The spatial distribution of leprosy cases during 15 years of a leprosy control program in Bangladesh: An observational study

Background  

An uneven spatial distribution of leprosy can be caused by the influence of geography on the distribution of risk factors over the area, or by population characteristics that are heterogeneously distributed over the area. We studied the distribution of leprosy cases detected by a control program to identify spatial and spatio-temporal patterns of occurrence and to search for environmental risk factors for leprosy.     

Potential plasma markers of type 1 and type 2 leprosy reactions: a preliminary report

Background  

The clinical management of leprosy Type 1 (T1R) and Type 2 (T2R) reactions pose challenges mainly because they can cause severe nerve injury and disability. No laboratory test or marker is available for the diagnosis or prognosis of leprosy reactions. This study simultaneously screened plasma factors to identify circulating biomarkers associated with leprosy T1R and T2R among patients recruited in Goiania, Central Brazil.     

Leprosy &; gangrene: A rare association; role of anti phospholipid antibodies

Background  

Leprosy still remains an important public health problem for many parts of the world. An association of gangrene with leprosy is a rare one & can have a number of causative mechanisms. We present a case with Leprosy & gangrene with positive anti phopholipid antibody titers.     

Immunologically reactive <Emphasis Type="Italic">M. leprae</Emphasis> antigens with relevance to diagnosis and vaccine development

Background  

Leprosy is a chronic infectious disease caused by Mycobacterium leprae that can manifest a wide variety of immunological and clinical outcomes ranging from potent humoral responses among borderline lepromatous (BL) and lepromatous (LL) patients to strong cellular responses among tuberculoid (TT) and borderline tuberculoid (BT) patients. Until recently, relatively little has been known about the immune responses to individual proteins of M. leprae recognized during leprosy.     

HLA-DR and HLA-DQ alleles in patients from the south of Brazil: markers for leprosy susceptibility and resistance

Background  

Many epidemiological studies have shown that the genetic factors of the host play a role in the variability of clinical response to infection caused by M. leprae. With the purpose of identifying genes of susceptibility, the present study investigated the possible role of HLA-DRB1 and DQA1/DQB1 alleles in susceptibility to leprosy, and whether they account for the heterogeneity in immune responses observed following infection in a Southern Brazilian population.     

Leprosy mimics adult onset Still’s disease in a Chinese patient

Background

Leprosy is an infectious disease that mainly involves the skin and peripheral nerves. It is caused by acid-fast, rod-shaped bacillus Mycobacterium leprae. In recent time, it has become a major global health concern which requires an early diagnosis and proper treatment in order to avoid lifelong neuropathy and disability. It is considered a ‘great mimicker’ as it exhibits a similar clinical features that resembles many connective tissue disease.

A Mycobacterium tuberculosis cluster demonstrating the use of genotyping in urban tuberculosis control

Background  

DNA fingerprinting of Mycobacterium tuberculosis isolates offers better opportunities to study links between tuberculosis (TB) cases and can highlight relevant issues in urban TB control in low-endemic countries.     

Rapid screening of MDR-TB using molecular Line Probe Assay is feasible in Uganda

Background  

About 500 new smear-positive Multidrug-resistant tuberculosis (MDR-TB) cases are estimated to occur per year in Uganda. In 2008 in Kampala, MDR-TB prevalence was reported as 1.0% and 12.3% in new and previously treated TB cases respectively. Line probe assays (LPAs) have been recently approved for use in low income settings and can be used to screen smear-positive sputum specimens for resistance to rifampicin and isoniazid in 1-2 days.     

Successful side-viewing endoscopic hemoclipping for Dieulafoy-like lesion at the brim of a periampullary diverticulum

Background  

Duodenal Dieulafoy's lesions are rare and only several cases were reported so far. Their characteristic appearance and location make it difficult to be diagnosed in the clinical practice. Massive bleeding often results from these lesions and can impede the accurate early treatment.     

Non-cirrhotic portal fibrosis related end stage liver disease in adults: evaluation from a study on living donor liver transplant recipients

Background  

That non-cirrhotic portal fibrosis (NCPF) can lead to end stage chronic liver disease (CLD) has been convincingly demonstrated only recently after the study of explant livers from clinically cirrhosis cases.     

Molecular genetic characteristics of influenza A virus clinically isolated during 2011‐2016 influenza seasons in Korea

Background

The influenza virus is reportedly associated with 3‐5 million cases of severe illness and 250 000‐500 000 deaths annually worldwide.

Objectives

We investigated the variation of influenza A virus in Korea and examined the association with death.

Methods

A total of 13 620 cases were enrolled in the Hospital‐based Influenza Morbidity & Mortality surveillance system in Korea during 2011‐2016. Among these cases, a total of 4725 were diagnosed with influenza using RT‐PCR (influenza A; n = 3696, influenza B; n = 928, co‐infection; n = 101). We used 254 viral sequences from the 3696 influenza A cases for phylogenetic analysis using the BioEdit and MEGA 6.06 programs.

