This article describes an atypical case of post-kala azar dermal leishmaniasis associated with complications due to delayed diagnosis and poor case management.
"A Study of Clinical Profile of Leprosy in Post Leprosy Elimination Era"iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
A Short Report on Status of Leprosy in India by Rahul Shukla in Advances in Complementary & Alternative Medicine
Hansen’s disease, known as leprosy in colloquial language has been able to maintain its prevalence in the Indian subcontinent due to the haggard socio-economic status, lack of awareness and multiple other predisposing factors. Leprosy has been found to suppress the immune system thereby accentuating the chance of secondary infections. Contrary to the long held prevalent notion that the disease is not very contagious but shows long term effects that may lead to permanent limb and nerve disfigurement. The chronic effects of the ailment also include loss of visual acuity along with deformed limbs. Despite the prevalence and emergence of substantial number of new cases of leprosy each year in most of the developed and developing nations, the disease has still not been identified as a major health problem. The major hurdle in tackling the disease is also stemmed from the under reporting of the ailment caused by the excommunication of the afflicted individuals. India accounts for a large chunk of the global burden of leprosy, contributing almost 3/5th of the newly documented cases per annum. Reemergence of leprosy has been evidenced due to development of resistance in the causative bacterial strain. Yet much has not been accomplished in developing therapeutic regimen to curb the rampage of this insidious enemy. The aim of this short communication aims at portraying the true scenario of leprosy and there by attract the attention of policy makers and implementers to take radical actions to eradicate the menace to public health.
The document provides information on the COVID-19 pandemic as of April 2020. It discusses the epidemiology and spread of the virus globally. Key points include:
- COVID-19 originated in Wuhan, China in late 2019 and has since spread to over 210 countries. As of April 2020, there were over 29 lakh confirmed cases and 200,568 deaths worldwide, with the US becoming the new epicenter.
- The virus spreads mainly person-to-person via respiratory droplets. Common symptoms include fever, cough and shortness of breath, though many cases are asymptomatic. Chest CT scans show bilateral lung involvement like ground-glass opacities or consolidation.
- While most cases are mild, the elderly and those
The document provides information on the novel coronavirus (COVID-19) pandemic, including:
1) It describes the epidemiology and spread of COVID-19 globally, with over 29 lakh reported cases across 210 countries as of April 2020, and identifies the United States as the new epicenter.
2) It summarizes the natural history and clinical presentation of COVID-19, which commonly includes fever, cough, and shortness of breath, and can progress to severe pneumonia and multi-organ failure in vulnerable groups.
3) It discusses diagnosis of COVID-19 using RT-PCR testing of respiratory samples and treatment being primarily supportive care and ventilation for severe cases, as there is no proven antiviral treatment yet.
Tuberculosis: A Rare Cause of Linear Labial Ulcerationkomalicarol
Oral location of tuberculosis is rare. It admits a clinical polymorphism and poses above all a problem of diagnosis. We report a
case of labial tuberculosis in a 16-year-old patient with underlying
lymph node localization.
Fungal keratitis is a fungal infection of the cornea that is common in developing nations. It is most often caused by filamentous fungi like Aspergillus, Fusarium, and Curvularia in tropical areas, and Candida species in temperate regions. Risk factors include corneal injury, topical steroid use, diabetes, and contact lens use. Symptoms include pain, blurred vision, photophobia, and corneal ulceration. Diagnosis involves corneal scraping and culture, though PCR is more rapid. Treatment consists of topical antifungals like natamycin, amphotericin B, or voriconazole, with systemic antifungals as adjunctive therapy for severe cases
"A Study of Clinical Profile of Leprosy in Post Leprosy Elimination Era"iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
A Short Report on Status of Leprosy in India by Rahul Shukla in Advances in Complementary & Alternative Medicine
Hansen’s disease, known as leprosy in colloquial language has been able to maintain its prevalence in the Indian subcontinent due to the haggard socio-economic status, lack of awareness and multiple other predisposing factors. Leprosy has been found to suppress the immune system thereby accentuating the chance of secondary infections. Contrary to the long held prevalent notion that the disease is not very contagious but shows long term effects that may lead to permanent limb and nerve disfigurement. The chronic effects of the ailment also include loss of visual acuity along with deformed limbs. Despite the prevalence and emergence of substantial number of new cases of leprosy each year in most of the developed and developing nations, the disease has still not been identified as a major health problem. The major hurdle in tackling the disease is also stemmed from the under reporting of the ailment caused by the excommunication of the afflicted individuals. India accounts for a large chunk of the global burden of leprosy, contributing almost 3/5th of the newly documented cases per annum. Reemergence of leprosy has been evidenced due to development of resistance in the causative bacterial strain. Yet much has not been accomplished in developing therapeutic regimen to curb the rampage of this insidious enemy. The aim of this short communication aims at portraying the true scenario of leprosy and there by attract the attention of policy makers and implementers to take radical actions to eradicate the menace to public health.
The document provides information on the COVID-19 pandemic as of April 2020. It discusses the epidemiology and spread of the virus globally. Key points include:
- COVID-19 originated in Wuhan, China in late 2019 and has since spread to over 210 countries. As of April 2020, there were over 29 lakh confirmed cases and 200,568 deaths worldwide, with the US becoming the new epicenter.
- The virus spreads mainly person-to-person via respiratory droplets. Common symptoms include fever, cough and shortness of breath, though many cases are asymptomatic. Chest CT scans show bilateral lung involvement like ground-glass opacities or consolidation.
- While most cases are mild, the elderly and those
The document provides information on the novel coronavirus (COVID-19) pandemic, including:
1) It describes the epidemiology and spread of COVID-19 globally, with over 29 lakh reported cases across 210 countries as of April 2020, and identifies the United States as the new epicenter.
2) It summarizes the natural history and clinical presentation of COVID-19, which commonly includes fever, cough, and shortness of breath, and can progress to severe pneumonia and multi-organ failure in vulnerable groups.
3) It discusses diagnosis of COVID-19 using RT-PCR testing of respiratory samples and treatment being primarily supportive care and ventilation for severe cases, as there is no proven antiviral treatment yet.
Tuberculosis: A Rare Cause of Linear Labial Ulcerationkomalicarol
Oral location of tuberculosis is rare. It admits a clinical polymorphism and poses above all a problem of diagnosis. We report a
case of labial tuberculosis in a 16-year-old patient with underlying
lymph node localization.
