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1.
Clin Case Rep ; 11(2): e6965, 2023 Feb.
Article in English | MEDLINE | ID: mdl-36817313

ABSTRACT

Osler-Weber-Rendu syndrome is an uncommon vascular disorder inherited as an autosomal dominant trait with varying penetrance and expression. A multidisciplinary approach is used for a detailed diagnostic workup and management based on the patient's symptoms at presentation.

2.
JNMA J Nepal Med Assoc ; 60(246): 214-217, 2022 Feb 15.
Article in English | MEDLINE | ID: mdl-35210641

ABSTRACT

Influenza has a common occurrence during its peak seasons. It usually causes disease of the respiratory tract including severe acute respiratory distress syndrome. However, it may also cause disease and complication of other organ systems. We present a rare complication of influenza in which a patient secondary to influenza developed massive middle cerebral artery ischemic stroke. The patient however survived following recovery of both severe acute respiratory distress syndrome and ischemic stroke after decompressive craniectomy and a prolonged intensive care unit stay. This case report is to highlight the importance of influenza related complications besides the pulmonary infliction which can lead to morbidity and even mortality if not managed on time.


Subject(s)
Influenza A Virus, H1N1 Subtype , Influenza, Human , Ischemic Stroke , Respiratory Distress Syndrome , Humans , Influenza, Human/complications , Influenza, Human/diagnosis , Middle Cerebral Artery , Respiratory Distress Syndrome/etiology
3.
JNMA J Nepal Med Assoc ; 60(254): 902-905, 2022 Oct 01.
Article in English | MEDLINE | ID: mdl-36705150

ABSTRACT

Vogt-Koyanagi-Harada disease is a multisystem autoimmune inflammatory disorder that affects the eyes, ears, skin, and the nervous system. It is a rare disease that mainly affects Asian, Hispanic, and Middle Eastern populations. Systemic steroids and immunosuppressants are frequently used to treat autoimmune diseases like this. Despite the fact that they reduce morbidity, immunosuppressants can have a number of side effects and are difficult to use, particularly when treating uncommon autoimmune illnesses. We present a case of a 56-year-old man who visited our health facility complaining of increased tears in both eyes along with bilateral blurring of vision. He was subsequently identified as having Vogt-Koyanagi-Harada disease. After prednisolone and methotrexate failed to have the desired effect, he was treated with azathioprine, which caused pancytopenia, and manifested as fever with positive blood culture for a coagulase-negative staphylococcus infection. Keywords: case reports; pancytopenia; steroid.


Subject(s)
Pancytopenia , Uveomeningoencephalitic Syndrome , Male , Humans , Middle Aged , Azathioprine/adverse effects , Uveomeningoencephalitic Syndrome/chemically induced , Uveomeningoencephalitic Syndrome/diagnosis , Uveomeningoencephalitic Syndrome/drug therapy , Pancytopenia/chemically induced , Prednisolone/therapeutic use , Immunosuppressive Agents/adverse effects
4.
JNMA J Nepal Med Assoc ; 60(251): 648-650, 2022 Jul 01.
Article in English | MEDLINE | ID: mdl-36705189

ABSTRACT

Hemodialysis is one of the treatment modalities for advanced kidney disease and can help an individual live an active life despite failing kidneys. Although it improves the quality of life, it is not completely risk-free. It has several complications, among which, thrombus formation is common. We report a case of a 63-year-old man who presented at our institution for regular hemodialysis with recurrent arteriovenous graft failure. Because doppler ultrasound is a non-invasive procedure that can identify a thrombus in a vein, it is the best initial option for patients with internal jugular vein thrombosis. The use of ultrasound not only can guide a catheter pathway but can also help in early diagnosis and prevent complications following catheterization in a vein with a thrombus. Keywords: central venous catheterization; chronic kidney disease; hemodialysis; thrombus.


Subject(s)
Catheterization, Central Venous , Central Venous Catheters , Thrombosis , Male , Humans , Middle Aged , Renal Dialysis/adverse effects , Renal Dialysis/methods , Central Venous Catheters/adverse effects , Quality of Life , Catheterization, Central Venous/adverse effects , Catheterization, Central Venous/methods , Thrombosis/diagnostic imaging , Thrombosis/etiology
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