JNMA; journal of the Nepal Medical Association
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JNMA J Nepal Med Assoc · May 2023
Arthralgia among Patients with COVID-19 Infection Admitted to the Department of Medicine of a Tertiary Care centre: A Descriptive Cross-sectional Study.
COVID-19 is a global pandemic that has affected millions of people worldwide. It predominantly affects the respiratory tract causing various respiratory symptoms. It also causes various musculoskeletal symptoms in the form of arthralgia and myalgia which may be incapacitating for some patients. The objective of this study was to find out the prevalence of arthralgia among patients with COVID-19 infection admitted to the Department of Medicine. ⋯ arthralgia; COVID-19; prevalence; tertiary care.
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Thrombotic microangiopathy is a pathological condition comprised of microvascular thrombosis involving any body organ leading to thrombocytopenia, coombs-negative hemolytic anemia, and end-organ damage. The clinical presentation of the case shows typical hemolytic uremic syndrome, however, lab reports show atypical hemolytic uremic syndrome (low C3). Pain abdomen and loose stool with some signs of dehydration were initial presentations. Early initiation of renal replacement therapy and management of dehydration was done. Simple diarrhea can also manifest as acute kidney injury with the hemolytic uremic syndrome. Hence we should keep hemolytic uremic syndrome as the differential diagnosis of diarrhea. Irrespective of lab parameters, early management in line with the typical hemolytic uremic syndrome should be done for better outcomes. ⋯ anemia; case reports; dehydration; renal replacement therapy.
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Primary anorectal melanoma is an extremely rare and aggressive mucosal melanocytic malignancy of the anorectal region. Because of the rarity of the tumor and vague clinical presentations, diagnosis at an early stage is a challenge for clinicians. In our context, where the hemorrhoid is a diagnosis of cultural familiarity for any sort of rectal pathology, these patients often present to us at a very advanced stage of the disease. Here, we present a case of a 55-year-old male patient with stage 2 anorectal melanoma who is on adjuvant chemotherapy following abdominoperineal resection with a permanent colostomy. Five cycles of dacarbazine and carboplatin have been given and the patient is doing well with the treatment. Abdominoperineal resection with excision of the tumor remains the mainstay of treatment; however, poor patient compliance with permanent colostomy is a major limiting factor of abdominoperineal resection. Even with the best interventions and care, the survival rate is not very good. ⋯ abdominoperineal resection; adjuvant chemotherapy; case reports; melanoma.
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JNMA J Nepal Med Assoc · May 2023
Depression among People Living With HIV/AIDS Undergoing Antiretroviral Therapy at a Tertiary Care Centre: A Descriptive Cross-sectional Study.
HIV affects mental health in multiple ways, including its direct pathophysiological effects, associated stigma, impacts on social, and economic dimensions, medications used for long durations and multiple secondary physical health issues that affect the clients and comorbid substance use. In the post-COVID era, in our socio-cultural and geographical context, depression among these populations needs assessment to evaluate their mental health care needs. The objective of this study was to find out the prevalence of depression among people living with HIV/AIDS undergoing antiretroviral therapy at a tertiary care centre. ⋯ depression; HIV; prevalence.
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JNMA J Nepal Med Assoc · May 2023
ReviewSurgical Management of Autosomal Dominant Polycystic Kidney Disease: Principles and Current Practice.
Autosomal dominant polycystic kidney disease is the third most common cause of renal failure with no definitive treatment available that can directly target the development and growth of the cysts. Endeavours are being made to retard the growth of the cysts and preservation of renal function through medical treatment. However, 50% of the autosomal dominant polycystic kidney disease-affected persons develop complications and end-stage renal disease by the age of fifty-five and need surgical intervention for the management of complications, creation of dialysis access and renal transplantation. This review highlights the principles and current practice pertinent to the surgical management of autosomal dominant polycystic kidney disease. ⋯ polycystic kidney disease; nephrectomy; transplantation.