Intracranial Interdural and Extradural Cerebellar Convexity Dermoid Cyst: A Case Report of Rare Tumor at the Rarest Location.

Intracranial dermoid cysts are rare dysembryonic tumors of benign nature. These are uncommon in adults. If present, they are usually located in the midline or along the lines of embryonic fusion.

Etoricoxib-induced pleural effusion: A case report.

Key Clinical Message: Drug-induced pleural effusion is extremely rare. It is the diagnosis of exclusion. This condition can be suspected if the patient has been exposed to a likely causative drug, develops new signs and symptoms, and has a remittance of these symptoms once the drug is withheld.

Eschar of scrub typhus.

We report a case of a 60-year-old farmer presented with chief complaints of fever, myalgia, and headache of one week duration. Head-to-toe examination revealed an area of central necrosis surrounded by erythema (suggestive of eschar) on nape of the neck. A diagnosis of scrub typhus was made and the patient improved following 7-days course of doxicycline.

Inadvertent extravasations of norepinephrine.

A male patient of diabetic ketoacidosis and septic shock was started on norepinephrine infusion following which he developed bulla and subcutaneous tissue ischemia in the event of inadvertent extravasations of norepinephrine. The patient improved after management with mechanical debridement of necrosed tissue and regular dressing of the wound. The use of higher concentration of norepinephrine via peripheral intravenous route may lead to vasoconstriction and subcutaneous tissue ischemia due to inadvertent extravasations.

Knowledge, attitude, and practice of stroke and thrombolysis among students preparing for undergraduate medical entrance examination in Kathmandu, Nepal.

Background: Stroke is a major disabling disease, especially for low and middle-income countries like Nepal. The aim of our study is to assess knowledge, attitude, and practice (KAP) among the students preparing for undergraduate medical entrance examination regarding risk factors, warning signs and symptoms, and management of stroke.

Methods: A cross-sectional, single staged study using self-structured questionnaire intended to assess KAP about stroke and thrombolysis was conducted.

Prevalence, Clinical Presentation, and Outcome of Tuberculosis in Patients with Chronic Kidney Disease at a Tertiary Care Hospital in Nepal.

Background: Tuberculosis (TB) is a serious public health threat in low- and middle-income countries like Nepal. Chronic kidney disease (CKD) patients are at higher risk of developing new infection as well as reactivation of TB. We aimed to determine the prevalence, clinical presentations, and outcome of TB in patients with CKD in Nepal.

The Assessment of Health-Related Quality of Life in Patients With Chronic Liver Disease: A Single-Center Study.

Aim The aim of this study was to investigate the factors affecting health-related quality of life (HRQOL) in Nepalese patients with chronic liver disease (CLD). Methods In this study, HRQOL was measured with validated Nepali versions of the short-form 36 (SF-36) survey. Socioeconomic factors, etiology, laboratory parameters, disease severity, and self-rated health perceptions on HRQOL were recorded for analysis.

Non-Small Cell Lung Cancer With Synchronous Peritoneal Adenocarcinoma: A Rare Independent Combination.

Lung cancer is one of the most common malignancies worldwide, and metastasis occurs in more than one-third of cases. Common sites of metastatic disease are the brain, spine, nerve, adrenal glands, bone, liver, and pleura. Peritoneal involvement, however, is rare, and peritoneal involvement found in lung cancer is presumed to be metastatic until proven otherwise.

Atypical Presentation of Myocardial Infarction in a Young Patient With Polycystic Ovarian Syndrome.

Polycystic ovarian syndrome (PCOS) is one of the common endocrinopathy noted in women of childbearing age groups. Patients with PCOS have increased cardiovascular risk factors compared with age-matched control; hence, these patients are believed to be at an increased risk for cardiovascular events. Here, we report a case of a young female with PCOS, who presented with atypical back pain in the thoracic region.

Ramsay Hunt syndrome.

We report a case of a 26-year-old previously healthy male who presented with peripheral facial nerve palsy and painful vesicular eruptions over an erythematous base on pinna and external auditory canal. A diagnosis of Ramsay Hunt syndrome was made. Patient improved with prednisolone, acyclovir, and physiotherapy.

Pharyngeal-Cervical-Brachial variant of Guillian-Barre Syndrome in Children.

