Epidemiology of tetanus in Jamaica, 1993-2010.
ConclusionsTetanus remains endemic in Jamaica, occurring more commonly in elderly men. Doctors should be educated about the importance of a high index of suspicion, an immunisation history and promoting booster shots in high-risk groups. PMID: 24595216 [PubMed - as supplied by publisher] (Source: Tropical Doctor)
Source: Tropical Doctor - March 4, 2014 Category: Tropical Medicine Authors: Harding HE, Cawich SO, Williams EW, Crandon IW, Williams-Johnson J Tags: Trop Doct Source Type: research

Antepartum uterine rupture in a twin gestation presenting as an advanced extrauterine pregnancy in a patient with a previous lower segment Caesarean section.
This report illustrates the need to consider a diagnosis of a ruptured uterus in any patient with a previous abdominal delivery who presents with mild abdominal tenderness and an ultrasonographic image suggestive of demised fetus in the intra-peritoneal cavity. PMID: 24577619 [PubMed - as supplied by publisher] (Source: Tropical Doctor)
Source: Tropical Doctor - February 27, 2014 Category: Tropical Medicine Authors: Ngene NC, Naidoo TD, Titus M, Moodley J, Craib S, Stutterheim J Tags: Trop Doct Source Type: research

Initiating and developing clinical services, training and research in a low resource setting: the Malawi ENT experience.
ConclusionsTo establish accessible and sustainable specialist ENT services in a poor country requires building on an established local health delivery system, careful planning and investment in personnel, infrastructure, training and data collection. PMID: 24569097 [PubMed - as supplied by publisher] (Source: Tropical Doctor)
Source: Tropical Doctor - February 25, 2014 Category: Tropical Medicine Authors: Mulwafu W, Nyirenda TE, Fagan JJ, Bem C, Mlumbe K, Chitule J Tags: Trop Doct Source Type: research

Myocardial injury following multiple bee stings.
We report a case of a 58-year-old woman with acute myocardial injury following massive bee envenomation. PMID: 24569098 [PubMed - as supplied by publisher] (Source: Tropical Doctor)
Source: Tropical Doctor - February 25, 2014 Category: Tropical Medicine Authors: Nisahan B, Selvaratnam G, Kumanan T Tags: Trop Doct Source Type: research

Abdominal and scrotal wall emphysema in a patient with severe ulcerative colitis.
We report a rare scenario where a patient presented with abdominal wall and scrotal emphysema after topical corticosteroid enema-induced traumatic rectal perforation. Topical corticosteroids were stopped immediately after identification of rectal perforation. The patient was managed conservatively with intravenous antibiotics. With this report we intend to sensitise clinicians and topical enema manufacturers regarding this rare complication. PMID: 24567445 [PubMed - as supplied by publisher] (Source: Tropical Doctor)
Source: Tropical Doctor - February 24, 2014 Category: Tropical Medicine Authors: Sharma M, Thandassery RB, Hilli SA, Kaabi SA Tags: Trop Doct Source Type: research

Outbreak of scrub typhus in North India: a re-emerging epidemic.
We describe an outbreak of 45 cases from our tertiary care center in north India. This outbreak included city dwellers who had no history of travel to hilly areas. The classical feature of scrub typhus, the eschar, was also noted rarely in these patients. The changing epidemiology of scrub typhus should be kept in mind while attending patients with acute febrile illness. PMID: 24557641 [PubMed - as supplied by publisher] (Source: Tropical Doctor)
Source: Tropical Doctor - February 20, 2014 Category: Tropical Medicine Authors: Sethi S, Prasad A, Biswal M, Hallur VK, Mewara A, Gupta N, Galhotra S, Singh G, Sharma K Tags: Trop Doct Source Type: research

Isolated cold abscess of the thigh in an immunocompetent infant.
We report a case of isolated cold abscess of the thigh following DPT vaccination in an immunocompetent child. The association with DPT vaccination is intriguing and requires further research. PMID: 24554090 [PubMed - as supplied by publisher] (Source: Tropical Doctor)
Source: Tropical Doctor - February 19, 2014 Category: Tropical Medicine Authors: Sharma J, Sharma T, Bhatt GC, Bhargava R Tags: Trop Doct Source Type: research

