JNMA; journal of the Nepal Medical Association
-
JNMA J Nepal Med Assoc · Oct 2023
Case ReportsIschemic Portal Venous Gas and Pneumatosis Intestinalis Managed Conservatively in a Patient with Rheumatic Heart Disease and Warfarin Induced Coagulopathy: A Case Report.
Mesenteric ischemia is a surgical emergency. The presence of hepatic portal venous gas and pneumatosis intestinalis is a frequent finding in computed tomography. Not all hepatic portal venous gas and pneumatosis intestinalis are due to mesenteric ischemia. A 70-year-old female, with a known case of diabetes mellitus, rheumatic heart disease and atrial fibrillation under warfarin presented with diffuse abdominal pain, multiple episodes of vomiting and ecchymosis in bilateral flanks. Evaluation of the coagulation profile suggested warfarin-induced coagulopathy. Portal venous gas was detected during an ultrasound examination. Subsequent contrast-enhanced computed tomography abdomen showed hepatic portal venous gas, pneumatosis intestinalis, paucity of branches of the ileocolic artery, and reduced enhancement of caecum and ascending colon. Mild ascites were present in the pelvis. Arterial blood gas analysis revealed compensated metabolic acidosis. The patient was managed conservatively and discharged after nine days of hospital admission. Conservative approach can be considered for suspected mesenteric ischemia in surgically unfit candidates. ⋯ case reports; mesenteric ischemia; portal vein; rheumatic heart disease; warfarin.
-
JNMA J Nepal Med Assoc · Oct 2023
Obstetric Cholestasis among Pregnant Women Visiting a Tertiary Care Centre.
Obstetric cholestasis is one of the most frequent hepatic disorders specific to pregnancy. It occurs commonly during the latter half of pregnancy. The data regarding this issue is rare in our settings. The aim of this study was to find out the prevalence of obstetric cholestasis among pregnant women visiting a tertiary care centre. ⋯ Nepal; obstetric cholestasis; pregnancy.
-
JNMA J Nepal Med Assoc · Oct 2023
Fissured Tongue among Patients Visiting the Department of Oral Medicine and Radiology in a Tertiary Care Centre.
Examination of the tongue and knowledge of its variation can aid clinicians in correctly assessing the cause of a patient's complaint. Despite World Health Organization recommendations to encourage more epidemiological assessment of oral mucosal variations and lesions, the volume of literature in this area is limited. This study aimed to find out the prevalence of fissured tongues among patients visiting the Department of Oral Medicine and Radiology in a tertiary care centre. ⋯ anatomic variation; fissured tongue; Nepal; oral mucosa; prevalence.
-
JNMA J Nepal Med Assoc · Oct 2023
Empagliflozin Use among Patients with Heart Failure in the Outpatient Department of Medicine in a Tertiary Care Centre.
Sodium-glucose co-transporter 2 inhibitors were initially used in the treatment of type 2 diabetes mellitus and subsequently, it was shown to be useful in heart failure among patients with or without diabetes mellitus. This study aimed to find out the prevalence of empagliflozin use among patients with heart failure in an outpatient department of medicine in a tertiary care centre. ⋯ heart failure; outpatient care; patient safety; SGLT-2 inhibitors.
-
JNMA J Nepal Med Assoc · Oct 2023
Down Syndrome Screening among Pregnant Women Visiting the Department of Obstetrics and Gynaecology of a Tertiary Care Centre.
The screening of Down's syndrome by the measurement of serum markers using dual and quadruple tests in the second trimester is done among obstetric patients between 13 to 22 weeks of gestation. The test readings are signified in terms of low-risk or high-risk. The aim of this study was to find out the prevalence of Downs syndrome screening among pregnant women visiting the Department of Obstetrics and Gynaecology of a tertiary care centre. ⋯ down syndrome; nuchal translucency; screening.