Tropical Doctor最新文献

Tuberculosis (TB)-related deaths are preventable, yet research on co-infections primarily focuses on human immunodeficiency virus (HIV)-positive patients, leaving a gap for HIV-negative individuals. Early clinical monitoring is vital for reducing mortality, but research lacks clear links between mortality scoring, microbiological data, and prognostic factors. Despite early mortality being absent among our participants, we found prognostic markers such as comorbidity, smear-negative TB, high bacterial load, and bacterial co-infection correlated with elevated CABI scores.

Background: Cutaneous larva migrans (CLM) is a zoonotic dermatosis usually acquired through direct contact with contaminated soil. We describe what appears to be the first reported case of CLM following a leech bite.

Our study investigated the prevalence and risk factors for generalised anxiety disorder (GAD) in children with epilepsy. A clinically significant level of anxiety was observed in 8% of children with epilepsy, especially those who are older, have frequent seizures, or have been on antiepileptic drugs for extended periods.

A suture length to wound length (SL:WL) ratio of ≥4:1 when closing laparotomy incisions seems to help prevent incisional hernias. However, this practice is often not followed. Our prospective study of 140 patients assessed emergency midline laparotomy wound closure by surgical residents; and compared wound outcomes between those with and without a SL:WL ratio of ≥4:1. The latter was achieved in only one patient. While the incidence of wound dehiscence and of incisional hernia at six months was similar in those with a SL:WL ratio of <3 and ≥3 (p = 0.73 and p = 0.32 respectively), it was significantly higher in those with a SL:WL ratio <2.5 than ≥2.5 (p = 0.005 and p = 0.02 respectively). Even if an ideal SL:WL ratio of ≥4:1 cannot be achieved, a SL:WL ratio of ≥3 would be adequate to prevent surgeon-related wound dehiscence and incisional hernias.

Haemophagocytic lymphohistiocytosis (HLH) is a deadly hyper-inflammatory clinical response marked by excessive inflammation and tissue damage that can be secondarily triggered by infections, autoimmune and malignancy. HLH is usually caused by viruses and rarely by bacterial infections such as Salmonella enterica serovar Typhi. Its rising incidence of extended drug-resistant (XDR) in low-income countries such as Pakistan can lead to numerous complications but rarely secondary HLH.

Chromobacterium violaceum is a Gram-negative bacterium, which is an environmental pathogen causing fatal opportunistic infection in tropical and subtropical areas. This facultative anaerobe produces small colonies with dark violet metallic pigmentation due to the pigment 'Violacein', hence the organism derives its name. We report an uncomplicated urinary tract infection by this rare but fatal pathogen in a young immunocompetent female, who fortunately recovered completely with oral antibiotic therapy.

Heat stroke is a life-threatening heat-related condition. It is characterised by a core body temperature >40°C with central nervous system abnormalities or organ dysfunction. In our study of 32 adult patients, multiorgan dysfunction was present in 84%. Vasopressors, intensive care, and mechanical ventilation were required in 44%. Mortality was 6.2%. Aggressive pre-hospital cooling treatment may significantly decrease mortality; thus, preventive strategies need to be developed urgently to implement such cooling facilities in public places.