Ophthalmic presentation of relapsed HTLV1- associated adult T-cell leukaemia lymphoma (ATLL) in a Trinidadian man.
Abstract The ophthalmic presentation of relapse in a patient with human T-lymphotropic virus type 1 (HTLV1) associated adult T-cell lymphoma leukaemia is described. Epidemiology, clinical features and therapeutic options are briefly reviewed. Antenatal screening and inclusion of HTLV1 in the differential diagnosis of inflammatory and neuromuscular eye conditions should be considered in endemic regions. PMID: 24549630 [PubMed - as supplied by publisher] (Source: Tropical Doctor)
Source: Tropical Doctor - February 18, 2014 Category: Tropical Medicine Authors: Charles KS, Leelah N, Murray DC Tags: Trop Doct Source Type: research

Premonitory signs and symptoms of envenoming by common krait (Bungarus caeruleus).
Abstract Between January 2005 and August 2011 141 victims of krait bite poisoning were admitted to the general hospital at Mahad. Clinical signs and symptoms preceding the development of neuroparalysis were analyzed. Fifty-six percent of patients were male. A total of 140 victims reported between midnight and 05:00. Patients awoke in the night due to abdominal colic (85%) and chest pain (72%). Patients gave a history of vomiting (42%), sweating (17%) and excessive salivation (35%). On arrival at hospital, 78% cases had dysphasia with pooling of saliva, 89% had heaviness in both eyelids and ptosis; 12.5% of patient...
Source: Tropical Doctor - February 18, 2014 Category: Tropical Medicine Authors: Bawaskar H, Bawaskar P, Bawaskar PH Tags: Trop Doct Source Type: research

Scrub typhus in Punjab: an acute febrile illness with multisystem involvement.
Abstract Scrub typhus is an important cause of acute febrile illness. This observational study describes the clinical features and complications of the patients diagnosed to have scrub typhus in Christian Medical College & Hospital, Ludhiana, Punjab, India. The diagnosis of scrub typhus was made by using Bioline SD Tsutsugamushi test kit which detects IgM, IgG or IgA antibodies to Orientia tsutsugamushi. Sixty-two patients of scrub typhus were seen during the study period of 1 year. The mean age of the study group was 39.9 years. All the patients presented with fever, and of these 31 (50%) had non-specific sym...
Source: Tropical Doctor - February 18, 2014 Category: Tropical Medicine Authors: Loomba V, Mani A, John M, Oberoi A Tags: Trop Doct Source Type: research

Loss of appetite and strength in the geriatric population: diagnostic symptoms for dengue.
This article looks at cases of patients who were tested for dengue based on their symptoms of weakness and loss of appetite, without fever as fever was absent in most cases. The article also examines the changes in weight that occur after diagnosis of dengue and compares it to weight loss (if any) that occurred prior to the diagnosis. Dealing with the anorexia and weight loss is challenging for physicians, patients and family members. PMID: 24504142 [PubMed - as supplied by publisher] (Source: Tropical Doctor)
Source: Tropical Doctor - February 6, 2014 Category: Tropical Medicine Authors: Hotchandani A Tags: Trop Doct Source Type: research

Reduction of mortality due to tetanus by immunisation and proper wound management of the patients in Sengerema Designated District Hospital, Tanzania.
Abstract Tetanus is a life-threatening, preventable infection with a high mortality. Our aim was to determine the changes in incidence and case fatality rate at Sengerema Designated District Hospital in a retrospective review of patients who had been hospitalised with tetanus between 1962 and 2012. In the 1970s and 1980s a vaccination campaign was organised in order to cover the whole district and to provide immunity for tetanus. Data are based on 476 cases with a fatal outcome in 305 cases. The case fatality rate has declined from 74% between 1982 and 1991 to 11.1% currently. Improved facilities are required in o...
Source: Tropical Doctor - February 5, 2014 Category: Tropical Medicine Authors: Melkert D, Kahema L, Melkert P Tags: Trop Doct Source Type: research

Hepatitis E presenting with thrombocytopaenia.
Abstract We hereby present the case of a 25-year-old man who presented at the emergency department of Civil Hospital Karachi, Pakistan with signs and symptoms of acute viral hepatitis. Serology tests revealed that the patient was suffering from hepatitis E viral (HEV) infection. Concurrently, the patient was also found to have thrombocytopaenia (TCP). His TCP became better after the resolution of his jaundice, with the patient requiring a transfusion of one mega unit of platelets. After ruling out other common causes of TCP and after a thorough literature search, we concluded that an immune-mediated mechanism seco...
Source: Tropical Doctor - January 28, 2014 Category: Tropical Medicine Authors: Masood I, Rafiq A, Majid Z Tags: Trop Doct Source Type: research

