RESUMEN
We report a rare case of massive maternal ascites complicating severe pre- eclampsia toxaemia (PET) seen in April 2013. This complication developed in association with the rise of blood pressure of 160/110 mmHg or more, worsening of proteinuria and hyperuricaemia. The onset of massive ascites caused respiratory compromise to the patient, thus necessitating immediate termination of pregnancy.
Asunto(s)
Ascitis/diagnóstico , Ascitis/terapia , Preeclampsia/diagnóstico , Preeclampsia/terapia , Resultado Fatal , Femenino , Humanos , Recién Nacido , Embarazo , Adulto JovenRESUMEN
Tuberculosis (TB) is a major public health problem in developing countries including Nepal. One of the common presentations of TB is pleural effusion. The diagnosis of tubercular pleural effusion can be difficult because of the low rate of detecting tubercule bacilli by direct stain and culture of pleural fluid for acid-fast bacilli (AFB). Pleural biopsy can be useful but is invasive and requires experts. In this context, pleural fluid Adenosine Deaminase (ADA) level has been proposed as easy, cheap and highly sensitive test for diagnosis of TB pleural effusion. The present study was undertaken to define the role ofpleural fluid ADA value in accurate diagnosis of TB pleural effusion. A Prospective analysis of 100 patients admitted in Nepal Medical College and teaching Hospital with pleural effusion was done. Pleural fluid ADA level was evaluated in all patients, and significance of pleural fluid ADA level in TB pleural effusion was studied. It was found that mean ADA level in pleural fluid was 105.8 +/- 67.23 U/L in cases of TB, as compared to 16.83 +/- 8.91 U/L in malignancy, 44.53 +/- 32.84 U/L in parapneumonic effusion and 15.94 +/- 4.88 U/L in patients with miscellaneous diagnosis. For a cut-off value of 42.19 U/L for diagnosis of TB pleural effusion, sensitivity was found to be 90.8% and specificity 82.8%. Almost all patients diagnosed to have TB pleural effusion responded completely to anti-tubercular treatment. So, we concluded that pleural fluid ADA analysis could be easy, cheap and highly sensitive and specific test for diagnosis of TB pleural effusion.
Asunto(s)
Adenosina Desaminasa/análisis , Exudados y Transudados/enzimología , Derrame Pleural/diagnóstico , Tuberculosis Pulmonar/diagnóstico , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Derrame Pleural/enzimología , Derrame Pleural/microbiología , Derrame Pleural Maligno/enzimología , Neumonía/complicaciones , Neumonía/enzimología , Estudios Prospectivos , Sensibilidad y Especificidad , Tuberculosis Pulmonar/complicaciones , Tuberculosis Pulmonar/enzimología , Adulto JovenRESUMEN
The cause of mad honey poisoning is the toxin grayanotoxin, found in honey obtained from the nectar of Rhododendron species on the higher altitudes. This case report is about seven cases of grayanotoxin poisoning that occurred after consumption of wild honey that was brought from the Himalayan belt of Nepal. Most of them presented with symptoms of blurring of vision, diplopia, nasea and vomiting and two of them presented with symptoms of cardiac depression. All of the cases responded well to intravenous fluid and/or pressor agents while none proved to be fatal
Asunto(s)
Miel/envenenamiento , Toxinas Biológicas/envenenamiento , Adulto , Humanos , Masculino , Rhododendron , Adulto JovenRESUMEN
This study was conducted to know the epidemiological and bacteriological profile of burn patients at Nepal Medical College Teaching Hospital. The charts of 50 burn patients admitted in department of surgery were reviewed retrospectively. All the epidemiological characteristics, mode of injury, time taken to reach hospital and involved body surface areas were noted. The charts were also reviewed for bacterial isolates from burn wounds and its sensitivity pattern for various antibiotics. Data was analyzed using the statistical package for social sciences (SPSS) for Windows. The mean age of patients was 31.8 years with male:female ratio of 1.3:1. Half of the patients were from Kathmandu. Fifty two percent of patients directly came to our hospital while rests were referred from other hospitals. The average time taken to reach hospital was 11.3 hours. Those patients who were referred from outside the valley took longer time (p = 0.002). Flame burn was the leading cause for injury (66.0%) followed by scald burn (16.0%), electric burn (14.0%) and acid burn (4.0%). Staphylococcus aureus (28.0%) was the commonest organism isolated from wound swab culture. Others were Klebsiella (16.0%), Pseudomonas (13.0%), Proteus (13.0%) and E.coli (13.0%). No growth was noted in 17.0% of patients. During the treatment, 14.0% of patients died and 4.0% left against medical advice. Remaining patients were discharged after complete recovery. Body surface area involvement was found to be a significant predictor of mortality (p < 0.001) and the length of hospital stay was significantly low for them (p = 0.05).