A Case of BRASH Syndrome Presenting With Refractory Hyperkalemia Requiring Intermittent Hemodialysis.

BRASH syndrome characterized by bradycardia, renal dysfunction, atrioventricular nodal blockade (AVNB), shock, and hyperkalemia presents diagnostic and management challenges due to its complex pathophysiology and varied clinical presentations. We describe a 90-year-old woman with a history of multiple comorbidities who was on beta blockers bisoprolol for heart failure, presented with shock, refractory hyperkalemia along with bradycardia that required intermittent hemodialysis. Initial management involved aggressive hyperkalemia medical therapy and fluid resuscitation, with subsequent consideration of renal replacement therapy hemodialysis following collaboration with a multidisciplinary team, including cardiology and nephrology specialists.

Dengue virus surveillance in Nepal yields the first on-site whole genome sequences of isolates from the 2022 outbreak.

Background: The 4 serotypes of dengue virus (DENV1-4) can each cause potentially deadly dengue disease, and are spreading globally from tropical and subtropical areas to more temperate ones. Nepal provides a microcosm of this global phenomenon, having met each of these grim benchmarks. To better understand DENV transmission dynamics and spread into new areas, we chose to study dengue in Nepal and, in so doing, to build the onsite infrastructure needed to manage future, larger studies.

Rectal foreign body and its association with social stigma and mental health: A case report.

Introduction: Rectal foreign bodies (FB), as a cause of surgical emergency are on the rise. The management is usually uneventful but delays in presentation are associated with complications and morbidity. Psychiatric illnesses account for a vast majority of FB insertion cases which is usually overlooked.

Dengue Virus Surveillance in Nepal Yields the First On-Site Whole Genome Sequences of Isolates from the 2022 Outbreak.

Background: The 4 serotypes of dengue virus (DENV1-4) can each cause potentially deadly dengue disease, and are spreading globally from tropical and subtropical areas to more temperate ones. Nepal provides a microcosm of this global phenomenon, having met each of these grim benchmarks. To better understand DENV transmission dynamics and spread into new areas, we chose to study dengue in Nepal and, in so doing, to build the onsite infrastructure needed to manage future, larger studies.

Pyopericardium progressing to cardiac tamponade in a patient with dengue fever.

Pyopericardium is a rare cause of cardiac tamponade. We present a case of a dengue fever patient who presented with cellulitis of the upper limbs, later manifesting cardiac tamponade, which was fatal. Although echocardiography on admission revealed a small pericardial effusion only, it later manifested as tamponade, causing cardiogenic shock.

Ancient hybridization and repetitive element proliferation in the evolutionary history of the monocot genus (Zingiberaceae).

Genome size variation is a crucial aspect of plant evolution, influenced by a complex interplay of factors. Repetitive elements, which are fundamental components of genomic architecture, often play a role in genome expansion by selectively amplifying specific repeat motifs. This study focuses on , a genus in the ginger family (Zingiberaceae), known for its 4.

Assessment of severity and feto-maternal outcomes among COVID-19 infected pregnant females hospitalized at tertiary care center in western Nepal.

Objective: There is a paucity of data assessing the severity of coronavirus disease 2019 (COVID-19) infection and feto-maternal outcomes in pregnant women in Nepal, especially during the third wave of the pandemic with the Delta variant. This study aimed to severity as well as maternal-fetal outcomes among pregnant women with COVID-19 infection.

Methods: In this cross-sectional study carried out amongst COVID-19 positive pregnant women visiting our institution for 6 months from January through June 2022, data surrounding COVID-19 severity and fetal outcomes were collected in a structured questionnaire.

Role of pre-operative counseling with NSQIP surgical risk calculator in the surgical patients.

Introduction: Patient satisfaction is important tool to monitor health care performance and quality of health plans, emphasizing effective counseling and consent processes. The objective of the study is to assess patient satisfaction and anxiety with the use of NSQIP surgical risk calculator in comparison to standardized questionnaires.

Methodology: This is an interventional prospective randomized study.

Dyslipidemia among Patients with Type 2 Diabetes Mellitus Visiting a Tertiary Care Centre.

Introduction: A triad of lipid and lipoprotein metabolism is known as dyslipidemia. Dyslipidemia is one of the major risk factors for cardiovascular diseases in diabetes mellitus which is a leading cause of morbidity and mortality worldwide. The aim of the study was to find out the prevalence of dyslipidemia among patients with type 2 diabetes mellitus visiting a tertiary care centre.

An unusual case report of transverse vaginal septum presenting as primary amenorrhea.

Introduction And Importance: Outflow tract disorders are uncommon causes of primary amenorrhea. Transverse vaginal septum (TVS) is a rare cause of outflow tract obstruction.

Case Presentation: A 15-year-old female presented to us with severe abdominal pain.

Neostigmine and atropine as a treatment for postdural puncture headache after spinal anesthesia in cesarean section: A case report.

Key Clinical Message: Neostigmine and atropine offer a promising treatment option for postdural puncture headache (PDPH) following spinal anesthesia in cesarean section, providing effective relief with a favorable risk-benefit profile.

Abstract: Postdural puncture headache (PDPH) is a common consequence of cesarean section surgeries after spinal anesthesia. This case study describes the successful treatment of PDPH with intravenous neostigmine and atropine.

Removing knotted or stuck epidural catheters: a systematic review of case reports.

Background: The knotting or in vivo entrapment of epidural catheters is an uncommon but challenging issue for anesthesiologists. This study aimed to identify the possible causes behind entrapped epidural catheters and the effective methods for their removal.

Methods: A systematic review of relevant case reports and series was conducted using the patient/population, intervention, comparison and outcome framework and keywords such as "epidural," "catheter," "knotting," "stuck," "entrapped," and "entrapment.

Drug Delivery Systems for Personal Healthcare by Smart Wearable Patch System.

Smart wearable patch systems that combine biosensing and therapeutic components have emerged as promising approaches for personalized healthcare and therapeutic platforms that enable self-administered, noninvasive, user-friendly, and long-acting smart drug delivery. Sensing components can continuously monitor physiological and biochemical parameters, and the monitoring signals can be transferred to various stimuli using actuators. In therapeutic components, stimuli-responsive carrier-based drug delivery systems (DDSs) provide on-demand drug delivery in a closed-loop manner.

A rare case of Boerhaave syndrome with cervico-thoracic esophageal junction rupture causing bilateral empyema; case report from Nepal.

Introduction And Importance: Boerhaave syndrome is a rare finding where spontaneous rupture of esophagus occurs, usually in distal segment. It is a life threatening condition that requires urgent surgical intervention.

Case Presentation: We present a case of 70 years male who presented with pleural effusion and later empyema following spontaneous rupture of cervico-thoracic junction of esophagus who was managed successfully with primary surgical repair.

Variations in exons 11 and 12 of the multi-pest resistance wheat gene are independently additive for leaf rust resistance.

Introduction: Characterization of germplasm collections for the wheat leaf rust gene Lr34 previously defined five haplotypes in spring wheat. All resistant lines had a 3-bp TTC deletion (null) in exon 11, resulting in the absence of a phenylalanine residue in the ABC transporter, as well as a single nucleotide C (Tyrosine in Lr34+) to T (Histidine in Lr34-) transition in exon 12. A rare haplotype present in Odesskaja 13 and Koktunkulskaja 332, both of intermediate rust resistance, had the 3-bp deletion typical of Lr34+ in exon 11 but the T nucleotide of Lr34- in exon 12.