JNMA; journal of the Nepal Medical Association
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JNMA J Nepal Med Assoc · Apr 2024
Case ReportsParaquat Toxicity Leading to Acute Kidney Injury: A Case Report in an Adult Patient.
Paraquat poisoning poses a significant and emerging public health challenge in developing countries. The distribution and usage of Paraquat, a potent herbicide, remain unrestricted in many regions despite its high fatality rate and absence of a specific antidote. Paraquat mostly involves lungs but can also involve the kidneys and liver. ⋯ Upon presentation, he had erosion on the tongue and posterior pharyngeal wall, along with deranged renal function tests and elevated serum creatinine levels. The patient developed acute kidney injury, with serum creatinine levels rapidly rising from normal to 3.85 mg/dl, accompanied by a decrease in daily urine output. He was managed conservatively, and his hospital stay was uneventful.
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JNMA J Nepal Med Assoc · Apr 2024
Multidetector Computed Tomography Used in Evaluation of Olfactory Fossa Depth in a Tertiary Hospital in Eastern Region of Nepal: A Descriptive Cross-sectional Study.
Olfactory fossa (OF) is a depression in most infero-medial portion of anterior cranial fossa formed by cribriform plate, crista galli and lateral lamella of cribriform plate (LLCP). LLCP being thinnest and extremely variable parts, more prone for iatrogenic injury during sinus surgery in case of asymmetric and deep OF. Multidetector computed tomography (MDCT) is frequently used imaging modality in the evaluation of paranasal sinus. The objective of the study is to classify the OF depth according to the Keros classification. ⋯ Keros type II OF is more common. The dangerous type III OF having low prevalence, more commonly seen on right side and in males.
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JNMA J Nepal Med Assoc · Apr 2024
Case ReportsSevere Acute Respiratory Distress in a Child with Hypereosinophilic Syndrome: A Case Report.
Hypereosinophilic syndrome with respiratory distress and multiorgan involvement is not so common in children. It is essential to identify this entity based on clinical, laboratory, and imaging features. ⋯ We present a case of an adolescent male in respiratory distress with marked eosinophilia and organs involving the lungs (pulmonary infiltrates with effusion), heart (pericardial effusion), and abdomen (ascites with infiltrates in the liver) which was managed with steroids and anthelmintics. The case highlights the importance of identifying patients with Hypereosinophilic syndrome in pursuing thorough evaluation and commencing therapy.
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JNMA J Nepal Med Assoc · Apr 2024
Healthcare System Sustainability Challenges in Nepal and Opportunities Offered by Alternative Healthcare Delivery Arrangements.
The burden of chronic diseases in Nepal is increasing due to demographic and epidemiological transitions; alongside the persistent impact of communicable, maternal, newborn, and child health diseases, this critical situation acts as the precursor to rising healthcare costs. Nepal struggles to sustain its healthcare system amidst political instability, pandemics, natural disasters, and slow economic growth, particularly when healthcare funding is mainly dependent on out-of-pocket payments. ⋯ Alternative healthcare delivery arrangements have a broad potential scope; they can involve strategic changes in how care is delivered and by whom, or they can also involve the application of information and communication technologies, e.g., telemedicine. This paper highlights the specific challenges to healthcare system sustainability in Nepal and the potential for high-value, lower-cost alternative healthcare delivery models to improve system performance in the longer term.
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JNMA J Nepal Med Assoc · Apr 2024
Patterns of Skin Disease among Prisoners in Central Prison in Nepal: A Descriptive Cross-sectional Study.
Skin diseases pose a significant health challenge globally, especially within prison settings where overcrowding and inadequate sanitation create a breeding ground for infections. Prisons, as part of society, exist in a dynamic equilibrium, serving as potential sources of infections that can spread beyond their confines. Despite facing similar challenges, there is a dearth of research focusing on skin diseases among inmates in Nepal. This study aims to assess patterns of skin diseases among prisoners. ⋯ The fungal and bacterial infections were common among the prisoners.