JNMA; journal of the Nepal Medical Association
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JNMA J Nepal Med Assoc · Nov 2022
Road Traffic Injuries among Patients Visiting the Emergency Department in a Tertiary Care Centre: A Descriptive Cross-sectional Study.
Road traffic injuries are preventable yet one of the most neglected public health issues. Road traffic injuries not only impact the health of the victim but also cause financial burden to the entire family. This study aimed to find out the prevalence of road traffic injuries in patients visiting the Emergency Department in a tertiary care centre. ⋯ automobiles; demography; Nepal; soft tissue injuries; traffic accidents.
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JNMA J Nepal Med Assoc · Nov 2022
Case ReportsRefractory Cardiogenic Shock Secondary to Acute Myocarditis in a Child with Multisystem Inflammatory Syndrome Associated with COVID-19: A Case Report.
Children with Coronavirus disease 2019 infection usually have mild symptoms but rarely may present with a life-threatening condition called a multisystem inflammatory syndrome. We report a case of COVID-19-related multisystem inflammatory syndrome in an 8-year-old boy who presented with cardiogenic shock due to acute myocarditis with no features of Kawasaki disease. Cardiogenic shock was refractory to fluids and inotropes. Later, this case was successfully managed with hydrocortisone and intravenous immunoglobulin. Therefore, this case report highlights keeping a lookout for such atypical presentations and early referral to a higher center for timely intervention and aggressive therapy specifically directed against the underlying inflammatory process to ameliorate the outcomes. ⋯ cardiogenic shock; COVID-19; kawasaki disease; myocarditis; Nepal.
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JNMA J Nepal Med Assoc · Nov 2022
Case ReportsAnti-N-methyl-D-aspartate Receptor Autoimmune Encephalitis: A Case Report.
Anti-N-methyl-D-aspartate receptor encephalitis is a form of autoimmune encephalitis with acute or subacute neuropsychiatric symptoms. Despite this fact, due to a couple of factors, this condition remains insufficiently acknowledged and is an under-recognised clinical scenario. We describe a case of a patient presenting with fever, headache and altered sensorium along with a history of disorientation, episodes of abnormal body movements and loss of consciousness in the later phase. She was initially thought to have Status epilepticus with tuberculous meningoencephalitis but her cognitive functions did not improve despite appropriate treatment. She displayed features away from the usual course of disease leading to suspicions of Autoimmune Encephalitis and Anti-N-methyl- D-aspartate receptor reports later confirmed the diagnosis. Methylprednisolone and Intravenous Immunoglobulin was started empirically and she was discharged in stable health with stabilised emotional and cognitive function with Azathioprine and Levetiracetam continued. Our findings suggested early diagnosis and prompt immunotherapy treatment beneficial for the outcome. ⋯ ase reports; encephalitis; immunotherapy; methylprednisolone.
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JNMA J Nepal Med Assoc · Nov 2022
Case ReportsLissencephaly with Congenital Hypothyroidism: A Case Report.
Lissencephaly is a malformation of cortical development associated with deficient neuronal migration and abnormal formation of cerebral convolutions or gyri. The lissencephaly spectrum consists of agyria, pachygyria, and subcortical band heterotopia. At least 19 genes have been identified in the causation of lissencephaly and related syndrome. Lissencephaly is associated with many other congenital disorders but the association of lissencephaly with congenital hypothyroidism is rarely reported. We report a case of a 10-year-old girl having lissencephaly with congenital hypothyroidism. Early diagnosis of lissencephaly and genetic counselling can be made in suspected cases and further possible interventions can be taken. Also, regular follow-up, monitoring, and better conservative management lead to a better prognosis. ⋯ congenital abnormalities; hypothyroidism; lissencephaly; neuronal migration disorders.
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JNMA J Nepal Med Assoc · Nov 2022
Hyponatremia in Patients Admitted to Intensive Care Unit of a Tertiary Center: A Descriptive Cross-sectional Study.
Hyponatremia is one of the common electrolyte abnormalities in intensive care unit settings. Hyponatremia may lead to an increased hospital stay, morbidity and mortality. Hyponatremia can occur due to a variety of iatrogenic as well as part of complex disease processes during hospital admission. The objective of this study was to find the prevalence of hyponatremia in patients admitted to the intensive care unit of a tertiary care centre. ⋯ cross-sectional study; prevalence; sodium.