JNMA; journal of the Nepal Medical Association
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JNMA J Nepal Med Assoc · Jun 2022
Middle Ear Barotrauma among Licensed Para-pilots of a Metropolitan City: A Descriptive Cross-sectional Study.
Middle ear barotrauma is a tissue injury to the ear secondary to inadequate pressure equalisation between the middle ear and the external environment. Paragliding, though an exciting sport, has its own risks and hazards. Para-pilots experience a variety of ear-related symptoms due to pressure discrepancies between the middle ear and ambient air. Middle ear barotrauma amongst para-pilots is a common yet neglected problem. The aim of this study was to find the prevalence of middle ear barotrauma among licensed para-pilots of a metropolitan city. ⋯ barotrauma; eustachian tube; Nepal; pilots.
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JNMA J Nepal Med Assoc · Jun 2022
Case ReportsLung Cancer with Brain Metastases Treated with Radiotherapy Followed by Bevacizumab Maintenance: A Case Report.
Brain metastases in a patient with non-small cell lung cancer carry a grave prognosis. Without effective interventions, the average survival rate is 6 months. Here, we present a case of a 59-year-old male with non-small cell lung cancer and multiple brain metastases treated with radiotherapy followed by bevacizumab maintenance with prolonged survival. There are limited studies establishing the efficiency and toxicity profile of anti-vascular endothelial growth factors for brain metastases. This reported case had a remarkable response with marked clinical and radiological improvement along with a tolerable toxicity profile. Showing the extent of effectiveness and efficacy of anti-vascular endothelial growth factor agents in the case of lung cancer with brain metastases is the main motto of our study. ⋯ bevacizumab; brain metastases; radiotherapy.
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JNMA J Nepal Med Assoc · Jun 2022
Case ReportsScrub Typhus Presenting as Unilateral Abducens Nerve Palsy: A Case Report.
Abducens nerve palsies associated with infectious diseases are rare. Scrub typhus is an acute, febrile, infectious illness caused by Orientia tsutsugamushi carried out by vector mite zoonosis and is highly endemic in the so-called "tsutsugamushi triangle". The organism has been reported to be capable of entering the nervous system, causing meningitis and focal neurologic abnormalities. We report a 23 years old previously healthy girl who presented with fever, pain abdomen, vomiting and classical pathognomic black eschar mark on the right proximal medial calf region. After exclusion of other common infectious causes, scrub typhus serology immunoglobulin M was positive and was diagnosed with scrub typhus associated with unilateral abducens nerve palsy which responded to doxycycline therapy. On the background of strong clinical suspicion, we underline its significance in the interpretation of the serologic testing and its role in guiding the further treatment respectively. ⋯ abducens nerve palsy; case report; Orientia tsutsugamushi; scrub typhus; zoonoses.
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Medicine is a line of work in which expectations run high, having a competitive spirit is considered a virtue and relentless hard work is deemed a reward in itself. Yet, in a strenuous environment such as this, communication about the struggles medical students face is found to be almost non-existent. This leads to medical students feeling burnt out, lost and inadequate, bringing about a drop in performance quality and/or quantity, which breeds further insecurity. This acts as a vicious cycle that is further perpetuated by the lack of effective communication, which becomes a bedrock for the deficit in support from peer groups, educators and authorities. There are different theories of motivation and these form the basis for exploring the different ways in which it can be increased. These methods, which contribute to enhancing productivity and curtailing stress, are detailed in the article. ⋯ cognition; medical students; motivation; self-concept.
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JNMA J Nepal Med Assoc · Jun 2022
Urinary Tract Infection among Post-renal Transplant Patients in the Department of Nephrology of a Tertiary Care Centre: A Descriptive Cross-sectional Study.
Urinary tract infection is the most common infection among renal transplant recipients and increases the risk of hospitalization or even death. The study aimed to find the prevalence of urinary tract infection among post-renal transplant patients in the Department of Nephrology of a tertiary care centre. ⋯ Escherichia coli; hypertension; kidney; transplants.