JNMA; journal of the Nepal Medical Association
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Benign tumors of the fallopian tube are uncommon. Teratomas are most frequently found in the ovary and fallopian tube teratoma is extremely rare. To date, around 70 cases have been described, and most of them were discovered by chance. Here we present two cases of fallopian tube dermoid cyst. The first case is of a woman who was unable to conceive for 4 years with a right ovarian dermoid. She was managed with laparoscopic cystectomy when she was found to have a small teratoma-like lesion at the fimbrial end of the left fallopian tube. The second case is of a female who underwent elective caesarian section and was found to have a teratoma-like lesion at the right fallopian tube. Histopathology of both cases were reported as mature cystic teratoma. These cases suggest the need for careful examination of the pelvic organs for other pathology apart from the primary surgical sites. ⋯ case reports; dermoid cyst; fallopian tube; infertility.
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JNMA J Nepal Med Assoc · May 2023
Mean Urea Reduction Ratio among Patients Undergoing Hemodialysis at a Tertiary Care Centre: A Descriptive Cross-sectional Study.
Chronic kidney disease is a major cause of mortality with a prevalence of 6%. Over the past half-century, hemodialysis has been the most preferred modality of treatment for sustaining the life of patients with end-stage kidney disease. Despite hemodialysis being freely available, achieving adequacy in hemodialysis is a challenging task. Inadequate dialysis is responsible for the high mortality. This study aimed to find out the mean value of the urea reduction ratio among patients undergoing hemodialysis at a tertiary care centre. ⋯ chronic kidney disease; dialysis; hemodialysis.
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JNMA J Nepal Med Assoc · May 2023
Case ReportsResistant Catatonia in a 10-year-old Child: A Case Report.
Catatonia is a psycho-motor disorder associated with various psychiatric, neurological, and medical illnesses. It is due to alteration in GABAergic circuits and basal ganglia. Management includes identifying the underlying cause and handling complications with supportive treatment. It can cause life-threatening complications like dehydration and cardiac arrest. The risks are more in children and adolescent populations. Benzodiazepines and electro-convulsive therapy are treatment modalities. In this case report we discuss about a child who was resistant to both lorazepam and electroconvulsive therapy. Resistance to both first-line management is a rare phenomenon. We were able to manage with a combination of antipsychotics and antidepressants. Catatonia in children may respond late to treatment. Symptomatic treatment, ruling out organic causes, and judicious use of pharmacotherapy can be beneficial in resistant cases. ⋯ benzodiazepines; case reports; catatonia; electroconvulsive therapy.
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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.
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JNMA J Nepal Med Assoc · May 2023
Blunt Abdominal Trauma among Patients Admitted to the Department of Surgery at a Tertiary Care Centre: A Descriptive Cross-sectional Study.
Blunt abdominal trauma bears significant morbidity and mortality worldwide and needs careful evaluation and management for a better outcome, where the resources are limited and the impact of the financial burden is very important. Previously, many cases used to be managed with operative procedures, and now the trend has been shifting to non-operative management. This study aimed to determine the prevalence of blunt abdominal trauma among patients admitted to the Department of Surgery of a tertiary care centre. ⋯ blunt injuries; conservative management; operative surgical procedure.