Arthroscopic management of recurrent synovial chondromatosis of the hip: a case report.

Synovial chondromatosis is a rare condition characterized by the chondral proliferation of synovium forming loose bodies which can lead to pain, swelling, and decreased range of movement of the affected joint. Case presentation: Here the authors report a case of eighteen years lady with recurrent hip synovial chondromatosis who was treated previously with hip arthrotomy and loose bodies removal and now she underwent arthroscopic loose bodies removal with partial synovectomy. Clinical discussion: In comparison to arthrotomy of the hip, arthroscopic management is a minimally invasive surgery that is associated with decreased postoperative pain, earlier improvement in range of motion, a shorter course of rehabilitation, and overall lower morbidity. Conclusion: Thus, the authors recommend arthroscopic removal of the loose bodies and partial synovectomy for the management of synovial chondromatosis of the hip.

Anterior Cruciate Ligament Tear Using Magnetic Resonance Imaging among Patients Undergoing Arthroscopy in a Tertiary Care Centre: A Descriptive Cross-sectional Study.

Introduction: Magnetic Resonance Imaging is the preferred imaging modality in patients having anterior cruciate ligament tears. The aim of this study was to find out the prevalence of anterior cruciate ligament tears using magnetic resonance imaging among patients undergoing arthroscopy in a tertiary care centre. Methods: A descriptive cross-sectional study was conducted in the Department of Orthopaedics and Traumatology of a tertiary care centre. Data from 17 November 2017 to 17 October 2022 were collected between 26 December 2022 and 30 December 2022 from the hospital records. Ethical approval was obtained from Institutinal Review Committee of the same institute (Reference number: 233/22). All patients with a knee injury who received arthroscopy were included in the study. Magnetic resonance imaging reports, arthroscopic findings and relevant data of each case were retrieved from the medical case records of patients. Convenience sampling method was used. Point estimate and 95% Confidence Interval were calculated. Results: Among patients with arthroscopy confirmed anterior cruciate ligament tear, 138 (91.39%) (86.92 to 95.86, 95% Confidence Interval) had anterior cruciate ligament tear diagnosed with magnetic resonance imaging. The mean age of the patients who had anterior cruciate ligament tear in the magnetic resonance imaging was 32.35±11.31 years. Out of them, 87 (63%) were males and 51 (37%) were females. The mean duration of the injury was 11.60±18.47 months. Conclusions: The prevalence of anterior cruciate ligament tear using magnetic resonance imaging among patients undergoing arthroscopy in tertiary care centres was similar when compared to other similar studies when conducted in similar settings. Keywords: anterior cruciate ligament tears; arthroscopy; cross-sectional studies; MRI.

Scar Pregnancy a Diagnostic Conundrum: A Case Report.

Cesarean scar pregnancy is a rare form of ectopic pregnancy which may lead to uterine rupture and catastrophic hemorrhage. We report a case of cesarean scar pregnancy in a 35-year-old female with the past history of cesarean section presented with complaints of amenorrhoea for 6 weeks and non-specific  pain. Two Transvaginal sonography was done 48 hours apart which suggested a cesarean scar pregnancy in one and cervical pregnancy on the other. Magnetic Resonace Imaging showed a well-defined cystic lesion of (21x19)mm2 embedded within the previous cesarean scar which confirmed the diagnosis of cesarean scar pregnancy. Laparotomy unveiled uterus around 6 weeks size and a (3x3)cm2 bulge was noted at the site of previous scar in lower uterine segment, where a small incision was given and the gestational sac was removed following which the uterine incision was closed with 2-0 polyglactin suture. High index of suspicion and prompt diagnosis is ofparamount for reducing morbidity and mortality.

Cotrimoxazole Induced Steven Johnson Syndrome: A Case Report.

Steven Johnson syndrome and toxic epidermal necrolysis are severe and rare adverse drug reactions usually caused by drugs like antiepileptics, penicillin and allopurinol and sometimes also due to infections, malignancy or idiopathic in some cases. Here we are reporting a case of a 50 years female who came with complaint of a burning sensation on the upper half of the body with atypical flat target lesion that later coalesced involving her face, chest and bilateral upper limbs. On examination, positive nikolsky sign and tenderness with <10% body surface area involvement was noticed. The diagnosis of cotrimoxazole induced Steven Johnson syndrome was made. Patient was shifted to ICU and given supportive care along with prophylactic teicoplanin, itraconazole and dexamethasone. The mechanism of eruptions in our patient was due to cotrimoxazole. Cotrimoxazole induced Steven Johnson syndrome is rare and the supportive management with broad spectrum antibiotic and the corticosteroid was enough to beat this life-threatening condition. Keywords: cotrimoxazole; pneumonia; Steven Johnson syndrome.

Left Chronic Otitis Media with Squamous Cell Carcinoma of the Middle Ear and Postauricular Mastoid Fistula: A Case Report.

Though squamous cell carcinoma is the commonest tumor, it rarely presents in the middle ear and follows a history of chronic ear discharge. Postauricular mastoid fistula is also a rare complication of chronic otitis media. These two pathological changes occurring simultaneously are even rarer. We report a rare case of a 37 years old male with a history of left-sided chronic ear discharge and conductive hearing loss. Squamous cell carcinoma along with postauricular mastoid fistula was diagnosed based on high-resolution computed tomography scan and histopathology. Left modified radical mastoidectomy with tympanic membrane grafting was done under general anesthesia. Often middle ear tumor is associated with long-standing ear discharge and this case is a very good example. The co-occurrence of the middle ear tumor with mastoid fistula is extremely rare as both the entities are rare in itself.

Full-time Studies and Volunteering.

Our volunteering began being a part of the editorial support team in the Journal of Nepal Medical Association. This has really built up our confidence to work as a team. During our days in Journal Office, a sudden knock of another opportunity stroke our door. The Administrative Officer of Nepal Medical Association asked us about volunteering in the Election of Nepal Medical Association which held from 17th to 21st Magh, 2076 and we accepted it. We also helped NMA during the pre-election procedure that needs to be done before going for the election. We think that was the work where we got the trust of NMA officers.