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http://www.webmedcentral.com/images/Header_Logo.giftext/html2011-09-02T16:41:44+01:00http://www.webmedcentral.com/Dr. Yeong Y LeeNecrotizing Enterocolitis with Circulatory Failure in an Adolescent with Dengue Hemorrhagic Fever: A Case Report
http://www.webmedcentral.com/article_view/2143
Necrotizing enterocolitis (NEC) usually occurs in adult patients with haematological malignancy and after chemotherapy. The mortality rate can be high with 50% of patients died of necrotic bowel, perforation and sepsis.We reported a 15 years old Malay male with no known medical illness presented with history of high grade fever, headache, severe myalgia, abdominal discomfort, nausea but no bleeding symptoms 4 days prior to admission. He was fully conscious without any circulatory failure or clinical evidence of plasma leakage. He had a platelet count of 96,000/mm3 and a positive dengue serology for IgM during admission. He was treated as dengue fever with fluids and close observation for worsening thrombocytopenia.Within two days of admission, patient complained of severe abdominal discomfort and passing out frequent loose stools. The abdomen was grossly distended with tenderness over his epigastric region. He rapidly progressed into dengue hemorrhagic fever and circulatory failure. The only two supine abdominal x-rays revealed dilated and thickened small bowels with pneumatosis intestinalis, a pathognomonic feature of NEC.text/html2010-09-05T18:16:52+01:00http://www.webmedcentral.com/Dr. Sasidharan SreenivasanTime To Revisit Neglected Tropical Diseases In The New Viewpoint
http://www.webmedcentral.com/article_view/517
Health is “a state of physical, mental and spiritual well-being, not merely an absence of disease or infirmity” (1). Health is a fundamental human right and crucial important factor that drives the world economic. International health plays a major role to the world peace and to a sustainable economic and social development of a country. Hence, it is important to maintain optimal human health. Globalization which increased the deep connections between individuals of many countries has increased the rapid spread of infectious diseases between individuals from different part of the world and this includes the spread of neglected tropical diseases (NTDs). It is improper for the world community to neglect certain diseases merely because the affected are the people from the poor countries, living in remote and rural areas. Thus, we would like to comment about the importance of revisiting the tropical diseases, especially the neglected tropical diseases from a new perspective.The neglected diseases are a group of tropical infections which are especially endemic in low-income populations in developing regions of the world such as Africa, Asia, and the Americas. NTDs are named neglected because these diseases mostly affected the poorest and the most marginalized communities, and have been largely eliminated elsewhere and thus are often forgotten (2). Lacking a strong political voice, people affected by these tropical diseases have a low profile and status in public health priorities and largely seen as non profitable to invest by the pharmaceutical manufacturers. More than 1 billion world populations (one sixth of the world's population) are affected by one or more NTDs primarily poor populations living in tropical and subtropical climates with low-income economies (2). Contaminated uncooked vegetables, contaminated water delivery systems, houseflies, overcrowding, poor hygiene, sharing beds during childhood and unsafe water have been cited as an important risks for infections in the developing world.These diseases affect the large amount of the world population, especially the bottom million societies. Thus, this scenario can no longer be overlooked. As we represent the civilized society of this modern era, it is our responsibility to solve this crisis for the benefit of the poor community as conventional drugs are unaffordable for them and health facilities are also inaccessible. The participation of global community and intersectoral engagement can definitely be the strength to achieve the goal “health for all” in all countries, both rich and poor. The time has come for the international society to revisit the NTDs with a new perspective.Although, today there is greater achievement in the medical world but its does not necessarily translate into sustainable health improvements especially among the poor people in the third world country. Hence, the third world countries mainly affected by NTDs needs preventive, curative, and rehabilitative services which are easily accessible to individuals and families in the community and at a cost that the community and country can afford to maintain their health. Little is invested in developing treatment for these NTDs, just because doesn’t promise any great turnover to the pharmaceutical manufacturers and felt that NTDs concerns were not theirs. This mental attitude should change by the global community and pharmaceutical manufacturers. Individuals' altruism and responsibility in the implementation of world society's well-being should be cultivated for the benefit of mankind especially for the poorest communities where conventional drugs are unaffordable or unavailable. We are at a critical time in the development of affordable health systems for the poorest communities which will ensure world peace and sustainable economic and social development. The current statuses in NTDs, with increasing demand, rising costs, and little investment, makes re-looking at of the NTDs timely and relevant. Hence, the international communities including government and non-governmental organisations have the duty to participate in the planning and implementation of affordable health systems to overcome NTDs related problems and to improve survival in the poorest countries but how to achieve these improvements remains a challenge. One of the major challenges is linking health and sustainable development. If we success to persuaded the missing linkages between health and sustainable development its will facilitate and encourage to increased the government spending in health and greater private sector involvement (3). This missing linkage in poor countries, such as Asian and African countries adversely affects the performance of health systems in terms of supply, with chronic underfunding of infrastructure and public health, reductions in the number and quality of health personnel, and worsening access to health care for the poor (4, 5).The fundamental research on neglected diseases always leads to new remedies to treat the diseases that affect the bottom million societies. However, this finding does not necessarily translate into the drugs and vaccines because this product has no market value due to the low buying power of the poor and marginalized population from the developing countries (6). Subsequently, this will be resulted a translational gap between research finding and health product development. We should appreciate the initiative taken by Merck and Company, the UK Wellcome Trust, world health organization (WHO), the United Nations Children’s Fund (UNICEF) and the Global Alliance for Vaccines and Immunisation (GAVI) on medical-research charity to bridge the translational research gap that exists between research finding and health product development to create vaccines aimed at low-income countries (7). The time has come for the researchers to actively involve in translational research and the development of new drugs for NTDs. In order to be successful in bridging the translational research gap, four main conditions should be achieved. First and foremost, we must create a market for products in the poor developing country with the expected benefit for the pharmaceutical manufacturer. The next step will be to induce investment in R&D for neglected diseases and to encourage the collaboration between the local scientist and international research foundations as well as technology. Thirdly, the knowledge and technology should be transfered to local scientist to sustain the research activity. Finally, the product must bring a positive result to the consumer and for their welfare. Various push and pull mechanisms should be introduced to materialize these three conditions by subsidizing the research input and rewarding the research output. These strategies can ensure the research benefits to reach the poor communities.text/html2011-12-19T15:38:26+01:00http://www.webmedcentral.com/Mr. Zachary J WrightOnchocerciasis Contracted in Togo: A Propos of One Clinical Case
http://www.webmedcentral.com/article_view/2712
We report the case of a 28-year-old French female referred for diffuse pruritus. One month prior to consultation, the patient presented with intense itching in her lower back and bilateral buttocks and thighs. Symptoms were worse at night. Blood differential revealed eosinophilia, and filarial serology was positive. An ophthalmic exam was performed and was negative. Skin snips showed microfilariae of Onchocerca volvulus. The patient was admitted and treatment with diethylcarbamazine (DEC) was clinically and biologically successful.text/html2012-05-30T12:11:29+01:00http://www.webmedcentral.com/Dr. Ann TsengUsing a Travel Clinic as a Global Health Experience in a Family Medicine Residency
http://www.webmedcentral.com/article_view/3405
Research has demonstrated that global health electives can improve recruitment into primary care. Travel medicine is one way resident physicians can be involved in global health without having to leave home for an international based elective. This report describes the implementation of a travel clinic in a family medicine residency practice and the development of a travel medicine elective geared toward senior family medicine residents.