Fungal keratitis is a fungal infection of the cornea that is common in developing nations. It is most often caused by filamentous fungi like Aspergillus, Fusarium, and Curvularia in tropical areas, and Candida species in temperate regions. Risk factors include corneal injury, topical steroid use, diabetes, and contact lens use. Symptoms include pain, blurred vision, photophobia, and corneal ulceration. Diagnosis involves corneal scraping and culture, though PCR is more rapid. Treatment consists of topical antifungals like natamycin, amphotericin B, or voriconazole, with systemic antifungals as adjunctive therapy for severe cases
Relapsing Polychondritis Case: An Important Diagnosis Not to Be Delayedsemualkaira
Relapsing Polychondritis (RP) is a rare disease characterized by
inflammation of cartilage and connective tissues with destructive
episodes. Although the pathogenesis is not completely known,
there is an autoimmunity in which antibodies against mainly type
II collagen play a role. In addition to chondritis of the ear, nose,
and trachea; organs having proteoglycan structure such as eyes,
the inner ear, heart, blood vessels, and kidneys can be affected, too.
A 25-year-old pregnant woman presented with an extensive lesion involving her nose, cheeks, upper lip, and lower eyelids. Biopsy showed necrotizing granulomatous inflammation and vasculitis consistent with Wegener's granulomatosis. She was positive for c-ANCA but had no other systemic involvement. After delivery, she was given steroids and cyclophosphamide but continued deteriorating and ultimately died from the locally advanced facial Wegener's granulomatosis.
Introduction: malignant syphilis is an uncommon form of secondary syphilis.This presentation usually occurs in immunocompromised patients, especially in those ones infected by human immunodeficiency virus (HIV). However, it is known that it might exceptionally affect individuals with normal immune response.
This case report describes an immunocompetent 30-year-old male patient who presented with widespread painful skin lesions and uveitis of the right eye. Laboratory tests initially were negative for syphilis but later tested positive, confirming the diagnosis of early malignant syphilis. Malignant syphilis is an uncommon form of secondary syphilis typically seen in immunocompromised individuals. However, this report describes the second known case of an immunocompetent patient presenting with both skin and ocular involvement. The patient was treated with intravenous ceftriaxone for 14 days and experienced an excellent clinical response.
Covid november 8 2020 ce presentation covid and eyes Dr. Sandra Lora Cremers CarolinaClavijo8
The document summarizes research on COVID-19 and its relationship to the eye and ocular surface. It discusses how COVID-19 may potentially enter the eye, eye symptoms observed in COVID-19 patients, and whether conditions like dry eye disease increase the risk of viral entry. It also addresses whether masks can increase dry eye and reviews treatment options for dry eye. The economic burden of dry eye is substantial, costing billions annually in the US.
1) The document discusses India's National Leprosy Eradication Programme, including its history, strategies, infrastructure, and treatment protocols.
2) Key statistics provided include that India accounts for 60.9% of global leprosy cases, with a prevalence rate of 5.0 per 10,000 people.
3) The program's objectives are to eliminate leprosy through early case detection, short-term multidrug therapy, health education, and rehabilitation. Treatment involves multidrug regimens administered monthly or daily depending on the type of leprosy.
This document discusses the history and regulation of the drug thalidomide. It notes that thalidomide was discovered in the 1960s to cause birth defects but has continued to be studied to treat other conditions. In 1998, the FDA approved thalidomide under the brand name Thalomid to treat erythemanodosumleprosum, a complication of leprosy. Due to the risks of birth defects, the FDA took steps to strictly control the drug's use, distribution, and monitoring of patients, especially women of childbearing age, to prevent another public health issue. Research into thalidomide's use for other diseases continues.
Management of Lichen Planus through Ayurvedaijtsrd
Lichen Planus is a papulosquamous disorder that may affect the skin, scalp, nails, and mucous membranes. The primary cutaneous lesions are pruritic, polygonal, flat topped, violaceous papules. In Ayurveda, all skin diseases are lined beneath the term Kustha Roga. Vitiated Dosha cause abnormal colour of skin and produce degenerative changes called Kustha. CASE REPORT A 50 year old female came to OPD of National Institute of Ayurveda, Jaipur having complains of black papules on her whole body for last10 years. Oral mucosa was also involved. Mahamanjishtha Kwatha, Trivrit Leha, Tikta Ghrita, Khadiradi Vati and a combination of Rasamanikaya, Shuddha Gandhaka, Manjishthadi Churna, was given orally, Eladi Taila was given for local application and Irimedadi Taila was given for Gandusha . RESULTS Patient got significant relief in itching and discolouration of skin. Ayurvedic principle of Kustha is effective in the management of Lichen Planus. Dr. Deepti | Dr. Sunil Kumar | Dr. Anurag Singh Chandel "Management of Lichen Planus through Ayurveda" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-3 | Issue-5 , August 2019, URL: https://www.ijtsrd.com/papers/ijtsrd27908.pdfPaper URL: https://www.ijtsrd.com/medicine/dermatology/27908/management-of-lichen-planus-through-ayurveda/dr-deepti
Circulating Tumor Cells and Cell-Free Nucleic Acids as Predictor Factors for ...AnonIshanvi
Pancreatic cancer remains as one of the most aggressive and deadliest of cancers largely due to formidable challenges in diagnosis and therapy. Consensus standard treatment for patients with nonmetastatic Pancreatic Cancer (PC) incorporates possible neoadjuvant chemotherapy with timely surgical resection and adjuvant chemotherapy. However, despite all the sophistication of modern radiological and endoscopic techniques, the decision regarding operability is often only made intra-operatively, therefore subjecting a patient to unnecessary surgical intervention, and postponing the possibility of starting early chemotherapy.
Research Progress in Chronic Lymphocytic LeukemiaAnonIshanvi
Cancer is an uncontrolled division of cell occurs due to genetic alterations and mutation. Chronic lymphocytic leukemia is the heterogeneous lymphocytic malignancy worldwide that leads to death.
Genetics of Breast and Ovary Cancers Associated with Hereditary Cancers and t...AnonIshanvi
Carriers of the BRCA-1/2 mutation have increased and variable risks of Breast Cancer (BC) and ovarian cancer and vary or are modified by common genetic variants and their incidence genetic testing and risk-reducing surgery has increased, they should receive advice and evaluation by the physician with experience in genetics.
Increased of Protein O-Fucosyl Transferase 1 and 2 Genes Expression in Gastri...AnonIshanvi
Gastric cancer is one of the most common cancers in the world. Gastric cancer usually occurs at an advanced age (average ≥ 65 years) and has symptoms similar to gastric ulcers and other gastric infections, its early diagnosis is one of the major problems of this type of cancer. Molecular mechanisms initiate cancer and the molecular changes of normal cells compared to cancer cells are very important. dysfunction of Fucosyl transferase enzymes is associated with gastric cancer.
