JNMA; journal of the Nepal Medical Association
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JNMA J Nepal Med Assoc · Jul 2020
Case ReportsMalposition of Central Venous Catheter Inserted under Ultrasound Guidance in Intensive Care Unit: A Case Series.
Malposition of central venous catheter tip inserted into the subclavian and internal jugular vein is a rare unavoidable complication that can be decreased if inserted under ultrasound guidance. We report case series of three patients, two of subclavian and another of internal jugular inserted central venous catheter, in which the catheter malpositioned into ipsilateral internal jugular and subclavian vein respectively but had no effect on patient management. From this, we want to emphasize that the effect of malposition of central venous catheter tip depends upon the indication for which central venous catheter was inserted; it can be detected bedside by ultrasound and flush test.
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JNMA J Nepal Med Assoc · Jul 2020
Case ReportsHead and Neck Cylindroma Masquerading as Squamous Cell Carcinoma: A Case Report.
Cylindroma is an uncommon skin appendageal tumor encountered by otorhinolaryngologists in the head and neck. We present a case of a 70-year-old lady who presented with an ulcerative lesion in the pre auricular region. These appendageal tumours can mimic more sinister lesions like squamous cell carcinoma which might warrant overtreatment. This report highlights the importance of harbouring knowledge of these benign tumours in order to provide appropriate management.
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JNMA J Nepal Med Assoc · Jul 2020
Case ReportsMechanical Thrombectomy for Basilar Artery Occlusion Stroke: A Case Report.
Posterior circulation strokes are potentially devastating events that carry a significant risk of morbidity and mortality. Acute basilar artery occlusion stroke is a rare posterior circulation stroke that needs emergent management. ⋯ It is possible to achieve excellent results with mechanical thrombectomy in acute basilar artery occlusion if timely diagnosis and reperfusion can be done. We are not aware of any previous publication from Nepal describing this technique in acute basilar artery occlusion.
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JNMA J Nepal Med Assoc · Jul 2020
Clinicodemographic Profile of Kidney Diseases in a Tertiary Hospital of Central Nepal, Chitwan: A Descriptive Cross-sectional Study.
Spectrum of kidney diseases differs significantly in developing and developed countries. However, there is no central registry regarding the nature of such diseases in Nepal and our center either. The study aims to know the clinicodemographic spectrum of kidney disease patients admitted to our hospital. ⋯ The commonest clinical presentation and the reason for admissions were end-stage renal disease and sepsis syndrome respectively.
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JNMA J Nepal Med Assoc · Jul 2020
Case ReportsAcute on Chronic Bilateral Subdural Hematoma in a Woman with a Remote History of Previous Subdural Hematoma Managed by Trephination: A Case Report.
Bilateral chronic subdural hematoma are not that common. It may be recurrent and rarely superimposed by acute bleed leading to rapid progression and poor clinical outcomes. We report the case of a seventy six years old lady with a history of traumatic subdural hematoma evacuated by trephination twenty years back, presenting at our hospital with a history of persistent headache and acute onset of several episodes of vomiting. ⋯ The patient developed bilateral pneumocephalus and chest infection post-surgery. Bilateral, recurrent subdural hematoma with acute superimposition of bleed is a rare entity that presents with signs of increased intracranial pressure as opposed to unilateral SDH. A single burr hole trephination can be an effective intervention in these cases.