JNMA; journal of the Nepal Medical Association
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JNMA J Nepal Med Assoc · Jun 2022
Case ReportsEsophageal Actinomycosis in an Immunocompetent Patient Mimicking Carcinoma: A Case Report.
Esophageal actinomycosis is a rare occurrence that presents a diagnostic challenge due to its vague clinical picture. The common symptoms include dysphagia, odynophagia and epigastric pain. These symptoms, although alarming, are usually non-specific. In this report, we describe an immunocompetent 38-year-old woman who presented with dysphagia and burning chest pain. Her initial examination and investigations suggested carcinoma of the oesophagus. On further evaluation and histopathology examination, she was diagnosed with esophageal actinomycosis and managed with antibiotics and symptomatic relief. She had significant improvement on follow up examination. The diagnosis of this condition in an immunocompetent patient can be confusing and requires a high degree of suspicion. ⋯ actinomycosis; carcinoma; case reports; esophagus.
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JNMA J Nepal Med Assoc · Jun 2022
Case ReportsCerebral Hemangiopericytoma Manifesting as Epilepsia Partialis Continua: A Case Report.
Cerebral hemangiopericytomas are very rare mesenchymal tumours arising from pericytes surrounding the blood vessels in the brain. Most patients present with headaches, focal neurological findings and focal seizures with or without generalisation. Our patient chiefly complained of an uncontrollable movement of her right hand that was initially fleeting but later became continuous. Her symptoms were initially described as tremors. We found an intracranial tumour as a cause of her symptoms, suspected the tumour to be a meningioma and performed surgical extirpation which resulted in symptom resolution. Histopathology and immunohistochemistry of the excised mass revealed that the tumour was hemangiopericytoma. The patient is being closely monitored for recurrences and metastasis. Hemangiopericytomas are very rare and they rarely result in the abnormal movements of epilepsia partialis continua. Differentiation of the abnormal movements of epilepsia partialis continua from tremors is very important as is the differentiation of the tumour from meningioma. ⋯ case reports; epilepsia partialis continua; hemangiopericytoma; solitary fibrous tumors.
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JNMA J Nepal Med Assoc · Jun 2022
Intra-abdominal Adhesions among Patients Undergoing Repeat Caesarean Section in Department of Obstetrics and Gynaecology of a Tertiary Care Centre: A Descriptive Cross-sectional Study.
Adhesions are one of the common complications encountered after caesarean section whose risk increases with the number of caesarean deliveries. This study aimed to find out the prevalence of intra-abdominal adhesions among patients undergoing repeat caesarean section in a tertiary care centre. ⋯ postoperative complications; repeat caesarean section; surgical adhesions.
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JNMA J Nepal Med Assoc · Jun 2022
Middle Ear Barotrauma among Licensed Para-pilots of a Metropolitan City: A Descriptive Cross-sectional Study.
Middle ear barotrauma is a tissue injury to the ear secondary to inadequate pressure equalisation between the middle ear and the external environment. Paragliding, though an exciting sport, has its own risks and hazards. Para-pilots experience a variety of ear-related symptoms due to pressure discrepancies between the middle ear and ambient air. Middle ear barotrauma amongst para-pilots is a common yet neglected problem. The aim of this study was to find the prevalence of middle ear barotrauma among licensed para-pilots of a metropolitan city. ⋯ barotrauma; eustachian tube; Nepal; pilots.
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JNMA J Nepal Med Assoc · Jun 2022
Case ReportsLung Cancer with Brain Metastases Treated with Radiotherapy Followed by Bevacizumab Maintenance: A Case Report.
Brain metastases in a patient with non-small cell lung cancer carry a grave prognosis. Without effective interventions, the average survival rate is 6 months. Here, we present a case of a 59-year-old male with non-small cell lung cancer and multiple brain metastases treated with radiotherapy followed by bevacizumab maintenance with prolonged survival. There are limited studies establishing the efficiency and toxicity profile of anti-vascular endothelial growth factors for brain metastases. This reported case had a remarkable response with marked clinical and radiological improvement along with a tolerable toxicity profile. Showing the extent of effectiveness and efficacy of anti-vascular endothelial growth factor agents in the case of lung cancer with brain metastases is the main motto of our study. ⋯ bevacizumab; brain metastases; radiotherapy.