Cardiac tamponade with scleroderma renal crisis in systemic sclerosis: a case report.

Introduction And Importance: Systemic sclerosis (SSc) is a rare autoimmune disease characterized by fibrosis of internal organs and vasculopathy. It commonly involves the skin and multiple organs, including the kidneys and cardiovascular system. Cardiac tamponade in SSc is an uncommon manifestation, often occurring alongside scleroderma renal crisis (SRC).

Coexisting systemic lupus erythematosus with lupus nephritis and sickle cell trait: a case report of rare combination.

Introduction And Importance: Systemic lupus erythematosus (SLE) and sickle cell disease (SCD) are relatively common disorders but their coexistence in an individual is rare. Because of the similarities in the musculoskeletal, central nervous system, and renal manifestations in both diseases, diagnosis of SLE in patients with SCD can be difficult to establish. Both the SCD and sickle cell trait (SCT) can have a cumulative assault in the progression of chronic kidney disease (CKD).

Wild honey grayanotoxin intoxication in rural Himalayan region of Nepal: a case report.

Introduction And Importance: Wild honey from Nepal's Himalayas contains grayanotoxin, derived from rhododendron flowers, and is used in alternative medicine. However, it can cause severe side effects like vomiting, hypotension, and bradycardia.

Case Presentation: A 52-year-old baker from Chame, Manang, Nepal experienced dizziness, vomiting, sweating, and hypersalivation 30 minutes after consuming a teaspoon of wild honey for mild abdominal pain.

Pediatric eosinophilic granulomatosis with polyangiitis presenting as a mediastinal mass in a 6-year-old boy.

Eosinophilic granulomatosis with polyangiitis (EGPA) is a small vessel vasculitis characterized by asthma, eosinophilia, and small vessel necrotizing granulomatosis with annual incidence of 0.5-4.2 cases per million.

Giant perineal lipoma: A rare case report.

Introduction And Importance: Lipomas are one of the most common benign tumors. The perineum, head, and acral areas are uncommon sites that require careful differential diagnosis and imaging.

Case Presentation: We here report a case of a 39-year-old female with a mass in the groin region.

Overuse of tetanus toxoid vaccine: a common but under-addressed issue in Nepal.

Introduction And Importance: Tetanus, though potentially fatal, is preventable with proper vaccination, but high tetanus titers from frequent or higher doses can lead to increased adverse events. In countries like Nepal, where tetanus vaccines are readily available over the counter, irrational and frequent dosing, especially in certain occupational groups, is a noted issue.

Case Presentation: A 28-year-old metal worker presented with a superficial cut on his forearm, managed with standard wound care, and reported a history of frequent tetanus vaccinations.

Use of ketamine in Super Refractory Status Epilepticus: a systematic review.

Objective: This review specifically investigates ketamine's role in SRSE management.

Methods: PubMed, EMBASE, and Google Scholar databases were searched from inception to May 1st, 2023, for English-language literature. Inclusion criteria encompassed studies on SRSE in humans of all ages and genders treated with ketamine.

Amyotrophic lateral sclerosis with respiratory failure and dysautonomia: a case report.

Unlabelled: Amyotrophic lateral sclerosis (ALS) is a disease that affects both upper and lower motor neurons, causing a range of symptoms beyond the motor system. Recent research has shown that the autonomic nervous system can also be affected, with symptoms such as orthostatic hypotension, fluctuations in blood pressure, and dizziness being reported.

Case Presentation: A 58-year-old male presented with left lower limb limping, difficulty climbing stairs, and left foot weakness, followed by right upper limb weakness and was diagnosed with ALS and received edaravone and riluzole treatment.

Organizing pneumonia as an initial presentation in a male lupus: A rare case report.

Organizing pneumonia (OP) is one of the rare pulmonary manifestations of systemic lupus erythematosus (SLE) which is infrequently reported as a presenting manifestation. Early diagnosis of lupus-related OP with the help of imaging, can drive to prompt initiation of immunosuppressive therapy leading to a better prognosis. We present a case of a 34-year-old young male who presented with fever, myalgia, and a dry cough for 1 month and was later diagnosed as SLE-related organizing pneumonia.

Painful tonic spasms in a patient with neuromyelitis optica spectrum disorder: A case report.

Painful tonic spasms initially described in association with multiple sclerosis are actually more common in patients with neuromyelitis optica spectrum disorder. Characterized by fierce pain and tonic posture of limbs, painful tonic spasms are common in patients during the recovery phase after the first episode of myelitis. A 68-year-old man presented with painful tonic spasm after 2 months of diagnosis of neuromyelitis optica spectrum disorder.

Severe hepatitis E infection in pregnancy: a case report.

