Purpose: To provide evidence-based recommendations to practicing clinicians on the management of patients with small-cell lung cancer.
Methods: An Expert Panel of medical oncology, thoracic surgery, radiation oncology, pulmonary, community oncology, research methodology, and advocacy experts were convened to conduct a literature search, which included systematic reviews, meta-analyses, and randomized controlled trials published from 1990 through 2022. Outcomes of interest included response rates, overall survival, disease-free survival or recurrence-free survival, and quality of life.
Introduction: Existing tests for the diagnosis of pleural tuberculosis (TB) have major limitations in terms of accuracy, time to diagnosis and drug resistance testing. A test which can diagnose pleural TB and detect resistance, like Xpert MTB/Rif, would be optimal for rapid diagnosis and treatment.
Methods: A prospective observational study was done in a tertiary care hospital in Eastern Nepal.
Hepatitis A virus infection is the commonest form of hepatitis in pediatric age group and common health problem in developing countries due to poor sanitation. The clinical spectrum of hepatitis A virus infection ranges from asymptomatic infection to fulminant hepatitis and the symptoms are primarily hepatobiliary or constitutional. Here, we present a case of 16 years old male who presented with complains of fever, vomiting, anorexia, right sided abdominal pain, shortness of breath and cough.
View Article and Find Full Text PDFIntroduction: and importance: We reported a case of secondary spontaneous pneumothorax (SSP) in a 70-years-old male with acute exacerbation of COPD (AE COPD) managed with improvised chest tube drain (ICD).
Case Presentation: He presented with sudden onset breathlessness and oxygen saturation of 78%. With prolonged expiration on auscultation, he was treated as AE COPD with oxygen therapy, nebulization with albuterol/ipratropium, and injectable antibiotics and steroids.
JNMA J Nepal Med Assoc
February 2022
Small cell lung cancer mostly arises centrally in the large bronchi. The literature search revealed very limited cases of small cell lung cancer arising at the upper part of the pulmonary sulcus near the thoracic inlet as superior sulcus tumor and also manifesting with typical Pancoast syndrome. We report a case of a 71 years old male patient, presenting with features of Pancoast syndrome including Horner's syndrome with completed three cycles of chemotherapy resulting in partial response which concludes that small cell lung carcinoma has to be considered despite the clinical findings like pancoast syndrome.
View Article and Find Full Text PDFJNMA J Nepal Med Assoc
November 2021
Non-bacterial thrombotic endocarditis is a rare condition characterized by noninfectious vegetation on cardiac valves which are often associated with malignancy. It often presents with features of embolism rather than cardiac failure. These are usually seen in autoimmune conditions, disseminated intravascular coagulation, malignancy of gut and lung but has also been reported in other malignancies as well.
View Article and Find Full Text PDFIntroduction: Pleurodesis is a procedure to achieve symphysis between the two layers of pleura aimed at preventing the accumulation of either air or fluid in the pleural space. In Nepal, intrapleural instillation of the chemical sclerosing agent is more commonly done as thoracoscopy facility is not easily available. However, iodopovidone is rarely used for this purpose in Nepal.
View Article and Find Full Text PDFIt is unusual to be able to visualize an entire cavity with such clarity.
View Article and Find Full Text PDFJNMA J Nepal Med Assoc
April 2020
Lung is the second most common site of hydatid disease, after liver. Pleural involvement of hydatid disease can occur, and usually follows the rupture of a pulmonary or hepatic hydatid cyst into the pleural space. When a patient presents with tension pneumothorax, zoonotic infections, especially hydatid disease of the lung, also has to be considered especially in areas with high burden of the disease.
View Article and Find Full Text PDFIntroduction: Anemia due to iron deficiency and chronic diseases is common occurrence in developing country like Nepal, the latter seen in patients with various inflammatory, autoimmune, and malignant disorders . The Intensive method of marrow iron examination, which this study has employed, provides clinically useful iron status classification in cases of functional iron deficiency. The aim of the study is to find out the prevalence of iron deficiency anemia in biochemically defined moderate to severe anemic patients in tertiary care center.
View Article and Find Full Text PDFBackground: Tobacco consumption is considered as one of the major risk factors for cardiovascular (CV) morbidity. However, the effect of paan masala tobacco (PMT) (a type of smokeless tobacco) consumption has not been well studied in our context. Our study is aimed to find an association of CV risk factors between PMT users and nonusers and to correlate those parameters with urinary cotinine level, a degradation product of nicotine occurring in tobacco.
View Article and Find Full Text PDFJNMA J Nepal Med Assoc
October 2019
Solvent abuse, as inhalant specially, in the form of low cost adhesives like dendrite is common in low income countries among children and the teens. This habit is often a stepping stone to harder drugs. The neurological and neuropsychological effects of solvent abuse are well explored.
View Article and Find Full Text PDFBackground: Drug-induced hypersensitivity reaction is of great clinical significance in therapeutics. The objective of this reporting of two cases is to show that anaphylaxis reaction can occur with pantoprazole.
Case Summaries: A 38-year-old female reported to the emergency ward in a critical condition, with a history of periorbital edema, edema of the skin, pruritus, nausea, vomiting, and difficulty breathing 20 minutes after ingestion of a pantoprazole 40 mg tablet.
Introduction: Ventilator associated pneumonia is an important intensive care unit acquired infection in mechanically ventilated patients. Early and correct diagnosis of Ventilator associated pneumonia is difficult but is an urgent challenge for an optimal antibiotic treatment.
Methods: A prospective observational study was conducted in Intensive Care Unit of a tertiary care hospital in Nepal.
http://ow.ly/M8MD3021q6n.
View Article and Find Full Text PDFERS hosted a 3-day course on thoracic imaging in Barcelona, Spain http://ow.ly/Y767p.
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