JNMA; journal of the Nepal Medical Association
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JNMA J Nepal Med Assoc · Oct 2005
Case ReportsSeptic induced abortion claiming life of a Nepalese woman.
This is a case report of septic induced abortion done at 16 weeks of gestation outside Kathmandu valley who presented to the emergency department of Tribhuvan University Teaching Hospital (TUTH) with peritonitis and septic shock. The case underwent emergency laparotomy and was treated surgically for perforated ileum and uterus by resection and end to end anastomosis of bowel and subtotal hysterectomy. ⋯ Unsafe abortion remains one of the major causes of maternal mortality in Nepal. Increasing public awareness about hazards of septic abortion and the provisions of law and decentralizing the trained manpower throughout the country would play a pivotal role in decreasing the incidence of septic induced abortion.
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JNMA J Nepal Med Assoc · Jul 2005
Case ReportsSevere post thermal burn cicatricial ectropion with corneal ulceration: an illustrative case.
Management of postburn cicatricial ectroption of the upper lid is always a challenge for the oculoplastic surgeon, as they are often associated with exposure keratitis and ulceration. Traditionally, split thickness grafts have been described for upper lid reconstruction and tarsorrhaphies have been discouraged. ⋯ The patient underwent full thickness skin grafting and tarsorrhaphy to release the ectropion with resolution of corneal ulceration. We believe that full thickness skin grafts and tarsorrhaphy are effective in correcting upper lid cicatricial ectropion, without functional compromise.
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Spinal tuberculosis is usually secondary to lung or abdominal involvement and may also be the first manifestation of tuberculosis. Spinal tuberculosis (often called Pott's disease) is by definition, an advanced disease, requiring meticulous assessment and aggressive systemic therapy. Physicians should keep the diagnosis in mind, especially in a patient from a group with a high rate of tuberculosis infection. ⋯ Surgery is necessary as an adjunct to antibiotic therapy if the vertebral infection produces an abscess, vertebral collapse, or neurologic compression. Some patents need aggressive supportive care owing to tuberculous meningitis or encephalopathy. Moreover, the importance of immediate commencement of appropriate treatment and its continuation for adequate duration along with the proper counseling of the patient and family members should not be underestimated for successful and desired outcome.
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JNMA J Nepal Med Assoc · Jul 2005
Poisoning : pattern and profile of admitted cases in a hospital in central Nepal.
An analysis of all poisoning cases admitted in medical and pediatric wards of Patan Hospital for one year (1st Jan to 31st Dec 2004) was carried out. A total of 154 cases were admitted which was 0.8% of total hospital admissions. Females outnumbered males and almost two-thirds patients were young adults (15-34 years). ⋯ Intensive care unit (ICU) service was required in 17% of patients; and almost 25% developed complications. Aspiration pneumonia and respiratory failure were the most frequently observed complications. Ninety four percent of admitted patients recovered completely; leaving a mortality rate of 5%.
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JNMA J Nepal Med Assoc · Jan 2005
Clinical TrialAortic aneurysm and dissection: evaluation with spiral CT angiography.
The study was undertaken for aortic evaluation and to see its usefulness for assessing aortic aneurysm, aortic dissection and pseudoaneurysm by spiral CT angiography (CTA). A total of 28 patients with aortic aneurysm (n=19), aortic dissection (n=5) and aortic pseudoaneurysm (n=4) were included. CTA findings were compared with ultrasonography in 14, digital subtraction angiography (DSA) in 14, MRI in 9; and surgical findings in 12 patients. CTA was an excellent imaging modality for comprehensive evaluation of aortic aneurysm, dissection and pseudoaneurysm combining the advantage of conventional contrast enhanced CT axial images and those of angiography in the form of 3D reformatted images.