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Introduction: Castleman's disease (CD), or benign angio-follicular lymph node hyperplasia, is an uncommon condition in childhood. When a child presents with a huge retroperitoneal mass and inconclusive findings on clinico-radiological evaluation or tissue sampling, management becomes exceedingly difficult. CD herein becomes an uncommon presentation of an uncommon diagnosis. Case presentation: A six-year-old girl with no past medical problems presented to the office with a slowly progressive, painless mass over the right lumbar region for a year. Abdominal ultrasound showed a well-defined oval mass in the right periumbilical region, further evaluation of which with a computed tomography scan suggested lymphoma. A preoperative core-cut biopsy could not confirm the findings and suggested a neoplastic lesion, probably an inflammatory myofibroblastic tumour or small round cell tumour. She underwent an exploratory laparotomy with in-toto excision of the mass. Intraoperatively, a solid retroperitoneal tumour measuring 8×8×6 cm was found. Histopathology and immunohistochemistry confirmed a unicentric CD of the hyaline-vascular type. At two years of follow-up, she remained asymptomatic and disease-free. Conclusion: While CD in children is rare, retroperitoneal localization of the same can further add to the diagnostic conundrum. However, if carefully considered, an en-bloc surgical resection offers complete treatment.
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Key Clinical message: Fascioliasis poses diagnostic challenges to clinicians for its broad spectrum of hepatobiliary symptoms and lower detection rates. Timely and precise identification avoids long-standing hepatic complications. Abstract: Fasciola hepatica, a trematode parasite, inhabits snails and sheep. Human hepatic fascioliasis is a neglected tropical disease with no specific tests. In this instance, the significance of clinical awareness, appropriate imaging, and serological investigations is demonstrated. A young Nepalese girl was diagnosed and managed successfully.
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INTRODUCTION: Vitamin B-12 deficiency is a frequent condition in the elderly population. High homocysteine levels, which can contribute to arterial damage and blood clots in blood vessels, usually indicate a deficiency in vitamin B-12. Different studies have shown an association of raised total homocysteine with incident Alzheimer's disease. This study aimed to evaluate the association between vitamin B-12 levels and the risk of Alzheimer's disease (AD). METHODS: A case-control study with a sample size of 90 was conducted at Tertiary hospital, Kathmandu. The participants who visited the psychiatric outpatient department from 2019 onward at Tertiary hospital, Kathmandu, were recruited. The Mini-Mental State Examination (MMSE) was administered to the participants by a trained medical doctor. The medical doctor used the MMSE scores to classify the participants into two groups: the healthy control group and the AD group. RESULTS: The AD group had higher percentages of hypertension (20.9%), diabetes (13.6%), smoking habit (27.3%), vitamin B-12 deficiency (22.7%), and alcohol consumption (13.8%) relative to the control group. Among these features, a significant association was found between alcohol and vitamin B-12 status and between systolic blood pressure and MMSE score. CONCLUSION: This study concluded that there is an association between low levels of vitamin B-12 and the risk of AD. Further studies are needed to determine the cause-effect.
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INTRODUCTION: The study of clinical anatomy is inseparable from cadaveric dissection. However, scarcity of cadavers is observed all over the world. So, body donation is propounded and is a major source of cadavers worldwide. However, nowadays, there is a scarcity of cadavers for the body dissection in the medical course & also due to the rise in the number of medical institutions in Nepal. This research aimed to find out the knowledge of medical and nursing students at a medical college regarding human body and organ donation. METHODS: A descriptive cross-sectional study was conducted among 400 medical and nursing students in a tertiary care hospital of Kathmandu valley. After obtaining ethical approval, a semistructured questionnaire was used to collect the data. Data were analyzed using Statistical Package for Social Sciences version 20.0. RESULTS: Most of the respondents, 360 (90%) knew that organs could be donated from living donors as well as cadavers. A majority of the respondents 374 (93.5%) said that bodies could be donated for educational and learning purposes. The eyes were the most commonly donated organ. One hundred seventy five (43.5%) of the respondents were motivated to donate their bodies or organs. Self-motivation followed by motivation through media by celebrities, family members, and faculties were seen among the participants. CONCLUSIONS: We need a proper voluntary body donation act to facilitate medical teaching with the proper motivation of people for this generous gift to further the knowledge and expand the field of medical science.