JNMA; journal of the Nepal Medical Association
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JNMA J Nepal Med Assoc · Jan 2024
Case ReportsJejunovesical Fistula Diagnosis After Normal Vaginal Delivery: A Case Report.
Enterovesical fistula represents an abnormal communication between the intestine and bladder. The causes are diverticulitis (56.3%), malignant tumours, which are located mainly in the intestine (20.1%), and Crohn's disease (9.1%). Other causes include iatrogenic injury (3.2%); trauma; foreign bodies in the intestinal tract; radiotherapy; chronic appendicitis; tuberculosis; and syphilis. Normal vaginal delivery as a cause for enterovesical fistula has not been reported in many publications yet. We report a case of a 30-year-old female, who developed an jejunovesical fistula after normal vaginal delivery. It was diagnosed after diagnostic cystoscopy and computed tomography of the abdomen and pelvis. There was jejuno-vesical fistula. Resection of the segment of the jejunum with side-to-side anastomosis with bladder repair was done. A follow-up cystogram was done which showed no contrast extravasation into the peritoneum. The patient was followed up for 9 months after surgery. ⋯ case reports; fistula; jejunum; urinary bladder.
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JNMA J Nepal Med Assoc · Jan 2024
Case ReportsPrimary Sjogren's Syndrome with Bicytopenia: A Case Report.
Sjogren's syndrome is a chronic multisystem autoimmune disease presenting a wide variety of clinical manifestations ranging from mild sicca symptoms to severe systemic symptoms involving pulmonary, renal, musculoskeletal, cutaneous, and haematological diseases. These symptomatic diversities can delay the correct diagnosis of Sjogren's Syndrome for a long time. Here, we report the case of a 59-year-old woman with fatigue and weakness in whom bicytopenia was documented. A thorough bicytopenia workup brought us to the final diagnosis of Sjogren's syndrome. Hydroxychloroquine was started which normalized the patient's blood parameters and clinical symptoms. The haematological alterations in Sjogren's syndrome are not pathognomonic. However, only bicytopenia can be the initial presentation of Sjogren's syndrome as in our patient. Therefore, inexplicable bicytopenia in a middle-aged female may alert the clinician about the possibility of Sjogren's syndrome. ⋯ autoimmune diseases; case reports; cytopenia; sjogren's syndrome.
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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 · Jan 2024
Diabetes Mellitus among Patients with Acute Ischemic Stroke Admitted to the Department of Medicine in a Tertiary Care Center.
Diabetes mellitus is a major public health concern and a continuously growing chronic disease worldwide. Diabetes mellitus is one of the modifiable, independent, and major risk factors of ischemic stroke. This study aimed to find the prevalence of diabetes mellitus among patients with acute ischemic stroke admitted to the Department of Medicine in a tertiary care centre. ⋯ diabetes mellitus; glycated hemoglobin; ischemic stroke.
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JNMA J Nepal Med Assoc · Jan 2024
Anterior Cruciate Ligament Reconstruction with Semitendinosus Tendon Autograft among Paramilitary Patients Undergoing Arthroscopic Surgery in a Tertiary Care Centre.
In orthopaedic practice, injuries to the anterior cruciate ligaments occur almost on an epidemic scale, yet it continues to be of interest in orthopaedic surgery whether semitendinosus or gracilis hamstring autografts can be used for better anterior cruciate ligament reconstruction. This study aimed to determine the prevalence of anterior cruciate ligament reconstruction using semitendinosus tendon autografts among paramilitary patients undergoing arthroscopic surgery in a tertiary care centre. ⋯ anterior cruciate ligament; grafts; semitendinosus tendon.