JNMA; journal of the Nepal Medical Association
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JNMA J Nepal Med Assoc · Dec 2022
Case ReportsExtragonadal Mixed Germ Cell Tumour of the Right Scapular Region: A Case Report.
Extragonadal germ cell tumours are rare; to the best of our knowledge, a location in the soft tissue of the right scapular region has never been previously reported in the literature. We report a case of a 9-years-old girl who presented with swelling over the right scapular region, treated by a combination of surgery and cisplatin-based chemotherapy. Immunohistochemistry and serum tumour markers concluded it to be an extragonadal mixed germ cell tumour. Our patient had a complete response up to 2 years of follow-up. This case is being reported here due to a very rare site of presentation with a diagnostic dilemma. A multidisciplinary, combining systemic chemotherapy and surgery is the most appropriate treatment strategy for extragonadal germ cell tumours, to ensure both local and systemic control. ⋯ germ cell tumor; immunohistochemistry; tumor markers.
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The rectal foreign body is a rare presentation, often related to sexual gratification, sexual assault, or the result of ingestion and rarely accidental, and with rising incidence. We present a case of a 47-year-old heterosexual male with an alleged history of accidental insertion of a foreign body through the anus three days prior without peritonitis or obstipation. After investigations, the patient underwent a failed sigmoidoscopic removal followed by exploratory laparotomy, foreign body removal, and an uneventful post-operative period. It should be noted that early diagnosis and timely intervention are important to prevent complications in rectal foreign bodies. Assessment of the shape, size, nature, and location of the object through appropriate imaging is necessary. Exploratory laparotomy is inevitable in cases of failed manual extraction techniques and complicated cases. ⋯ case reports; foreign bodies; laparotomy; rectum; sigmoidoscopy.
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JNMA J Nepal Med Assoc · Dec 2022
Acute Kidney Injury among Patients Visiting the Nephrology Unit in a Tertiary Care Centre: A Descriptive Cross-sectional Study.
Acute kidney injury is an abrupt decline in renal function often associated with a decrease in urine output. It is the leading cause of in-hospital mortality worldwide with prolonged hospital stays, the requirement of mechanical ventilation and short-term dialysis. The aim of the study was to find out the prevalence of acute kidney injury among patients visiting the Nephrology unit in a tertiary care centre. ⋯ acute kidney injury; mortality; renal replacement therapy.
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Takayasu's arteritis is a chronic vasculitis of medium and large vessels. The most involved vessel is the aorta and its major branches. The disease is primarily seen in young women. The described incidence of the disease ranges from 0.3 to 3.3 million per year. The vessels are characterized by mononuclear infiltration and granulomatous inflammation of vascular media, which leads to arterial wall thickening with stenosis, occlusion, and aneurysmal dilation. Here we present a case of Takayasu's arteritis in a 26-year-old woman who presented with syncope and dizziness with thickened walls of the arch of the aorta and its branches in Magnetic Resonance Imaging angiogram finding. Women of Japanese descent are not the only ones who can develop Takayasu's arteritis; it can affect anyone. Therefore, early diagnosis and treatment are warranted. When the disease is dormant, the outcome seems favourable. ⋯ aortitis syndrome; arteritis; case reports; pulseless disease; young female arteritis.
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JNMA J Nepal Med Assoc · Dec 2022
Complete Stone Clearance after Retrograde Intrarenal Surgery among Patients with Urolithiasis in a Tertiary Care Centre: A Descriptive Cross-sectional Study.
Retrograde intra-renal surgery using flexible scopes and laser energy is a newer alternative in stone disease treatment armamentarium. It is claimed to be superior to other modalities for stone clearance, complications and hospital stay. The aim of this study was to find out the prevalence of complete stone clearance after retrograde intra-renal surgery among patients with urolithiasis in a tertiary care centre. ⋯ laser; miniaturization; postoperative complications.