The impact of the SARS-CoV-2 infection in all areas at the national and international level is undeniable, the aftermath of this “tornado” will be visible for a long time, even when the infection manages to be controlled. Two aspects of great interest to those of us who work in the area of oncology must be considered: on the one hand, the need to contain and control the devastating effects of the disease forced a reorganization in the operation of services, giving priority to COVID, conversion of medical units to hospitals COVID created a high-risk scenario for patients with other types of pathologies; This reorganization includes the allocation of large amounts of budget to COVID areas to the detriment of patients with other types of equally serious diseases - such as cancer, among others - who cannot wait for care in better times.
Meta-Analysis of Lateral Lymph Node Dissection for Mid Lower Rectal Cancer: I...AnonIshanvi
Presence of lateral lymph node metastasis in rectal cancer was originally reported in the 1950s.Lateral lymph node metastasis occurs in 15 to 20% of patients with locally advanced low rectal cancer which escalates likelihood of local recurrence and reduced survival following neoadjuvant chemoradiotherapy (nCRT) and Total Mesolectal Excision (TME).
Analyzing Speech Outcomes in Hemiglossectomy Patients Using Telecare PlatformAnonIshanvi
This study analyzed speech outcomes in 20 patients who underwent hemiglossectomy for tongue cancer and reconstruction using a radial forearm free flap. The study aimed to evaluate the feasibility of using telemedicine for clinical research during COVID-19 and to analyze factors influencing postoperative speech outcomes. Patients completed speech evaluations remotely with speech language pathologists, assessing range of motion, speech clarity, articulation rate, and a speech handicap questionnaire. Early tumor stage, no radiation therapy, and base of tongue cancer were associated with better speech outcomes, particularly range of motion and clarity. Telemedicine was found to be an effective platform for conducting this clinical research during the pandemic.
Uterine Myoma, Risk Factor and Pathophysiology: A Review ArticleAnonIshanvi
This document reviews uterine myomas (fibroids), including their risk factors and pathophysiology. Some key points:
- Uterine myomas are benign muscle tumors that are common in women of reproductive age. Risk factors include age, family history, ethnicity, obesity, diet, pregnancy history, and smoking.
- The tumors are thought to be sensitive to estrogen and progesterone levels, which may explain why they typically grow during reproductive years and shrink after menopause.
- Cells in uterine myomas have a higher density of estrogen receptors compared to normal uterine muscle cells, and they convert estrogen to weaker forms less efficiently. This creates a relatively hyperestrogenic environment conducive to tumor growth.
Functional Disparity of Carcinoma Associated Fibroblasts in Different Stages ...AnonIshanvi
This document reports on a study that found functional differences between carcinoma-associated fibroblasts (CAFs) isolated from two different stages of breast cancer in a mouse model. CAFs isolated from stage 2 tumors (CAF-II) exhibited higher expression of immune-suppressive enzymes IDO and TGF-β compared to CAFs from stage 4 tumors (CAF-IV), which exhibited higher expression of iNOS and IL-10. This suggests the tumor microenvironments influenced by CAFs differ between cancer stages, which may contribute to varying responses to cancer therapies depending on the stage. Further research is needed to fully understand how CAF functions change during cancer progression and their potential as therapeutic targets at different stages.
Linitis plastica is a diffuse form of gastric cancer and accounts for about 10% of all cases of gastric malignancy and its exact general population distribution is unknown. There are no characteristic or specific symptoms, the symptoms are similar to those of other forms of stomach cancer and can manifest as a feeling of fullness after eating, nausea and vomiting, epigastric pain, weight loss, and progressive dysphagia [1]. Plastic linitisis characterized by malignant glandular proliferation of cricoid cells in the fibrous stroma, which ultimately leads to thickening and rigidity of the stomach wall.
This document discusses principles of cancer screening and summarizes a proposed cancer screening program called CitiScreen. It begins by outlining the Wilson-Jungner criteria for cancer screening approved by the WHO. It then discusses updated screening criteria and reviews the scientific basis for cancer screening through randomized controlled trials and other methods. The document summarizes CitiScreen's goal of comprehensive cancer screening through a combination of technologies and outlines screening patterns for specific cancers like breast, ovarian, lung, and colorectal cancer.
On February 21, 2020, at Codogno Hospital (in the Lodi?s Province, Lombardy, Italy), Italy?s Coronavirus ?patient one? was discovered. In the following week the cases within the Province of Lodi increased exponentially and it was interpreted as a disease cluster originating from the hospital.
More Related Content
Similar to Atypical Presentation of Post-Kala Azar Dermal Leishmaniasis in Bhutan
Relapsing Polychondritis Case: An Important Diagnosis Not to Be Delayedsemualkaira
Relapsing Polychondritis (RP) is a rare disease characterized by
inflammation of cartilage and connective tissues with destructive
episodes. Although the pathogenesis is not completely known,
there is an autoimmunity in which antibodies against mainly type
II collagen play a role. In addition to chondritis of the ear, nose,
and trachea; organs having proteoglycan structure such as eyes,
the inner ear, heart, blood vessels, and kidneys can be affected, too.
A 25-year-old pregnant woman presented with an extensive lesion involving her nose, cheeks, upper lip, and lower eyelids. Biopsy showed necrotizing granulomatous inflammation and vasculitis consistent with Wegener's granulomatosis. She was positive for c-ANCA but had no other systemic involvement. After delivery, she was given steroids and cyclophosphamide but continued deteriorating and ultimately died from the locally advanced facial Wegener's granulomatosis.
Introduction: malignant syphilis is an uncommon form of secondary syphilis.This presentation usually occurs in immunocompromised patients, especially in those ones infected by human immunodeficiency virus (HIV). However, it is known that it might exceptionally affect individuals with normal immune response.
This case report describes an immunocompetent 30-year-old male patient who presented with widespread painful skin lesions and uveitis of the right eye. Laboratory tests initially were negative for syphilis but later tested positive, confirming the diagnosis of early malignant syphilis. Malignant syphilis is an uncommon form of secondary syphilis typically seen in immunocompromised individuals. However, this report describes the second known case of an immunocompetent patient presenting with both skin and ocular involvement. The patient was treated with intravenous ceftriaxone for 14 days and experienced an excellent clinical response.
Covid november 8 2020 ce presentation covid and eyes Dr. Sandra Lora Cremers CarolinaClavijo8
The document summarizes research on COVID-19 and its relationship to the eye and ocular surface. It discusses how COVID-19 may potentially enter the eye, eye symptoms observed in COVID-19 patients, and whether conditions like dry eye disease increase the risk of viral entry. It also addresses whether masks can increase dry eye and reviews treatment options for dry eye. The economic burden of dry eye is substantial, costing billions annually in the US.
