JNMA; journal of the Nepal Medical Association
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JNMA J Nepal Med Assoc · Jan 2023
Cutaneous Tuberculosis among Patients Presenting to Dermatology Outpatient Department of a Tertiary Care Centre: A Descriptive Cross-sectional Study.
Cutaneous tuberculosis is an uncommon form of extrapulmonary tuberculosis. It can present in various morphological presentations leading to a late diagnosis in many cases. It is mainly associated with significant scarring and morbidity. It is classified as paucibacillary or multibacillary depending on the bacillary load. Similarly, it can be acquired through either an endogenous or an exogenous source. The mainstay of treatment is anti-tubercular medications. The objective of the study was to find out the prevalence of cutaneous tuberculosis among patients presenting to the dermatology outpatient department of a tertiary care centre. ⋯ cutaneous; extrapulmonary tuberculosis; tuberculid.
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JNMA J Nepal Med Assoc · Jan 2023
Case ReportsIncidental Intraoperative Diagnosis of Term Conjoined Twins: A Case Series.
Conjoined twins (Siamese twins) represent the rarest form of twin pregnancy. Reported here are two rare cases of conjoined term twins presented to the department of Obstetrics and Gynaecology within 3 months. The first case, 32 years of gravida 6 parity 5 referred from periphery after full trial of labour following multi-organ dysfunction and term intrauterine dead twins. Intraoperatively it was dead conjoined thoraco-omphalopagus females. The patient died after 3 days following multiorgan dysfunction syndrome and disseminated intravascular coagulation. The second case, 22 years gravida 2 parity 1 also referred from periphery in second stage of labour with diagnosis of 39 weeks intrauterine dead twins with obstructed labour, delivered by caesarean with intraoperative conjoined dead females of thoracophagus type. Twins are high-risk pregnancy. This rare diagnosis with complications could have been prevented by regular antenatal checkups, ultrasonography performed by radiologists and early referral antenatally in labour along with multidisciplinary approach. ⋯ conjoined; monozygotic twinning; siamese twins; twins.
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JNMA J Nepal Med Assoc · Jan 2023
Appendicitis among Patients Admitted to the Department of Surgery of a Tertiary Care Centre: A Descriptive Cross-sectional Study.
The prevalence of appendicitis is widespread among both adult and pediatric populations. Despite being so common, its diagnosis remains difficult. Initially, acute appendicitis is managed conservatively. To reduce morbidity and mortality, surgery must be performed promptly. The main objective of the study is to find out the prevalence of appendicitis among patients admitted to the department of surgery of a tertiary care centre. ⋯ appendectomy; appendicitis; prevalence; surgery.
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JNMA J Nepal Med Assoc · Jan 2023
Acute Kidney Injury in COVID-19 Patients Admitted at a Tertiary Care Centre: A Descriptive Cross-sectional Study.
Coronavirus disease can affect the renal system in various forms ranging from mild proteinuria to acute kidney injury, some even needing renal replacement therapy. This study aimed to find out the prevalence of acute kidney injury in patients admitted with COVID-19 at a tertiary care centre. ⋯ acute kidney injury; COVID-19; Nepal.
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JNMA J Nepal Med Assoc · Jan 2023
Role of Mesenchymal Stem Cells on Tonsillar Hypertrophy: An Unexplored Enigma.
Tonsillar or adenoid hypertrophy is a common childhood finding which can cause significant health problems like respiratory infections and sleep apnea. Though normal growth of children is also attributed to such enlargement, infection, environmental pollutants, allergens, and gastroesophageal reflux are proposed triggering factors for tonsillar hypertrophy. While tonsilar enlargement in adults is more associated with malignancy and chronic infections like the human immunodeficiency virus, the immunology of childhood adenotonsillar hypertrophy is less understood. We postulate that upon stimulation, mesenchymal stem cells are found to reduce the secretion of interferon-gamma but increase the secretion of interleukin-4 from activated T cells. Both of these factors inhibit apoptosis in the tonsillar tissue leading to its hypertrophy. Under the umbrella of evidence, it implicates the role of mesenchymal stem cells in tonsillar hypertrophy. However, further longitudinal large studies are needed to validate the proposition. ⋯ interleukin-4; mesenchymal stem cell; tonsillar hypertrophy.