Unlabelled: Hepatitis E virus causes self limiting hepatitis most of the times but, during pregnancy it can lead to severe hepatitis along with various complications thereby increasing the mortality.

Case Presentation: A 27-year-old woman gravida two, para one at 38 weeks and 6 days of gestation presented with multiple episodes of nonbilious vomiting, severe dehydration, and later developed right upper quadrant abdominal pain. The patient had a positive serological test for the hepatitis E virus, and liver enzymes were severely elevated.

Guillain-Barré syndrome complicating early pregnancy: a case report from Nepal.

Unlabelled: Guillain-Barré syndrome (GBS) is an immunological demyelinating disorder characterized by progressive, ascending flaccid weakness, usually resulting after infection or some immune stimulation. Its occurrence during pregnancy is rare and due to attribution of its symptoms to pregnancy, diagnosis might be delayed.

Case Presentation: A 39-year-old G4P3L2A0 woman at 13 weeks 6 days period of gestation presented with acute, symmetrical, ascending type of flaccid quadriparesis leading to slurring of speech, swallowing difficulty, and eventually respiratory failure.

Pregnancy in an isthmocele: A rare case from Nepal.

An infrequent form of ectopic pregnancy, pregnancy in an isthmocele can be hazardous due to hemorrhage or uterine rupture. With no clear guidelines for the management of this condition, surgery is the preferred option.

Porokeratosis of gluteal region: A case report.

Genitogluteal porokeratosis is a rare localized disorder of keratinization. Due to the rarity of the case and non-specific keratotic lesion, it is often misdiagnosed until a histological examination is performed. Treatment of this condition can be challenging, which comprises various topical and systemic drugs, lasers, cryotherapy, phototherapy, and also surgical intervention.

Cyst of rete ovarii: A case report.

Rete ovarii giving rise to cysts, and benign and malignant tumors is a rare entity. Radiological and histopathological examinations can be used to make the diagnosis of rete cyst and differentiate it from cystic tumor of ovarian origin, with surgery being the treatment of choice.

Successful management of postpartum hemorrhage and surgical site infection in a pregnant woman under warfarin for heart valve replacement: A case report.

Introduction And Importance: Pregnant women under warfarin for mechanical heart valves can pose a variety of challenges which requires fine tuning of various anticoagulants throughout the pregnancy and in the postpartum period as hemorrhage can lead to maternal and fetal morbidity and mortality.

Case Presentation: A 36-year-old woman gravida two, para one at 35 weeks 5 days gestation, with hypothyroidism with mitral valve replacement and tricuspid valve repair due to rheumatic heart disease underwent emergency lower section cesarean section for fetal bradycardia. B-lynch suturing was eventually done to control atonic postpartum hemorrhage.

Thoraco-omphalopagus conjoined twin: A rare case report.

Introduction And Importance: Conjoined twins represent a rare phenomenon and the etiology has not been clarified yet. There is a high rate of stillbirth and neonatal deaths resulting in very few cases surviving long enough for surgical separation.

Case Presentation: A 33-year-old gravida 2 para 1 mother without any first and second trimester antenatal care visits was diagnosed to have conjoined twins in the third trimester.

Pure Sertoli cell tumor of the ovary: A case report.

Pure Sertoli cell tumors are an uncommon variant of rare ovarian Sertoli-Leydig cell tumors. Due to nonspecific clinical and imaging features, diagnosis is often made after histopathological examination. The prognosis is excellent as most are detected in the early stages and surgical resection is often curative in most cases.

Guillain-Barré syndrome associated with Coronavirus disease 2019: A case from Nepal.

Coronavirus disease 2019 (COVID-19) has now spread widely after the outbreak since December 31, 2019. Guillain-Barré syndrome is an immunological postinfectious neuropathy, which has been reported to be a rare but possible complication COVID-19. We report a case of Guillain-Barré syndrome associated with COVID-19 in Nepal.

Clinical spectrum and management of dystonia in patients with Japanese encephalitis: A systematic review.

Background: Japanese encephalitis (JE) is a potentially fatal viral infection with a wide range of manifestations and can also present with a variety of movement disorders (MD) including dystonia. Dystonic features in JE are uncommon. Here, we have tried to summarize the clinical features and management of dystonia among JE patients with a comprehensive literature search.

Prevalence of vancomycin-resistant enterococci in Asia-A systematic review and meta-analysis.

What Is Known And Objective: The rise of vancomycin-resistant enterococci (VRE) has been a major health problem in most countries of the world including Asia, since its discovery. There is a paucity of data on VRE in many countries of Asia as well as limited pooled estimates. Therefore, we performed a systematic review and meta-analysis to estimate a pooled prevalence of VRE in Asia.