SLE and dental erosion: a lethal cocktail.
Abstract A 13-year-old Pacific Island girl presented complaining of fever, joint pain and dry mouth. She was using limes to relieve her dry mouth. On examination, the most striking clinical finding was severe dental erosion and caries. Autoimmune serology confirmed a diagnosis of systemic lupus erythematosus (SLE) with possible Sjögren's syndrome. The case illustrates the devastating consequence of excessive consumption of acidic citrus juice in sicca syndrome. PMID: 24464153 [PubMed - as supplied by publisher] (Source: Tropical Doctor)
Source: Tropical Doctor - January 24, 2014 Category: Tropical Medicine Authors: Fegan D, Glennon MJ Tags: Trop Doct Source Type: research

Trench foot: a relatively rare condition in tropical countries - a case report.
We present here a case report of trench foot in a child who was put on hip spica for her hip ailment. Although rare, awareness on the part of the clinician can prevent this potentially serious condition and early diagnosis and treatment can prevent further consequences. PMID: 24448485 [PubMed - as supplied by publisher] (Source: Tropical Doctor)
Source: Tropical Doctor - January 21, 2014 Category: Tropical Medicine Authors: Kant KS, Agarwal A, Suri T, Gupta N, Verma I, Shaharyar A Tags: Trop Doct Source Type: research

Characteristics of patients admitted to the emergency department due to tick bite.
k O, Baydin A Abstract Crimean-Congo haemorrhagic fever (CCHF) is a tick-borne disease endemic in Turkey since 2002. Çorum is one of the leading five cities in Turkey in which CCHF disease is seen most. We studied characteristics of the patients with tick bites in our emergency department (ED) and determined the fatality rate of the disease in city of Çorum for the first time. We retrospectively analysed the characteristics of the patients admitted to our ED from the medical files of 21,680 patients in a 5-year period. The number of patients with definite diagnosis and who have died was determined. O...
Source: Tropical Doctor - January 15, 2014 Category: Tropical Medicine Authors: Erenler AK, Kulaksiz F, Ulger H, Erdem M, Koçak C, Söylemez F, Oztürk O, Baydin A Tags: Trop Doct Source Type: research

Diagnosis and treatment of children with severe influenza A from the 2009/2010 pandemic in Tianjin, China.
Abstract The clinical characteristics and treatments of severe influenza A (H1N1) in infected children were discussed and analysed. We found that such severe cases predominantly manifested respiratory symptoms; symptoms affecting the nervous system are also rare but dangerous. The clinical data of eight children with severe influenza A (H1N1) were analysed retrospectively. These children generally manifested fever and flu-like symptoms, short-term aggravation with dyspnoea. One case exhibited neurological symptoms. After continuous positive airway pressure and immunological regulation were administered, the clinic...
Source: Tropical Doctor - January 10, 2014 Category: Tropical Medicine Authors: Ning J Tags: Trop Doct Source Type: research

Biliary ascariasis: an uncommon cause for recurrent biliary colic after biliary sphincterotomy and common bile duct stone removal.
We report an unusual case where a patient presented with recurrent biliary colic after cholecystectomy and common bile duct stone extraction and was diagnosed to have biliary ascariasis with the help of endoscopic ultrasound examination of the biliary system. PMID: 24407145 [PubMed - as supplied by publisher] (Source: Tropical Doctor)
Source: Tropical Doctor - January 9, 2014 Category: Tropical Medicine Authors: Thandassery RB, Jha AK, Goenka MK Tags: Trop Doct Source Type: research

CSF pseudocyst: an unusual cause of abdominal distension in a child.
We present the case of a 4 year old child in whom a VP shunt was placed for tubercular meningitis 5 months earlier. The clinical presentation, classic imaging findings and management of CSF pseudocyst in a child are discussed. PMID: 24407146 [PubMed - as supplied by publisher] (Source: Tropical Doctor)
Source: Tropical Doctor - January 9, 2014 Category: Tropical Medicine Authors: Pahwa S, Sherwani P, Anand R Tags: Trop Doct Source Type: research

