Tropical doctor
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There are few published reports of hypertrophic cardiomyopathy (HCM) in Africans, partly due to lack of Echocardiography machines at most hospitals. Among 6680 patients referred for echocardiography at Muhimbili National Hospital between June 1998 and October 2002, 134 (0.19%) patients had HCM. ⋯ Due to the diverse clinical features only eight (5.9%) patients had a correct diagnosis of HCM prior to their ECHO. The important role of echocardiography in the diagnosis of HCM is stressed with a plea for the increasing availability of this non-invasive technique for early and accurate diagnosis.
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Increasingly, international health links are evolving between UK health-care institutions and those in developing countries, the core aims of which are to seek the transfer of ideas, knowledge, skills and training. This study aimed to evaluate established health links, what constitutes them and how they are supported. Benefits and challenges associated with the links, as perceived both by link coordinators in the UK and their overseas partners, were explored. ⋯ Many of the health links showed signs of evolving from uniprofessional links between individual institutions into broader, multidisciplinary community partnerships. The main challenges facing health links arise from cultural differences, funding problems, communication difficulties and bureaucracy. There was broad agreement that greater recognition of the value and importance of health links by the NHS and closer collaboration between government departments to provide support and resources could promote wider and more effective link partnerships.
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Otogenic tetanus is common in a developing country like India. However, adequate sedation and elimination of spasms by medical treatment is sufficient in most cases. ⋯ The authors report a 2-year-old girl who relapsed twice after near complete recovery. This communiqué is intended to highlight that tetanus is still a significant health problem in third-world countries and a relapse after such a dreadful disease is terrifying.