JNMA; journal of the Nepal Medical Association
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JNMA J Nepal Med Assoc · Oct 2023
Mandibular Third Molar Impaction among Patients Visiting Outpatient Dental Department of a Tertiary Care Centre.
Mandibular third molar impaction is the most common impaction as third molars are last to erupt at the age of 17-25 years. Despite its high prevalence and negative impacts, there is limited study about mandibular third molar impaction. The aim of this study is to find out the prevalence of mandibular third molar impaction among patients visiting the outpatient Dental Department of a tertiary care centre. ⋯ impacted tooth; pericoronitis; prevalence; third molar.
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JNMA J Nepal Med Assoc · Oct 2023
Case ReportsKlippel-Feil Syndrome Associated with Renal and Cardiac Anomalies in an Infant: A Case Report.
Klippel-Feil syndrome is a rare congenital bone disorder characterised by a triad of short neck, low posterior hairline and limited lateral bending of the neck with an annual incidence of 1 in 40,000 live births. It has remained an obscure term in the medical literature because of its variability in presentation and wide spectrum of anomalies involving multiple organ systems. It is unusual to find a case that has all three classical triad features. Here, we present a case of a 9-month-old infant who manifests not only all three classical triad features associated with Klippel-Feil syndrome but also demonstrates the presence of congenital heart disease, scoliosis, and renal ectopia. An early comprehensive evaluation of a suspected case is essential for diagnosis and counselling which impacts its prognosis, helps minimize social stigma and affords parents the opportunity to consider cosmetic surgery as an option, should they choose to pursue it. ⋯ case reports; congenital; heart diseases; Klippel-Feil syndrome; scoliosis.
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JNMA J Nepal Med Assoc · Oct 2023
Dyslipidemia among Patients with Type 2 Diabetes Mellitus Visiting a Tertiary Care Centre.
A triad of lipid and lipoprotein metabolism is known as dyslipidemia. Dyslipidemia is one of the major risk factors for cardiovascular diseases in diabetes mellitus which is a leading cause of morbidity and mortality worldwide. The aim of the study was to find out the prevalence of dyslipidemia among patients with type 2 diabetes mellitus visiting a tertiary care centre. ⋯ cardiovascular disease; dyslipidemia; prevalence; type 2 diabetes mellitus.
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JNMA J Nepal Med Assoc · Oct 2023
Case ReportsAbdominal Wall Dyskinesia in a Child Presenting as Belly Dancers' Syndrome: A Case Report.
Belly dancer's dyskinesia or syndrome is a rare condition characterized by involuntary, undulating, infrequent diaphragm movements. The etiologies for this disorder include nervous system disorders (peripheral or central), drug-induced, psychological, or idiopathic. This article describes a 10-year-old boy with an underlying psychological stressor who suddenly experienced involuntary abdominal wall movements after salbutamol nebulization. After a detailed history, physical examination, and abdominal ultrasound that revealed rapid rhythmic diaphragm movements, the child was diagnosed with salbutamol-induced belly dancer's dyskinesia with an underlying psychological problem. These movements subsided with medical and psychological therapy for two weeks. Belly dancer's dyskinesia is a complex disorder that is difficult to diagnose but can be managed with medical treatment and psychological counseling alone in a few patients. In contrast, in other cases, surgical intervention may be required. ⋯ case reports; dyskinesias; salbutamol.
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JNMA J Nepal Med Assoc · Oct 2023
Case ReportsIschemic Portal Venous Gas and Pneumatosis Intestinalis Managed Conservatively in a Patient with Rheumatic Heart Disease and Warfarin Induced Coagulopathy: A Case Report.
Mesenteric ischemia is a surgical emergency. The presence of hepatic portal venous gas and pneumatosis intestinalis is a frequent finding in computed tomography. Not all hepatic portal venous gas and pneumatosis intestinalis are due to mesenteric ischemia. A 70-year-old female, with a known case of diabetes mellitus, rheumatic heart disease and atrial fibrillation under warfarin presented with diffuse abdominal pain, multiple episodes of vomiting and ecchymosis in bilateral flanks. Evaluation of the coagulation profile suggested warfarin-induced coagulopathy. Portal venous gas was detected during an ultrasound examination. Subsequent contrast-enhanced computed tomography abdomen showed hepatic portal venous gas, pneumatosis intestinalis, paucity of branches of the ileocolic artery, and reduced enhancement of caecum and ascending colon. Mild ascites were present in the pelvis. Arterial blood gas analysis revealed compensated metabolic acidosis. The patient was managed conservatively and discharged after nine days of hospital admission. Conservative approach can be considered for suspected mesenteric ischemia in surgically unfit candidates. ⋯ case reports; mesenteric ischemia; portal vein; rheumatic heart disease; warfarin.