JNMA; journal of the Nepal Medical Association
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JNMA J Nepal Med Assoc · Jun 2020
Contextualizing Critical Care Medicine in the Face of Covid-19 Pandemic.
Critical Care Medicine is a specialty dealing with the comprehensive management of patients having, or at risk of developing, acute, life threatening organ dysfunction. The glaring need of critical care services and human resources for critical care have become more evident in the face of the current COVID-19 Pandemic. At this juncture, when the world is facing threat to humanity with an increasing number of deaths due to COVID 19 pandemic, the discussion about the need for ICU beds and human resources for critical care management has re-surfaced and is being increasingly realized. ⋯ If the number of confirmed cases of COVID-19 continue to rise at the current pace, the shortage of critical care facilities will become more glaring than ever before. The current pandemic is a tremendous opportunity for health planners to accelerate action and ensure that the country is well-equipped to contain the COVID-19 pandemic. We need to be working towards infrastructure and human resource strengthening and expansion in critical care, in order to efficiently contain the pandemic.
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JNMA J Nepal Med Assoc · Jun 2020
Case ReportsTranscatheter Embolization of Ruptured Uterine Artery Pseudoaneurysm: A Case Report.
A 30-years-old post-cesarean lady presented with a secondary post-partum hemorrhage for a week, complicated by anemia, which required blood transfusion. Despite conservative medical management, the bleeding persisted and ultrasonography demonstrated a ruptured left uterine artery pseudoaneurysm. ⋯ Her bleeding was controlled with an uneventful post-procedure period and was discharged after two days. This case report summarizes the procedure of transcatheter embolization of uterine artery pseudoaneurysm in a tertiary care hospital in Nepal.
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JNMA J Nepal Med Assoc · Jun 2020
Case ReportsA Child Lost to Follow Up Carrying Beta Thalassemia Major: A Case Report.
Thalassemia is inherited autosomal recessive disorders characterized by reduced rate of hemoglobin synthesis due to a defect in alpha or beta globin chain synthesis. Maldives has a beta thalassemia prevalence rate of 16-18%. Classical symptoms of beta thalassemia are common on those patients who present late for blood transfusion which is common among the south Asian countries due to resource poor situation. ⋯ Reporting this case will help health worker to manage cases accordingly. A five and half year prior diagnosed case of beta thalassemia at age of 2 years and lost to follow up presented with cough, Dyspnoea, Irritability, fatigue with classic symptom of beta thalassemia. She was managed with blood transfusion and kept on continuous follow up for transfusion and iron overload management.
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JNMA J Nepal Med Assoc · Jun 2020
Case ReportsSymptomatic Imperforate Hymen in Early Infancy: A Case Report.
Imperforate hymen, though a congenital anomaly, usually presents late in puberty as lower abdominal pain, primary amenorrhea, and cyclical pain. Blood collects in vagina and uterus, proximal to imperforate hymen leading to their distention. Its presentation at infancy is a rare entity. ⋯ Contrast enhanced computed tomography abdomen showed large abdominopelvic cystic lesion posterior to the urinary bladder and anterior to the rectum consistent with a highly distended vagina. She was managed by the incision of the imperforate hymen and drainage of the pus. A high index of suspicion is necessary whenever a female infant presents with abdomino-pelvic mass with symptoms of fever or urinary retention.
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JNMA J Nepal Med Assoc · Jun 2020
Clinical Profile and Endoscopic Findings in Patients with Upper Gastrointestinal Bleed Attending a Tertiary Care Hospital: A Descriptive Cross-sectional Study.
Upper gastrointestinal bleeding is a common acute medical emergency. Endoscopy is the gold standard diagnostic and therapeutic tool in the management of upper gastrointestinal bleed. This study was undertaken to address the clinical profile, endoscopic profile, and outcomes in patients with upper gastrointestinal bleed. ⋯ Upper gastrointestinal bleeding is a common acute medical emergency. Early upper gastrointestinal endoscopy preferably within 24 hours is recommended for diagnosis, timely intervention, and management of the patients with an upper gastrointestinal bleed that helps in reducing morbidity and mortality.