JNMA; journal of the Nepal Medical Association
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JNMA J Nepal Med Assoc · Jul 2022
Case ReportsLoss of Consciousness and Cardiac Arrest as an Atypical Presentation of Tubercular Meningitis: A Case Report.
Tubercular meningitis is a devastating presentation of extra pulmonary tuberculosis, with fatality in each case without treatment. A 39 years male, a regular consumer of alcohol and a known case of major depressive disorder, presented with the alleged history of using an electric heater in a closed room, and presented to emergency with unconsciousness and cardiac arrest. As his neurological status didn't improve over 72 hrs, a magnetic resonance imaging brain was done which was non-conclusive. Electroencephalogram revealed diffuse right fronto-parietal seizure activity ceasing with midazolam injection, hence levetiracetam was started. Lumbar puncture revealed increased adenosine deaminase and nil white blood cells. Repeat lumbar puncture showed lymphocytic-predominant pleocytosis, elevated protein and low glucose. The patient was started on anti-tubercular therapy and an injection of dexamethasone was added. Repeat electroencephalogram didn't show any seizure-like activity. It is important to be aware of variety of presentations of tubercular meningitis. Delay in treatment leads to irreversible neurological damage and even death. ⋯ cardiac arrest; case report; tubercular meningitis; unconsciousness.
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JNMA J Nepal Med Assoc · Jul 2022
Abnormal Chest Computed Tomography Findings among Admitted Symptomatic COVID-19 Patients in a Tertiary Care Centre: A Descriptive Cross-sectional Study.
COVID-19 has emerged as a pandemic and has varied clinical presentation. Computed Tomography scans of the chest play an important role in evaluating the lung parenchymal changes and aids in better planning the management of COVID-19 patients. The purpose of this study was to find the prevalence of abnormal chest computed tomography findings among admitted symptomatic COVID-19 patients in a tertiary care centre. ⋯ COVID-19; Nepal; pneumonia; prevalence.
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JNMA J Nepal Med Assoc · Jul 2022
Antibiotics Use in Hospitalised COVID-19 Patients in a Tertiary Care Centre: A Descriptive Cross-sectional Study.
Antimicrobial resistance is a global health problem. The widespread and improper antibiotics use is the leading cause of antimicrobial resistance. Bacterial co-infection in COVID-19 patients is the basis for the use of antibiotics in the management of COVID-19. COVID-19 pandemic has seriously impacted antibiotic stewardship and increased the global usage of antibiotics, worsening the antimicrobial resistance problem. The use of antibiotics among COVID-19 patients is high but there are limited studies in the context of Nepal. This study aimed to find out the prevalence of antibiotic use among hospitalised COVID-19 patients in a tertiary care centre. ⋯ antibiotics; bacterial infection; co-infection; COVID-19.
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JNMA J Nepal Med Assoc · Jul 2022
Menopausal Symptoms among Postmenopausal Women Visiting Outpatient Department of a Tertiary Care Centre: A Descriptive Cross-sectional Study.
Menopause is defined as the complete cessation of menstruation for consecutive 12 months which occurs due to the loss of follicular activity of ovaries from the late 40s to early 50s. The menopausal symptoms are often distressing but lack of awareness leads to failure in addressing the problem. This study aimed to find out the prevalence of menopausal symptoms among postmenopausal women visiting the outpatient department of a tertiary care centre. ⋯ cross-sectional study; menopause; prevalence; somatic symptoms.
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JNMA J Nepal Med Assoc · Jul 2022
Anxiety among Pregnant Women Attending Obstetrics Unit of a Tertiary Care Centre during the COVID-19 Pandemic: A Descriptive Cross-sectional Study.
The disastrous effect of COVID-19 pandemic on the mental health of vulnerable populations like pregnant women should not be neglected. The objective of the study was to find out the prevalence of anxiety among pregnant women attending the obstetrics unit of a tertiary care centre during the COVID-19 pandemic. ⋯ anxiety; COVID-19; pregnancy.