JNMA; journal of the Nepal Medical Association
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Hypoplastic left heart syndrome is a rare critical congenital heart defect constituting a prevalence of 1/3,500 to 1/12,500 live births in which there is obstructions to the blood flow within the left heart. Here we present a case of a full-term 38 weeks male baby with a birth weight of 3.5 kg, and no obvious physical deformity referred to our centre at 22 hours of life for respiratory distress and cyanosis. At 23 hours of life, he was diagnosed with hypoplastic left heart syndrome and kept on Prostaglandin E1 infusion till the 12th day of life. The baby had a large ventricular septal defect and atrial septal defect with a severely hypoplastic left ventricle, hypoplastic aortic root, ascending aorta and post-ductal coarctation of the aorta. The diagnosis was reconfirmed by computed tomography cardiac angiography on the 10th day of life with the same cardiac findings suggestive of hypoplastic left heart syndrome. ⋯ case reports; congenital heart disease; hypoplastic left heart syndrome.
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JNMA J Nepal Med Assoc · Aug 2023
Case ReportsPersistent Vitello-Intestinal Duct Masquerading as Acute Appendicitis: A Case Report.
The vitello-intestinal duct normally regresses with the development. But, in certain cases, it could persist and present as Meckel's diverticulum. Here we report a case of an eight-year-old boy presenting with peri-umbilical abdominal pain, vomiting and loose stool. He was initially diagnosed and managed as acute appendicitis but did not improve, rather developed features of intestinal obstruction. Exploratory laparotomy was done which revealed persistent vitello-intestinal duct and was managed surgically. This case report highlights that in any case of suspected acute appendicitis, the complications of persistent vitello-intestinal duct should be considered as one of the differentials. ⋯ appendicitis; case reports; intestinal obstruction; laparotomy; omphalomesenteric duct.
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JNMA J Nepal Med Assoc · Aug 2023
Ramp Tear among Patients Undergoing Arthroscopic Anterior Cruciate Ligament Reconstruction in a Tertiary Care Centre.
Ramp tear is a specific injury that affects the posterior horn of the medial meniscus and its meniscosynovial or meniscocapsular attachments. The actual prevalence of ramp lesion is unknown due to the high probability of misdiagnosis or underdiagnosis caused by the low sensitivity of imaging modalities and poor visualization during arthroscopy. This study aimed to find out the prevalence of ramp tear among patients undergoing arthroscopic anterior cruciate ligament reconstruction in a tertiary care centre. ⋯ anterior cruciate ligament injuries; anterior cruciate ligament reconstruction; arthroscopy.
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JNMA J Nepal Med Assoc · Aug 2023
Previous Abdominal Scars among Patients Undergoing Laparoscopic Cholecystectomy in a Tertiary Care Centre.
Abdominal scars result from various open abdominal surgeries. Laparoscopic surgery in previous open abdominal surgery possesses various challenges to the surgeon like gaining access to the abdominal cavity, and difficulty in dissection due to dense adhesions from previous surgeries for various intraabdominal pathologies. This study aimed to find out the prevalence of previous abdominal scars among patients undergoing laparoscopic cholecystectomy in a tertiary care centre. ⋯ laparoscopic cholecystectomy; open surgery; prevalence.
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JNMA J Nepal Med Assoc · Aug 2023
Acid Peptic Disease among Patients with Acute Abdomen Visiting the Department of Emergency Medicine in a Tertiary Care Centre.
Acid peptic disease is caused by excessive acid secretion or weakened mucosal defense. Symptoms include epigastric pain, bloating, and nausea. Factors like gastric acid, Helicobacter pylori infection, alcohol consumption, smoking, and stress contribute to peptic ulcers. Imbalances between offensive and defensive factors can lead to ulcers. Acid-related disorders impact the quality of life and mortality. Accurate diagnosis and prompt treatment are vital. This study aimed to find out the prevalence of acid peptic disease among patients with acute abdomen in the Department of Emergency Medicine in a tertiary care centre. ⋯ acute abdomen; gastroenteritis; Helicobacter pylori; peptic ulcer.