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Trop Doct [journal]
- Alternative medicine use at Vila Central Hospital: a survey of 'custom medicine' use in patients and staff a decade later. [JOURNAL ARTICLE]
- Trop Doct 2014 Mar 6.
A structured questionnaire was administered to 50 medical patients, 50 surgical patients and 50 staff members at Vila Central Hospital, Vanuatu. A similar study was conducted 10 years earlier. In the intervening decade, Vanuatu has seen unprecedented population growth, increasing expatriate numbers, and the introduction of mobile phone and Internet networks. Given these social transformations, this study aimed to identify changes in custom medicine use over this period. Fifty-nine percent of interviewees had used custom medicine at least once, compared to 86% reported in the 2003 study. Thirty-two percent had used custom medicine in the last 12 months, a significant decline from 60% in the previous study. Collectively, rates of custom medicine use have declined but especially in the physical therapies such as bone setting. We believe this declining custom medicine use reflects an overall weakening traditional culture within Vanuatu and believe that within a generation, custom medicine knowledge will likely be lost.
- Global Positioning System: a new tool for measurement of animal bites in a rural area near Bangalore, South India. [JOURNAL ARTICLE]
- Trop Doct 2014 Mar 6.
This exploratory study was conducted in villages near Bangalore, South India with the primary objective of spatial mapping animal bite cases using Global Positioning System (GPS) technology. GPS technology was useful as a new tool in accurate measurement of animal bite cases.
- Epidemiology of tetanus in Jamaica, 1993-2010. [JOURNAL ARTICLE]
- Trop Doct 2014 Mar 4.
BackgroundAlthough tetanus is still endemic in Jamaica, the epidemiologic profile has not been evaluated.MethodsAdmission registers at the main tertiary referral hospital were accessed to identify all patients diagnosed with tetanus from 1 January 1993 to 1 December 2010.ResultsThere were 26 cases of tetanus (annual incidence of 0.57 cases per 1,000,000 population). Tetanus was more common in men (5.2:1) at a mean age of 59 ± 18.1 years. Persons in high-risk occupations (farmers, gardeners and construction workers) accounted for 52% of cases.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.
- Antepartum uterine rupture in a twin gestation presenting as an advanced extrauterine pregnancy in a patient with a previous lower segment Caesarean section. [JOURNAL ARTICLE]
- Trop Doct 2014 Feb 27.
We present a case of spontaneous antepartum uterine rupture through a previous lower segment Caesarean section (LSCS) scar with clinical features mimicking an advanced extrauterine pregnancy (AEUP) in a twin pregnancy at 28 weeks gestation. 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.
- Myocardial injury following multiple bee stings. [JOURNAL ARTICLE]
- Trop Doct 2014 Feb 25.
Envenomation by the honey bee can cause multi-organ dysfunction as a result of toxic effects and may cause a severe anaphylactic reaction. Acute myocardial ischemia is an extremely rare complication of bee envenomation. We report a case of a 58-year-old woman with acute myocardial injury following massive bee envenomation.
- Initiating and developing clinical services, training and research in a low resource setting: the Malawi ENT experience. [JOURNAL ARTICLE]
- Trop Doct 2014 Feb 25.
BackgroundSub-Saharan Africa countries like Malawi have a paucity of ear, nose and throat (ENT) data, services and training opportunities.ObjectiveTo reflect on new Malawian ENT experience and to propose guidelines to poorly resourced countries.DesignAnalysis of data predating and following establishment of ENT services in Malawi.ResultsIn 2008 the first and only Malawian ENT specialist established ENT services with external funding. Fifteen clinical officers have been trained and a nurse placed at each outreach hospital. In 2012, 15,284 consultations were recorded: 543 (3.6%) from outreach clinics. Forty-nine percent needed medical treatment, while 45% needed medical advice. Surgery was performed on 2.7% of patients; 21% for foreign bodies in the nose and throat and 18% for foreign bodies and biopsies of ears.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.
- Abdominal and scrotal wall emphysema in a patient with severe ulcerative colitis. [JOURNAL ARTICLE]
- Trop Doct 2014 Feb 24.
Severe ulcerative colitis can be associated with bowel perforation. Bowel perforation rarely leads on to abdominal wall and scrotal wall emphysema. Bowel perforation in such cases can be spontaneous or iatrogenic (colonoscopy-related). 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.
- Outbreak of scrub typhus in North India: a re-emerging epidemic. [JOURNAL ARTICLE]
- Trop Doct 2014 Feb 20.
Scrub typhus is re-emerging in India. 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.
- Isolated cold abscess of the thigh in an immunocompetent infant. [JOURNAL ARTICLE]
- Trop Doct 2014 Feb 19.
Isolated cold abscess of the thigh without active tuberculosis elsewhere in the body is a rare entity, and only a few cases have been reported in the literature. 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.
- Scrub typhus in Punjab: an acute febrile illness with multisystem involvement. [JOURNAL ARTICLE]
- Trop Doct 2014 Feb 18.
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 symptoms. All others had some complication, namely ARDS/ALI in 18 (29%), neurological involvement in 12 (19.4%), acute kidney injury (AKI) in 16 (25.8%), hypotension in eight (12.9%), thrombocytopenia in 23 (37.1%), hepatitis in 34 (54.8%) and MODS in 19 (30.7%). Eschar was present only in nine patients. Three patients expired due to multi-organ failure, hypotension and metabolic acidosis.