Broncho-hepatico-cutaneous fistula in a case of amoebic liver abscess.
Abstract Pulmonary complications occur in 7-20% of patients with amoebic liver abscess(ALA) and may present as pleural effusion, empyema, lung abscess or a bronchohepatic fistula. Rupture into a bronchus presents as sudden coughing with expectoration of chocolate-coloured sputum and is usually managed by postural drainage, bronchodilators and anti-amoebic drugs. A young boy presented with a large amoebic liver abscess of about 1 L volume which ruptured into the lung. He required surgical drainage of the liver abscess as even after intubation he was not able to maintain adequate ventilation. Following this h...
Source: Tropical Doctor - January 8, 2014 Category: Tropical Medicine Authors: Kaur N, Maheshwari K, Gupta A Tags: Trop Doct Source Type: research

Mediastinal tubercular lymph node eroding into pericardium causing acute pyopericardium and cardiac tamponade.
We describe a case of extensive mediastinal tubercular lymph node mass in which the caseous necrotic material found its way into pericardial sac causing acute pyopericardium and cardiac tamponade. PMID: 24401544 [PubMed - as supplied by publisher] (Source: Tropical Doctor)
Source: Tropical Doctor - January 8, 2014 Category: Tropical Medicine Authors: Kasilingam SK, Sinha N, Kambar V, Govindagoudar MB Tags: Trop Doct Source Type: research

Pregnancy with bilateral tubercular pleural effusion: challenges.
We describe the intensive care management of a 27-year-old pregnant woman admitted to our hospital with life threatening respiratory distress and circulatory shock. She continued to have severe metabolic and respiratory acidosis with shock in spite of the resuscitative measures undertaken. At that point, a bedside lung ultrasonography showed bilateral pleural effusion which was followed with therapeutic thoracocentesis of the right side. This resulted in the stabilization of the respiratory mechanics and haemodynamics of the patient. The pleural fluid culture tested positive for acid fast bacilli after 4 weeks in the inten...
Source: Tropical Doctor - January 6, 2014 Category: Tropical Medicine Authors: Ahuja V, Gombar S, Kumar N, Goyal N, Gupta K Tags: Trop Doct Source Type: research

Gynaecological laparoscopic surgery: eight years experience in the Yaounde Gynaeco-Obstetric and Paediatric Hospital, Cameroon.
Abstract This is a retrospective analysis of eight years of gynaecological laparoscopic surgery in a resource-limited setting. All gynaecological patients managed by laparoscopy at the Yaoundé Gynaeco-Obstetric and Paediatric Hospital from 1 January 2004 to 30 November 2011 were included. Amongst the 9194 gynaecological surgeries performed during the study period, 6.9% (633) were done by laparoscopy. Most of the women underwent an operative laparoscopy (568/592; 95.9%). The most common indication was infertility (415/592; 70.1%). Diagnostic laparoscopies were mostly indicated for chronic pelvic pain (18/24;...
Source: Tropical Doctor - January 6, 2014 Category: Tropical Medicine Authors: Mboudou E, Morfaw FL, Foumane P, Sama JD, Mbatsogo BA, Minkande JZ Tags: Trop Doct Source Type: research

Box jellyfish envenomation: case report of effective lemon and oil emulsion treatment.
Abstract Box jellyfish are highly venomous and numerous possible treatments for envenomation have already been reported in the published literature. The hand of a 55-year-old scuba diver was stung in the Gulf of Guinea resulting in two crops of coalescing vesicles with intense pain and lymphadenopathy. Traditional therapies such as hot water, cold packs and acetic acid were ineffective. Symptoms were rapidly relieved after the application of a lemon-oil emulsion balm. Treatments for jellyfish envenomation generally aim to either denature the jellyfish venom or prevent the discharge of the venom. Lemon-oil emulsion...
Source: Tropical Doctor - December 11, 2013 Category: Tropical Medicine Authors: Hamann CR, Hamann D, Richardson C, Seeburger J Tags: Trop Doct Source Type: research

Clinico-epidemiological profile of seven adults with spotted fever from a tertiary care hospital in South India.
We present seven patients with SF treated between January 2007 and January 2008 in a tertiary care hospital in South India. All presented during the rainy season, with rash (100%) and generalized oedema (71%) being the most common features. There was one death due to type I respiratory failure. Renal failure, shock, aseptic meningitis and hepatitis were other significant abnormalities detected in these patients. Clinicians need to be aware of SF and suspect it in appropriate patients. PMID: 24334402 [PubMed - as supplied by publisher] (Source: Tropical Doctor)
Source: Tropical Doctor - December 11, 2013 Category: Tropical Medicine Authors: Gopinath KG, Chrispal A, Boorugu H, Chandy S, Prakash JJ, Abraham AM, Abraham O, Thomas K Tags: Trop Doct Source Type: research

