JNMA; journal of the Nepal Medical Association
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Kaplan's lesion is a rare complex metacarpophalangeal joint dislocation. A 7-year-old female child presented with pain, swelling and inability to move her right index finger. Her mother gave a history of sustaining a fall injury on the same hand around 3 weeks back. Radiographs showed a complex dorsal metacarpophalangeal joint dislocation. As the injury was already 3 weeks old at presentation, a few attempts at closed reduction were tried, under anaesthesia, which was unsuccessful. So, the patient underwent open reduction through a dorsal approach. At a 1-year follow-up, the patient was pain-free and had regained full range of motion of the index finger metacarpophalangeal joint. The differential diagnosis of Kaplan's lesion should be considered when a child presents with finger dislocation. ⋯ joint dislocations; metacarpophalangeal joint; open reduction.
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JNMA J Nepal Med Assoc · Nov 2022
Malnutrition among Cancer Patients in a Tertiary Care Centre: A Descriptive Cross-sectional Study.
Malnutrition is one of the most frequent disorders among cancer patients. It is seen in 50-90% of cancer patients. This high prevalence of malnutrition is very concerning as it is associated with reduced effective treatment, functional status, quality of life and survival. The aim of the study was to find out the prevalence of malnutrition among cancer patients in a tertiary care centre. ⋯ malnourishment; nutritional deficiency; screening.
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JNMA J Nepal Med Assoc · Nov 2022
Road Traffic Injuries among Patients Visiting the Emergency Department in a Tertiary Care Centre: A Descriptive Cross-sectional Study.
Road traffic injuries are preventable yet one of the most neglected public health issues. Road traffic injuries not only impact the health of the victim but also cause financial burden to the entire family. This study aimed to find out the prevalence of road traffic injuries in patients visiting the Emergency Department in a tertiary care centre. ⋯ automobiles; demography; Nepal; soft tissue injuries; traffic accidents.
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JNMA J Nepal Med Assoc · Nov 2022
Case ReportsRefractory Cardiogenic Shock Secondary to Acute Myocarditis in a Child with Multisystem Inflammatory Syndrome Associated with COVID-19: A Case Report.
Children with Coronavirus disease 2019 infection usually have mild symptoms but rarely may present with a life-threatening condition called a multisystem inflammatory syndrome. We report a case of COVID-19-related multisystem inflammatory syndrome in an 8-year-old boy who presented with cardiogenic shock due to acute myocarditis with no features of Kawasaki disease. Cardiogenic shock was refractory to fluids and inotropes. Later, this case was successfully managed with hydrocortisone and intravenous immunoglobulin. Therefore, this case report highlights keeping a lookout for such atypical presentations and early referral to a higher center for timely intervention and aggressive therapy specifically directed against the underlying inflammatory process to ameliorate the outcomes. ⋯ cardiogenic shock; COVID-19; kawasaki disease; myocarditis; Nepal.
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JNMA J Nepal Med Assoc · Nov 2022
Case ReportsAnti-N-methyl-D-aspartate Receptor Autoimmune Encephalitis: A Case Report.
Anti-N-methyl-D-aspartate receptor encephalitis is a form of autoimmune encephalitis with acute or subacute neuropsychiatric symptoms. Despite this fact, due to a couple of factors, this condition remains insufficiently acknowledged and is an under-recognised clinical scenario. We describe a case of a patient presenting with fever, headache and altered sensorium along with a history of disorientation, episodes of abnormal body movements and loss of consciousness in the later phase. She was initially thought to have Status epilepticus with tuberculous meningoencephalitis but her cognitive functions did not improve despite appropriate treatment. She displayed features away from the usual course of disease leading to suspicions of Autoimmune Encephalitis and Anti-N-methyl- D-aspartate receptor reports later confirmed the diagnosis. Methylprednisolone and Intravenous Immunoglobulin was started empirically and she was discharged in stable health with stabilised emotional and cognitive function with Azathioprine and Levetiracetam continued. Our findings suggested early diagnosis and prompt immunotherapy treatment beneficial for the outcome. ⋯ ase reports; encephalitis; immunotherapy; methylprednisolone.