JNMA; journal of the Nepal Medical Association
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Evans syndrome is defined as the concomitant or sequential association of warm autoimmune hemolytic anaemia with immune thrombocytopenia, and less frequently autoimmune neutropenia. It is associated with non-cross-reacting auto-antibodies directed against antigens specific to red blood cells, platelets or neutrophils. Clinical symptoms could be related to hemolysis and thrombocytopenia. ⋯ The first-line treatment of Evans syndrome is intravenous corticosteroids or intravenous immunoglobulins and second-line treatment with rituximab or splenectomy for those who are refractory to steroids. Here is a case of a fifty-year-old- female who presented with bleeding from the mouth and gums, bluish patches over the shin and trunk along with generalised weakness and severe backache. We are interested in reporting this case because the presentation of patients with such scenarios on our part will compel the treating physician to overlook Evans syndrome and get it underdiagnosed.
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The complete absence of limbs is a rare occurrence. Though the causes are various, it is hard to elicit most of the time. ⋯ Increasing the feasibility of the scan can help in the early diagnosis and management. Here, we report a rare combination of limb defects that we managed in a district-level hospital and highlight the difficulties in the management and referral of the patients while working in rural areas.
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JNMA J Nepal Med Assoc · May 2022
Oral Potentially Malignant Disorders among Patients Attending the Department of Oral Medicine and Radiology of a Tertiary Care Dental Hospital: A Descriptive Cross-sectional Study.
Despite oral cancer being a common cancer in Nepal, little is known about oral potentially malignant disorders which have a high likelihood of malignant transformation. This study aims to find out the prevalence of oral potentially malignant disorders among patients attending the Department of Oral Medicine and Radiology of a tertiary care dental hospital. ⋯ Nepal; oral cancer; prevalence; tobacco.
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Cronkhite-Canada Syndrome is a rare disease characterised by diffuse gastrointestinal polyposis, abdominal pain, diarrhoea, cutaneous and mucosal hyperpigmentation, alopecia, and onychodystrophy. Here we report a case of a 40-year-old female with Cronkhite-Canada Syndrome, who presented with the complaints of diffuse abdominal pain, blood mixed stools, and diarrhoea associated with tenesmus. She had nausea and reduced appetite and lost 10 kgs in 3 months. ⋯ She received respective antibiotics and protein diets that helped relieve the symptoms. After 4 weeks of steroids, her symptoms improved drastically. Corticosteroids, treating co-infection along with nutritional counselling can be helpful to relieve the symptoms.
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JNMA J Nepal Med Assoc · May 2022
Lumbar Disc Degenerative Disorder among Patients Undergoing Magnetic Resonance Imaging in a Tertiary Care Centre: A Descriptive Cross-sectional Study.
Magnetic resonance imaging is the standard imaging modality for detecting disc pathology due to its advantage of lack of radiation, multiplanar imaging capability, excellent spinal soft-tissue contrast, and precise localization of intervertebral discs changes. The aim of the study is to find out the prevalence of lumbar disc degenerative disorder among patients undergoing magnetic resonance imaging in a tertiary care hospital. ⋯ disc degeneration; low back pain; magnetic resonance imaging.