JNMA; journal of the Nepal Medical Association
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JNMA J Nepal Med Assoc · Jun 2023
Traumatic Brain Injury among Patients Admitted in Neurosurgical Unit in a Tertiary Care Centre: A Descriptive Cross-sectional Study.
Traumatic brain injuries are one of the leading causes of mortality, morbidity, and economic burden in context to Nepal. Non-contrast computed tomography is used for rapid diagnosis and repeat computed tomography helps to detect the progression and complications of cerebral injury. The aim of this study was to find out the prevalence of traumatic brain injury among patients admitted in the neurosurgical unit in a tertiary care centre. ⋯ contusion; craniotomy; traumatic brain injury.
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JNMA J Nepal Med Assoc · Jun 2023
Case ReportsAnti-Glomerular Basement Membrane Disease in a 10-year-old Child: A Case Report.
Anti-glomerular basement membrane disease is an extremely uncommon entity in children. It has an incidence of 0.5 to 1 per million per year in adults and is even more uncommon in children. It occurs due to autoantibody against glomerular basement membrane collagen and is characterized by rapidly progressive glomerulonephritis with or without pulmonary hemorrhage. As the literature on anti-glomerular basement membrane disease is limited from our part of the world, it is important to consider it as the rare cause of rapidly progressive glomerulonephritis as early intervention improves prognosis. We report a case of a 10-year-old male who initially presented with glomerulonephritis and later was diagnosed with anti-glomerular basement membrane disease. ⋯ basement membrane; case reports; glomerulonephritis; kidney.
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JNMA J Nepal Med Assoc · Jun 2023
Case ReportsTuberous Sclerosis Complex in a 17-month-old: A Case Report.
Tuberous sclerosis complex is a rare autosomal dominant genetic disorder that affects multiple organ systems, primarily affecting the central nervous system. It develops with a pathogenic mutation in tumour suppressor genes i.e. Tuberous Sclerosis Complex 1 or Tuberous Sclerosis Complex 2 which codes for protein hamartin and tuberin leading to unopposed hyperactivation of the mammalian target of the rapamycin signalling pathway. It presents with a triad of facial angiofibroma, intellectual disability, and epilepsy. We present a case of a 17-month female toddler with abnormal body movement with loss of consciousness and later developing into generalised jerky movements. On magnetic resonance imaging, a diagnosis of tuberous sclerosis was made. The patient underwent symptomatic management with anti-epileptic. As seizures in these cases are subtle, they remain undiagnosed for a long time leading to delays in management and developing refractory seizures. ⋯ angiofibroma; case reports; seizures; tuberous sclerosis; tumor suppressor gene.
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JNMA J Nepal Med Assoc · Jun 2023
Case ReportsCauda Equina Syndrome in a Military Personnel: A Case Report.
Cauda equina syndrome is a rare but severe neuro-spinal disorder commonly caused due to lumbar disc herniation, which occurs mostly at lower levels of L4-S1. We report a case of 38-year-old male soldier deployed on a foreign mission who presented to a level 1 military hospital 4 months back with complaints of decreased movement of bilateral lower limbs and severe low back pain radiating to the right lower limb for 2 hours. He was referred to a higher centre and diagnosed with cauda equina syndrome due to massive disc herniation at levels L2-L3. He underwent laminotomy and discectomy of the extruded intervertebral disc after 48 hours. On subsequent follow-up, his bladder and lower limbs sensations were normal however, he had bowel incontinence, hypotonia, hyporeflexia, and no significant improvement in power. Hence, early diagnosis, referral, and timely intervention affect the outcomes in a cauda equina syndrome patient. ⋯ case reports; cauda equina syndrome; disc herniation; low back pain; military personnel.
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JNMA J Nepal Med Assoc · Jun 2023
Subclinical Hypothyroidism among Patients with COVID-19 Infection in a Tertiary Care Centre: A Descriptive Cross-sectional Study.
Hypothyroidism occurs as a consequence of chronic autoimmune inflammation of the thyroid gland, which occurs due to the reduced function in the secretion of thyroid hormones. The coronavirus disease infection has shown many complications in all organic systems, during the acute phase of infection and in the post-COVID-19 period. SARS-CoV-2 may induce thyroid dysfunction that is usually reversible, including subclinical and atypical thyroiditis. The aim of this study was to find out the prevalence of subclinical hypothyroidism among patients with COVID-19 infection in a tertiary care centre. ⋯ COVID-19; hypothyroidism; thyroid gland.