynecology, dermatology and medicine team. Keywords: puerperium; toxic epidermal necrolysis; vancomycin.