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Trop Doct [journal]
- Household training vs. mass campaigns: a better method of health communication for preventing malaria. [JOURNAL ARTICLE]
- Trop Doct 2014 Aug 26.
Malaria is endemic in several states of India with high tribal population. Effective use of long-lasting insecticide treated bed nets (LLITNs) can reduce the burden of malaria in these settings. This study assessed the knowledge and behaviour regarding malaria in a tribal population and compared two health education strategies for enhancing effective utilisation of bed nets. A community-based intervention study was carried out among 218 households in two villages. One community received household level training on effective utilisation of LLITNs while the others received training in a mass campaign and outcomes were measured after 2 months. The study showed that the proportion utilising LLITNs was significantly higher among those receiving household level training as compared to those who received the mass campaign. Household level training appears to be a more effective form of health education for improving knowledge and promoting use of LLITNs in these isolated community groups.
- Immediate hypersensitivity reaction following liposomal amphotericin-B (AmBisome) infusion. [JOURNAL ARTICLE]
- Trop Doct 2014 Aug 19.
Liposomal amphotericin-B (AmBisome) is now becoming first choice for the treatment of visceral leishmaniasis (kala-azar) patients due to high efficacy and less toxicity. The reported incidence of hypersensitivity reactions to liposomal amphotericin-B (AmBisome), especially during therapy, is very rare. We report two patients with kala-azar: one developed breathing difficulties and hypotension followed by shock and the other had facial angioedema with chest tightness during treatment. Both patients were managed with immediate action of injection: adrenaline, diphenhydramine and hydrocortisone. In our experience, AmBisome can cause severe hypersensitivity reactions that warrant proper support and close supervision.
- Comments on 'Current emerging situation of dengue in India': with regard to the clinical and laboratory characteristics of paediatric dengue in India. [JOURNAL ARTICLE]
- Trop Doct 2014 Aug 5.
Dengue is a major public health problem in India. We evaluated clinical and laboratory characteristics of 700 suspected dengue patients below the age of 12 years. Serum samples of the patients were analysed for dengue NS1 antigen and IgM antibody by ELISA, and were correlated with clinical and haematological parameters. The positivity percentage of the serological tests showed an inverse relationship with age. Positive NS1 antigen and IgM antibody results were significantly associated with patients aged less than 3 years and more than 3 years, respectively. Maximum association with features of haemodynamic instability was seen in infants. The haemorrhagic manifestations of thrombocytopaenia, leucopaenia and anaemia were associated more with older age groups. This study provides evidence for age-related differences in clinical and laboratory features of paediatric dengue in an Indian setting.
- Wonder of Life (kalanchoe pinnata) leaves to treat diabetic foot infections in Trinidad & Tobago: a case control study. [JOURNAL ARTICLE]
- Trop Doct 2014 Jul 31.
: Wonder of Life (kalanchoe pinnata) leaves are commonly used to treat diabetic foot infections. These patients are usually non-compliant with conventional medical therapy. We surmised that these patients would have a higher incidence of treatment failures. Patients admitted with diabetic foot infections were separated into two groups: a Study Group comprised patients who used topical kalanchoe pinnata and a Medical Therapy Group contained patients who were compliant with conventional treatment. The patients were observed over the course of their hospitalisation.There were 382 patients in the Medical Therapy Group and 96 in the Study Group, who waited 9.21 ± 5.3 days (Mean ± SD) before seeking medical attention. There were similar rates of all amputations (34.8% vs. 37.5%; P = 0.643) and mortality (0.8% vs. 1.0%; P = 1.000) in the Study and Medical Therapy groups.There may be value in the use of topical kalanchoe pinnata to treat diabetic foot infections.
- Thrombocytopenia in malaria: its usefulness in a clinical setting. A study from Western Rajasthan, India. [JOURNAL ARTICLE]
- Trop Doct 2014 Jul 31.
