44 results match your criteria: "Tribhuvan University Institute of Medicine Kathmandu Nepal.[Affiliation]"

Mayer-Rokitansky-Küster-Hauser syndrome (MRKHS) is a rare congenital disorder characterized by agenesis of the uterus and upper two-thirds of the vagina. It affects around 1 in 4000-5000 females and is of two types: type 1, also known as isolated Müllerian aplasia or Rokitansky, which involves only uterovaginal agenesis, and type 2, presents as uterovaginal agenesis along with renal, cardiac, and other organ anomalies. Despite the absence of vaginal and uterine structures, individuals with MRKHS typically present with normal secondary sexual characteristics and ovarian functions.

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Key Clinical Message: Normal pressure hydrocephalus is rarely associated with Belly dancer's dyskinesia and seizure.

Abstract: Belly dancer's dyskinesia (BDD) is characterized by bilateral, sluggish, involuntary, repetitive, and rhythmic motions of the anterior abdominal wall. We present a rare case of a 78-year-old man diagnosed with normal pressure hydrocephalus associated with BDD and seizure who presented with left-sided weakness of the body and abnormal body movements.

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Key Clinical Message: Gaint fungating BCC is rare and aggressive. Early health-seeking behavior may result in positive outcomes.

Abstract: Fungating giant basal cell carcinoma (BCC) is a rare and aggressive form of BCC infrequently reported in the literature.

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Dolutegravir, the most recent antiretroviral drug with high efficacy, good tolerability, infrequent drug-drug interactions, and a favorable safety profile has not been reported in current literature as a cause of acquired sideroblastic anemia. Here, we present a 35-year-old male patient who was diagnosed with acquired sideroblastic anemia to Dolutegravir therapy.

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Key Clinical Message: A newborn with a rare form of biliary atresia had posterior fossa bleed and subarachnoid hemorrhage despite vitamin K prophylaxis, indicating biliary atresia is a causality rather than chance.

Abstract: Biliary atresia frequently causes surgical jaundice, resulting in delayed vitamin K deficiency. We report a 28-day-old newborn diagnosed with a rare form of biliary atresia presented with an unusual association of posterior fossa bleed and subarachnoid hemorrhage despite vitamin K prophylaxis.

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Subarachnoid block with local anesthetic agents is a well-established anesthesia technique among pregnant females for labor analgesia and cesarian delivery. Although it is considered a reliable and safe technique for both mothers and fetuses, unexpected high or low levels of block may occur due to accidental injection of these agents into different meningeal spaces other than intended. Hypotension, bradycardia, headache, and failed anesthesia are common complications of spinal anesthesia.

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A rare extrapulmonary presentation of tuberculosis: Breast tuberculosis.

Clin Case Rep

July 2023

Department of Pathology National Academy of Medical Sciences Kathmandu Nepal.

Key Clinical Message: Breast abscess of long duration can be tubercular origin in both developing and developed countries despite its rarity.

Abstract: A 34-year-old lady presented with painful lump on her breast for 2 months, which was diagnosed with mammary tuberculosis on basis of aspiration cytology and successfully treated with antitubercular drugs. Breast abscess of long duration may be tubercular etiology in both developing and developed nations.

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Article Synopsis
  • Anemia is prevalent in chronic obstructive pulmonary disease (COPD) patients, affecting around 23% of the studied group, and is linked to higher mortality rates post-discharge.
  • The study was conducted in a medical setting over a year, with a focus on understanding the relationship between anemia and various factors such as age, sex, and smoking status in COPD patients.
  • Results show that older age groups are more likely to suffer from anemia, while current smokers are less likely, highlighting the need for further research on whether treating anemia could improve outcomes for COPD patients.
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Hepatic portal venous gas is diagnosed via computed tomography due to unusual imaging features. HPVG when linked with pneumatosis intestinalis has a high mortality rate and required urgent intervention. We present a case of a 26-year-old young adult with superior mesenteric artery thrombosis who presented with severe abdominal pain.

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Pheochromocytoma is often diagnosed prior to pregnancy. Sometimes, the disease may be diagnosed for the first-time during pregnancy masking itself as a hypertensive disease in pregnancy. Early diagnosis and timely, appropriate management reduce possible maternal and fetal complications.

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Stiff Person Syndrome (SPS), a progressive Central Nervous System disorder is accompanied by progressive muscle rigidity, hyperreflexia, and spasms mainly in truncal and proximal leg muscles mainly associated with autoimmune disorders. Here, we report a rare case of SPS in a middle-aged Nepalese man with uncontrolled diabetes mellitus and ketonuria.