Results

We found that the sequences of A/H3N2 in the 2011‐2012 season belong to subgroup 3C.1, whereas the sequences in the 2012‐2013 season pertain to subgroup 3C.2. The sequences in the 2013‐2014 and 2014‐2015 seasons involve subgroups 3C.3a and 3C.2a. The A/H1N1pdm09 subtype belongs to subgroup 6 and contains two clusters. In addition, sequence analysis confirmed the several substitutions of internal genes and gene substitutions associated with drug resistance (I222V in NA and S31N in M2) in the fatal cases. While statistical analysis found no significant associations between genetic differences in the viruses and mortality, mortality was associated with certain host factors, such as chronic lung disease.

Conclusions

In conclusion, influenza A virus clade changes occurred in Korea during the 2011‐2016 seasons. These data, along with antigenic analysis, can aid in selecting effective vaccine strains. We confirmed that fatality in influenza A cases was related to underlying patient diseases, such as chronic lung disease, and further studies are needed to confirm associations between mortality and viral genetic substitutions.     

Potential preventability of spontaneous bacterial peritonitis

Background  

Antibiotic prophylaxis can reduce the incidence of the first episode and recurrent episodes of spontaneous bacterial peritonitis (SBP) in high-risk cirrhotic patients. However, recent data suggest that SBP prophylaxis may be underused. It is unclear how many cases of cirrhosis that develop SBP might actually be prevented with antibiotic prophylaxis.     

Outcomes of post-cataract surgery endophthalmitis referred to a tertiary center from local hospitals in the south of China

Background  

Endophthalmitis after cataract surgery is an uncommon but devastating complication. Prophylactic intracameral injection of cefuroxime 1 mg at the end of surgery decreases the incidence five-fold. The visual outcome can be good (53% of cases having a visual acuity [VA] of better than 20/40) if treatment is initiated rapidly and follows the Endophthalmitis Vitrectomy Study (EVS) guidelines; but even with the best treatment, some patients end up with a poor visual outcome. Previous studies on postoperative endophthalmitis mainly focus on the cases performed in metropolitan tertiary hospitals; however, little information is available on the cases performed in local hospitals in rural areas.     

Duration of shedding of respiratory syncytial virus in a community study of Kenyan children

Background  

Our understanding of the transmission dynamics of respiratory syncytial virus (RSV) infection will be better informed with improved data on the patterns of shedding in cases not limited only to hospital admissions.     

Factors associated with mortality in patients with tuberculosis

Background  

Known risk factors for death following a diagnosis of tuberculosis may not be applicable to current U.S. cases. We evaluated the factors associated with all-cause mortality in patients with tuberculosis in Washington State.     

Rigid bronchoscopy for pin extraction in children at the Children's Hospital in Rabat, Morocco

Purpose

The aim of this work is to present the clinical and therapeutic aspects of pin inhalation in the airways, as well as the benefit of rigid bronchoscopy for extraction in children.

Materials and methods

Five hundred and twenty-four cases of inhaled foreign body are identified in the multipurpose pediatric intensive care unit in the children's hospital in Rabat between January 2005 and December 2010. Thirty-six (6.8%) of them are due to pin inhalation. A retrospective study was conducted to define the epidemiological characteristics, clinical treatment and outcome of pin inhalation in the airways.

Results

Thirty-six cases of pin inhalation are identified, all females. The age varies from 10 to 15 years. The consultation period is 2 days. Symptoms are dominated by coughing and stinging sensation. In 61.11% (22 cases), the pin is lodged in the right airways, in 22.22% (eight cases) in the left airways and in 5.5% (two cases) at the trachea. In 63.8% (23 cases), the pin is removed at the first attempt. We did not record any severe complications. No deaths recorded.

Conclusion

Pin inhalation is a common occurrence in young girls. The extraction can be done safely by rigid bronchoscopy under general anesthesia. Particular attention should be paid to prevention and educational programs to reduce the incidence of pin inhalation.     

Maturity-onset diabetes of the young (MODY): how many cases are we missing?

Aims/hypothesis  

Maturity-onset diabetes of the young is frequently misdiagnosed as type 1 or type 2 diabetes. A correct diagnosis of MODY is important for determining treatment, but can only be confirmed by molecular genetic testing. We aimed to compare the regional distribution of confirmed MODY cases in the UK and to estimate the minimum prevalence.     

Recurrent advanced colonic cancer occurring 11 years after initial endoscopic piecemeal resection: a case report

Background  

The high frequency of local recurrence occurring after endoscopic piecemeal resection (EPMR) for large colorectal tumors is a serious problem. However, almost all of these cases of local recurrence can be detected within 1 year and cured by additional endoscopic resection. We report a rare case of recurrent advanced colonic cancer diagnosed 11 years after initial EPMR treatment.     

Reversible renal impairment induced by treatment with the angiotensin II receptor antagonist candesartan in a patient with bilateral renal artery stenosis

Background  

It is well established that ACE-inhibitors should be avoided in patients with renal artery stenosis. In recent years it has also been recommended that caution should be demonstrated when angiotensin II blockers are used in the same type of patients but the evidence is based only on few cases.