JNMA; journal of the Nepal Medical Association
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JNMA J Nepal Med Assoc · Oct 2022
Case ReportsAzathioprine Induced Pancytopenia in a Patient with Vogt-Koyanagi-Harada Disease: A Case Report.
Vogt-Koyanagi-Harada disease is a multisystem autoimmune inflammatory disorder that affects the eyes, ears, skin, and the nervous system. It is a rare disease that mainly affects Asian, Hispanic, and Middle Eastern populations. Systemic steroids and immunosuppressants are frequently used to treat autoimmune diseases like this. Despite the fact that they reduce morbidity, immunosuppressants can have a number of side effects and are difficult to use, particularly when treating uncommon autoimmune illnesses. We present a case of a 56-year-old man who visited our health facility complaining of increased tears in both eyes along with bilateral blurring of vision. He was subsequently identified as having Vogt-Koyanagi-Harada disease. After prednisolone and methotrexate failed to have the desired effect, he was treated with azathioprine, which caused pancytopenia, and manifested as fever with positive blood culture for a coagulase-negative staphylococcus infection. ⋯ case reports; pancytopenia; steroid.
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JNMA J Nepal Med Assoc · Oct 2022
Anterior Cruciate Ligament Injury among Patients with Knee Injury Visiting the Out-patient Department of Orthopaedics of a Tertiary Care Centre: A Descriptive Cross-sectional Study.
Anterior cruciate ligament injury diagnoses are often missed at initial presentation. Though better diagnosed by physical examinations when done by orthopaedics surgeons, proper history is also important in diagnosing it. This study aimed to find the prevalence of anterior cruciate ligament injury among patients with knee injury visiting the out-patient Department of Orthopaedics of a tertiary care centre. ⋯ anterior cruciate ligament; diagnosis; history; orthopaedics.
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JNMA J Nepal Med Assoc · Oct 2022
Poisoning among Patients Presenting to the Department of Emergency Medicine of a Tertiary Care Centre: A Descriptive Cross-sectional Study.
Poisoning is one of the major public health problems worldwide. The World Health Organization has estimated 0.3 million deaths a year due to various poisoning agents; pesticides being the leading one. Poisoning is one of the leading causes of emergency room visits. It has become a significant public health issue in Nepal. This study aimed to find out the prevalence of poisoning among patients presenting to the Department of Emergency Medicine of a tertiary care centre. ⋯ emergency department; poisoning; prevalence.
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JNMA J Nepal Med Assoc · Oct 2022
Case ReportsProtein S Deficiency with Recurrent Deep Vein Thrombosis and Post Thrombotic Syndrome: A Case Report.
Protein S is a vitamin K-dependent protein that acts as a break in secondary hemostasis by inactivating activated factor V and activated factor VIII. We report a case of a 40 years old male who had the first episode of deep vein thrombosis of the left lower limb 10 years back, which despite treatment, reoccurred 3 months later in the bilateral lower limb. Thrombophilic screening showed severe protein S deficiency. The patient then developed deep vein thrombosis of both upper limbs. The patient was advised to place an inferior vena cava filter, which he denied. The patient is now presenting with multiple episodes of post-thrombotic syndrome. Such attacks are treated with elastic compression stockings, rivaroxaban, and morphine. However, despite medication, the pain has not yet subsided. Hence, even though protein S deficiency is the rare cause of deep vein thrombosis when recurrent should be considered despite its rare occurrence. ⋯ deep vein thrombosis; protein S deficiency; rivaroxaban.
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JNMA J Nepal Med Assoc · Oct 2022
High Social Support System among Elderly in a Hilly District: A Descriptive Cross-sectional Study.
Social support is an important contributing factor that promotes the health of the elderly by providing them with positive experiences, socially satisfying roles, or the ability to cope with stressful situations. The objective of this research study is to ind out the prevalence of a high social support system among the elderly in a Hilly district. ⋯ elderly; social support; social support system.