JNMA; journal of the Nepal Medical Association
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JNMA J Nepal Med Assoc · Jul 2024
Case ReportsSurvival of Misdiagnosed 2,4-Dichlorophenoxyacetic Acid Poisoning Masquerading as Organophosphorus Poisoning: A Case Report.
Herbicide such as 2,4-Dichlorophenoxyacetic acid is commonly used in wheat growing regions and is being ingested with suicidal intent due to easy availability and lack of regulation for buying it. Various articles suggest high fatality upon ingestion of this compound. We report a rare survival of a 24-year-old male who ingested about 45 ml of the compound and presented with symptoms similar to organophosphate poisoning. ⋯ He started getting better and was discharged on fourth day. Detailed history taking can prevent misdiagnosis of 2,4-Dichlorophenoxyacetic acid poisoning. Early diagnosis and adequate supportive management of urinary alkalinization and forced diuresis can improve patient outcomes and reduce fatality.
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JNMA J Nepal Med Assoc · Jul 2024
Alternate Care Sites: A Novel Concept in Nepal During Disaster and Public Health Emergencies.
Nepal has a health care system that is complicated by access, affordability, and availability. The geographical difficulty makes the health care reach to public more difficult. ⋯ Incorporating the identification of Alternate Care Sites into the Hospital Disaster Preparedness Plan represents a crucial transition from theoretical discussion to practical implementation for strengthening healthcare facilities.. This paper discusses the concept of Alternate Care site and its implementation in Nepal's health emergency preparedness for disaster and public health emergencies.
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JNMA J Nepal Med Assoc · Jul 2024
MEST C Score and Treatment Response in IgA Nephropathy in a Tertiary Care Hospital: A Descriptive Cross-sectional Study.
IgA nephropathy is the leading cause of primary glomerulonephritis worldwide. The Oxford classification can predict IgA nephropathy prognosis through renal biopsy however its applicability to the Nepalese population remains unexplored. This study aimed to evaluate the MEST-C score and treatment response in patients with IgA nephropathy. ⋯ The S1 and T1/2 components of the MEST-C score had higher rates of partial remission and progression to end-stage renal disease, while other indices showed mixed results. The risk of failing to achieve complete increased with an IFTA of more than 25%.
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JNMA J Nepal Med Assoc · Jul 2024
Case ReportsLevamisole Induced Agranulocytosis in a Child with Steroid Dependent Nephrotic Syndrome: A Case Report.
Levamisole has been used as an effective immunomodulator. Levamisole has been used for nephrotic syndrome due to its immunostimulant, immunomodulating, and steroid-sparing effects. ⋯ This is a case report of a 5-year-old girl who had steroid-dependent nephrotic syndrome for which she was started on levamisole as per her weight, following which she had falling total leukocyte count levels on every visit. Thus, this case report emphasizes identifying this rare side effect and its management.