NDA Journal 2021

discharge. Posters detailing the regimen for extended VTE prophylaxis to be put up in Doctor’s office for the junior doctors to follow. Re-audit after implementing changes. A case of Confusion with Ataxia Dr Arun Baral Multiple anatomically and physiologically relatable symptoms can co-arise in an individual at one point of time and although a possibility, not all the symptoms can always be explained by a single diagnosis. We herein report a case of a 76 years old male driving-instructor with an acute presentation of unsteadiness and confusion. Initially, it was thought to be a part of a single process, for example an encephalitis and the patient was extensively investigated for autoimmune and para-neoplastic encephalitis with no significant findings on blood investigations, LP, CT-CAP, MRI brain and PET scan. The patient had worsening ataxia and motor symptoms with no pronounced sensory symptoms and eventually developed bilateral wrist drop and was almost bed-bound. MRI Neck showed significant stenosis in C4/C5 with myelomalacia of the cord for which the patient underwent a decompressive cervical laminectomy. The patient had a significant improvement of motor symptoms after the surgery and was discharged with a new diagnosis of mild Alzheimer’s disease for his cognitive impairment. This case illustrates the potential for delayed diagnosis in patient with multiple relatable symptoms and highlights the importance of thorough medical history, including collateral history. COVID-19 and Laparotomies Dr Deborah Gurung BACKGROUND: During COVID-19 pandemic (February- August 2020), study conducted on COVID test, test results, surgeries in the patients, operation and follow-up. CASE: • In the study of 69 people who were tested for COVID 19, 46 were negative, 22 were not tested followed by 1 access denied. We reported surgical treatment received at the maximum was Colectomies. 50% of the cases do not have surgical complications. During admission and 3 months follow-up, no covid cases were seen. CONCLUSION: Wearing a full PPE during the operation, introducing green pathway (Covid test, isolation and special HDU stay) and following the covid guidelines leads to no covid cases during hospitalisation and follow-up. BDKarki Memorial CupTrainee PresentationAbstracts NDA UK JOURNAL, JULY 2021