Combining continuing education with expert consultation via telemedicine in Cambodia.
We present a Cambodian surgical centre's experience with a collaboration in which complicated orthopaedic cases were presented to a panel of consultants using free online videoconferencing software, providing a combined opportunity for both continuing education and the enhancement of patient care. Effects of the case conference on patient care were examined via a retrospective review and clinician perspectives were elicited via a qualitative survey. The case conference altered patient care in 69% of cases. All Cambodian staff reported learning from the conference and 78% reported changes in their care for patients not pres...
Source: Tropical Doctor - December 9, 2013 Category: Tropical Medicine Authors: Engle X, Aird J, Tho L, Bintcliffe F, Monsell F, Gollogly J, Noor S Tags: Trop Doct Source Type: research

Incidence of surgically drained cutaneous abscess in relation to climate in Mayotte, Comoros.
Abstract Although skin infections are common in tropical countries, there is scant data quantifying the relationship with climate conditions. The aim of this study was to assess the incidence and seasonality of skin abscess in Mayotte, Comoros. We collected data on patients with cutaneous abscesses requiring surgical drainage from January 2009 to December 2010. A total of 3423 abscesses were recorded. The overall annualized incidence was 785 cases per 100,000 population (95% confidence interval 754-814). The incidence rate peaked in children and abscesses were highest during the rainy season (964 cases per 100,000...
Source: Tropical Doctor - December 9, 2013 Category: Tropical Medicine Authors: Guerrier G, Montera AM, Mousset M, Steer A Tags: Trop Doct Source Type: research

Diagnosis of filariasis on cytology: a series of 24 cases.
Abstract Filariasis has a worldwide distribution, with a special predilection for tropical and subtropical areas. The microfilaria wanders in lymphatics and can be accidentally trapped in the needle during fine-needle aspiration cytology, thus leading to its incidental detection. This is a retrospective study of 24 cases of microfilarial infestation diagnosed on cytology. Accurate recognition and detection of the parasite leads to the institution of specific treatment and prevents chronic manifestations of the disease. PMID: 24311546 [PubMed - as supplied by publisher] (Source: Tropical Doctor)
Source: Tropical Doctor - December 5, 2013 Category: Tropical Medicine Authors: Handa U, Kundu R, Singhal N, Mohan H Tags: Trop Doct Source Type: research

Improving paediatric tuberculosis and HIV clinical record keeping: the use of audit and a structured pro forma in a South African regional level hospital.
We report on the impact of revisions made to an existing pro forma facilitating routine assessment and the management of paediatric HIV and tuberculosis (TB) in KwaZulu-Natal, South Africa. An initial documentation audit in 2010 assessed 25 sets of case notes for the documentation of 16 select indicators based on national HIV and TB guidelines. Using the findings of this initial audit, the existing case note pro forma was revised. The introduction of the revised pro forma was accompanied by training and a similar repeat audit was undertaken in 2012. This demonstrated an overall improvement in documentation. The three indic...
Source: Tropical Doctor - December 5, 2013 Category: Tropical Medicine Authors: Goenka A, Annamalai M, Dhada B, Stephen CR, McKerrow NH, Patrick ME Tags: Trop Doct Source Type: research

Leptospirosis and dengue fever: a predictive model for early differentiation based on clinical and biochemical parameters.
Abstract Leptospirosis and dengue fever are increasingly seen as causes of tropical febrile illness and often are clinically indistinguishable. This two-year prospective study from a tertiary care centre comprised 200 patients including 68 men (mean 34.8 years) with dengue and 73 (mean 46.19 years) with leptospirosis. Oliguria, icterus, muscle tenderness, anaemia, leukocytopenia, thrombocytopenia, elevated erythrocyte sedimentation rate (ESR), acute renal failure (ARF) and hypoalbuminaemia appeared more commonly in leptospirosis in comparison to dengue. Eighteen per cent mortality was observed in leptospirosis com...
Source: Tropical Doctor - December 5, 2013 Category: Tropical Medicine Authors: Varma MD, Vengalil S, Vallabhajosyula S, Krishnakumar PC, Vidyasagar S Tags: Trop Doct Source Type: research