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Background And Aims: Central nervous system (CNS) infection is one of the most common causes of morbidity, mortality, and hospital admission worldwide. The natural history of CNS infection is quite fatal. Early diagnosis and treatment have been proven to have a crucial role in patients' survival.

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is a beta-hemolytic, non-motile, catalase-negative, gram-positive member of the group. When compared to other members of this group like and , infections are more substantial. In this case, we present a 47-year-old male patient who was found to have abscesses in his lungs, liver, and brain.

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Solitary fibrous tumors (SFTs) are a rare group of spindle cell neoplasm of submesothelial origin with malignant potential and can present as hypoglycemia secondary to excess secretion of insulin-like growth factor II (IGF-II) from the tumor. Early diagnosis and treatment are very important in such cases to prevent hypoxic injury to the brain secondary to hypoglycemia. Here, we are presenting a case of a 45-year-old male patient, who presented with recurrent episodes of hypoglycemia spells, and later on, it was diagnosed that hypoglycemic spells were secondary to fibroma.

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Symptoms of Guillain-Barre Syndrome (GBS) may be mistaken for typical puerperal changes, delaying diagnosis. Surgery and anesthesia may be triggers for GBS with an overall increase in pro-inflammatory cytokines in the postpartum period. We report a unique case of GBS in the postpartum period who made a good recovery with supportive measures.

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Macrocheilia, as an initial manifestation of leprosy, is uncommon. We present a case of a 50-year-old female, with lower lip swelling, initially diagnosed as Cheilitis Granulomatosa Miescher. Unresponsiveness to local intralesional corticosteroids necessitated further evaluation.

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An increased rate of hospitalizations due to right-sided infective endocarditis is currently witnessed due to the rapid rise of IV drug use. In this case report, we aim to discuss the long-term outcome and highlight the various diagnostic approaches and management difficulties that are encountered in these cases.

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Sarcoidosis is a disease with unknown aetiology and pathogenesis which affects young adults and is usually a non-necrotizing granulomatous disease seen in histology. Variants of the disease, such as necrotizing sarcoidosis, were first described by Liebow in 1973 and are rarely seen. This case report describes the case of a 60-year-old Bengali female who presented with vague symptoms and was found to have chronic granulomatous inflammation with foci of calcifications involving the lungs, liver and spleen consistent with necrotizing sarcoidosis.

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Article Synopsis
  • Community-acquired pneumonia (CAP) is a significant health issue, and researchers aim to find reliable markers to predict its severity and mortality, focusing on the neutrophil-lymphocyte ratio (NLR) as a potential solution.
  • A systematic review analyzing data from nine studies, totaling 3,340 patients, found that elevated NLR (cutoff value over 10) is an effective predictor of adverse outcomes like in-hospital mortality and ICU admission.
  • The study concludes that NLR is a simple and cost-effective marker that can help healthcare professionals assess the prognosis of patients with CAP.
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We report an interesting case of a young man who revealed extensive spontaneous dissection of the RCA in diagnostic angiography. It was surprising that despite an extensive dissection, the patient remained hemodynamically stable on medical management throughout the procedure and during the post-procedure hospital stay.

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Guillain-Barre syndrome (GBS) is an acquired inflammatory polyradiculoneuropathy that often follows infection with a virus or bacteria and in rare occasions, vaccination may precede GBS. We present a case of 80-year-old male patient who presented with chief complaints of progressive, ascending bilateral lower extremity paresthesia and weakness following first dose of Moderna vaccine. His symptoms got exacerbated after 2nd dose.

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Although IgG4-RD has CNS manifestations, cerebellar involvement has only been reported in three cases. Our patient presented with cerebellar symptoms, several cerebellar infarcts were evident on the brain MRI, and CT abdomen revealed retroperitoneal tumor. Endoscopic biopsy confirmed IgG4-RD.

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Introduction: Lewy bodies are the pathological hallmarks of Parkinson's disease. There is a need for effective biomarker that is cost effective, less invasive, and easily reproducible with good sensitivity and specificity and can be used to diagnose the condition early and track its severity and progression. Alpha-synuclein (α-syn), an integral component of the Lewy body, is found in saliva and can be a potential answer to the above concerns.

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is one of the common causes of infective endocarditis (IE). IE can present with various neurological complications such as stroke, brain abscess, and meningitis, the mortality rate can be very high in such cases.

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Cerebral Venous Thrombosis is a rare extra-intestinal manifestation of ulcerative colitis. Ulcerative colitis is a hypercoagulable state and, if poorly managed, can predispose to thrombosis, including thrombosis of the cerebral veins.

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