JNMA; journal of the Nepal Medical Association
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JNMA J Nepal Med Assoc · Jul 2022
Depression among Online Respondent Oral Healthcare Workers during COVID-19 Pandemic: A Descriptive Cross-sectional Study.
COVID-19 outbreak brought unprecedented pressure on dental and oral health care workers leading to increased depression. This study aimed to find the prevalence of depression among online respondent oral healthcare workers during the COVID-19 pandemic. ⋯ COVID-19; depression; oral health.
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JNMA J Nepal Med Assoc · Jul 2022
Modern Paediatric Radiology: Meeting the Challenges in CT and MRI.
Radiology plays a very important part in the diagnosis, treatment, and follow-up of children. Computed tomography and magnetic resonance imaging are the two most crucial developments in the modern era. However, the two modalities have their challenges to overcome. Radiation dose is the most unwanted side effect of computed tomography scans while longer scan time along with sedation is a major disadvantage in children during magnetic resonance imaging. Paediatric-specific protocol selection and limiting the exposure to the area of interest aid in reducing the dose during computed tomography scans. Faster scan protocols and sequences can result in imaging without sedation in magnetic resonance imaging. Considering the radiation exposure, "as low as reasonably achievable" principle should be followed strictly in the paediatric population. In this article, possible ways for minimising the radiation dose in computed tomography, as well as effective, short, and sedation-free magnetic resonance imaging, are discussed. ⋯ computed X-ray tomography; magnetic resonance imaging; pediatrics; radiation exposure; X-ray.
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JNMA J Nepal Med Assoc · Jul 2022
Case ReportsDelayed Diagnosis of Pemphigus Vulgaris Initially Presenting as an Oral Ulcer: A Case Report.
Pemphigus vulgaris is a rare autoimmune mucocutaneous blistering disease clinically presenting as vesicles, bullae, and erosion and histologically characterized by suprabasal split and acantholysis. It usually affects mucous membranes and skin. Recurrent oral ulcers can only be the clinical manifestation before progressing into skin lesions. This can lead to the delayed diagnosis of this disease. Here we report a case of pemphigus vulgaris which was diagnosed after years of suffering from an oral ulcer that eventually progressed to widespread skin blistering and ulceration. The patient was treated with oral prednisolone which showed improvement within a week. Physicians should consider the differential diagnosis of pemphigus vulgaris in patients presenting with a recurrent oral ulcer. ⋯ delayed diagnosis; oral ulcer; pemphigus vulgaris.
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JNMA J Nepal Med Assoc · Jul 2022
Case ReportsD-penicillamine Induced Myasthenia Gravis in Wilson's Disease: A Case Report.
Myasthenia gravis is a neuromuscular junction disorder characterised by fluctuating muscle weakness, improved by using anti-cholinesterase drugs. In addition to the autoimmune aetiology, various factors such as infections, surgery, and drugs are known to precipitate the condition. We report a case of a 15-year-old boy with D-penicillamine-induced myasthenia gravis who presented with facial diplegia, dysphagia, and drooling of saliva, 6 years after the initiation of treatment for Wilson's disease. Therefore, clinicians should be more vigilant while prescribing patients with chelating drugs like D-penicillamine with regular monitoring of the new symptoms and keeping a very low threshold for the suspicion of myasthenia gravis. ⋯ d-penicillamine; myasthenia gravis; pyridostigmine; Wilson's disease.
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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.