JNMA; journal of the Nepal Medical Association
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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.
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JNMA J Nepal Med Assoc · Nov 2022
Case ReportsUrine Discoloration Associated with Metronidazole: A Case Report.
Metronidazole belongs to the nitroimidazole group of antibiotics. It is used for the treatment of anaerobic and protozoal organisms. Its common side effects are nausea, vomiting, headache, and abdominal pain. Urine discolouration is one of the rare side effects of metronidazole. We report a case of 4-years-old male, a known case of Steroid resistant nephrotic syndrome; Focal Segmental Glomerulosclerosis type who developed reddish discolouration of urine following the introduction of oral metronidazole which reverted back to its usual colour within 24 hours of discontinuing metronidazole. With no evidence of other possible causes, urine discolouration was linked with the use of metronidazole. Urine discoloration as a side effect of metronidazole is rarely reported in the literature. This case report of the rare adverse effects of the commonly used drug can be of importance in the scientific community. Urine discolouration could be considered a side effect of metronidazole when there is no other obvious cause. ⋯ flagyl; hematuria; metronidazole; side effects of drugs.
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JNMA J Nepal Med Assoc · Nov 2022
Trismus among Preclinical Students in a Medical College: A Descriptive Cross-sectional Study.
Trismus is a condition of reduced mouth opening due to tonic constrictions of the muscles of mastication. Trismus greatly affects health-related quality of life and thus daily life activities. The aim of this study was to find out the prevalence of trismus among preclinical students in a medical college at a tertiary care teaching hospital. ⋯ prevalence; temporomandibular joint; trismus.
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The journey of medical school is a roller coaster ride and learning how to survive is going to take much effort. Being consistent and having a reason that pushes you every moment, support from friends and family, and guidance from seniors can ease this pathway. Though it can be hypothetical to say that these measures would help comfortably sail through the medical journey, experiences and learnings gained at a similar cost of effort are undeniable and they can certainly make a difference. Perseverance, determination and motivation are essential to keep the flame burning. ⋯ learning; medical students; medical school.
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JNMA J Nepal Med Assoc · Nov 2022
Feeding Intolerance among Preterm Neonates Admitted to the Neonatal Intensive Care Unit at a Tertiary Care Centre: A Descriptive Cross-sectional Study.
Premature infants frequently suffer from feeding intolerance related to prematurity and are highly associated with morbidity and mortality. Breast milk is fundamental to the improvement of the infant's immature vulnerable framework and decreases child mortality. The aim of this study was to find out the prevalence of feeding intolerance in premature neonates admitted to the neonatal intensive care unit of a tertiary care centre. ⋯ feeding patterns; food intolerance; morbidity; mortality; preterm infants.