JNMA; journal of the Nepal Medical Association
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JNMA J Nepal Med Assoc · Nov 2023
Diabetes Mellitus among Patients with Non-alcoholic Fatty Liver Disease Visiting the Outpatient Department of Internal Medicine in a Tertiary Care Centre.
Diabetes mellitus is a chronic metabolic illness which is mainly associated with reduced physical activity and obesity. Diabetes mellitus and non-alcoholic fatty liver disease may coexist and synergistically lead to poor clinical outcomes. The aim of the study was to find out the prevalence of diabetes mellitus among patients with non-alcoholic fatty liver disease in a tertiary care centre. ⋯ diabetes mellitus; fatty liver; non-alcoholic fatty liver disease; prevalence.
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JNMA J Nepal Med Assoc · Nov 2023
Case ReportsLaparoscopic Cholecystectomy in Situs Inversus Totalis with Stage 5 Chronic Kidney Disease: A Case Report.
Situs inversus totalis is a rare congenital anomaly in which the abdominal and thoracic organs are transposed in a mirror image. Diagnosis and management of cholelithiasis in patients with situs inversus totalis pose a challenge due to the anatomical variation. A laparoscopic cholecystectomy in such a case can be technically challenging, especially for a right-handed surgeon. In this case report, we present a case of a 38-year-old male with symptomatic cholelithiasis in a chronic kidney disease stage five patient under maintenance hemodialysis planned for recipient renal transplant. A laparoscopic cholecystectomy considered the gold standard for symptomatic cholelithiasis was performed with a three-port technique. The technical challenges anticipated due to anatomical variation were managed by intraoperative modifications. In conclusion, laparoscopic cholecystectomy in patients with situs inversus totalis can be done with technical modifications and re-orientation of visual motor skills. ⋯ case reports; cholecystectomy; situs inversus.
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JNMA J Nepal Med Assoc · Nov 2023
Hearing Loss among Children Visiting Department of Otolaryngology and HNS of a Tertiary Care Centre.
Hearing loss is defined as the partial or total reduction in auditory acuity. Hearing loss can cause detrimental effects on speech, language, developmental, educational, and cognitive outcomes in children. This study aimed to find out the prevalence of hearing loss among children visiting the Department of Otolaryngology and HNS of a tertiary care centre. ⋯ audiology; audiometry; hearing loss; outpatients; prevalence.
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Sturge-Weber syndrome is a rare congenital neurocutaneous syndrome with an incidence of 1 in 50000 characterised by facial capillary malformation and vascular anomalies in the brain and eye. We present the case of a five-year-old child diagnosed with Sturge-Weber syndrome. The patient exhibited high-grade fever, headaches, and generalized tonic-clonic seizures. The history revealed a port-wine stain on the face and a history of seizures from the age of four months. Diagnostic imaging confirmed the presence of leptomeningeal vascular malformation, calcification in the brain, and abnormal electroencephalogram patterns, establishing the diagnosis of Sturge-Weber syndrome. Treatment with antiepileptic drugs led to seizure control. This case underscores the importance of early diagnosis and tailored treatment strategies for patients with Sturge-Weber syndrome. ⋯ brain; case reports; port-wine stain; seizures; Sturge-Weber syndrome.
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JNMA J Nepal Med Assoc · Nov 2023
Vitamin B12 Deficiency among Metformin Treated Type 2 Diabetic Mellitus Patients Visiting the Department of Medicine of a Tertiary Care Centre.
About 424.9 million people worldwide are affected by Diabetes mellitus. Prevalence among people 20-79 years old in Nepal was 4% in 2017. It is associated with microvascular and macrovascular complications such as peripheral neuropathy leading to risk of foot ulcers and amputation, and impaired sensation in their feet. The study aimed to find the prevalence of vitamin B12 deficiency among metformin-treated type 2 diabetic patients visiting the Department of Medicine of a tertiary care centre. ⋯ diabetic neuropathy; metformin; type 2 diabetes; vitamin B12.