JNMA; journal of the Nepal Medical Association
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Bachelor of Medicine and Bachelor of Surgery is a roller coaster journey that is educational yet emotional. Because of how the context and responsibilities change throughout time, learning is exciting. Nevertheless, the exposure to basic science during this course teaches us to be diligent, committed, and compassionate, and it also gets us ready for the next stage of clinical practice. For us as students, the primary areas that change as a result of this transformation are professional networking, workload, patient interaction, time management, leadership, and communication skills. In this journey, the transition is inevitable so we need to adapt to change seamlessly. Additionally, extracurricular activities play a significant role in this journey. ⋯ clinical medicine; communication; educational activity; leadership.
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Paragonimiasis contributes to significant foodborne zoonosis worldwide. The major mode of transmission in humans is by consumption of uncooked or undercooked crabs and crayfish harbouring Paragonimus metacercariae. It begins with symptoms like fever and lower respiratory involvement from a few months to a year, mimicking those of tuberculosis and leading to diagnostic delay. Here, we report two cases of paragonimiasis during a period of nine months. Both cases presented with symptoms of productive cough with rusty sputum, chest pain, along with eosinophilia, and pleural effusion and had a history of consumption of smoked crab from the local river. The diagnosis was established by microscopic demonstration of Paragonimus ova in the sputum. They were treated with praziquantel and recovered. Indeed, it is challenging to diagnose paragonimiasis due to the lack of its specific symptoms but should be considered in the differential diagnosis of eosinophilia and pleural effusion in such lung diseases. ⋯ case reports; eosinophilia; paragonimiasis; pleural effusion.
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JNMA J Nepal Med Assoc · Mar 2023
Pregnancy Induced Hypertensive Disorders among Patients Admitted to the Department of Obstetric and Gynecology in a Tertiary Care Centre: A Descriptive Cross-sectional Study.
Hypertensive disorder of pregnancy is among the leading causes of maternal and perinatal mortality in developing countries. There are only few studies regarding this topic so this study helps us to improve our management protocol thereby reducing maternal and foetal morbidity and mortality. The aim of this study was to find out the prevalence of pregnancy induced hypertensive disorder among patient admitted to the Department of Obstertric and Gynecology in a tertiary care centre. ⋯ preeclampsia; pregnancy induced hypertension; prevalence.
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JNMA J Nepal Med Assoc · Mar 2023
Positive Pivot Shift Test among Patients with Displaced Anterior Tibial Spine Fractures Undergoing Arthroscopic Fixation in a Tertiary Care Centre: A Descriptive Cross-sectional Study.
Understanding of displaced anterior tibial spine fractures has evolved over the years and is now considered to be anterior cruciate ligament avulsion injuries rather than intra-articular fractures. However, there are very few studies available evaluating the presence or absence of a pivot shift test, which is specific in diagnosing anterior cruciate ligament insufficiency, in patients with anterior tibial spine fractures. This study aimed to find out the prevalence of the positive pivot shift test among patients with displaced anterior tibial spine fractures undergoing arthroscopic fixation in a tertiary care centre. ⋯ anterior cruciate ligament; arthroscopy; knee fractures; physical examination.
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JNMA J Nepal Med Assoc · Mar 2023
Case ReportsPromising Response of Paclitaxel in Metastatic Transitional Cell Carcinoma of Distal Ureter Complicated with Hydroureteronephrosis: A Case Report.
Ureteric carcinoma is the rarest of all urothelial malignancies, and little attention has been given to it. Palliation in these groups of patients is a dilemma in the clinics. Use of chemotherapeutic agents in ureteric carcinoma is a double edged sword, as these patients had already impaired renal function due to post-renal failure and nephrotoxic nature of most of the chemotherapeutic agents can further deteriorate the renal function, making the management approach, a relatively visionary task. Here, we present a case of a 77-year-old female with metastatic ureteric carcinoma locally complicated with hydroureteronephrosis, coming to us with gross haematuria, lower abdominal pain along with cough. Apart from age factor of the lady, presence of hydroureteronephrosis and pulmonary metastases was another challenge for us. Paclitaxel remains the mainstay of our treatment. ⋯ carcinoma; case reports; metastasis; paclitaxel.