Imposter syndrome is the fear of being discovered as an intellectual fraud. It is an internal experience of believing that you are not as competent as others perceive you to be. It lowers a person’s inner self-confidence, self-esteem that impedes work performance and this phenomenon is more prevalent among medical students. However, talking openly about it with peers, rooting positive thoughts, and building confidence help us to the appropriate reality of our situation and counter our negative self-talk.
Introduction and Importance: Orbital rhabdomyosarcoma (RMS) is a highly malignant, mesenchymal orbital tumor of childhood with a predilection in children less than 20 years of age. It presents as a space-occupying lesion in the orbit, most commonly over the superior nasal quadrant of the orbit. The patient usually presents with rapid onset unilateral proptosis and eyelid edema. Case Ppresentation: In this article, a 14-year-old male presented with rapidly progressive swelling of the right orbit. On ocular examination, there was nonaxial inferolateral proptosis of the right eye. Computed tomography revealed a large soft tissue density tissue lesion in the right nasal cavity and meati measuring at least 3.2×2.7×5.4 cm in size with the erosion of the right orbit along with extension of the lesion in the extraconal compartment of the orbit. An MRI of the brain with contrast showed a heterogeneously enhancing altered signal intensity lesion. Debulking was planned, and a biopsy of the mass was sent that gave an impression of alveolar RMS. He also received radiotherapy and chemotherapy at one of the cancer hospitals in Nepal. Postsurgical follow-up showed gradual improvement in the visual acuity of the right eye. No evidence of metastasis and recurrence was found upon subsequent follow-up. Conclusion: Thus, early diagnosis and prompt treatment is most for a favorable prognosis in the case of RMS. The main aim of this article was to briefly overview a rare case of RMS, its clinical presentation, diagnosis, treatment modalities, and its prognosis.
Expectant management of incomplete abortion is a watch full waiting without intervention for certain period of time so that the retained product of conception will be expelled spontaneously. This study was carried out to see feasibility and safety of expectant management of incomplete abortion. It was observational descriptive study which was carried out in Nepal Medical College Teaching Hospital from July to December 2020 in 60 patients of spontaneous incomplete abortion. The patients which fulfill the inclusion criteria were sent home after bleeding has settled and ultrasound was carried after two weeks to see the success of the treatment. The success of the expectant management was found in 86.7%. There were heavy bleeding in 6.7% cases, unscheduled surgical evacuation was done in 13.3% cases. Blood transfusion was carried out in 5.0% of cases. The number of cases complained of severe low abdomen pain were 8.3% and limitation of activity were present in 10.0% of cases. There was one (1.7%) patient who showed the sign of genital infection. With the success of 86.7% of expectant management of incomplete abortion in our study we can consider expectant management of incomplete abortion as a safe option. However, small percentage of complications such as heavy bleeding, emergency surgical evacuation and severe pain are seen.
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