JNMA; journal of the Nepal Medical Association
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JNMA J Nepal Med Assoc · Jun 2020
Case ReportsCombined Penetrating Keratoplasty Followed by Pars Plana Vitrectomy for Firecracker Induced Bilateral Corneal and Intraocular Foreign Body: A Case Report.
Firecracker induced open globe injury is a big challenge for ophthalmic surgeons. Its association with the intraocular foreign body makes the diagnosis and treatment even more difficult resulting in poor anatomical and visual outcomes. We report a case of a 35-year-old male who presented with bilateral, multiple corneal and intraocular foreign body due to firecracker explosion. ⋯ Combined penetrating keratoplasty and cataract surgery were done in both eyes followed by pars plana vitrectomy for intraocular foreign body removal. The final best-corrected visual acuity of the patient stood to be 6/6 and 6/9 in the right and left eye respectively. The encouraging result in our case prompts ophthalmologists for a timely stepwise multidisciplinary approach in all open globe injuries with intraocular foreign body cases having poor initial acuity.
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JNMA J Nepal Med Assoc · Jun 2020
Case ReportsMassive Gastrointestinal Bleeding Masquerading Coagulopathy in Acute Viral Hepatitis: A Case Report.
Hepatitis A virus infection is typically an acute self-limiting illness associated with general nonspecific symptoms such as fever, malaise, anorexia, nausea, vomiting, abdominal pain or discomfort, and diarrhea. This may have atypical manifestation like prolonged cholestasis. Despite having varying typical and atypical manifestations such a case may present with life-threatening bleeding from a co-existing surgical cause such as perforation of Meckel's diverticulum.
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JNMA J Nepal Med Assoc · Jun 2020
Case ReportsRadial Head Dislocation with Ipsilateral Proximal Shaft of Radius Fracture: A Case Report.
Radial head dislocations are uncommon in adults. They are commonly seen in children and are generally associated with proximal ulna fracture. ⋯ Due to the rarity of this complex injury, in the absence of keen observation and meticulous attention, the correct diagnosis might be missed leading to unsatisfactory management and related complications. Here, a similar case of radial head dislocation with associated proximal radial shaft fracture has been presented.
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JNMA J Nepal Med Assoc · Jun 2020
Case ReportsManagement of Neglected Post-traumatic Bilateral Facet Dislocation of Sub-axial Cervical Spine: A Case Series.
Neglected bilateral facet dislocation of the lower cervical spine is a rare condition and found mostly in developing countries like Nepal. Delayed presentation makes treatment more challenging concerning decompression, reduction, neurological recovery, and overall outcome. ⋯ All of those were treated surgically by combined anterior-posterioranterior approaches with the same principle. One patient had a complete neurological recovery, the second one recovered partially with few long-term complications and the third one did not improve at all.
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JNMA J Nepal Med Assoc · Jun 2020
Prevalence of Hemolysis, Elevated Liver Enzymes, Low Platelet Count Syndrome in Pregnant Women in a Tertiary Care Hospital.
Hemolysis, Elevated Liver Enzymes, Low Platelet count syndrome refers to biological syndrome occurring in pre-eclamptic and eclamptic women. There is a higher rate of maternal and perinatal morbidity and mortality due to the syndrome. So, the objective of the study is to find the prevalence and maternal- perinatal outcome in the syndrome. ⋯ Hemolysis, Elevated Liver Enzymes, Low Platelet count syndrome is one of the major causes of maternal and perinatal morbidity and mortality. Hence early recognition and prompt management may improve maternal and fetal outcomes.