1) The document discusses India's National Leprosy Eradication Programme, including its history, strategies, infrastructure, and treatment protocols.
2) Key statistics provided include that India accounts for 60.9% of global leprosy cases, with a prevalence rate of 5.0 per 10,000 people.
3) The program's objectives are to eliminate leprosy through early case detection, short-term multidrug therapy, health education, and rehabilitation. Treatment involves multidrug regimens administered monthly or daily depending on the type of leprosy.
This document discusses the history and regulation of the drug thalidomide. It notes that thalidomide was discovered in the 1960s to cause birth defects but has continued to be studied to treat other conditions. In 1998, the FDA approved thalidomide under the brand name Thalomid to treat erythemanodosumleprosum, a complication of leprosy. Due to the risks of birth defects, the FDA took steps to strictly control the drug's use, distribution, and monitoring of patients, especially women of childbearing age, to prevent another public health issue. Research into thalidomide's use for other diseases continues.
Management of Lichen Planus through Ayurvedaijtsrd
Lichen Planus is a papulosquamous disorder that may affect the skin, scalp, nails, and mucous membranes. The primary cutaneous lesions are pruritic, polygonal, flat topped, violaceous papules. In Ayurveda, all skin diseases are lined beneath the term Kustha Roga. Vitiated Dosha cause abnormal colour of skin and produce degenerative changes called Kustha. CASE REPORT A 50 year old female came to OPD of National Institute of Ayurveda, Jaipur having complains of black papules on her whole body for last10 years. Oral mucosa was also involved. Mahamanjishtha Kwatha, Trivrit Leha, Tikta Ghrita, Khadiradi Vati and a combination of Rasamanikaya, Shuddha Gandhaka, Manjishthadi Churna, was given orally, Eladi Taila was given for local application and Irimedadi Taila was given for Gandusha . RESULTS Patient got significant relief in itching and discolouration of skin. Ayurvedic principle of Kustha is effective in the management of Lichen Planus. Dr. Deepti | Dr. Sunil Kumar | Dr. Anurag Singh Chandel "Management of Lichen Planus through Ayurveda" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-3 | Issue-5 , August 2019, URL: https://www.ijtsrd.com/papers/ijtsrd27908.pdfPaper URL: https://www.ijtsrd.com/medicine/dermatology/27908/management-of-lichen-planus-through-ayurveda/dr-deepti
Similar to Atypical Presentation of Post-Kala Azar Dermal Leishmaniasis in Bhutan (10)
Circulating Tumor Cells and Cell-Free Nucleic Acids as Predictor Factors for ...AnonIshanvi
Pancreatic cancer remains as one of the most aggressive and deadliest of cancers largely due to formidable challenges in diagnosis and therapy. Consensus standard treatment for patients with nonmetastatic Pancreatic Cancer (PC) incorporates possible neoadjuvant chemotherapy with timely surgical resection and adjuvant chemotherapy. However, despite all the sophistication of modern radiological and endoscopic techniques, the decision regarding operability is often only made intra-operatively, therefore subjecting a patient to unnecessary surgical intervention, and postponing the possibility of starting early chemotherapy.
Research Progress in Chronic Lymphocytic LeukemiaAnonIshanvi
Cancer is an uncontrolled division of cell occurs due to genetic alterations and mutation. Chronic lymphocytic leukemia is the heterogeneous lymphocytic malignancy worldwide that leads to death.
Genetics of Breast and Ovary Cancers Associated with Hereditary Cancers and t...AnonIshanvi
Carriers of the BRCA-1/2 mutation have increased and variable risks of Breast Cancer (BC) and ovarian cancer and vary or are modified by common genetic variants and their incidence genetic testing and risk-reducing surgery has increased, they should receive advice and evaluation by the physician with experience in genetics.
Increased of Protein O-Fucosyl Transferase 1 and 2 Genes Expression in Gastri...AnonIshanvi
Gastric cancer is one of the most common cancers in the world. Gastric cancer usually occurs at an advanced age (average ≥ 65 years) and has symptoms similar to gastric ulcers and other gastric infections, its early diagnosis is one of the major problems of this type of cancer. Molecular mechanisms initiate cancer and the molecular changes of normal cells compared to cancer cells are very important. dysfunction of Fucosyl transferase enzymes is associated with gastric cancer.
The impact of the SARS-CoV-2 infection in all areas at the national and international level is undeniable, the aftermath of this “tornado” will be visible for a long time, even when the infection manages to be controlled. Two aspects of great interest to those of us who work in the area of oncology must be considered: on the one hand, the need to contain and control the devastating effects of the disease forced a reorganization in the operation of services, giving priority to COVID, conversion of medical units to hospitals COVID created a high-risk scenario for patients with other types of pathologies; This reorganization includes the allocation of large amounts of budget to COVID areas to the detriment of patients with other types of equally serious diseases - such as cancer, among others - who cannot wait for care in better times.
Meta-Analysis of Lateral Lymph Node Dissection for Mid Lower Rectal Cancer: I...AnonIshanvi
Presence of lateral lymph node metastasis in rectal cancer was originally reported in the 1950s.Lateral lymph node metastasis occurs in 15 to 20% of patients with locally advanced low rectal cancer which escalates likelihood of local recurrence and reduced survival following neoadjuvant chemoradiotherapy (nCRT) and Total Mesolectal Excision (TME).
Analyzing Speech Outcomes in Hemiglossectomy Patients Using Telecare PlatformAnonIshanvi
This study analyzed speech outcomes in 20 patients who underwent hemiglossectomy for tongue cancer and reconstruction using a radial forearm free flap. The study aimed to evaluate the feasibility of using telemedicine for clinical research during COVID-19 and to analyze factors influencing postoperative speech outcomes. Patients completed speech evaluations remotely with speech language pathologists, assessing range of motion, speech clarity, articulation rate, and a speech handicap questionnaire. Early tumor stage, no radiation therapy, and base of tongue cancer were associated with better speech outcomes, particularly range of motion and clarity. Telemedicine was found to be an effective platform for conducting this clinical research during the pandemic.
Uterine Myoma, Risk Factor and Pathophysiology: A Review ArticleAnonIshanvi
This document reviews uterine myomas (fibroids), including their risk factors and pathophysiology. Some key points:
- Uterine myomas are benign muscle tumors that are common in women of reproductive age. Risk factors include age, family history, ethnicity, obesity, diet, pregnancy history, and smoking.
- The tumors are thought to be sensitive to estrogen and progesterone levels, which may explain why they typically grow during reproductive years and shrink after menopause.
