https://hdl.handle.net/20.500.14356/1012 2026-04-13T10:34:28Z https://hdl.handle.net/20.500.14356/1175 Title: Rectal Perforation: A Rare Complication Following Uncomplicated Vaginal Delivery Authors: Pun, Sunita; Poudel, Atit; Pant, Padam Raj Pant Abstract: Abstract Rectal perforation during vaginal delivery is an uncommon event. It can cause complications including pelvic abscess and other life threatening illnesses, if not treated early. We here report a 24 years lady presented with a week long history of abdominal pain and fever associated with rectal discharge three weeks after uncomplicated vaginal delivery. Abdominal computed tomography findings suggestive of rectal perforation and revealed a huge pelvic abscess. A pigtail catheter was inserted into the pelvic abscess under transrectal ultrasound guidance and drained successfully. The patient recovered uneventfully and discharged 5 days after admission. Keywords: Pelvic abscess; rectal perforation; uncomplicated vaginal delivery Description: Case Report 2021-01-01T00:00:00Z https://hdl.handle.net/20.500.14356/1173 Title: An Experience with Intravitreal Dexamethasone Implant for Uveitic Macular Oedema Authors: Kharel, Ranju; Sitaula; Shrestha, Saurav Man Abstract: Abstract Intravitreal steroid implants are the latest trend for uveitis macular oedema treatment. Dexamethasone intravitreal implants are new in our contexts but we report 2 cases of uveitic cystoid macular oedema where this implant proved very useful in the treatment of recalcitrant macular oedema where other treatment modality fails. Two cases of non-infectious uveitis and intermediate uveitis with recalcitrant uveitic macular oedema underwent dexamethasone intravitreal implantation. Their central macular thickness & central macular volume reduced significantly with the implant. With the reduction in macular parameters, the best-corrected visual acuity also improved and visual rehabilitation was achieved. Thus, dexamethasone intravitreal implant helps in sustained drug delivery inside the vitreous leading to resolution of uveitic macular oedema in recalcitrant cases. Keywords: Macular oedema; ozurdex; steroid; uveitis; vision Description: Case Report 2021-01-01T00:00:00Z https://hdl.handle.net/20.500.14356/1172 Title: Late Onset Dipeptidyl Peptidase -4 Inhibitor Associated Seronegative Rheumatoid Arthritis Authors: Vaidya, Binit; Adhikari, Bhojraj; Bhochhibhoya, Manisha; Nakarmi, Shweta Abstract: Abstract Drug-induced arthritis is not an uncommon scenario. DPP-4 inhibitors could potentially cause adverse-events mediated by cytokine-induced inflammation leading to arthritis. The activity of the DPP-4 enzyme could be inversely related to the development of rheumatoid arthritis, explaining the increased inflammatory activity with its inhibition by a drug. We discuss a 72-year-old gentleman with twenty-three years of history of type 2 diabetes mellitus, who after 6 years of treatment with a DPP-4 inhibitor, developed features of inflammatory arthritis and fulfilled the criteria for seronegative rheumatoid; which eventually subsided after stopping the drug. Keywords: DDP-4 inhibitor; diabetes mellitus; Nepal; rheumatoid arthritis; seronegative Description: Case Report 2021-01-01T00:00:00Z https://hdl.handle.net/20.500.14356/1170 Title: Pseudomyxoma Peritonei - A Case Report Authors: Tuladhar, Ruhee; Shrestha, Eliza; Shrestha, Rishikesh Narayan; Thapa, Anita; Rajak, Ashik Abstract: Abstract A 53-year-old lady presented with post-menopausal bleeding (spotting) for two days and abdominal pain for three months. CT scan revealed bilateral adnexal mass and ascites; and CEA and CA19.9 was raised. Histopathology of the resected tissues revealed mucinous carcinoma of bilateral ovaries and colon with omental metastasis. Generally, pseudomyxoma peritonei arises from primary ovarian or appendiceal adenomas or adenocarcinomas. Keywords: Adenocarcinomas; ascites; metastases; mucinous carcinoma; pseudomyxoma peritonei Description: Case Report 2021-01-01T00:00:00Z