Tetanus is still a deadly disease: a report of six tetanus cases and reminder of our knowledge.
Abstract We analysed the data in the medical records of six patients admitted for tetanus in the intensive care unit (ICU) of the anaesthesia department in the Medical Faculty of Ataturk University from 1 January 2010 to 31 December 2012. All patients received the generalized form of treatment for tetanus in the ICU. The average age of the patients was 65.33 ± 13.45 years. Treatment modalities were administered to the patients in accordance with the literature. Four patients died despite all therapeutic interventions and two patients were discharged uneventfully. All those who died had chronic...
Source: Tropical Doctor - December 3, 2013 Category: Tropical Medicine Authors: Aksoy M, Celik EC, Ahiskalioglu A, Karakaya MA Tags: Trop Doct Source Type: research

Hypokalaemic periodic paralysis in rural northern India - most have secondary causes.
Abstract Hypokalaemic periodic paralysis (HPP) is a life-threatening condition. Our aim was to study the clinical profile and laboratory parameters of HPP patients and to develop an algorithm to determine the causes of HPP. 84 patients presented with HPP over a 3 year period. 58 (69.0%) were found to have renal tubular acidosis (RTA). The other causes were idiopathic HPP (8 (9.5%)), acute gastroenteritis (4 (4.8%)), suspected primary hyperaldosteronism and familial HPP (2 each (2.4%)) and suspected Gitelman/Bartter Syndrome and thyrotoxic periodic paralysis (1 each (1.2%)). The number of cases peaks in the hot sea...
Source: Tropical Doctor - November 25, 2013 Category: Tropical Medicine Authors: Kumar V, Armstrong L, Seshadri M, Finny P Tags: Trop Doct Source Type: research

Coccidioidomycosis masquerading as skeletal tuberculosis: an imported case and review of coccidioidomycosis in India.
We describe a possible imported case of osteo-articular coccidioidomycosis in India. Culture of the computed tomography-guided aspirate revealed the growth of Coccidioides spp., which was identified as Coccidioides posadasii by sequencing of the internal transcribed spacer (ITS) region of rDNA. He was successfully treated with amphotericin B followed by itraconazole. All the previous published reports of coccidioidomycosis cases diagnosed in India are also reviewed in order to increase the awareness of this disease in non-endemic areas. PMID: 24265192 [PubMed - as supplied by publisher] (Source: Tropical Doctor)
Source: Tropical Doctor - November 21, 2013 Category: Tropical Medicine Authors: Capoor MR, Sen B, Varshney P, Verghese M, Shivaprakash MR, Chakrabarti A Tags: Trop Doct Source Type: research

Under the counter, underground or unethical medicines? An African perspective.
We report on the problems associated with unsuitable prescribing of medication in an African setting. PMID: 24265193 [PubMed - as supplied by publisher] (Source: Tropical Doctor)
Source: Tropical Doctor - November 21, 2013 Category: Tropical Medicine Authors: Alfa-Wali M, Mohammed I, Yusuph H Tags: Trop Doct Source Type: research

Tuberculosis of knee region in children: a series of eight cases.
Abstract Our study retrospectively reviewed the presentation, healing response, and functional results of eight cases of unilateral knee tuberculosis in children. The patients were evaluated for pain, instability, deformity, range of motion, and limb length discrepancy. Seven cases presented radiologically with Kerri and Martini's stage 1 or 2 and one in stage 4. Epiphyseal involvement was present in five cases. At final follow-up, all the knees were painless and stable. A full range of motion was recovered in the early stages. Limb length discrepancy was seen in six cases. Radiologically, despite clinical healing...
Source: Tropical Doctor - November 19, 2013 Category: Tropical Medicine Authors: Kant KS, Agarwal A, Suri T, Gupta N, Verma I, Shaharyar A Tags: Trop Doct Source Type: research

Ascariasis of gallbladder: a rare case report and a review of the literature.
We report a case of a 15-year-old boy who presented with complaints of pain in the abdomen, vomiting, pruritus, and fever on-and-off for 10 days. On radiological examination, an ultrasonography of the abdomen showed a dilated gallbladder with multiple linear echogenic, tubular, parallel lines inside the lumen of the gallbladder, common bile duct and intrahepatic biliary radicles. The zigzag and coiling movement of a worm was noted in the lumen of the gallbladder on real time B-mode ultrasonography. The patient was successfully treated with an anthelminthic drug. On follow up no evidence of the worm was noted in the gallbla...
Source: Tropical Doctor - November 19, 2013 Category: Tropical Medicine Authors: Khanduri S, Parashari UC, Agrawal D, Bhadury S Tags: Trop Doct Source Type: research