- Cells in uterine myomas have a higher density of estrogen receptors compared to normal uterine muscle cells, and they convert estrogen to weaker forms less efficiently. This creates a relatively hyperestrogenic environment conducive to tumor growth.
Functional Disparity of Carcinoma Associated Fibroblasts in Different Stages ...AnonIshanvi
This document reports on a study that found functional differences between carcinoma-associated fibroblasts (CAFs) isolated from two different stages of breast cancer in a mouse model. CAFs isolated from stage 2 tumors (CAF-II) exhibited higher expression of immune-suppressive enzymes IDO and TGF-β compared to CAFs from stage 4 tumors (CAF-IV), which exhibited higher expression of iNOS and IL-10. This suggests the tumor microenvironments influenced by CAFs differ between cancer stages, which may contribute to varying responses to cancer therapies depending on the stage. Further research is needed to fully understand how CAF functions change during cancer progression and their potential as therapeutic targets at different stages.
Linitis plastica is a diffuse form of gastric cancer and accounts for about 10% of all cases of gastric malignancy and its exact general population distribution is unknown. There are no characteristic or specific symptoms, the symptoms are similar to those of other forms of stomach cancer and can manifest as a feeling of fullness after eating, nausea and vomiting, epigastric pain, weight loss, and progressive dysphagia [1]. Plastic linitisis characterized by malignant glandular proliferation of cricoid cells in the fibrous stroma, which ultimately leads to thickening and rigidity of the stomach wall.
This document discusses principles of cancer screening and summarizes a proposed cancer screening program called CitiScreen. It begins by outlining the Wilson-Jungner criteria for cancer screening approved by the WHO. It then discusses updated screening criteria and reviews the scientific basis for cancer screening through randomized controlled trials and other methods. The document summarizes CitiScreen's goal of comprehensive cancer screening through a combination of technologies and outlines screening patterns for specific cancers like breast, ovarian, lung, and colorectal cancer.
On February 21, 2020, at Codogno Hospital (in the Lodi?s Province, Lombardy, Italy), Italy?s Coronavirus ?patient one? was discovered. In the following week the cases within the Province of Lodi increased exponentially and it was interpreted as a disease cluster originating from the hospital.
COVID-19 is a new strain of Coronaviruses virus declared by the World Health Organization (WHO) as a pandemic on March 11th, 2020. While the majority of patients with COVID-19 typically have characteristic respiratory presentations subsequently
Deadenylase Expression in Small Cell Lung Cancer Related To Clinical Characte...AnonIshanvi
Lung cancer is the second common malignancy and the most aggressive cancer worldwide with late diagnosis and poor prognosis. The search for biomarkers that promote early diagnosis and improve therapeutic strategies focuses to the understanding of the mechanisms underlying cancer development and progression
Marital Status and Survival in Patients with Multiple Myeloma: The Role of Ma...AnonIshanvi
Despite better understanding of Multiple Myeloma (MM) and the development of novel therapeutic strategies which improved overall survival, MM still remain largely incurable. This warrants a better understanding of socio-demographic factors that may influence disease course and outcomes across MM patient
A 43-Year-Old Male with PCM1-JAK2 Gene Fusion Experienced T-Lymphoblastic Lym...AnonIshanvi
Myeloid/lymphoid neoplasms associated with eosinophilia and PCM1-JAK2 is a provisional entity in WHO 2016. Prior case reports have shown quite a few clinical presentations in different patients with this chromosome translocation,characterized by eosinophilia in combination with myelodysplastic/ myeloproliferative neoplasms, acute myeloid leukemia(AML) and rarely, T-lymphoblastic lymphoma(T-LBL) or B-acute
Stereotactic Radiation Therapy of Lung Cancers and Subsequent Parenchymal Alt...AnonIshanvi
Stereotactic body radiation therapy (SBRT) is one of the standard radical treatments in stage I nonsmall cell lung cancer (NSCLC) and an option for lung metastases. The pulmonary parenchymal CT alterations at 3, 6 and 12 months are the object of a prospective analysis in patients submitted to SBRT, to define factors affecting the different radiological alteration
Hypoparathyroidism - Not Only after StrumectomyUnusual Presentations of the R...AnonIshanvi
Hypoparathyroidism (HypoPT) is an endocrine disease with low calcium and inappropriately low (insufficient) circulating PTH levels. HypoPT may have an autoimmune pathogenesis, however, the most common causes of chronic HypoPT are iatrogenic: mostly thyroid or parathyroid surgery. Much less frequently HypoPT...
Higher Rates of Helicobacter Pylori Infection and Gastric Intestinal Metaplas...AnonIshanvi
The rate of Helicobacter pylori (H. pylori) infection is higher in minority patients in the United States [1]. Gastric intestinal metaplasia (IM) is associated with H. pylori infection and carries an increased risk for gastric cancer over time, in particular for patients from regions of high gastric cancer incidence [2]
Critical Role of PET-Scan in Unravelling the Dual Pathology- Review of Litera...AnonIshanvi
Simultaneous presentation of two lymphatic haematological malignancies is extremely rare. Adequate and optimal diagnostic steps including various imaging techniques and histopathological biopsies are required unpin the exact diagnoses to be able to deliver the best management strategies
Dr. Tan's Balance Method.pdf (From Academy of Oriental Medicine at Austin)GeorgeKieling1
Home
Organization
Academy of Oriental Medicine at Austin
Academy of Oriental Medicine at Austin
Academy of Oriental Medicine at Austin
About AOMA: The Academy of Oriental Medicine at Austin offers a masters-level graduate program in acupuncture and Oriental medicine, preparing its students for careers as skilled, professional practitioners. AOMA is known for its internationally recognized faculty, award-winning student clinical internship program, and herbal medicine program. Since its founding in 1993, AOMA has grown rapidly in size and reputation, drawing students from around the nation and faculty from around the world. AOMA also conducts more than 20,000 patient visits annually in its student and professional clinics. AOMA collaborates with Western healthcare institutions including the Seton Family of Hospitals, and gives back to the community through partnerships with nonprofit organizations and by providing free and reduced price treatments to people who cannot afford them. The Academy of Oriental Medicine at Austin is located at 2700 West Anderson Lane. AOMA also serves patients and retail customers at its south Austin location, 4701 West Gate Blvd. For more information see www.aoma.edu or call 512-492-303434.
Discover the benefits of homeopathic medicine for irregular periods with our guide on 5 common remedies. Learn how these natural treatments can help regulate menstrual cycles and improve overall menstrual health.
