JNMA; journal of the Nepal Medical Association
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JNMA J Nepal Med Assoc · Jul 2022
Case ReportsDelayed Diagnosis of Pemphigus Vulgaris Initially Presenting as an Oral Ulcer: A Case Report.
Pemphigus vulgaris is a rare autoimmune mucocutaneous blistering disease clinically presenting as vesicles, bullae, and erosion and histologically characterized by suprabasal split and acantholysis. It usually affects mucous membranes and skin. Recurrent oral ulcers can only be the clinical manifestation before progressing into skin lesions. This can lead to the delayed diagnosis of this disease. Here we report a case of pemphigus vulgaris which was diagnosed after years of suffering from an oral ulcer that eventually progressed to widespread skin blistering and ulceration. The patient was treated with oral prednisolone which showed improvement within a week. Physicians should consider the differential diagnosis of pemphigus vulgaris in patients presenting with a recurrent oral ulcer. ⋯ delayed diagnosis; oral ulcer; pemphigus vulgaris.
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JNMA J Nepal Med Assoc · Jul 2022
Autoimmune Thyroid Disease in Patients with Hypovitaminosis D in Department of Biochemistry of a Tertiary Care Centre: A Descriptive Cross-sectional Study.
Autoimmune thyroid disease is characterised by the generation of autoantibodies against self-antigens such as thyroid peroxidase, thyroglobulin, and thyroid-stimulating hormone receptor. Recent studies have implicated the role of hypovitaminosis D to immune dysfunction, failure of self-tolerance and generation of autoantibodies. This study aimed to find out the prevalence of autoimmune thyroid disease among hypovitaminosis D patients in a tertiary care centre. ⋯ autoimmune diseases; prevalence; thyroid; vitamin D.
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JNMA J Nepal Med Assoc · Jul 2022
Diabetes Mellitus among Adult Outpatients Visiting a Tertiary Care Centre: A Descriptive Cross-sectional Study.
Diabetes mellitus is a chronic metabolic disease characterised by elevated blood sugar levels and is a pandemic of public health importance. Screening programs can help reduce morbidity and mortality by preventing or delaying complications. This study aimed to find out the prevalence of diabetes mellitus among adult outpatients visiting a tertiary care centre. ⋯ diabetes mellitus; hospital; Nepal; outpatient.
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JNMA J Nepal Med Assoc · Jul 2022
Case ReportsLoss of Consciousness and Cardiac Arrest as an Atypical Presentation of Tubercular Meningitis: A Case Report.
Tubercular meningitis is a devastating presentation of extra pulmonary tuberculosis, with fatality in each case without treatment. A 39 years male, a regular consumer of alcohol and a known case of major depressive disorder, presented with the alleged history of using an electric heater in a closed room, and presented to emergency with unconsciousness and cardiac arrest. As his neurological status didn't improve over 72 hrs, a magnetic resonance imaging brain was done which was non-conclusive. Electroencephalogram revealed diffuse right fronto-parietal seizure activity ceasing with midazolam injection, hence levetiracetam was started. Lumbar puncture revealed increased adenosine deaminase and nil white blood cells. Repeat lumbar puncture showed lymphocytic-predominant pleocytosis, elevated protein and low glucose. The patient was started on anti-tubercular therapy and an injection of dexamethasone was added. Repeat electroencephalogram didn't show any seizure-like activity. It is important to be aware of variety of presentations of tubercular meningitis. Delay in treatment leads to irreversible neurological damage and even death. ⋯ cardiac arrest; case report; tubercular meningitis; unconsciousness.
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JNMA J Nepal Med Assoc · Jul 2022
Mean Six Minute Walk Distance of Healthy Healthcare Workers of a Tertiary Care Centre: A Descriptive Cross-sectional Study.
The six-minute walk test is a sub-maximal exercise test used in clinical populations to determine functional exercise capacity. It is a safe, simple, and inexpensive test. There are a number of reference equations described for estimating six-minute walk distance in healthy subjects in different countries. However, there is a lack of standard reference value for six minute walk distance in healthy Nepalese population. The aim of the study was to find the mean six minute walk distance of healthy healthcare workers of a tertiary care centre. ⋯ exercise test; health personnel; healthy volunteer; walk test.