JNMA; journal of the Nepal Medical Association
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JNMA J Nepal Med Assoc · May 2019
Case ReportsLeiomyosarcoma of the Inferior Venacava: A Case Report.
Leiomyosarcoma of inferior venacava is a rare tumor. Female are most commonly affected and middle segment of inferior vena cava is the commonest site. The diagnosis can sometimes be challenging as patients present with non-specific symptoms. ⋯ Histopathological examination revealed a capsulated, multilobated tumor arising from muscle layer of inferior venacava with extraluminal growth pattern and tumor cells showing cytoplasmic positivity for immuno-histochemical stain smooth muscle actin. With the diagnosis of leiomyosarcoma of inferior venacava, excision of tumor was done with tangential excision of 4 cm length of inferior venacava with primary repair. Keywords: inferior venacava; leiomyosarcoma; smooth muscle actin.
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JNMA J Nepal Med Assoc · May 2019
Prevalence of Teenage Pregnancy in A Community Hospital of Rural Nepal: A Cross-sectional Study.
Teenage pregnancy is a public health concern. Maternal and neonatal health outcomes are negatively impacted in teenage pregnancy. The objective of the study is to find the prevalence of teenage pregnancy in a community hospital of rural Nepal. ⋯ The trend of teenage pregnancy remains almost same over ten years in the Okhaldhunga Community Hospital. The overall prevalence of teenage delivery is higher than the national figure. Low birth weight babies, premature delivery, perineal and cervical tears were the common complications. Further health education and awareness programs might help to reduce the teenage pregnancy rate.
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Cesarean scar pregnancy is a rare variant of ectopic pregnancy where the fertilized ovum gets implanted in the myometrium of the previous cesarean scar. The incidence of Caesarean Scar Pregnancy among ectopic pregnancies is 6.1% and it is seen in approximately 1 in 2000 normal pregnancies. As trophoblastic invasion of the myometrium can result in uterine rupture and catastrophic hemorrhage termination of pregnancy is the treatment of choice if diagnosed in the first trimester. ⋯ We present a case report of a 24-year-old female G2P1L1with ruptured cesarean scar pregnancy who underwent emergency laparotomy and subsequently hysterectomy. In this case report, we aim to discuss ruptured cesarean scar pregnancy as obstetric emergency and methods by which we can make an early diagnosis that it can be managed appropriately so as to prevent maternal morbidity and mortality. Keywords: cesarean; hysterectomy; maternal mortality; pregnancy; scar; uterine rupture.
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JNMA J Nepal Med Assoc · May 2019
Prevalence of Depression in Patients with Chronic Kidney Disease Stage 5 on Hemodialysis at a Tertiary Care Center.
Co-morbid depression impacts negatively on quality of life in Chronic Kidney Disease patients. This study was done to calculate prevalence of depression in patients on hemodialysis (HD) using Patient Health Questionnaire-9, Hamilton Rating Scale for Depression-17 and International Classification of Disease-10 classification of mental and behavioural disorders. ⋯ There is a high prevalence of depression in patients with Chronic Kidney Disease stage 5 on hemodialysis compared to general population.