Visit Us: https://drdeepikashomeopathy.com/service/irregular-periods-treatment/
“Environmental sanitation means the art and science of applying sanitary, biological and physical science principles and knowledge to improve and control the environment therein for the protection of the health and welfare of the public”.The overall importance of sanitation are to provide a healthy living environment for everyone, to protect the natural resources (such as surface water, groundwater, soil ), and to provide safety, security and dignity for people when they defecate or urinate .Sanitation refers to public health conditions such as drinking clean water, sewage treatment, etc. All the effective tools and actions that help in keeping the environment clean come under sanitation. Sanitation refers to public health conditions such as drinking clean water, sewage treatment. All the effective tools and actions that help in keeping the environment clean and promotes public health is the necessary in todays life.
Gene therapy can be broadly defined as the transfer of genetic material to cure a disease or at least to improve the clinical status of a patient.
One of the basic concepts of gene therapy is to transform viruses into genetic shuttles, which will deliver the gene of interest into the target cells.
Safe methods have been devised to do this, using several viral and non-viral vectors.
In the future, this technique may allow doctors to treat a disorder by inserting a gene into a patient's cells instead of using drugs or surgery.
The biggest hurdle faced by medical research in gene therapy is the availability of effective gene-carrying vectors that meet all of the following criteria:
Protection of transgene or genetic cargo from degradative action of systemic and endonucleases,
Delivery of genetic material to the target site, i.e., either cell cytoplasm or nucleus,
Low potential of triggering unwanted immune responses or genotoxicity,
Economical and feasible availability for patients .
Viruses are naturally evolved vehicles that efficiently transfer their genes into host cells.
Choice of viral vector is dependent on gene transfer efficiency, capacity to carry foreign genes, toxicity, stability, immune responses towards viral antigens and potential viral recombination.
There are a wide variety of vectors used to deliver DNA or oligo nucleotides into mammalian cells, either in vitro or in vivo.
The most common vector system based on retroviruses, adenoviruses, herpes simplex viruses, adeno associated viruses.
Breast cancer: Post menopausal endocrine therapyDr. Sumit KUMAR
Breast cancer in postmenopausal women with hormone receptor-positive (HR+) status is a common and complex condition that necessitates a multifaceted approach to management. HR+ breast cancer means that the cancer cells grow in response to hormones such as estrogen and progesterone. This subtype is prevalent among postmenopausal women and typically exhibits a more indolent course compared to other forms of breast cancer, which allows for a variety of treatment options.
Diagnosis and Staging
The diagnosis of HR+ breast cancer begins with clinical evaluation, imaging, and biopsy. Imaging modalities such as mammography, ultrasound, and MRI help in assessing the extent of the disease. Histopathological examination and immunohistochemical staining of the biopsy sample confirm the diagnosis and hormone receptor status by identifying the presence of estrogen receptors (ER) and progesterone receptors (PR) on the tumor cells.
Staging involves determining the size of the tumor (T), the involvement of regional lymph nodes (N), and the presence of distant metastasis (M). The American Joint Committee on Cancer (AJCC) staging system is commonly used. Accurate staging is critical as it guides treatment decisions.
Treatment Options
Endocrine Therapy
Endocrine therapy is the cornerstone of treatment for HR+ breast cancer in postmenopausal women. The primary goal is to reduce the levels of estrogen or block its effects on cancer cells. Commonly used agents include:
Selective Estrogen Receptor Modulators (SERMs): Tamoxifen is a SERM that binds to estrogen receptors, blocking estrogen from stimulating breast cancer cells. It is effective but may have side effects such as increased risk of endometrial cancer and thromboembolic events.
Aromatase Inhibitors (AIs): These drugs, including anastrozole, letrozole, and exemestane, lower estrogen levels by inhibiting the aromatase enzyme, which converts androgens to estrogen in peripheral tissues. AIs are generally preferred in postmenopausal women due to their efficacy and safety profile compared to tamoxifen.
Selective Estrogen Receptor Downregulators (SERDs): Fulvestrant is a SERD that degrades estrogen receptors and is used in cases where resistance to other endocrine therapies develops.
Combination Therapies
Combining endocrine therapy with other treatments enhances efficacy. Examples include:
Endocrine Therapy with CDK4/6 Inhibitors: Palbociclib, ribociclib, and abemaciclib are CDK4/6 inhibitors that, when combined with endocrine therapy, significantly improve progression-free survival in advanced HR+ breast cancer.
Endocrine Therapy with mTOR Inhibitors: Everolimus, an mTOR inhibitor, can be added to endocrine therapy for patients who have developed resistance to aromatase inhibitors.
Chemotherapy
Chemotherapy is generally reserved for patients with high-risk features, such as large tumor size, high-grade histology, or extensive lymph node involvement. Regimens often include anthracyclines and taxanes.
Pictorial and detailed description of patellar instability with sign and symptoms and how to diagnose , what investigations you should go with and how to approach with treatment options . I have presented this slide in my 2nd year junior residency in orthopedics at LLRM medical college Meerut and got good reviews for it
After getting it read you will definitely understand the topic.
This presentation gives information on the pharmacology of Prostaglandins, Thromboxanes and Leukotrienes i.e. Eicosanoids. Eicosanoids are signaling molecules derived from polyunsaturated fatty acids like arachidonic acid. They are involved in complex control over inflammation, immunity, and the central nervous system. Eicosanoids are synthesized through the enzymatic oxidation of fatty acids by cyclooxygenase and lipoxygenase enzymes. They have short half-lives and act locally through autocrine and paracrine signaling.
Nano-gold for Cancer Therapy chemistry investigatory projectSIVAVINAYAKPK
chemistry investigatory project
The development of nanogold-based cancer therapy could revolutionize oncology by providing a more targeted, less invasive treatment option. This project contributes to the growing body of research aimed at harnessing nanotechnology for medical applications, paving the way for future clinical trials and potential commercial applications.
Cancer remains one of the leading causes of death worldwide, prompting the need for innovative treatment methods. Nanotechnology offers promising new approaches, including the use of gold nanoparticles (nanogold) for targeted cancer therapy. Nanogold particles possess unique physical and chemical properties that make them suitable for drug delivery, imaging, and photothermal therapy.
Storyboard on Acne-Innovative Learning-M. pharm. (2nd sem.) CosmeticsMuskanShingari
Acne is a common skin condition that occurs when hair follicles become clogged with oil and dead skin cells. It typically manifests as pimples, blackheads, or whiteheads, often on the face, chest, shoulders, or back. Acne can range from mild to severe and may cause emotional distress and scarring in some cases.
**Causes:**
1. **Excess Oil Production:** Hormonal changes during adolescence or certain times in adulthood can increase sebum (oil) production, leading to clogged pores.
