JNMA; journal of the Nepal Medical Association
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JNMA J Nepal Med Assoc · Jul 2022
Case ReportsCentral Venous Catheter-related Thrombosis in a Dialysis Patient: A Case Report.
Hemodialysis is one of the treatment modalities for advanced kidney disease and can help an individual live an active life despite failing kidneys. Although it improves the quality of life, it is not completely risk-free. It has several complications, among which, thrombus formation is common. We report a case of a 63-year-old man who presented at our institution for regular hemodialysis with recurrent arteriovenous graft failure. Because doppler ultrasound is a non-invasive procedure that can identify a thrombus in a vein, it is the best initial option for patients with internal jugular vein thrombosis. The use of ultrasound not only can guide a catheter pathway but can also help in early diagnosis and prevent complications following catheterization in a vein with a thrombus. ⋯ central venous catheterization; chronic kidney disease; hemodialysis; thrombus.
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JNMA J Nepal Med Assoc · Jul 2022
Case ReportsVaricella Pneumonia in an Immunocompetent Middle-aged Adult Male: A Case Report.
Varicella pneumonia is uncommon among adults and can present as potentially life-threatening complications of varicella. Here we report a case of a 43-year-old man with no known history of chronic disease and no allergic history who presented to our hospital emergency department with widespread skin eruptions over the entire body and hemoptysis. Varicella pneumonia was diagnosed based on the patient being in contact with his 6-year-old son who had contracted chickenpox 10 days back, typical cutaneous lesions, pulmonary symptoms and radiographic findings. The patient was treated with oral acyclovir and was admitted to the intensive care unit for monitoring. The patient recovered completely after 10 days of treatment. ⋯ chickenpox; pneumonia; skin eruptions.
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JNMA J Nepal Med Assoc · Jul 2022
Case ReportsExtraosseous Ewing Sarcoma in a Pelvic Region: A Case Report.
Ewing sarcoma is the second most common malignant bone tumour in children. It rarely originates from extraskeletal soft tissue sites such as the upper thigh, buttocks, upper arm and shoulder. Primary extraosseous Ewing sarcoma located in the pelvic region is rare. We report a 17-year-female who had gradual onset of progressive lower abdominal mass and pain. A computed tomography scan revealed well defined lobulated heterogeneously enhancing lesion noted in the pelvic region measuring approximately 12.9 x 9.8 x 9.3 cm. Incisional biopsy showed a small round blue cell tumour which was strongly positive for Cluster of Differentiation 99, vimentin, Friend Leukaemia Integration 1 with 40% Ki-67. Following treatment with chemotherapy, surgery and radiotherapy, there was complete resolution of the tumour. Although extraosseous Ewing sarcoma is rare, it can occur virtually in any soft tissue site. Therefore, clinicians need to distinguish it from soft tissue sarcoma because rapid progression, early diagnosis and timely treatment are crucial for a favourable prognosis. ⋯ Ewing sarcoma; neoadjuvant chemotherapy; radiation therapy.
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JNMA J Nepal Med Assoc · Jul 2022
Anxiety and Depression among Patients with Chronic Kidney Disease Undergoing Haemodialysis in a Tertiary Care Centre: A Descriptive Cross-sectional Study.
Chronic kidney disease is a global public health problem with psychological issues and other adverse issues like renal failure, cardiovascular disease, and premature deaths. This study aimed to find out the prevalence of anxiety and depression among patients with chronic kidney disease undergoing haemodialysis in a tertiary care centre. ⋯ anxiety; chronic kidney disease; depression; hemodialysis.
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JNMA J Nepal Med Assoc · Jul 2022
Raised D-dimer among Admitted COVID-19 Patients in a Tertiary Care Centre: A Descriptive Cross-sectional Study.
Patients with COVID-19 are characterised by abnormal levels of inflammatory biomarkers. Elevated D-dimer in COVID-19 patients is associated with increased mortality. This study aimed to find out the prevalence of raised D-dimer among COVID-19 patients in a tertiary care centre. ⋯ COVID-19; D-dimer; Nepal; prevalence.