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Browsing by Author "Ghimire, Sharmila"

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    Misdiagnosis of a Term Abdominal Ectopic Pregnancy: A Case Report
    (Nepal Medical Association, 2025) Bista, Kumar Bahadur; Pariyar, Rakesh; Poudel, Aashis; Ghimire, Sharmila; Yadav, Kalpana Kumari
    Abstract Abdominal ectopic pregnancy is a rare and life-threatening condition, often misdiagnosed due to its nonspecific clinical presentation and imaging challenges. We present a case of a 20-yearold primigravida at 39+6 weeks of gestation that was initially misdiagnosed as complete placenta previa with transverse lie and was only identified as abdominal ectopic pregnancy intraoperatively. An emergency cesarean section was planned for suspected placenta previa, during which an intact amniotic sac was found in the peritoneal cavity, with placental attachment to the greater omentum, left ovary, and fallopian tube for which cesarean section was converted to the laparotomy. The baby was live at birth but succumbed to respiratory distress on the third day of life. A multidisciplinary team helped in optimizing maternal outcomes. Early recognition, appropriate imaging, and surgical expertise are essential to reduce morbidity and mortality.
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    Missed T8-T9 translational fracture with intact neurology: A Case report
    (Nepal Medical Association, 2025) Sharma, Niraj Kumar; Banjade, Rishi Ram; Pokharel, Sabin; Ghimire, Sharmila
    Abstract Translational fracture of the thoracic spine, though rare due to its stability, is often associated with spinal cord injury and neurological deficits. Few cases present with intact neurology. We report a case of a 28-year-old woman who, after a road traffic accident, had persistent back pain with intact neurology. The initial chest radiograph showed a subtle deformity that was missed, likely because a lateral view was not done, and the patient was discharged. Persistent back pain led to CT imaging, revealing a T8–T9 translational fracture, left 4th and 5th posterior rib fractures near the costovertebral junction, and a T7 transverse process fracture. MRI confirmed these findings. She underwent posterior instrumentation and decompression, with symptom relief, and remained asymptomatic on follow-up. Translational thoracic spine fractures, typically associated with neurological deficits, can be missed when neurology is intact. Timely imaging and intervention are crucial for optimal outcomes.

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