JNMA; journal of the Nepal Medical Association
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JNMA J Nepal Med Assoc · Jul 2022
Case ReportsDelayed Diagnosis of Pemphigus Vulgaris Initially Presenting as an Oral Ulcer: A Case Report.
Pemphigus vulgaris is a rare autoimmune mucocutaneous blistering disease clinically presenting as vesicles, bullae, and erosion and histologically characterized by suprabasal split and acantholysis. It usually affects mucous membranes and skin. Recurrent oral ulcers can only be the clinical manifestation before progressing into skin lesions. This can lead to the delayed diagnosis of this disease. Here we report a case of pemphigus vulgaris which was diagnosed after years of suffering from an oral ulcer that eventually progressed to widespread skin blistering and ulceration. The patient was treated with oral prednisolone which showed improvement within a week. Physicians should consider the differential diagnosis of pemphigus vulgaris in patients presenting with a recurrent oral ulcer. ⋯ delayed diagnosis; oral ulcer; pemphigus vulgaris.
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In the midst of the COVID-19 pandemic, volunteering enabled us to support people facing difficulties in locating healthcare facilities. Working as a medical support volunteer allowed us to interact closely with patients. We assisted them by providing information on the availability of hospital beds, intensive care unit beds, ventilators and oxygen cylinders. We had numerous beautiful as well as dreadful experiences and learned valuable lessons during the process. We experienced a wide range of emotions, from the joy of informing about the availability of a vacant bed to the guilt and dilemma of having to prioritise in such a crisis. We learnt about how an empathetic approach and active listening helps to connect people. ⋯ COVID-19 pandemic; medical students; telehealth; volunteerism.
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JNMA J Nepal Med Assoc · Jun 2022
Positive Microbiological Stains of Corneal Scrapings among Patients with Keratitis in a Tertiary Care Centre: A Descriptive Cross-sectional Study.
Keratitis, an ocular emergency, requires rapid and accurate treatment to prevent vision impairment. Wet mount direct microscopy examination of corneal scraping smear using gram and 10% potassium hydroxide stain helps in early diagnosis and treatment. The main objective of this study was to find out the prevalence of positive microbiological stains of corneal scrapings among patients with keratitis in a tertiary care centre. ⋯ keratitis; microscopy; Nepal.
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JNMA J Nepal Med Assoc · Jun 2022
Case ReportsDiaphragmatic Hernia in a Preterm with Congenital Heart Defects with Successful Outcome: A Case Report.
Congenital diaphragmatic hernia is an anatomical defect of the diaphragm that is often associated with serious cardiopulmonary complications. It can also be associated with many other problems like multi systemic anomalies, chromosomal aneuploidy and prematurity. Of these, cardiac defects, liver herniation and prematurity seem to have a pivotal role in affecting the outcomes of repair. We hereby present a preterm newborn with such multiple defects repaired on 15th day of life and post operatively managed in a Neonatal Intensive Care Unit with a successful outcome. The key learning objective for our team in this case was to identify the steps taken that led to a successful management of a low birth weight preemie with multiple defects in a resource limited set up. ⋯ congenital diaphragmatic hernia; preterm; surgical repair; ventricular septal defect.
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JNMA J Nepal Med Assoc · Jun 2022
Oval Type of Human Mandibular Condyle in Panoramic Radiographs of a Tertiary Care Centre: A Descriptive Cross-sectional Study.
Mandibular condyle is a prominent structure in the mandible, which forms the temporomandibular joint. An oval-shaped condyle is considered to be present with a normal temporomandibular joint and any morphological variation of the condyle is assumed to be pathologic in temporomandibular disorders. The aim of the study was to find out the prevalence of oval shaped mandibular condyle among orthopantomogram radiographs of patients visiting the tertiary care centre. ⋯ condyle; mandible; Nepal; X-ray.