2. **Clogged Pores:** When dead skin cells and oil block hair follicles, bacteria (usually Propionibacterium acnes) can thrive, causing inflammation and acne lesions.
3. **Hormonal Factors:** Fluctuations in hormone levels, such as during puberty, menstrual cycles, pregnancy, or certain medical conditions, can contribute to acne.
4. **Genetics:** A family history of acne can increase the likelihood of developing the condition.
**Types of Acne:**
- **Whiteheads:** Closed plugged pores.
- **Blackheads:** Open plugged pores with a dark surface.
- **Papules:** Small red, tender bumps.
- **Pustules:** Pimples with pus at their tips.
- **Nodules:** Large, solid, painful lumps beneath the surface.
- **Cysts:** Painful, pus-filled lumps beneath the surface that can cause scarring.
**Treatment:**
Treatment depends on the severity and type of acne but may include:
- **Topical Treatments:** Such as benzoyl peroxide, salicylic acid, or retinoids to reduce bacteria and unclog pores.
- **Oral Medications:** Antibiotics or oral contraceptives for hormonal acne.
- **Procedures:** Such as chemical peels, extraction of comedones, or light therapy for more severe cases.
**Prevention and Management:**
- **Cleanse:** Regularly wash skin with a gentle cleanser.
- **Moisturize:** Use non-comedogenic moisturizers to keep skin hydrated without clogging pores.
- **Avoid Irritants:** Such as harsh cosmetics or excessive scrubbing.
- **Sun Protection:** Use sunscreen to prevent exacerbation of acne scars and inflammation.
Acne treatment can take time, and consistency in skincare routines and treatments is crucial. Consulting a dermatologist can help tailor a treatment plan that suits individual needs and reduces the risk of scarring or long-term skin damage.
Nutritional deficiency Disorder are problems in india.
It is very important to learn about Indian child's nutritional parameters as well the Disease related to alteration in their Nutrition.
The Children are very vulnerable to get affected with respiratory disease.
In our country, the respiratory Disease conditions are consider as major cause for mortality and Morbidity in Child.
Atypical Presentation of Post-Kala Azar Dermal Leishmaniasis in Bhutan
1. Annals of Clinical and Medical
Case Reports
ISSN 2639-8109
Case Report
AtypicalPresentationofPost-KalaAzarDermalLeishmaniasisin
Bhutan
Pradhan A1#
, Tobgay T2#
, Dorjee S2
, Wangdi T3
, Zhou G4
and Karunaweera ND5*
1
Jigmi Dorji Wangchuck National Referral Hospital, Bhutan
2
Khesar Gyalpo University of Medical Sciences of Bhutan
3
Vector-borne Disease Control Programme, Ministry of Health
4
Program in Public Health, University of California, Irvine, USA.
5
Department of Parasitology, Faculty of Medicine, University of Colombo, Sri Lanka.
#Equal contribution as first authors
2. Key words
Leishmania donovani; Skin lesions;
Neglected tropical disease; Indian sub-
continent; Asia; Kala azar elimination;
Cutaneous leishmaniasis
3. Introduction
1. Abstract
This article describes an atypical case of post-kala azar dermal leishmaniasis associated with
complications due to delayed diagnosis and poor case management. The grave consequences
of the prolonged disease process, which included facial disfigurement, visual impairment and
distress both to the patient and the family with increased the risk of infection spread in the
community are elaborated.
Bhutan is a member of the leishmaniasis elimination network in Asia and the government con-
tinues to invest in maintenance of the national healthcare system. The case study highlights the
gaps in the healthcare system with hardships faced by a patient to access quality healthcare and
poor patient outcome used as proxy indicators. It also point towards the key challenges faced
by a resource poor nation like Bhutan in achieving universal health coverage and reaching the
set goals for disease elimination unless the national health care system is carefully reviewed and
deficiencies are adequately addressed.
leishmaniasis, unless diagnosed early and treated effectively may
Bhutan plans to achieve Universal Health Coverage (UHC) early
[1] and to eliminate leishmaniasis by 2020. However, leishmani-
asis surveys have not been conducted since 2006 [2]. Therefore,
the existing VL incidence data [3] are unreliable and are based on
clinical suspicion while the actual cases may go unrecorded due to
the dearth of healthcare professionals. The causative agent of VL in
Bhutan is Leishmania donovani, closely related to the Indian sub-
type with several Phlebotomus spp. identified as probable vector(s)
[4].
This article reports the first case of Post-Kala Azar Dermal Leish-
maniasis (PKDL) from Bhutan with an atypical presentation. Its
complex nature, prolonged history and resultant complications
underscore the need for careful review of the healthcare delivery
system in Bhutan, with a focus on successful control of Neglect-
ed Tropical Diseases (NTDs). This case adds to the evidence that
result in considerable debility and devastating socio-economic
consequences and therefore, poses as a formidable challenge to
achieve UHC in Bhutan.
4. Methodology
Patient consent was sought as per study protocol and ethics ap-
proval granted by Research Ethic Board of Health, Bhutan. Wecol-
lected information through review of medical records, laboratory
reports and prescriptions maintained since 1999 and patient and
family member interviews.
5. Case Description
We present the case of a 37-year-old female, a mother of three
children from the eastern part of Bhutan, seen by a dermatolo-
gist in 2014 at Jigmi Dorji Wangchuck National Referral Hospital
(JDWNRH). The patient presented with extensive erythematous
plaques on forehead, central face, peri-oral, cheeks that extended
*Corresponding Author (s): Nadira D. Karunaweera, Department of Parasitology, Faculty of
Medicine, University of Colombo, Sri Lanka, Tel: +94(11)2699284, E-mail: nadira@parasit. Citation: Nadira D, Pradhan A and Tobgay T, Atypical Presentation of Post-Kala Azar Dermal Leishmania-
cmb.ac.lk sis in Bhutan. Annals of Clinical and Medical Case Reports. 2020; 3(5): 1-4.
Volume 3 Issue 5- 2020
Received Date: 10 Apr 2020
Accepted Date: 25 Apr2020
Published Date: 27 Apr2020
3. Volume 3 Issue 5-2020 Case Report
Figure 2: Microscopic image (X1000) of punch biopsy tissue section
stained with hematoxylin and eosin (H and E). Arrow points to
Leishman-Donovan parasite bodies
6. Socio-Economic Aspects
The patient lives with her children and parents in a remote village
of Kalapang. Her husband is a cook and lives away from home in
another district. The family lives by subsistence farming. A narrow
walking path leads to the village. Residents walk for 4-5 hours to
reach the nearest town to hire a taxi to reach Mongar, where the
eastern regional referral hospital is located. It takes a further two
day-bus rides to reach Thimphu, the capital city to access services
of the dermatologist. Over a period of 20 years (1999 to 2019), she
has visited multiple health centers incurring a considerable cost
that the family could barely afford. Chronic and debilitating form
of disease has had devastating impact on her and her family in
terms of economic, social stigmatization andisolation.
