Browsing by Author "Mishra, D"
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Publication Cold Abscess of the Thigh in an Infant(Kathmandu University, 2013) Mishra, D; Mohta, A; Arora, PABSTRACT Local and minor adverse reactions to diphtheria–pertussis–tetanus (DPT) vaccination are usually mild and appear within 48 hours of vaccination. We herein report a rare association with intramuscular DPT injection and discuss pertinent issues. Primary tuberculous abscess was the final diagnosis. KEY WORDS Abscess, child, tuberculosisPublication Interaction between warfarin and tamoxifen: A case report(Kathmandu University, 2007) Mishra, D; Paudel, R; Kishore, PV; Palaian, S; Bista, D; Mishra, PWarfarin is a commonly used anticoagulant with documented reports of drug interactions. Tamoxifen is used in the adjuvant hormonal treatment of women with oestrogen-receptor- positive breast cancer. Warfarin and tamoxifen are known to interact with each other with a resultant increase in the bleeding tendency. These reports are mainly from the white population. We report a case of drug interaction between warfarin and tamoxifen with an acute onset. This report suggests that when these drugs are co administered, careful monitoring of the coagulation profile is needed. Key words: Drug interaction, Tamoxifen, WarfarinPublication Macrophage activation syndrome in an inadequately treated patient with systemic onset juvenile idiopathic arthritis(Kathmandu University, 2009) Juneja, M; Jain, R; Mishra, DAbstract Macrophage activation syndrome is a rare and potentially life threatening complication of childhood rheumatic disorders. It is described most commonly with systemic onset juvenile idiopathic arthritis (soJIA). The major clinical manifestations are non-remitting fever, hepatosplenomegaly, lymphadenopathy, bleeding diathesis, altered mental status and rash and may mimic a flare of soJIA. The characteristic laboratory findings are leucopenia, thrombocytopenia and dramatic elevation of urinary β2 microglobulin. Corticosteroids and Cyclosporine are the drugs commonly used in its management. Early diagnosis and prompt treatment can be life saving. We report a case of 12 year old female child with inadequately treated systemic onset juvenile idiopathic arthritis who developed fatal macrophage activation syndrome. The diagnosis and management of macrophage activation syndrome are discussed. Key words: Macrophage activation syndrome, systemic onset juvenile idiopathic arthritis, leucopenia, children.Publication Macrophage activation syndrome in an inadequately treated patient with systemic onset juvenile idiopathic arthritis(Kathmandu University, 2009) Juneja, M; Jain, R; Mishra, DAbstract Macrophage activation syndrome is a rare and potentially life threatening complication of childhood rheumatic disorders. It is described most commonly with systemic onset juvenile idiopathic arthritis (soJIA). The major clinical manifestations are non-remitting fever, hepatosplenomegaly, lymphadenopathy, bleeding diathesis, altered mental status and rash and may mimic a flare of soJIA. The characteristic laboratory findings are leucopenia, thrombocytopenia and dramatic elevation of urinary β2 microglobulin. Corticosteroids and cyclosporine are the drugs commonly used in its management. Early diagnosis and prompt treatment can be life saving. We report a case of 12 year old female child with inadequately treated systemic onset juvenile idiopathic arthritis who developed fatal macrophage activation syndrome. The diagnosis and management of macrophage activation syndrome are discussed. Key words: Macrophage activation syndrome, systemic onset juvenile idiopathic arthritis, leucopenia, children.