To assess the occurrence of thrombocytopaenia in hospitalised patients of malaria and to correlate its severity with the type of malaria in Western Rajasthan.A total of 100 patients with proven malaria were included in this study. Haematological parameters were determined by using an automated analyser. Fifty malaria-free patients were taken as controls.In the study group of 100 patients; 45 patients had P. vivax malaria, 38 had P. Falciparum malaria and mixed malaria was detected in 17 patients. Out of 100 patients, 89 patients had thrombocytopaenia while out of 50 controls only eight (16%) patients had thrombocytopaenia (P < 0.001). Ninety-one percent of patients with thrombocytopaenia also had anaemia. Thrombocytopaenia was more commonly associated with complicated malaria compared to uncomplicated malaria (P < 0.001).Any patient in a malaria endemic zone presenting with acute febrile illness and having thrombocytopaenia and anaemia should be alerted to the possibility of malarial infection.
- The 'Malawi device': a durable, reusable, low cost device from own materials for emergency ventilation during percutaneous tracheostomy. [JOURNAL ARTICLE]
- Trop Doct 2014 Jul 10.
The use of a tracheostomy is routine in current intensive care practice to facilitate weaning patients requiring prolonged respiratory support from mechanical ventilation. Percutaneous tracheostomy has become an established technique with an acceptable risk profile in appropriately selected patients, and has the advantage that it can be performed at the bedside without the need for an operating theatre. This is particularly relevant in a resource-poor setting. Ideally, percutaneous tracheostomy requires the presence of two skilled persons; one to perform the tracheostomy while the other controls the airway and withdraws the endo-tracheal tube at the appropriate time. This is not always possible in a resource poor setting with limited manpower. Without two operators, it is possible for the tracheal tube to become displaced before the completion of the tracheostomy with potentially disastrous consequences. We describe a method by which the airway and ventilation can be maintained if accidental tracheal extubation occurs before completion of a percutaneous tracheostomy. The 'Malawi Device', a cheap and simple modification of readily available equipment, enables a single operator to maintain the airway and ventilate the patient when the above scenario occurs.
- Dengue epidemiological trend in Oman: a 13-year national surveillance and strategic proposition of imported cases. [JOURNAL ARTICLE]
- Trop Doct 2014 Jul 3.
Dengue fever has emerged as a major public health problem globally in the past three decades. A 13-year national surveillance data analysis was done to describe the epidemiology and its trend of dengue disease in Oman reported between 2001 and 2013. Laboratory-confirmed dengue virus infections reported were studied retrospectively during the study period. A total of 64 laboratory confirmed cases were reported. All the patients contracted the disease during their visit to South-East Asian countries, hence classified as imported cases. The majority of the cases were reported in the year 2012 (23.4%). The most important clinical characteristics were fever (90.6%), myalgia (35.9%) and rash/petechial rash (20.3%). Thrombocytopenia was seen in 31.2% of the study subjects. The mortality was nearly 4.6% and all other patients made a full recovery. The most effective measure for travellers is taking precautions to avoid mosquito bites.
- Massive intrathoracic lipoma: a report of two cases, one being congenital. [JOURNAL ARTICLE]
- Trop Doct 2014 Jun 30.
Massive intrathoracic lipomas are uncommon. Few cases have been reported worldwide. We report two cases, one of which was congenital. They were managed by thoracotomy and complete excision, with excellent outcomes.
- Maternal and neonatal complications of macrosomia. [JOURNAL ARTICLE]
- Trop Doct 2014 Jun 23.
This case control study, aimed at identifying complications of macrosomia, was conducted in two major hospitals of Yaoundé, Cameroon over a 6-month period from 1 October 2012. Maternity records were compared of births weighing ≥4000 g with those weighing between 3000 g and 3500 g. The main outcome variables were mode of delivery, low genital lacerations, Apgar score, birth injuries, postpartum haemorrhage and early neonatal death. Data were analysed using SPSS 18.0. Chi-square test or Fisher's exact test and t-test were used for comparison. P < 0.05 was considered statistically significant. Maternal complications observed were poor uterine contractions during labour, second-degree perineal tears, Caesarean section, instrumental delivery and postpartum haemorrhage. Neonatal complications were birth injuries, poor 5-minute Apgar score and early neonatal death. In our setting, macrosomia is associated with increased maternal and neonatal complications.
- Global warming and altitude malaria. [EDITORIAL]
- Trop Doct 2014 Jun 9; 44(3):125-127.