JNMA; journal of the Nepal Medical Association
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Medical graduates studying on full and partial scholarships are subjected to a mandatory two years of bonding service program to overcome regional inequalities in the distribution of health workers between rural and urban areas. It might be a challenging journey, but it is crucial for the personal and professional growth of young doctors. Working in places distant from home and medical school can also be difficult, especially when the doctors are not adequately trained. During the bond, young graduates are exposed to a variety of clinical and non-clinical circumstances, which can aid in their maturation.
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JNMA J Nepal Med Assoc · May 2022
Rheumatic Heart Disease among Patients with Valvular Heart Disease Admitted to the In-patient Department of a Tertiary Care Centre: A Descriptive Cross-sectional Study.
Valvular heart disease continues to cause significant morbidity and mortality around the world, with rheumatic heart disease accounting for the bulk of cases in developing nations. The aim of this study is to find out the prevalence of rheumatic heart disease among patients with valvular heart disease admitted to the in-patient department of a tertiary care centre. ⋯ epidemiology; prevalence; rheumatic heart disease.
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JNMA J Nepal Med Assoc · May 2022
Vitamin D Deficiency among Patients Presenting to Outpatient Department of Medicine of a Tertiary Care Centre: A Descriptive Cross-sectional Study.
Vitamin D deficiency is a global health concern with over billions of people worldwide being vitamin D deficient or insufficient. Many epidemiological studies have reported cardiovascular diseases, autoimmune diseases and neoplastic diseases to be associated with vitamin D levels. This study aims to find out the prevalence of vitamin D deficiency in patients presenting to the outpatient Department of Medicine of a tertiary care center. ⋯ avitaminosis; prevalence; vitamin deficiency.
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Evans syndrome is defined as the concomitant or sequential association of warm autoimmune hemolytic anaemia with immune thrombocytopenia, and less frequently autoimmune neutropenia. It is associated with non-cross-reacting auto-antibodies directed against antigens specific to red blood cells, platelets or neutrophils. Clinical symptoms could be related to hemolysis and thrombocytopenia. ⋯ The first-line treatment of Evans syndrome is intravenous corticosteroids or intravenous immunoglobulins and second-line treatment with rituximab or splenectomy for those who are refractory to steroids. Here is a case of a fifty-year-old- female who presented with bleeding from the mouth and gums, bluish patches over the shin and trunk along with generalised weakness and severe backache. We are interested in reporting this case because the presentation of patients with such scenarios on our part will compel the treating physician to overlook Evans syndrome and get it underdiagnosed.
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The complete absence of limbs is a rare occurrence. Though the causes are various, it is hard to elicit most of the time. ⋯ Increasing the feasibility of the scan can help in the early diagnosis and management. Here, we report a rare combination of limb defects that we managed in a district-level hospital and highlight the difficulties in the management and referral of the patients while working in rural areas.