JNMA; journal of the Nepal Medical Association
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JNMA J Nepal Med Assoc · Nov 2023
Case ReportsCervical Ectopic Pregnancy with Unsupervised Intake of Medications for Abortion: A Case Report.
Cervical ectopic pregnancy is the rarest form of ectopic pregnancy, where implantation occurs in the mucosa of the endocervical canal, below the internal os. Medical abortion is a safe and effective method of termination of early intrauterine pregnancies when carried out under the supervision of trained service providers. Unfortunately, unsupervised misuse of such methods can lead to grave morbidities, especially in ectopic pregnancies. We report a case of a 29-year-old female with cervical ectopic pregnancy, with a history of self-induced medical abortion. Her assumption that her pregnancy had been terminated caused a delay in seeking treatment, which led to complications during management. Ultrasonography revealed features suggestive of cervical ectopic pregnancy and evacuation of the fetus and placenta was done using curettage, during which she had uncontrolled severe vaginal bleeding leading to need of emergency hysterectomy. ⋯ case reports; cervical; ectopic pregnancy; hysterectomy; induced abortion.
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JNMA J Nepal Med Assoc · Nov 2023
Multidrug-resistant among Non-Fermenting Gram-negative Bacteria Isolated in the Department of Microbiology of a Tertiary Care Centre.
Infection caused by Non-fermenting Gram-negative bacteria (NFGNB) like Pseudomonas aeruginosa and Acinetobacter baumannii leads to life-threatening conditions. These bacteria are often multidrug-resistant which leads to limited therapeutic options leading to treatment failure. Little information is available regarding the prevalence and resistance pattern of such bacteria in our country. The aim of the study was to find out the prevalence of multidrug-resistant among non-fermenting Gram-negative bacteria isolated in the Department of Microbiology of a tertiary care centre. ⋯ Acinetobacter baumannii; antibiotic; Pseudomonas aeruginosa; prevalence.
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JNMA J Nepal Med Assoc · Nov 2023
Special Sensory Function Deficit among Patients with Post-COVID-19 Visiting a Tertiary Care Centre.
Several patients who recover from COVID-19 infection continue to have persistent symptoms even after recovery from the disease. The special sensory functions such as taste, smell and hearing are affected by COVID-19 infection even after recovery from the illness. The aim of the study was to find out the prevalence of special sensory deficits among patients with post-COVID-19 visiting a tertiary care centre. ⋯ anosmia; COVID-19; hearing loss.
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JNMA J Nepal Med Assoc · Nov 2023
Case ReportsLaparoscopic Cholecystectomy in Situs Inversus Totalis with Stage 5 Chronic Kidney Disease: A Case Report.
Situs inversus totalis is a rare congenital anomaly in which the abdominal and thoracic organs are transposed in a mirror image. Diagnosis and management of cholelithiasis in patients with situs inversus totalis pose a challenge due to the anatomical variation. A laparoscopic cholecystectomy in such a case can be technically challenging, especially for a right-handed surgeon. In this case report, we present a case of a 38-year-old male with symptomatic cholelithiasis in a chronic kidney disease stage five patient under maintenance hemodialysis planned for recipient renal transplant. A laparoscopic cholecystectomy considered the gold standard for symptomatic cholelithiasis was performed with a three-port technique. The technical challenges anticipated due to anatomical variation were managed by intraoperative modifications. In conclusion, laparoscopic cholecystectomy in patients with situs inversus totalis can be done with technical modifications and re-orientation of visual motor skills. ⋯ case reports; cholecystectomy; situs inversus.
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JNMA J Nepal Med Assoc · Nov 2023
Diabetes Mellitus among Patients with Non-alcoholic Fatty Liver Disease Visiting the Outpatient Department of Internal Medicine in a Tertiary Care Centre.
Diabetes mellitus is a chronic metabolic illness which is mainly associated with reduced physical activity and obesity. Diabetes mellitus and non-alcoholic fatty liver disease may coexist and synergistically lead to poor clinical outcomes. The aim of the study was to find out the prevalence of diabetes mellitus among patients with non-alcoholic fatty liver disease in a tertiary care centre. ⋯ diabetes mellitus; fatty liver; non-alcoholic fatty liver disease; prevalence.