JNMA; journal of the Nepal Medical Association
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JNMA J Nepal Med Assoc · Sep 2023
Case ReportsRemarkable Recovery in a Patient with Lethal Dose Paraquat Poisoning: A Case Report.
Paraquat emerges as a formidable medical dilemma in Southeast Asia, its toxic effects attributed to the generation of free radicals and oxidative stress, with a specific predilection for diverse tissues, most notably the lungs. The scarcity of effective treatment modalities in resource-constrained settings magnifies the magnitude of the paraquat poisoning predicament. This report outlines the successful management of a 25-year-old man who ingested a lethal dose of paraquat. The patient presented solely with dysphagia devoid of accompanying symptoms, regardless of ingesting a fatal quantity of paraquat. The diagnosis was made based on history and a thorough clinical examination. Early, aggressive treatment with pulse therapy of steroids and antioxidants led to unexpected and quirky recovery. The case stresses the importance of prompt management and highlights the need for more research and public education to prevent future cases. ⋯ antioxidants; case reports; corrosive; paraquat; steroids.
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JNMA J Nepal Med Assoc · Sep 2023
Migraine among Patients Presenting With Headaches to the Department of Internal Medicine in a Tertiary Care Centre.
Migraine is one of the common neurovascular disorders characterized by persistent headaches ranging from moderate to severe pain. It has a high prevalence affecting more than one billion population each year across the world and has high morbidity, especially among young adults and females. The exact cause and mechanism of the migraine is unknown. The aim of this study was to find out the prevalence of migraine among patients presenting with headaches to the Department of Internal Medicine in a tertiary care centre. ⋯ aura; headache; migraine; prevalence.
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Immature teratoma is one of the rare malignant germ cell tumours presented in pregnancy. Here, we present 26-year-old pregnant women who had an incidental finding of left adnexal mass in an anomaly scan at 19 weeks of pregnancy. Laparotomy with peritoneal fluid cytology, left salpingo-oophorectomy and omental biopsy at 20 weeks of pregnancy revealed immature teratoma stage 1A, grade 2 in the histopathology report. However, she followed up with the metastatic mass in the pouch of Douglas at 30 weeks of pregnancy in magnetic resonance imaging despite being counselled for possible chemotherapy and surveillance. A baby with a good Apgar score and grade 3 immature teratoma in the metastatic mass was revealed following the exploratory laparotomy and cesarean section at 36 weeks of pregnancy. Fertility-sparing surgery with chemotherapy during pregnancy for high-grade tumours may result in a good prognosis. ⋯ case reports; chemotherapy; immature teratoma; pregnancy; surgery.
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JNMA J Nepal Med Assoc · Sep 2023
Volunteering Experience of the Poor Patient Fund during Medical School.
Access to healthcare poses significant financial hurdles for economically disadvantaged patients especially in developing countries like Nepal, presenting as one of the most prominent obstacles in ensuring their right to proper medical support. In response to this issue, a student-run organization called, 'Our Attempt Towards Health' has established the poor patient fund to assist those in need. The poor patient fund helps economically deprived patients with their treatment costs by providing them financial assistance and at the same time medical students have the opportunity to volunteer, creating an early and empathetic connection with patients. This experience fosters a sense of purpose and responsibility towards patients, while also honing valuable communication, counseling, and teamwork skills. ⋯ healthcare; medical students; volunteerism.
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JNMA J Nepal Med Assoc · Sep 2023
Levonorgestrel Implant Continuation among Postpartum Women Admitted to the Department of Obstetrics and Gynecology of a Tertiary Care Centre.
Jadelle (Levonorgestrel) implant is a long-acting reversible contraceptives which is recommended for post-partum contraceptive device due to their high efficacy, convenience, and cost-effectiveness. The continuation of Jadelle implant prevents unintended pregnancies and maintain healthy spacing between the pregnancies, thus improving maternal and child health outcomes. However, Government has endorsed the long-acting reversible contraceptives as immediate post-partum contraception, the status of Jadelle implant continuity is unknown. The aim of this study was to find out the prevalence of levonorgestrel implant continuation among postpartum women admitted to the Department of Obstetrics and Gynecology of a tertiary care centre. ⋯ contraception; family planning; levonorgestrel; postpartum period; pregnancy.