JNMA; journal of the Nepal Medical Association
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Sandifer syndrome is an extra oesophageal manifestation of gastrointestinal reflux disease that usually presents with torticollis and dystonia (often mimicking epilepsy). Here, we describe a case of a four and a half years old child with convulsion, neck contortion, and irritability. Gastrointestinal reflux disease was suspected on the earlier visit of the patient based on the presenting symptom of vomiting and cough. ⋯ The case was confirmed by a medication trial for gastrointestinal reflux disease. This syndrome is often misdiagnosed as infantile seizure and musculoskeletal disorder. So, physicians need to have a sound knowledge of Sandifer Syndrome while assessing a child presenting with convulsion and torticollis.
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JNMA J Nepal Med Assoc · Nov 2021
Demography of Total Joint Replacement Surgeries Performed in a Tertiary Care Hospital: A Cross-sectional Survey.
Total joint replacement of hip and knee is considered as one of the most successful orthopedic surgeries in the twenty-first century because of the only solution to end-stage arthritis of these joints. The real burden of the problem is yet to be established in developing countries like Nepal. This study aims to describe the demographic findings of the joint replacement surgeries among total lower limb surgeries in a tertiary care hospital. ⋯ Total joint replacements of the hip were more common among the lower limb surgeries.
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JNMA J Nepal Med Assoc · Nov 2021
Case ReportsMacrophage Activation Syndrome secondary to Systemic Juvenile Idiopathic Arthritis: A Case Report.
Macrophage activation syndrome is a rare but a life threatening condition commonly associated with Systemic Juvenile Idiopathic Arthritis. Its clinical presentation includes fever, hepatosplenomegaly, hypertriglyceridemia, hypofibrinogenemia, hyperferritinemia and impaired liver enzymes. ⋯ A 12 year male presented with a history of intermittent fever and was started on antibiotics but failed to respond after several days of hospital stay. After a series of investigations to rule out multiple diagnoses he was diagnosed as a case of Macrophage Activation Syndrome secondary to Systemic onset Juvenile Arthritis and was treated with steroids.
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JNMA J Nepal Med Assoc · Nov 2021
Case ReportsRecurrent Dermatofibrosarcoma Protuberance: A Case Report.
Dermatofibrosarcoma protuberance represents less than 0.1% of all tumors, treatment of which requires wide local excision (≥5cm) but recurrence is not rare. Here we present a 32-year male presented with a swelling of 15 x 6cm over the left lumbar region for which he underwent excision three years ago, the histopathological examination of the swelling, showed a malignant mesenchymal tumor and Immunohistochemistry features were suggestive of Dermatofibrosarcoma protuberance. ⋯ Although the tumor was confined to the skin and subcutaneous tissue in the present case, the patient didn't undergo any adjuvant radiotherapy to avoid a possible relapse that would infiltrate deeper structures for the first time. Being a recurrent tumor, long-term follow-up is strongly recommended.
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JNMA J Nepal Med Assoc · Nov 2021
Case ReportsLaryngeal Schwannoma, Alarming Mass of Airway: A Case Report.
Laryngeal schwannomas are rare tumors of neural sheath origin. They normally present as a slow-growing, encapsulated, submucosal mass commonly in the supraglottic region. We describe a 13-year-old boy presenting with a 4-month history of progressive worsening dysphagia. ⋯ Definite complete excision of the tumor was planned and endoscopic excision of the mass was performed with removal of ipsilateral aryepiglottic fold, arytenoid and false vocal cord with retracheotomy. Rapid occurrence of mass after debulking and biopsy was demonstrated in this case. Though rare, neurogenic tumors of the larynx are life-threatening and need complete removal.