Scrub typhus and malaria co-infection causing severe sepsis.
We report a case of dual infection of scrub typhus and malaria in a 48-year-old woman. PMID: 24249027 [PubMed - as supplied by publisher] (Source: Tropical Doctor)
Source: Tropical Doctor - November 18, 2013 Category: Tropical Medicine Authors: Mahajan SK, Kaushik M, Raina R, Thakur P Tags: Trop Doct Source Type: research

Diphtheria in a 7-year-old child in north-eastern Nigeria - management in a resource-poor setting.
We report a case of a 7-year-old unimmunized child who presented with a 2 week history of nasal quality speech, hoarseness of the voice, regurgitation of feeds, and unstable gait. He had a previous history of fever, severe sore throat and bloody nasal discharge. A throat swab was negative for Corynebacterium diphtheria; however, he had received antibiotics at a primary care clinic prior to presentation. A clinical diagnosis of diphtheria with neurologic complication was made and the child was started on oral erythromycin, nasogastric tube feeding and daily physiotherapy, following which he improved. We did not prescribe di...
Source: Tropical Doctor - November 18, 2013 Category: Tropical Medicine Authors: Goni BW, Gofama MM, Lawan GM, Haruna Y, Bukar B, Musa KI Tags: Trop Doct Source Type: research

Foreskins: leave them alone.
PMID: 24249029 [PubMed - as supplied by publisher] (Source: Tropical Doctor)
Source: Tropical Doctor - November 18, 2013 Category: Tropical Medicine Authors: King M Tags: Trop Doct Source Type: research

Anaesthesia in Ethiopia: providers' perspectives on the current state of the service.
Abstract The improvement of surgical and anaesthetic safety in low-resource settings is hampered by a lack of reliable information on the current provision of these services. Ethiopia is one of the world's poorest countries and, despite large amounts of both foreign and domestic investment, still reports some of the worst health outcomes. However, information on anaesthesia and surgical provision is sparse. This work reproduces a questionnaire study, first used in Uganda in 2006, to survey practising anaesthetists regarding the current state of anaesthesia services across Ethiopia. The results indicate that a larg...
Source: Tropical Doctor - November 15, 2013 Category: Tropical Medicine Authors: Bashford T Tags: Trop Doct Source Type: research

The Uyo Trauma Registry-developed for sustainable audit of trauma care and cause in Nigeria.
Abstract The Cape Town Trauma Registry (CTTR) was developed as a minimum data set for low-resource settings and was applied in a southern Nigerian tertiary hospital. Based on the outcome of the study, the CTTR was modified to produce the Uyo Trauma Registry. Using the CTTR, data was obtained prospectively from injured patients who presented to the Accident and Emergency Department of the University of Uyo Teaching Hospital over a 7 week period in June and July 2012. The final data set was determined based on the ease of capture of each item and its relative importance to injury surveillance. The goal for satisfact...
Source: Tropical Doctor - November 14, 2013 Category: Tropical Medicine Authors: Nottidge TE, Dim M, Udoinyang CI, Udoh IA Tags: Trop Doct Source Type: research

Comments on 'Novel multidrug therapy for disseminated rhinosporidiosis, refractory to dapsone - case report'
Abstract Disseminated rhinosporidiosis can be successfully treated with multidrug therapy. Orally administered drugs can take longer to reach the affected areas in the presence of haemorrhage, oedema and inflammation. Wherever possible, surgical excision followed by drug therapy would be more effective. PMID: 24231685 [PubMed - as supplied by publisher] (Source: Tropical Doctor)
Source: Tropical Doctor - November 14, 2013 Category: Tropical Medicine Authors: Bhat V Tags: Trop Doct Source Type: research

From the toe to the head: metastatic endophalmitis following staphylococcal purpura fulminans.
We report on the case of a 42-year-old man without any co-morbidities who presented with fever and purpura fulminans and later developed metastatic endophthalmitis. He was treated with intravenous and intravitreal vancomycin. The case is reported because of the rare co-occurrence of purpura fulminans and endophthalmitis. PMID: 24231686 [PubMed - as supplied by publisher] (Source: Tropical Doctor)
Source: Tropical Doctor - November 14, 2013 Category: Tropical Medicine Authors: Sharma A, Sharma V Tags: Trop Doct Source Type: research