7. Discussion
PKDL that manifests as painless macular and/or papulo-nodular
skin lesions may be a rich source of parasites, promoting transmis-
sion. Therefore, early patient management with appropriate drugs
is critical to contain the infection spread [5]. Its pathophysiology is
obscure and associated risk factors remain debatable [6, 7]. As per
records 10-20% in the Indian subcontinent [6, 8] and almost 50%
in Sudan are affected [9] months to years after apparent drug-cure
of VL or as a sequel of asymptomatic infections [6]. Mucosal in-
volvement rarely occurs [10-12]. Blephero-conjuctivitis and uveitis
as sequelae are known with organisms demonstrated in extra/in-
tra ocular and adnexal muscles [13]. Associated eye inflammation
may have grave consequences (aptly demonstrated through this
http://www.acmcasereport.com/
case study). Diagnosis of PKDL is based on clinical picture and
epidemiological pattern as confirmation through parasite isolation
has low sensitivity [14] nevertheless can be improved with the use
of molecular techniques [6]. Serological diagnosis (rk39 or ELISA)
though useful to detect exposure to infection, the interpretation of
its results may be difficult due to post-VL persistence of antibod-
ies. Availability of effective treatment options in endemic areas re-
mains important to minimize both the resultant morbidity due to
PKDL and the risk of further community spread. The latter is due
its potential to act as a reservoir for VL and trigger the emergence
of infection in non-endemic areas or its re-emergence in areas that
have successfully eliminated the disease. PKDL is, therefore, of
considerable public health significance in the region [15].
8. Conclusion
This case portrays the challenges faced by patients and clinicians in
PKDL management, particularly in resource-poor settings where
the disease is generally prevalent. It highlights areas that need at-
tention within the healthcare system, including the need for na-
tional-level guidelines for leishmaniasis treatment and more effec-
tive disease-awareness programs for public as well as healthcare
personnel. Active case detection studies to assess the true burden
of leishmaniasis (including PKDL) will also help to understand the
magnitude of the problem. The apparent hurdles to achieve UHC
in Bhutan highlight the need for remodeling of services based on
primary healthcare principles to ensure equality in access to qual-
ity healthcare.
9. Acknowledgements
The study was supported through funds awarded by the National
Institute of Allergy and Infectious Diseases of the National Insti-
tutes of Health, USA under Award Number U01AI136033. The
content is solely the responsibility of the authors and does not
necessarily represent the official views of the National Institutes of
Health. Editing and review of manuscript by Richard Carter, For-
merly from the University of Edinburgh, United Kingdom is grate-
fully acknowledged.
References
1. World Health Organization. 2019 Health SDG profile: Bhutan. WHO
Regional Office for South-East Asia.2019.
2. Bhattacharya SK, Rinzin N, Chusak P, Dash AP, Chowdhury R, To-
bgay T, et al. Occurrence and significance of Kala-Azar in Bhutan.
Indian J Med Res. 2010; 132: 337-8.
3. Ministry of Health. Annual health bulletin 2017. Policy & Planning
Division, Ministry of Health, Royal Government of Bhutan, Thim-
phu; 2017.
3
4. Volume 3 Issue 5-2020 Case Report
4. Yangzom T, Cruz I, Bern C, Argaw D, den Boer M, Vélez ID, et al.
Endemic transmission of visceral leishmaniasis in Bhutan. Am J
Trop Med Hyg. 2012; 87:1028-37.
5. World Health Organization. Post-kala-azar dermal leishmaniasis: a
manual for case management and control: report of a WHO consul-
tative meeting, Kolkata, India, 2-3 July 2012.
6. Zijlstra EE, Alves F,Rijal S, Arana B, Alvar J. Post-kala-azar dermal
leishmaniasis in the Indian subcontinent: A threat to the South-East
Asia Region Kala-azar Elimination Programme. PLoS Negl Trop
Dis. 2017; 11: e0005877.
7. Das S, Mandal R, Rabidas VN, Verma N, Pandey K, Ghosh AK, et
al. Chronic arsenic exposure and risk of post kala-azar dermal leish-
maniasis development in India: a retrospective cohort study. PLoS
Negl Trop Dis. 2016; 10:e0005060.
8. Uranw S, Ostyn B, Rijal A, Devkota S, Khanal B, Menten J, et al.
Post-kala-azar dermal leishmaniasis in Nepal: A retrospective co-
hort study (2000-2010). PLoS Negl Trop Dis. 2011; 5: e1433.
9. Zijlstra EE, Khalil EA, Kager PA,El-Hassan AM. Post-kala-azar der-
mal leishmaniasis in the Sudan: clinical presentation and differential
diagnosis. Br J Dermatol. 2000; 143: 136-43.
10. Salam MA, Siddiqui MA, Nabi SG, Bhaskar KRH, Mondal D. Post-
kala-azar dermal leishmaniasis with mucosal involvement: an un-
usual case presentation including successful treatment with milte-
fosine. J Health Popul Nutr. 2013; 31: 294-7.
11. Ramesh V,Kaushal H, Mishra AK, Singh R, Salotra P.Clinico-epide-
miological analysis of Post kala-azar dermal leishmaniasis (PKDL)
cases in India over last two decades: A hospital based retrospective
study Infectious Disease epidemiology. BMC Public Health. 2015;
15: 1092.
12. Rathi SK, Pandhi RK, Khanna N, Chopra P. Mucosal and peri-ori-
ficial involvement in post-kala-azar dermal leishmaniasis. Indian J
Dermatol Venereol Leprol. 2004; 70:280-2.
13. Khalil EAG, Musa AM, Younis BM, Elfaki MEE, Zijlstra EE, Elhas-
san AM. Blindness following visceral leishmaniasis: A neglected
post-kala-azar complication. Trop Doct. 2011; 41: 139-40.
14. Zijlstra EE. Biomarkers in post-kala-azar dermal leishmaniasis.
Front Cell Infect Microbiol. 2019; 9: 228.
15. Molina R, Ghosh D, Carrillo E. Infectivity of post-kala-azar dermal
leishmaniasis patients to sand flies: revisiting a proof of concept in the
context of the kala-azar elimination program in the Indian Subconti-
nent. Clin Infect Dis. 2017; 65: 150-3.
http://www.acmcasereport.com/ 4