JNMA; journal of the Nepal Medical Association
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Nepal stands in a vulnerable position when it comes to counterfeit medicines as two of its major trade partners countries are leading producers of falsified healthcare products. The impacts that it can lead to are a lower standard of healthcare delivery to the public, increased cost of treatment, antibiotic resistance, and even fatality. The time of crisis as the Coronavirus disease 2019 pandemic is often seen as an opportunity to endorse substandard products in greater amounts. The people's doubt over the medicine is another issue generated by this malpractice that can lead to problems like vaccine hesitancy which can have scary outcomes so forth in a pandemic situation like this. Stronger national policies and vigilant authorities are prime to overcoming flourishing counterfeit culture as it is a peak time when we can not put public health at stake. ⋯ counterfeit medicines; Nepal; patient safety; substandard medicines.
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Dengue is a disease which spreads by the bite of an infected Aedes mosquito. Reading about a disease in a textbook and experiencing it as a patient is a completely different thing. This article highlights the feeling of a medical student as a patient. It provides the reader with an idea of how Basic Science knowledge can be used for rational decision-making. Self- prescription of medication without consulting a doctor can be more harmful in many circumstances. We also need to be aware of the warning signs of Dengue virus infection. ⋯ clopidogrel; dengue; medical student.
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JNMA J Nepal Med Assoc · Dec 2022
Mean Tip Apex Distance in Patients undergoing Dynamic Hip Screw Fixation for Pertrochanteric Fractures without using Traction Table: A Descriptive Cross-sectional Study.
Dynamic Hip Screw fixation has shown to be equally effective compared to cephalomedullary nailing. The effectiveness of dynamic hip screw fixation for pertrochanteric fractures without using traction table is not well investigated. This study aimed to find out the mean tip apex distance in patients undergoing dynamic hip screw fixation for pertrochanteric fractures without using traction table. ⋯ fracture fixation; hip fractures; operating tables.
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Twin-twin transfusion syndrome occurs in multiple gestations and involves a chronic flow of blood from one twin to another twin and is a rare entity. We present a case of 32-years-old primigravida with a twin pregnancy who presented with increasing abdominal girth inappropriate with her gestational age at 21 weeks of her pregnancy. Ultrasound findings were suggestive of twin-twin transfusion syndrome. The patient was provided with treatment options but due to polyhydramnios and short cervix, the patient went into spontaneous labour the same day with a poor pregnancy outcome. Twin-twin transfusion syndrome leads to a high rate of perinatal morbidity due to its poorly understood aetiology and difficulty in diagnosing and treatment. Early diagnosis during antenatal ultrasound is important in reducing morbidity and mortality rates. ⋯ case reports; fetoscopy; oligohydramnios; polyhydramnios; twins.
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JNMA J Nepal Med Assoc · Dec 2022
Case ReportsAutoimmune Hepatitis Leading to Liver Cirrhosis: A Case Report.
Autoimmune hepatitis is a rare form of chronic liver inflammation that begins as acute hepatitis and progresses to chronic liver disease. It presents with varied clinical features from acute hepatitis to chronic liver diseases like chronic viral hepatitis and alcoholic liver disease, making it difficult to diagnose in the absence of a high index of suspicion and adequate laboratory support. Autoimmune hepatitis is divided into two categories autoimmune hepatitis-1 and autoimmune hepatitis-2 based on the antibodies involved. We discuss the case of a 37-year-old woman who developed autoimmune hepatitis-1, with swelling and epigastric pain. These symptoms later progressed to liver cirrhosis leading to the death of the patient. Autoimmune hepatitis is extremely sensitive to immunosuppressive medication, it is necessary to maintain a high suspicion index for the disease because a prompt diagnosis can be an integral step toward a better prognosis of the disease. ⋯ autoimmune hepatitis; case reports; chronic hepatitis; liver cirrhosis.