Tropical doctor
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On 24 July 2005, six members of a single family were admitted to the Medicine and Pediatrics Department of Khulna Medical College Hospital, Khulna, Bangladesh, with a history of ingestion of puffer fish. All patients developed toxic manifestations. The cases were clinically analysed with successful outcomes.
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Dapsone is a component of multi-drug therapy (MDT) for the treatment of all types of leprosy. It is known that dapsone hypersensitivity syndrome (DHS) complicates the treatment in a proportion of patients. We performed a retrospective study of patients commenced on MDT between 1990 and 2006; 2% developed DHS and 0.25% died due to DHS.
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Due to the insidious nature of infant anaemia, this disorder frequently remains undetected and untreated by health-care workers in resource-poor settings. We assessed the accuracy of a low-cost and simple diagnostic tool, the haemoglobin colour scale (HCS), in estimating haemoglobin (Hb) values in infants between zero and four months of age. In a rural hospital in Zambia, blood samples were analysed for Hb concentration by HCS and HemoCue method. ⋯ Limits of agreement were -2.39 to 1.51, -1.80 to 2.20 and -1.98 to 1.75 g/dL, respectively. Disagreement with HemoCue measurements of more than 2 g/dL was noted in only 4% of all blood samples. We conclude that the HCS provides Hb estimations in infants aged 0-4 months that are sufficiently accurate to improve timely recognition of anaemia in settings where there is no laboratory.
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The aim of this study was to describe the aetiology of congestive cardiac failure (CCF) in children with suspected structural abnormalities presenting to a regional hospital in southwestern Uganda. The method used was a prospective descriptive study of successive admissions of children with persistent cardiac signs after routine treatment of CCF. Children with severe anaemia (haemoglobin [Hb]<7 g/dL), pneumonia, sepsis or severe malnutrition were excluded. ⋯ The aetiology of heart failure in this cohort (n = 58) was due to congenital heart disease (35%), renal hypertensive disease (26%), rheumatic heart disease (17%), cardiomyopathies (12%), endomyocardial fibrosis (7%) and tamponade (3%). In conclusion, this study confirmed the ongoing prevalence of congenital heart disease, rheumatic heart disease and endomyocardial fibrosis in this area. The cardiac effect of renal hypertension was a new and significant finding.