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Tropical Doctor

Vivek Agrawal, Rohit Ranjan
Syphilis is notorious and a great imitator of all diseases. It is a chronic bacterial infection, caused by the sexually transmitted spirochete, Treponema pallidum. Though it has drastically reduced in prevalence, its recent resurgence (especially with HIV disease) is worrying. Without treatment, the disease can progress over years through a series of clinical stages and lead to irreversible neurological or cardiovascular complications. The disease may occur in any organ, including the testis, and is commonly mistaken for malignancy...
November 4, 2018: Tropical Doctor
Sagar Jawale, Gnanaraj Jesudian
Diagnostic laparoscopies are a very useful diagnostic tool especially in rural areas. However, the very high costs of the current diagnostic equipment make them unavailable to most of the rural centres. We describe a low-cost laparoscope that does away with the telescope and rod lens system and offers very good quality pictures for diagnostic laparoscopy at small fraction of the cost of current laparoscopic surgical instruments.
November 4, 2018: Tropical Doctor
Sagar A Jawale, Gnanaraj Jesudian, Rajendra Nehete
This case series of 51 patients (age range = 11-17 years; 30-month follow-up) describes a new modified approach to treatment of distal and mid-penile hypospadias that has fewer complications. The meatal locations were sub-coronal (51%), coronal (45%) and mid-penile (4%). Forty patients had chordee. Urethra with the corpus spongiosum was dissected off the corpus cavernosum up to the peno-scrotal junction. The distal 5 mm stenotic and avascular part of the urethral tube was excised. The elastic urethra was then stretched and sutured to form a neo-meatus...
November 4, 2018: Tropical Doctor
Shipra Agrwal, Aashima Dabas, Mukta Mantan, Sangeeta Yadav
Hemophagocytic lymphohistiocytosis (HLH) is a syndrome of unchecked activation of the immune system leading to phagocytosis of blood cells and proliferation of histiocytes in solid organs. HLH can be primary or secondary to infective, autoimmune and malignant conditions. Scrub typhus is an infective illness caused by Orientia tsutsugamushi, transmitted by mite. The illness ranges from mild fever with rash to severe multisystem illness. Scrub typhus has rarely been associated with secondary HLH. We report an infant with scrub typhus who progressed to develop HLH with central nervous system involvement with fatal outcome...
October 26, 2018: Tropical Doctor
Fegan David, Glennon Mary Jacqueline
Chronic leg ulcers in children in tropical developing countries are common. They are difficult to diagnose clinically and to manage. Our case illustrates that even in areas where yaws is endemic and point of care testing is available, the diagnosis remains difficult.
October 15, 2018: Tropical Doctor
T G Sindhu, M G Geeta, P Krishnakumar, S Sabitha, K K Ajina
This study was conducted to analyse the clinical characteristics of measles in infants and to compare them with those in older children. Clinical and sociodemographic details of all hospitalised children with suspected measles were recorded and confirmed cases were analysed further. Twenty-four infants and 34 children aged >1 year were included. Most infants were boys and 15 (62.5%) of them were aged <9 months. Early onset of rash (within three days of fever in 62.5% of cases) occurred in infants. The complications of measles in infants included bronchopneumonia (n = 17, 71%), acute diarrhoea (n = 8, 33%), meningitis (n = 1, 4%) and staphylococcal sepsis (n = 2, 8%)...
October 14, 2018: Tropical Doctor
Ashok Kumar Pannu, Navneet Sharma
Thyrotoxicosis can present as a sporadic form of hypokalaemic periodic paralysis. The condition is associated with massive intracellular shift of potassium, mainly in skeletal muscles. As the total body stores of potassium remain normal, overzealous potassium supplementation targeting serum potassium level results in a poor outcome. We present a fatal case of thyrotoxic hypokalaemic periodic paralysis.
October 10, 2018: Tropical Doctor
Sunil Taneja, Neha Agarwal
Autoimmune haemolytic anaemia due to malaria or following its treatment with artesunate is rare. A child presented with severe anaemia after being treated with artesunate for P. vivax malaria. Blood transfusion was difficult as cross-matching showed major incompatibility; group O negative blood under the cover of steroids was transfused. Oral steroids were given for six weeks. The patient made a complete recovery.
October 6, 2018: Tropical Doctor
Shibani Bhatia, Shrutakirthi D Shenoi, Kanthilatha Pai, Srilatha Ps
Granuloma multiforme (GM) is a chronic granulomatous skin condition which is clinically characterised by annular lesions mainly over sun-exposed areas and histologically by focal necrobiosis and histiocytic granulomas. Its significance lies in the fact that it can clinically resemble tuberculoid leprosy and hence it can be missed. Here, we report a case of GM from India in a 55-year-old female agriculturist, with multiple asymptomatic large annular rings of papules over the photo-distributed areas. Histopathology helps in confirming the diagnosis and in differentiating it from similar clinical and histologic mimics such as granuloma annulare, tuberculoid leprosy, interstitial granulomatous dermatitis or annular sarcoid...
October 4, 2018: Tropical Doctor
Sidharth Tandon, Surabhi Sinha, Jasmeet Singh
We present a rare case report of a 28-year-old man with a five-month history of bizarre extensive erythematous plaques on the abdomen extending in a dermatomal fashion to the left upper back.
October 4, 2018: Tropical Doctor
Valerie Brueton, Richard Brueton
Improving hospital safety is challenging in resource-poor countries. Before a new hospital opened in Malawi, we simulated a patient's pathway from admission to discharge, through which we identified associated administrative and clinical activities. Newly recruited hospital personnel enacted the simulation: admission procedures; preoperative clinical assessment; patient preparation for theatre and surgery; safety checks of surgical and anaesthetic equipment; adherence to aseptic technique; postoperative care; and hospital discharge...
