JNMA; journal of the Nepal Medical Association
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JNMA J Nepal Med Assoc · Oct 2022
Blindness among Patients with Type II Diabetes Mellitus Presenting to the Outpatient Department of Ophthalmology of a Tertiary Care Centre: A Descriptive Cross-sectional Study.
Diabetic retinopathy is a major microvascular complication of diabetes, and may progress to sight-threatening stages causing blindness with a consequent decrease in their quality of life. This study aimed to find out the prevalence of blindness among patients with type II diabetes mellitus attending the Outpatient Department of Ophthalmology of a tertiary care hospital. ⋯ blindness; diabetic retinopathy; prevalence.
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JNMA J Nepal Med Assoc · Oct 2022
Case ReportsMethemoglobinemia due to Hemolysis Secondary to Infection in a Child: A Case Report.
Methemoglobinemia is a rare condition characterised by hypoxic state manifesting as headache, nausea, fatigue, and confusion. We report a 2-year-old boy presenting with fever and cough for 7 days with an episode of hypoxia as the saturation declined and did not improve on face mask oxygenation. On further evaluation, acute intravascular hemolysis was established following decreased haemoglobin level, increased levels of lactate dehydrogenase, and unconjugated bilirubin in the setting of documented infection. Assessment of arterial blood gas showed a significantly raised saturation gap and detection of methemoglobin confirmed the diagnosis. He was managed conservatively with packed red blood cells transfusion following which hypoxia was corrected. Methemoglobinemia as a result of hemolysis can be a non-cardio-respiratory cause of hypoxia and inciting aetiology needs to be addressed. ⋯ case reports; hemolysis; hypoxia; infection; methemoglobinemia.
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JNMA J Nepal Med Assoc · Oct 2022
Case ReportsMultiple Wasp Stings Leading to Rhabdomyolysis Induced Acute Kidney Injury with Incidental Ectopic Kidney: A Case Report.
Rhabdomyolysis refers to skeletal muscle breakdown causing a release of different intracellular proteins including myoglobin and several electrolytes in the bloodstream. Elevations diagnose rhabdomyolysis in serum creatine kinase. Mass envenomation by multiple wasp stings can cause rhabdomyolysis followed by acute kidney injury, although it is scarce. A 24-year-old male presented to our tertiary centre in an anaphylaxis-like state after multiple wasps sting, rapidly developing rhabdomyolysis followed by acute kidney injury. Despite having an ectopic kidney with a pre-existing renal parenchymal disease, he recovered and was discharged, which in itself is a rare entity of low clinical incidence. Wasp stings can potentially result in serious clinical manifestations, which need to be watched over, assessed and promptly treated. ⋯ acute kidney injury; case reports; creatine kinase; hymenoptera; rhabdomyolysis.
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From the beginning of day one in medical school, students are always looking for ways to do something practical and skilled based instead of just reading a textbook. Having said that, learning a skill to save a life is the most fascinating thing. Although as a student, they may not have to attend to the patient, they could be present in accidents outside of the hospital, where they should be able to perform the necessary actions to save a life. After attending the training, one becomes somewhat confident that they can take control of the situation because they will know what to do until the emergency services arrive. ⋯ cardiac arrest; cardiopulmonary resuscitation; life; medical students; workshops.