Tropical Doctor最新文献

Cleft lip and/or palate (CLP) is among the most common congenital anomalies worldwide. While primary surgical repair is essential, comprehensive CLP care also depends on equally important secondary services such as speech therapy, audiologic support, orthodontic care, and revision surgeries. In many low- and middle-income countries (LMICs), these services remain limited or inaccessible, resulting in suboptimal long-term functional, aesthetic, and psychosocial outcomes. Our narrative review searched across PubMed and Embase databases to identify the availability, delivery models, and outcomes of secondary CLP services in LMICs. We found 17 relevant studies and mapped existing evidence, identified key gaps, and explored barriers related to workforce shortages, training, infrastructure, and financial constraints. Our findings highlight the urgent need to strengthen multidisciplinary CLP care pathways beyond primary surgery. Investments in sustainable local capacity, tele-health enabled service models, task-sharing, and community-based interventions are crucial to achieving equitable, high-quality CLP outcomes in resource-limited settings.

Neurobrucellosis can present as raised intracranial pressure (headache, diplopia, and papilledema) without fever or meningeal signs. Steroids might be helpful in the management.

Meigs syndrome is characterised by the triad of ovarian fibroma associated with ascites and pleural effusion, the latter of which resolves after removal of the fibroma. This uncommon but important clinical entity mimics malignancy in postmenopausal females. We present two such cases.

Chikungunya fever is an arboviral disease and remains a major public health concern in India ever since its first emergence in 1963 in Kolkata. Delhi has witnessed several outbreaks over the years. This retrospective study was performed to examine the epidemiological dynamics on all clinically suspected Chikungunya cases tested by ELISA for anti-CHIK virus IgM antibodies from 2010 to 2020 at a tertiary care hospital in Delhi. Archived data of suspected patients screened for CHIKV IgM by ELISA were retrieved for the period 2010-2020. Epidemiological data was used in the study. GIS mapping was done for the positive cases. Among the 445 samples tested, 57.3% were positive with the greatest number of cases (76.5%) in 2016 and significantly higher number of cases in monsoon & post-monsoon periods (p < 0.005). Seropositivity was highest in patients aged 45-54 years (69.6%); however, the disease did not show predilection for a specific gender. GIS mapping showed the burden of Chikungunya infection was concentrated in a 5-10 km radius from the study site with significant presence of cross-border cases. Our study indicates a geographically concentrated burden of Chikungunya in East and South East Delhi with ebbs and flow over time in the past decade. In view of non-availability of any licensed vaccine for this disease, surveillance of active cases, vector management and mapping of disease may help in prevention strategies.

Melioidosis, an infection caused by the Gram-negative bacterium Burkholderia pseudomallei, has earned the nickname 'the great mimicker' owing to its tendency to resemble common infections, often leading to a delayed diagnosis and high mortality. We report three cases where it mimicked scrub typhus, tubercular arthritis, and Klebsiella pneumoniae infection. The diagnosis of melioidosis was achieved by extensive workup; our case series sends the lesson that none should stop and settle for less, but continuously search for the actual pathogen where no adequate response to treatment is perceived.