Tropical Doctor

We report a tale of two cases of neonates, where India Ink preparation of cerebrospinal fluid (CSF) received in glass vials was suggestive of Cryptococcus ; however, the absence of correlation and report of cases sequentially from the same unit raised alarm bells. Repeat smears using routine in-house and newly prepared stains were prepared and repeat sampling was collected in a strictly sterile specimen container, which resulted in negative microscopy for repeat samples (uncentrifuged and centrifuged). The source of contamination was found to be non-sterile glass vials used for CSF collection...

Our study compared the diagnostic accuracy of the 10% alcohol-formalin cell-block (CB) technique against traditional smears (CS) in serous effusions over 1 year. CB outperformed CS by detecting 7 missed cases and diagnosing 177 benign, 5 suspicious and 26 malignant cases compared to CS's 180 benign, 9 suspicious and 19 malignant cases. Using histopathology as a gold standard, CB showed a sensitivity of 96.4%, specificity of 98.3% and diagnostic accuracy of 98.1%, significantly higher than CS's 79.3% sensitivity, specificity of 97...

Acute febrile illness (AFI) in pregnancy is a neglected cause of maternal and foetal mortality and morbidity in low-and middle-income countries. This prospective cohort studied antenatal and postpartum women admitted with acute fever to a tertiary care university teaching hospital from July 2014 to March 2015 for aetiology, maternal and foetal complications, and the impact on maternal mortality ratio (MMR) and perinatal mortality rate. Among the 180 women admitted with AFI, urinary tract infection 54(30%) was the commonest cause, followed by airborne infections (67; 37...

The availability of radioisotopes for sentinel lymph node biopsy (SLNB) in breast carcinoma is limited in low- and middle-income countries and thus the need for other reliable tracers exists. We aimed to validate the effectiveness of fluorescein sodium (FS) together with methylene blue dye (MBD) for patients with node-negative early breast carcinoma in a prospective cross-sectional study. Patients underwent SLNB using FS and MBD followed by axillary dissection to validate results. Sentinel lymph node (SLN) identification rate and false negative rate were assessed for all three tracers/combinations (MBD, FS, and MBD + FS)...

Mycosis fungoides (MF) is the most common type of cutaneous lymphoma. However, granulomatous MF remains a rare subtype. Its incidence is estimated in the literature to be 6.3%. Clinical and pathological diagnosis of this entity is difficult owing to clinical heterogenicity and various histopathological mimics. We report one such case.

Histoid leprosy is an uncommon variant of lepromatous leprosy. It poses a diagnostic challenge because of its distinctive clinical and histopathological features. It presents as smooth papules and nodules that rarely ulcerate. We present the case of a 22-year-old Nigerian man with a 2-year history of multiple, dome-shaped papules and nodules on the skin with necrotic centres. General examination showed right axillary lymphadenopathy, non-pitting oedema, foot ulcer, and glove and stocking sensation loss. Despite previous misdiagnoses, histopathological examination showed dermal expansion by histiocytes arranged in a storiform pattern...

No abstract text is available yet for this article.

No abstract text is available yet for this article.

Our report describes the characteristics of patients admitted to the intensive care unit of the National Hospital of Samoa during the 2019-2020 measles epidemic. The study design was a retrospective review of clinical records; the age range was 2 months to 51 years, with the majority of cases in the 2-23 month age group (71%). Vaccination status was unknown or unrecorded for 17 (24%). Of the 54 (75%) who were not fully vaccinated, 35 (65%) did not survive. Almost all (98%) presented with multiple complications on admission, mostly pneumonia (91%)...

Treatable surgical diseases account for a significant proportion of the global burden of disease, particularly in low- and middle-income communities. The number of deaths owing to poor surgical care or its non-availability has been reported to exceed those from HIV/AIDS, tuberculosis and malaria combined. The Ugandan government and its development partners aim to put in place measures to achieve universal health coverage for all communities. These include construction and equipping health facilities, training of health workers, opening up road networks, and poverty alleviation programmes...

Scabies is a neglected tropical disease and has been highlighted as a target for control. Sarcoptic mange affects animals, but mange is also considered a zoonosis. We present rapid assessment data on scabies and sarcoptic mange collected from key informants via a web-based questionnaire in Ceará State (1265 data entries). A total of 181/184 (98.3%) municipalities reported the occurrence of human scabies; 149 (80.9%) current occurrence; 168 (91.3%) severe cases; and 113 (61.4%) severe cases currently. Sarcoptic mange was reported from 149/184 (80...

We discuss an illustrative case of Escherichia coli infected scalp abscess with osteomyelitis following a cephalhaematoma in a 19-day-old neonate. Cephalhaematoma is a common occurrence in neonates after prolonged labour, instrument-assisted, and traumatic deliveries and resolves spontaneously in the majority of cases. Infection may follow haematogenous dissemination or direct inoculation via a skin breach. Complications such as scalp abscess, sepsis, and osteomyelitis of the skull present with local signs, including increasing size, local erythema and tenderness, and fluctuant swelling...

No abstract text is available yet for this article.

There are no standard guidelines regarding time for initiation of feeds in moderate to severely asphyxiated neonates and data regarding the same in neonates are scanty. Case sheets of all neonates born ≥34 weeks of gestation who satisfied the definition were analysed. The early feeding group was defined as those in whomh feeds were started <24 h and the late feeding group as those started ≥24 h of life. The primary outcome of the study was time to achieve full enteral feeds. A total of 184 neonates were enrolled...

The aim of this study was to assess the sensitivity and specificity of ultrasonography in the diagnosis of carpal tunnel syndrome. The cross-sectional area of the median nerve at the carpal tunnel for a positive diagnosis had a sensitivity of ∼ 98.6% but a specificity of 60%. The measure of the difference in cross-sectional area of the median nerve at the carpal tunnel and at the level of pronator quadratus had much better sensitivity and specificity of 97.1% and 80%, respectively. Signs of nerve flattening, palmar bowing and increased nerve vascularity were valuable in confirming the diagnosis...

No abstract text is available yet for this article.

No abstract text is available yet for this article.

Our cohort study aimed to compare serum C-reactive protein (CRP) and procalcitonin (PCT) levels in children with community-acquired pneumonia defined by WHO. The former differentiated between pneumonia and severe pneumonia while the latter was better for the outcome of pneumonia.

No abstract text is available yet for this article.

Can a smart phone application be reliably used for laryngoscopy? This thesis was tested for peri-operative evaluation of vocal cords in patients undergoing thyroid and parathyroid surgery.