JNMA; journal of the Nepal Medical Association
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JNMA J Nepal Med Assoc · Sep 2022
Case ReportsUse of Novel Biological Agent in Severe Ulcerative Colitis with Poor Response to Initial Therapy: A Case Report.
Ulcerative colitis is a condition of chronic inflammation affecting the large intestine. The disease is typically characterized by periods of active inflammation alternating with periods of remission. ⋯ The patient was initially treated with mesalamine and azathioprine which did not result in significant clinical improvement but the addition of subcutaneous adalimumab showed a remarkable response with drastic improvement in just one year of treatment. Hence, adalimumab could be considered as an option in the management of severe cases in Nepal.
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JNMA J Nepal Med Assoc · Sep 2022
Sickle Cell Anaemia among Tharu Population Visiting the Outpatient Department of General Medicine in a Secondary Care Centre: A Descriptive Cross-sectional Study.
Sickle cell anaemia is a global health issue in which a mutation of the β-globin gene changes normal haemoglobin in sickle-shaped red blood cells. The objective of this study was to find out the prevalence of sickle cell anaemia among the Tharu population visiting the outpatient Department of General Medicine in a secondary care centre. ⋯ The prevalence of sickle cell anaemia was higher when compared to other studies conducted in similar settings. The government needs to emphasise more effort in diagnosing cases as well as increasing the testing centre.
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JNMA J Nepal Med Assoc · Sep 2022
Obstructive Lung Disease among Patients Performing Spirometry in a Tertiary Care Centre: A Descriptive Cross-sectional Study.
Obstructive lung disease is a leading cause of morbidity and mortality worldwide which causes economic and social burdens. Spirometry is a standard test for screening and evaluating patients with symptoms of chronic respiratory diseases and is the investigation of choice for identifying airflow obstruction. Chronic obstructive lung disease prevalence, mortality, and morbidity vary across different countries. The study aimed to find out the prevalence of obstructive lung disease among the patients performing spirometry in a tertiary care centre. ⋯ The prevalence of obstructive lung disease in our study was higher compared to other studies from the similar setting. Spirometry should be used more frequently for diagnosis and to stratify patients for appropriate treatment.
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JNMA J Nepal Med Assoc · Sep 2022
Secondary Prevention of Rheumatic Heart Disease in Nepal: Are We Going Backward?
A secondary level of prophylaxis has proven to be the most successful in Nepal, a country with an endemic rate of rheumatic heart disease, in combating the severe issues associated with rheumatic heart disease. The use of benzathine penicillin G in secondary prophylaxis of rheumatic heart disease, recommended by several guidelines, has been increasingly abandoned in Nepal due to a lack of national guidelines and the termination of the prior programs. ⋯ Nepal urgently needs to develop new national guidelines and ensure their effective implementation in order to slow the increase in the number of rheumatic heart disease patients. In this article, we explore the limitations, challenges, and advantages of using the consensus-supported intramuscular benzathine penicillin G as the first-line drug for the secondary prevention of rheumatic heart disease.
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JNMA J Nepal Med Assoc · Sep 2022
Role of Conservative Management in Stump Appendicitis: A Case Series.
Stump appendicitis is a rare, delayed complication of appendectomy. It is seen following both open and laparoscopic appendectomy and may occur weeks to years following the initial appendectomy. We report two cases of stump appendicitis seen at our hospital. ⋯ Although the usually recommended treatment for stump appendicitis is completion appendectomy, conservative management may be suitable for some patients. This report highlights the possibility of utilizing a conservative approach in the management of stump appendicitis compared to the recommended operative intervention. Awareness of the possibility of stump appendicitis is crucial for early diagnosis and treatment, to prevent potentially catastrophic complications.