JNMA; journal of the Nepal Medical Association
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JNMA J Nepal Med Assoc · Nov 2021
Case ReportsVitamin B12 Deficiency Resembling Acute Leukemia: A Case Report.
Vitamin B12 deficiency in children can cause megaloblastic anemia, poor growth, and increased chances of infections. It is an important reversible cause of bone marrow suppression which at the time of presentation can mimic hematological malignancy. Therefore, it should be considered as a differential diagnosis in cases suspected of acute leukemia. ⋯ Pancytopenia with severe anemia was present along with 19% reactive/atypical cells in peripheral blood smear suggesting acute leukemia. However, bone marrow aspiration and biopsy showed features of megaloblastic anemia. Vitamin B12 level measured was very low and treatment with cyanocobalamin caused drastic improvement in the child's condition.
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JNMA J Nepal Med Assoc · Nov 2021
Case ReportsActinomycosis of Gallbladder in Cholecystectomy Specimen: A Case Report.
Actinomyces are a part of the normal flora of the cervicofacial region, gastrointestinal tract, and urogenital tract, but can cause infections when the normal mucosal barrier is lost. Herein, we report a rare case of actinomycosis of the gallbladder in a 60-years-old-female. The patient presented with right hypochondrium pain since three months; ultrasonography showed cholelithiasis with thick oedematous wall. ⋯ Histological examination revealed an inflamed gallbladder with colonies of radiating filamentous structures having numerous sulphur granules which on gram staining showed filamentous gram-positive rods. The diagnosis of Actinomycosis of gallbladder was made. After cholecystectomy, prolonged antimicrobial therapy is recommended for patient with actinomycosis to prevent recurrence and even mortality.
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JNMA J Nepal Med Assoc · Nov 2021
Abnormal Ultrasonographic Findings among Referred Patients with Pain Abdomen in the Radiology Department of a Tertiary Care Center: A Descriptive Cross-sectional Study.
Correct and prompt diagnosis is essential for the appropriate management of patients. Often, children and their caretakers cannot provide a reliable history to allow clinicians to determine the cause of the pain. This study's objective was to find out the prevalence of abnormal ultrasonographic findings among referred patients with pain abdomen in the radiology department of a tertiary care center of Nepal. ⋯ Most of the cases of pain abdomen showed abnormalities in ultrasound. Clinical evaluation should be used together with ultrasound abdomen in order to arrive at a correct diagnosis.
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JNMA J Nepal Med Assoc · Nov 2021
Case ReportsRecurrent Dermatofibrosarcoma Protuberance: A Case Report.
Dermatofibrosarcoma protuberance represents less than 0.1% of all tumors, treatment of which requires wide local excision (≥5cm) but recurrence is not rare. Here we present a 32-year male presented with a swelling of 15 x 6cm over the left lumbar region for which he underwent excision three years ago, the histopathological examination of the swelling, showed a malignant mesenchymal tumor and Immunohistochemistry features were suggestive of Dermatofibrosarcoma protuberance. ⋯ Although the tumor was confined to the skin and subcutaneous tissue in the present case, the patient didn't undergo any adjuvant radiotherapy to avoid a possible relapse that would infiltrate deeper structures for the first time. Being a recurrent tumor, long-term follow-up is strongly recommended.
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JNMA J Nepal Med Assoc · Nov 2021
Drug-drug Interactions between Hypoglycemic and Non-hypoglycemic Medication in Diabetic Patients with Comorbidities in a Tertiary Care Center: A Descriptive Cross-sectional Study.
Drug-drug interaction is one of the causes of adverse drug reactions. Generally, drug-drug interaction is common in multidrug therapy. Diabetic patients, particularly due to associated comorbidities tend to have various drug-drug interactions due to the effect of multiple drugs. The objective of this study was to find out the prevalence of drug-drug interactions in diabetic patients. ⋯ Our study showed the prevalence of drug-drug interactions in diabetic patients to be higher than other studies done in similar settings. Based on the severity, we observed two types of drug-drug interactions; close monitoring drug-drug interactions and minor drug-drug interactions.