HIV Care Outcomes in Relation to Racial Redlining and Structural Factors Affecting Medical Care Access Among Black and White Persons with Diagnosed HIV—United States, 2017

AIDS and Behavior - Black/African American (Black) versus White persons are unequally burdened by human immunodeficiency virus (HIV) in the United States. Structural factors can influence social...     

Fatal aortic rupture during balloon dilatation of recoarctation.

In an eight year old boy with a patch aortoplasty, the aorta ruptured during balloon angioplasty for recoarctation. At necropsy a 1.5 cm long, full thickness tear and a separate, smaller, intimal tear were found. Histological examination showed thinning of the elastic laminae of the aorta. Angioplasty for recoarctation may be dangerous in patients with a patch aortoplasty.     

Snake bite induced cellulitis leading to infected open dislocation of the first metacarpophalangeal joint – A rare complication

Non-traumatic open dislocation of the first metacarpophalangeal joint is a rare phenomenon. We present a rare such occurrence secondary to snake bite induced cellulitis. A 22-year-old girl presented with pain and instability of her right thumb two months. She had snake bite two months back following which she developed cellulitis which gradually became infected. She presented with raw area over her dorsal aspect of the thumb with active infection. Radiographs revealed metacarpophalangeal joint dislocation. She underwent debridement, stabilisation and soft tissue coverage. At final follow up, she was pain free and the wound healed completely.     

Lingual tuberculosis

Oral tuberculosis is very rare and when present they are usually secondary to pulmonary tuberculosis. Tuberculous lesions of the tongue have become so infrequent that they are virtually a forgotten disease entity and may pose a diagnostic problem. The case reported in this paper emphasizes the importance of including tuberculosis in the differential diagnosis of any chronic oral ulcer. The low number of oral infections by M. tuberculosis could be due to underreporting.     

Gestational diabetes: The public health relevance and approach

The prevalence of diabetes is increasing globally and the causes attributed are the ageing population, urbanization, obesity epidemic, physical inactivity and stressful modern life. While all these factors contribute to the epidemic of DM, intra-uterine exposures and gestational programming are emerging as potential risk factors. Gestational programming is a process whereby stimuli or stresses that occur at critical or sensitive periods of foetal development, permanently change structure, physiology, and metabolism, which predispose individuals to disease in adult life. If the stimulus happens to be glucose intolerance in pregnancy, gestational diabetes mellitus (GDM) manifests. Diagnosis of GDM in a woman predisposes her and her offspring for increased risk of developing glucose intolerance and obesity in the future. GDM may play a crucial role in the increasing prevalence of diabetes and obesity and hence has become a public health priority issue. There has to be an excellent coordination and cooperation between all the stake holders of health delivery care system. A great understanding of the importance of GDM and its consequences by the Government and public will go a long way in containing the epidemic of diabetes.     

Blood conservation strategies in orthopedic surgeries: A review

In orthopedics management of surgical blood loss is an important aspect which has evolved along with modern surgeries. Replacement of lost blood by transfusion alone is not the answer as was considered earlier. Complications like infection and immune reaction due to blood transfusion are a major concern. Today numerous techniques are available in place of allogenic blood transfusion which can be employed safely and effectively. In this article we have reviewed these techniques, their merits and demerits.