JNMA; journal of the Nepal Medical Association
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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
Contextualizing Critical Care Medicine in the Face of Covid-19 Pandemic.
Critical Care Medicine is a specialty dealing with the comprehensive management of patients having, or at risk of developing, acute, life threatening organ dysfunction. The glaring need of critical care services and human resources for critical care have become more evident in the face of the current COVID-19 Pandemic. At this juncture, when the world is facing threat to humanity with an increasing number of deaths due to COVID 19 pandemic, the discussion about the need for ICU beds and human resources for critical care management has re-surfaced and is being increasingly realized. ⋯ If the number of confirmed cases of COVID-19 continue to rise at the current pace, the shortage of critical care facilities will become more glaring than ever before. The current pandemic is a tremendous opportunity for health planners to accelerate action and ensure that the country is well-equipped to contain the COVID-19 pandemic. We need to be working towards infrastructure and human resource strengthening and expansion in critical care, in order to efficiently contain the pandemic.
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JNMA J Nepal Med Assoc · Jun 2020
Pain and Oral Health Related Quality of Life among Patients Undergoing Fixed Orthodontic Treatment: A Descriptive Cross-sectional Study.
Fixed orthodontic procedures such as separator placement, archwire placement and activations, application of orthopaedic forces, and debonding of brackets produce pain in patients. This study was conducted to assess pain and oral health-related quality of life among patients undergoing orthodontic treatment. ⋯ The pain intensity experienced by patients was variable. Most participants had moderate pain but few patients perceived no pain at all. The participants had at least one or other oral health impacts due to fixed orthodontic treatment. Orthodontists should counsel the patients regarding possible discomfort so that there is no discontinuation of treatment due to pain.
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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
Anterior Tooth Width Measurements among Patients in a Tertiary Hospital of Nepal: A Descriptive Cross-sectional Study.
The knowledge of anterior tooth width and their relationships with each other is essential for any esthetic and prosthodontic rehabilitation. The objective of this study is to measure the width of the anterior teeth of patients coming to a teritary hospital of Nepal. ⋯ Our findings of the average values of the anterior teeth and their difference from the central incisors on each side showed an agreement with the optimal relationships of anterior teeth, with the exception of the maxillary lateral incisors, which were 0.5mm larger than the values of the optimal relationship.