Guillian-Barre Syndrome (GBS) typically presents as symmetrical ascending flaccid muscle weakness with areflexia, and with or without sensory symptoms. However, some patients may present atypically, and accordingly, different variants of GBS have been reported in the literature. Pharyngeal-cervical-brachial variant is one of the rare variants and is characterized by muscle weakness extending from the oropharyngeal and neck area to the proximal upper extremities.

Remote Supratentorial Subdural Hematoma Following Craniectomy and Evacuation of Hypertensive Cerebellar Hematoma.

Remote acute subdural hematoma following a decompressive craniotomy or craniectomy is a rare phenomenon. Only few cases of postoperative contralateral acute subdural hematomas have been reported in the literature review till date. This case report details a case of a 32-year-old hypertensive male who presented with severe headache, multiple episodes of vomiting, slurring of speech, nystagmus and ataxic gait for one day.

Idiopathic Eosinophilic Pleural Effusion Treated Successfully with Corticosteroid Therapy: A Clinical Case Report.

A pleural effusion is defined to be eosinophilic when 10% or more of the white blood cells in pleural fluid are eosinophils. Despite the multitude of studies enumerating the causes of eosinophilic pleural effusion (EPE), 14%-25% of such cases remain idiopathic even after thorough work-up. We report a case report of a 28-year-old never smoker male from the Rukum district of Nepal who presented to the emergency department (ED) with a chief complaint of shortness of breath associated with a low grade fever, nonproductive cough, and pleuritic right-sided chest pain for two weeks.

Safety and Efficacy of Mepolizumab in Patients with Eosinophilic Granulomatosis with Polyangiitis.

Eosinophilic granulomatosis with polyangiitis (EGPA) is a rare form of vasculitis disorder which involves multiple organ systems and is characterized by asthma, pulmonary infiltrates, sinusitis, neuropathy, and peripheral eosinophilia. It also has an effect on the heart, skin, kidneys, and gastrointestinal tract. Interlukin-5 (IL-5) is involved in maturation and activation of eosinophil, the production of which is increased in the EGPA.

A Systematic Review of Marijuana Use and Outcomes in Patients with Myocardial Infarction.

The prevalence of marijuana use is increasing after its legalization in a few states of the United States (US). Smoking marijuana is found to be associated with an increased risk of myocardial infarction (MI) immediately after its use. However, knowledge about the impact of marijuana on outcomes following MI is limited.

Rheumatic Heart Disease with Multiple Systemic Emboli: A Rare Occurrence in a Single Subject.

Valvular heart disease is one of the more common diseases in low- and middle-income countries, when associated with atrial fibrillation (AF), carries a risk of multisystemic embolizations. We report a case of 37-year-old man with multiple systemic emboli consisting of acute ischemic stroke, acute myocardial infarction, and acute limb ischemia. This is a rare occurrence in a single subject.

Assessment of Validity of SF 36 Questionnaire Using Nepali Language to Determine Health-related Quality of Life in Patients with Chronic Liver Disease: A Pilot Study.

Objectives: The main objective of this study was to translate and validate the short form 36 (SF-36) health survey questionnaire into the Nepali language using a standard protocol to determine health-related quality of life (HRQoL) in patients with chronic liver disease (CLD).

Methods: We conducted a cross-sectional study among 40 patients with CLD. A formal translation of SF-36 from English into the Nepali language was performed.

Spontaneous rupture of seminoma in undescended testis with hemoperitoneum: a rare presentation.

Cryptorchidism is associated with increased risk of malignancy and infertility. We present a case of a 30-year-old man who presented to the Emergency Department of our tertiary care hospital with spontaneous intra-abdominal rupture of the seminoma in undescended testis with hemoperitoneum. This is a rare presentation of seminoma and emphasises the importance of scrotal examination in young men presenting with acute abdomen.

Isolated Splenic Cold Abscesses with Perisplenic Extension: Treated Successfully without Splenectomy.

Splenic tuberculosis (TB) in the form of multiple splenic cold abscesses with perisplenic extensions is a rare disease, especially in an immunocompetent host. It demonstrates diagnostic complexity, which makes identification of the disease difficult. We report a case of an immunocompetent adult male who presented with fever, pain in the left lower chest, decreased appetite, and significant weight loss.