JNMA; journal of the Nepal Medical Association
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Reported here is a rare near-miss case of stroke in pregnancy presented to the Department of Obstetrics and Gynaecology. A 38 years gravida 8 was referred from a private hospital on 18 November 2022 with hemorrhagic stroke, a known case of chronic hypertension at 37 weeks of gestation with previous cesarean section and acute kidney injury. At a private hospital computed tomography head was done it showed intracerebral haemorrhage. On cesarean, intraoperatively it was a live female with thick meconium. The patient was kept in intensive care with a mechanical ventilator, antihypertensives, antibiotics, and analgesics. Serum creatinine was increasing daily. Suture was cut on the 7th postoperative and two times dialysis was done on the 8th and 9th postoperative days. Stroke in pregnancy is a rare diagnosis and it could have been prevented by regular antenatal visits and early referral antenatally along with a multidisciplinary approach. ⋯ case reports; hypertension; intracerebral haemorrhage; pregnancy; stroke.
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JNMA J Nepal Med Assoc · Apr 2023
Case ReportsTerbinafine-induced Toxic Epidermal Necrolysis in Pregnancy: A Case Report.
Toxic epidermal necrolysis in pregnancy is a rare disease that can have an adverse effect on Toxic epidermal necrolysis in pregnancy is a rare disease that can have an adverse effect on pregnancy outcomes. Common etiology of the condition includes medication triggered followed by mycoplasma infection. Almost one-third of cases are idiopathic. Despite the rarity of data, terbinafine causing toxic epidermal necrolysis has been reported. Toxic epidermal necrolysis manifests as a macule, erythema followed by a blister in the chest and spreading to other parts of the body. Removal of the offending agent and supportive management is the cornerstone of management. Here we report 22-year-old primipara pregnant women presenting with toxic epidermal necrolysis after 3 weeks of oral terbinafine use with good pregnancy outcomes. ⋯ case reports; pregnancy; Stevens-Johnson syndrome; toxic epidermal necrolysis.
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Adhesion is a leading cause of small bowel obstruction. Adhesive small bowel obstruction has significant challenges in diagnosis, treatment and prevention with considerable impact on morbidity and socioeconomic burden. Small bowel obstruction caused by adhesion or any other aetiology is clinically indistinguishable due to similar clinical presentation. Computed Tomography scans and water-soluble contrast studies are more specific in diagnosis and possess value in predicting the need for surgery. Surgical management is indicated only in complicated cases or failed conservative treatments with the majority resolving with non-operative management. However, there is no clear-cut consensus about the timing of operative intervention. Meticulous surgical practice is the keystone in preventing adhesion formation despite the availability of numerous pharmacological and surgical strategies. This review aims to update the current knowledge of the pathophysiology of adhesion formation, treatment options and various prevention modalities of adhesive small bowel obstruction. ⋯ diagnosis; laparotomy; prevention; surgery.
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JNMA J Nepal Med Assoc · Apr 2023
Gallstone among Patients Presenting to the Department of Surgery in a Tertiary Care Center: A Descriptive Cross-sectional Study.
Gallstone is the most common biliary pathology. Once thought of as a disease of the western world, the incidence and burden of cholelithiasis are increasing in Asia. Its literature from Nepal is however still primitive. The study aimed to find out the prevalence of gallstone among patients presenting to the Department of Surgery in a tertiary care centre. ⋯ cholelithiasis; gallbladder; prevalence.
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JNMA J Nepal Med Assoc · Apr 2023
Anxiety among Faculty Members of Academic Institutions of a Metropolitan City: A Descriptive Cross-sectional Study.
Anxiety is one of the common mental disorders frequently occurring in the community. It has been a major contributor to public ill health. Very few studies have been conducted on anxiety among academic professionals working in educational institutions. The aim of this study was to find out the prevalence of anxiety among faculty members of academic institutions of a metropolitan city. ⋯ anxiety; faculties; prevalence.