September 30, 2018: Tropical Doctor
Sailaja Devi Kallur, Tarakeswari Surapaneni, Hari Kishan Boorugu, Nuzhat Aziz, Anisha Ramniklal Gala, Swathi Donnuri
The incidence of dengue has risen in India in recent years. Evidence suggests that dengue in pregnancy may be associated with adverse maternal and fetal outcomes. The aim of our study was to analyse outcomes in pregnant women with confirmed dengue infection who had the benefit of close monitoring and intensive management at a tertiary maternity facility. We reviewed hospital data of 44 (0.11%) such women at Fernandez Hospital, a tertiary maternity unit, during the five-year period from 2011 to 2016. Maternal and fetal variables were collected from case sheets...
September 30, 2018: Tropical Doctor
Amir Abdoli, Mohammad Barati, Majid Pirestani, Abdolhossein Dalimi
Toxoplasmosis is an opportunistic infectious disease in immunocompromised patients, including cancer patients, whose detection is by molecular and serological methods. A total of 106 blood samples from patients with different types of cancer were evaluated for anti- Toxoplasma gondii IgG and IgM antibodies by the enzyme-linked immunosorbent assay (ELISA) and the parasite DNA by nested polymerase chain reaction (PCR). These were detected in 41.51% (44/106) and 0.94% (1/106), respectively, but T. gondii IgM antibody was not detected at all...
September 30, 2018: Tropical Doctor
Nishanth Dev
Vector-borne diseases cause a significant burden on healthcare facilities. An increasing number of cases reported with multiple co-infections only add to the ordeal. The presence of co-infection may modify clinical and laboratory parameters significantly making diagnosis and treatment a challenge. Cases of malaria and dengue with other infections such as chikungunya, leptospirosis and hepatitis have been reported previously. We report a case of acute febrile illness with altered sensorium which was eventually diagnosed to have quadruple infection with malaria, dengue, chikungunya and Japanese encephalitis...
September 27, 2018: Tropical Doctor
(no author information available yet)
No abstract text is available yet for this article.
September 26, 2018: Tropical Doctor
Elie Nkwabong, Ingrid Laure Bessi Badjan, Zacharie Sando
This cross-sectional descriptive study, aimed at accessing the accuracy of Pap smear in diagnosing cervical precancerous lesions, was carried out between 3 January and 30 April 2017. All women screened for cervical dysplasia by means of Pap smear with biopsy done for confirmation were subsequently recruited. Data were analysed using SPSS 20.0. A total of 231 women were screened for cervical dysplasia using Pap smear with 75 biopsies performed. Cervical dysplasia was noticed in 54 cases. The sensitivity, specificity, positive predictive and negative predictive values of Pap smear were 55...
September 15, 2018: Tropical Doctor
Mohamed S Muneer, Ahmed E Elhassan, Ahmed M Osman, Abdelmohaymin A Abdalla, Mohamed A Abdelrahim, Suad M Ali, Ihab B Abdalrahman
Breaking bad news is a global challenge for all types of health providers. Our study assessed the attitude and practice from the doctors' perspective in a patriarchal society. A descriptive cross-sectional hospital-based study was conducted, involving doctors from both medical and surgical departments. Almost half of the respondents believed that Sudanese patients do not like to know their diagnosis, and a slightly higher proportion had no previous training on how to break bad news. Some 20% indicated that they would conceal the diagnosis from a patient if his or her relatives so requested...
August 28, 2018: Tropical Doctor
Daniel Yeomans, Simon M Graham, Nyengo C Mkandawire, William J Harrison, Daniel C Perry
In low-income countries, where surgical expertise and resources are limited, displaced supracondylar fractures of the distal humerus are routinely managed with traction or closed reduction and casting. This is in contrast to high-income nations, where percutaneous K-wire fixation forms the mainstay of treatment. The aim of our study is to present the published evidence regarding the outcome of conservatively managed displaced supracondylar fractures in children. A systematic review of the literature was performed identifying 46 studies evaluating the outcome of displaced supracondylar fractures managed non-operatively...
August 28, 2018: Tropical Doctor
Ashish Jain, Sanchit Jain, Neha Singh, Sushant Kumar Meinia, Nilotpal Chowdhury
There is scant documentation of the stability of common haematological parameters on storage of blood samples under tropical conditions. K2 EDTA samples in multiple vials were taken from 20 healthy blood donors, baseline readings taken, and stored at 33℃ and 37℃. Readings from the stored vials were taken after 1, 3 and 6 h. The percent change against the baseline readings at each time point for each storage temperature was calculated. Platelet counts showed an unacceptable shift within 1 h at 37℃ and 3 h at 33℃; red cell volume related parameters showed an unacceptable shift within 3 h at 37℃ and 6 h at 33℃...
August 28, 2018: Tropical Doctor
Sudipta Patra, Vandana Ke, Chaitanya Tellapragada, Chiranjay Mukhopadhyay
The aim of our study was to examine and compare the clinical presentations, complications, laboratory findings, treatment and outcome of patients with acute, subacute and chronic forms of brucellosis in a tertiary care setting. This hospital-based observational study was undertaken between April 2015 and March 2017. Patients diagnosed with brucellosis, either by blood culture or serology or both, were recruited. A total of 94 cases of brucellosis of acute, subacute and chronic forms were observed in 78.7%, 15...
August 27, 2018: Tropical Doctor
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