Brucellosis as an aetiology of septic arthritis.
We report a case of monoarthritis caused by Brucella melitensis. PMID: 24231687 [PubMed - as supplied by publisher] (Source: Tropical Doctor)
Source: Tropical Doctor - November 14, 2013 Category: Tropical Medicine Authors: Hasanoglu I, Guven T, Maras Y, Guner R, Tasyaran MA, Acikgoz ZC Tags: Trop Doct Source Type: research

Central nervous system involvement in scrub typhus.
Abstract Scrub typhus is an emerging infectious disease in India. Among its protean clinical manifestations, central nervous system involvement is common. In this prospective observational study, altered sensorium, headache, seizures and aseptic meningitis were found to be common central nervous system manifestations. Prompt treatment with doxycycline reduces morbidity and mortality. PMID: 24226290 [PubMed - as supplied by publisher] (Source: Tropical Doctor)
Source: Tropical Doctor - November 12, 2013 Category: Tropical Medicine Authors: Boorugu H, Chrispal A, Gopinath K, Chandy S, Prakash JJ, Abraham AM, Abraham O, Thomas K Tags: Trop Doct Source Type: research

Primary hydatid disease of brachialis and biceps brachii muscles: a case report.
We report a case of primary hydatic cyst located simultaneously in both the biceps brachii and brachialis muscles, treated with wide resection surgery and pre- and postoperative anthelmintic chemotherapy. PMID: 24226291 [PubMed - as supplied by publisher] (Source: Tropical Doctor)
Source: Tropical Doctor - November 12, 2013 Category: Tropical Medicine Authors: Aydin BK, Acar MA, Sumer S, Demir NA, Erkocak OF, Ural O Tags: Trop Doct Source Type: research

Visceral larva migrans: presenting as multiple liver abscesses.
We report two cases of VLM which presented with high grade fever and abdominal pain for 3-4 months. Marked peripheral eosinophilia, multiple confluent perivenous lesions in the right lobe of liver with characteristic migratory tracts on imaging and biopsy evidence of necrotizing eosinophilic granulomas led to the diagnosis. Complete recovery was achieved with repeated courses of a combination of anthelmintics. PMID: 24100348 [PubMed - as supplied by publisher] (Source: Tropical Doctor)
Source: Tropical Doctor - October 7, 2013 Category: Tropical Medicine Authors: Ramachandran J, Chandramohan A, Gangadharan SK, Unnikrishnan L, Priyambada L, Simon A Tags: Trop Doct Source Type: research

Pulmonary cryptococcosis presenting as wandering multiple bilateral shadows and hilar and mediastinal lymph node enlargement in the lungs.
We present a case of pulmonary cryptococcosis presenting as wandering multiple bilateral shadows and hilar and mediastinal lymph node enlargement in which the fluconazole treatment suppressed the symptoms. This case illustrates the complex nature of immunological responses in the lungs and highlights the need to consider the existence of cryptococcal allergies. PMID: 24096908 [PubMed - as supplied by publisher] (Source: Tropical Doctor)
Source: Tropical Doctor - October 4, 2013 Category: Tropical Medicine Authors: Pan JW, Zhang N, Jin YH, Ye ZT, Ma MQ, Cai XP, Cao Z Tags: Trop Doct Source Type: research

Initial combination of injectable and oral anti-tuberculosis agents for the treatment of severe disseminated tuberculosis.
We report an HIV-infected patient presenting with severe disseminated tuberculosis with extensive intestinal involvement which was successfully treated with an initial combination regimen of injectable and oral anti-tuberculosis agents. We discuss and emphasize the importance of an initial regimen with injectable and oral agents for treating severe forms of tuberculosis. PMID: 24096909 [PubMed - as supplied by publisher] (Source: Tropical Doctor)
Source: Tropical Doctor - October 4, 2013 Category: Tropical Medicine Authors: Boff DF, Goldani LZ Tags: Trop Doct Source Type: research

A rare cause of septic arthritis: melioidosis.
We present a case of a 50-year-old farmer who was diabetic and a chronic alcoholic, who presented to us with pneumonia, followed by septic arthritis. He was ultimately diagnosed as having melioidosis. PMID: 24067292 [PubMed - as supplied by publisher] (Source: Tropical Doctor)
Source: Tropical Doctor - September 25, 2013 Category: Tropical Medicine Authors: Caldera AS, Kumanan T, Corea E Tags: Trop Doct Source Type: research