JNMA; journal of the Nepal Medical Association
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JNMA J Nepal Med Assoc · Oct 2020
Case ReportsKnuckle Pigmentation as an Early Cutaneous Sign of Vitamin B12 Deficiency: A Case Report.
Vitamin B12 deficiency can present with variable hematological, neuropsychiatric, and mucocutaneous changes. Hyperpigmentation, specifically involving the knuckles has been described in vitamin B12 deficiency, but usually,these patients are symptomatic with systemic manifestations like megaloblastic anemia, pancytopenia, or neurological deficits. ⋯ This case also highlights the importance of recognizing this cutaneous sign as an early marker of vitamin B12 deficiency; thereby enabling the clinician to treat the disease before it leads to irreversible neurological complications. Keywords: knuckle pigmentation;treatment;vitamin B12 deficiency.
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Nepal, predominantly inhabited by people driven by the principles of Hinduism and Buddhism, has seen the practice of burning incense sticks for a very long time. There has been an extensive practice of burning incense sticks in temples, monasteries, and even regularly in indoor household settings. This article puts light on the constituents of smoke coming from a burning incense stick and on the possible risks, they possess for occupational hazards and indoor air pollution. Keywords: hazard;incense;Nepal.
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JNMA J Nepal Med Assoc · Oct 2020
Case ReportsDual Antiepileptics Induced Stevens-Johnson Syndrome: A Case Report.
Stevens-Johnson syndrome and Toxic Epidermal Necrolysis are acute mucocutaneous reactions hallmark of which is widespread necrosis and detachment of epidermis. SJS/TEN fall under the single disease spectrum with an incidence rate of 1.0 to 6.0 per 1000000 and 0.4 to 1.2 per 1000000 respectively. Here, we present a case of a 46 years female who developed a generalized erythematous rash over her body, 26 days after being exposed to phenytoin and sodium valproate. ⋯ The mortality rates for SJS and TEN are up to 10% and 30-50% respectively. Early identification of SJS, discontinuation of triggering medicines, and prompt initiation of supportive therapy improve the prognosis. Keywords: adverse drug reactions;antiepileptic drugs;case report;stevens-johnson syndrome.
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JNMA J Nepal Med Assoc · Oct 2020
Guiding Documents for Disaster Risk Reduction and Management in Health Care System of Nepal.
The incidence of disaster events has increased over the years. Nepal is vulnerable to various kinds of natural disasters especially earthquakes and floods and infectious disease outbreaks like Dengue and Covid-19 pneumonia. So, it is important to review and know our existing disaster risk reduction and management plans, rules, and regulations of our country to improve disaster risk management for resilience and enhancing disaster preparedness for effective response and to “Build Back Better: in recovery rehabilitation and reconstruction.†Nepal has sufficient guiding documents to guide disaster management. Keywords: disaster;Nepal;preparedness.
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JNMA J Nepal Med Assoc · Oct 2020
Interpersonal Violence during the COVID-19 Lockdown Period in Nepal: A Descriptive Cross-sectional Study.
The government issued a country-wide lockdown in Nepal as a measure to curb the spread of COVID-19 pandemic. This has resulted in various difficult experiences which includes financial loss, separation from loved ones, grief, uncertainty over disease status and loss of freedom. During these stressful situations, interpersonal violence is likely to be aggravated. To avoid the occurrence of adverse events such as impulsive acts, homicide, or suicide, it is important to identify high-risk individuals. ⋯ There was prevalence of interpersonal violence during the COVID-19 lockdown. In addition to the fear regarding pandemic, victims have to face domestic violence placing them at a double injustice. Identification of vulnerable groups and proper management of survivors must be prioritized given the unanimous consensus on the rise of interpersonal violence during periods of heightened stress.