JNMA; journal of the Nepal Medical Association
-
JNMA J Nepal Med Assoc · Nov 2021
Case ReportsActinomycosis of Gallbladder in Cholecystectomy Specimen: A Case Report.
Actinomyces are a part of the normal flora of the cervicofacial region, gastrointestinal tract, and urogenital tract, but can cause infections when the normal mucosal barrier is lost. Herein, we report a rare case of actinomycosis of the gallbladder in a 60-years-old-female. The patient presented with right hypochondrium pain since three months; ultrasonography showed cholelithiasis with thick oedematous wall. ⋯ Histological examination revealed an inflamed gallbladder with colonies of radiating filamentous structures having numerous sulphur granules which on gram staining showed filamentous gram-positive rods. The diagnosis of Actinomycosis of gallbladder was made. After cholecystectomy, prolonged antimicrobial therapy is recommended for patient with actinomycosis to prevent recurrence and even mortality.
-
JNMA J Nepal Med Assoc · Nov 2021
Case ReportsVitamin B12 Deficiency Resembling Acute Leukemia: A Case Report.
Vitamin B12 deficiency in children can cause megaloblastic anemia, poor growth, and increased chances of infections. It is an important reversible cause of bone marrow suppression which at the time of presentation can mimic hematological malignancy. Therefore, it should be considered as a differential diagnosis in cases suspected of acute leukemia. ⋯ Pancytopenia with severe anemia was present along with 19% reactive/atypical cells in peripheral blood smear suggesting acute leukemia. However, bone marrow aspiration and biopsy showed features of megaloblastic anemia. Vitamin B12 level measured was very low and treatment with cyanocobalamin caused drastic improvement in the child's condition.
-
JNMA J Nepal Med Assoc · Nov 2021
Robson's Group 2 Criteria among Total Caesarean Sections in a Tertiary Care Hospital: A Descriptive Cross-sectional Study.
Globally, there is a dramatic rise in cesarean section rate which has increased the maternal morbidity and adverse effects in a subsequent pregnancy. Robson's classification will aid in the optimization of the cesarean section use, assessment of the strategies aimed to decrease the cesarean section rate and thus improve the clinical practices and quality of care in various health care facilities. The main aim of this study is to find out the prevalence of caesarean section for Robson's group 2 among total caesarean sections done in a tertiary care hospital. ⋯ This study showed that the prevalence of caesarean section which lies in Robson's group 2 in our study is higher than the standard of World Health Organization. It showed that Robson's group 2 was one of the significant contributors to the greater caesarean section rate. Improved case selection, standardization, and protocol for induction of labour as well as regular audit could also reduce caesarean section rates.
-
JNMA J Nepal Med Assoc · Nov 2021
Abnormal Ultrasonographic Findings among Referred Patients with Pain Abdomen in the Radiology Department of a Tertiary Care Center: A Descriptive Cross-sectional Study.
Correct and prompt diagnosis is essential for the appropriate management of patients. Often, children and their caretakers cannot provide a reliable history to allow clinicians to determine the cause of the pain. This study's objective was to find out the prevalence of abnormal ultrasonographic findings among referred patients with pain abdomen in the radiology department of a tertiary care center of Nepal. ⋯ Most of the cases of pain abdomen showed abnormalities in ultrasound. Clinical evaluation should be used together with ultrasound abdomen in order to arrive at a correct diagnosis.
-
JNMA J Nepal Med Assoc · Nov 2021
Persistent Positivity of Reverse Transcriptase-Polymerase Chain Reaction Test among Patients with COVID-19 in Rural Teaching Hospital: A Descriptive Cross-sectional Study.
The persistence positivity detected for severe acute respiratory syndrome coronavirus 2 ribonucleic acid by real-time reverse transcriptase-polymerase chain reaction test in asymptomatic coronavirus disease 2019 positive patients has attracted a lot of attention. There is limited data on the duration of viral shedding. We aimed to determine the proportion of coronavirus disease patients with persistent positivity of real-time reverse transcriptase-polymerase chain reaction test in a teaching hospital of Nepal. ⋯ This study concludes that there might be a persistent positivity of the polymerase chain reaction test among patients with COVID-19. The majority of the patients were test positive for 8-14 days, and some were positive till 60-70 days.