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The Ivory Tower Paradox of Global South: When tertiary care meets the frontlines. 全球南方的象牙塔悖论：当三级保健遇到第一线时。
IF 0.6 4区 医学
Tropical Doctor Pub Date : 2026-10-01 Epub Date: 2026-06-15 DOI: 10.1177/00494755261461076
Sanjay Kumar Yadav, Dhananjaya Sharma, Michael Cotton
{"title":"The Ivory Tower Paradox of Global South: When tertiary care meets the frontlines.","authors":"Sanjay Kumar Yadav, Dhananjaya Sharma, Michael Cotton","doi":"10.1177/00494755261461076","DOIUrl":"10.1177/00494755261461076","url":null,"abstract":"","PeriodicalId":49415,"journal":{"name":"Tropical Doctor","volume":" ","pages":"611-612"},"PeriodicalIF":0.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148254292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Scrotal exploration for suspected testicular torsion: Lessons from 61 consecutive cases presenting at an adult emergency room. 阴囊探查诊断疑似睾丸扭转：来自成人急诊室61例连续病例的经验教训。
IF 0.6 4区 医学
Tropical Doctor Pub Date : 2026-10-01 Epub Date: 2026-04-30 DOI: 10.1177/00494755261446073
James Edward Mensah, Geoffrey Birinkorang, Ernest Kwame Adjepong-Tandoh, Enoch Tackie, John Nkrumah, Kofi Tawiah Mensah
{"title":"Scrotal exploration for suspected testicular torsion: Lessons from 61 consecutive cases presenting at an adult emergency room.","authors":"James Edward Mensah, Geoffrey Birinkorang, Ernest Kwame Adjepong-Tandoh, Enoch Tackie, John Nkrumah, Kofi Tawiah Mensah","doi":"10.1177/00494755261446073","DOIUrl":"10.1177/00494755261446073","url":null,"abstract":"<p><p>This study assessed the clinical presentation, diagnosis, and outcomes of patients presenting with acute scrotal pain as an adult emergency who underwent scrotal exploration. A retrospective review was conducted at Korle Bu Teaching Hospital, Ghana, over 5 years. Sixty-one patients aged 10-72 years (median 21) were included. Clinical findings, use of Doppler ultrasound, operative findings, and outcomes were analysed. Testicular torsion was confirmed in 44 patients (72.1%). Clinical evaluation alone achieved a diagnostic accuracy of 74%, while Doppler ultrasound, performed in 55.7% of cases, showed 88.5% sensitivity for torsion. Orchidectomy was required in 39.3% due to gangrenous testes, while 32.8% had viable testes salvaged. Delayed presentation (>72 h) was strongly associated with testicular gangrene (χ<sup>2</sup> = 31.47, p < 0.00001). Delayed presentation reduces testicular salvage, and in resource-limited settings, careful clinical examination remains central to diagnosing suspected torsion and guiding timely surgical intervention.</p>","PeriodicalId":49415,"journal":{"name":"Tropical Doctor","volume":" ","pages":"670-674"},"PeriodicalIF":0.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147822860","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Prevalence and predictors of coeliac disease in patients with irritable bowel syndrome: A prospective study from Rajasthan, India. 肠易激综合征患者乳糜泻的患病率和预测因素：印度拉贾斯坦邦的一项前瞻性研究
IF 0.6 4区 医学
Tropical Doctor Pub Date : 2026-10-01 Epub Date: 2026-06-15 DOI: 10.1177/00494755261459504
Dholavan Mayur, Ankit Agarwal, Chhagan Lal Birda, Vivek Chowdary Gogineni, Terence Susngi, Mahendra Kumar Garg, Bharat Kumar, Ashish Agarwal
{"title":"Prevalence and predictors of coeliac disease in patients with irritable bowel syndrome: A prospective study from Rajasthan, India.","authors":"Dholavan Mayur, Ankit Agarwal, Chhagan Lal Birda, Vivek Chowdary Gogineni, Terence Susngi, Mahendra Kumar Garg, Bharat Kumar, Ashish Agarwal","doi":"10.1177/00494755261459504","DOIUrl":"10.1177/00494755261459504","url":null,"abstract":"<p><p>Our study aims to assess the prevalence of coeliac disease (CD) among patients with irritable bowel syndrome (IBS), a recognised high-risk group for CD, in Rajasthan. We found 9/287 consecutive adult IBS patients seropositive or with biopsy-confirmed CD. Lower haemoglobin levels were independently associated with CD.</p>","PeriodicalId":49415,"journal":{"name":"Tropical Doctor","volume":" ","pages":"684-688"},"PeriodicalIF":0.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148254309","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Intravenous hypertonic dextrose in conservatively managed adhesive small bowel obstruction: An exploratory observational study. 静脉注射高渗葡萄糖治疗粘连性小肠梗阻：一项探索性观察研究。
IF 0.6 4区 医学
Tropical Doctor Pub Date : 2026-10-01 Epub Date: 2026-05-06 DOI: 10.1177/00494755261449090
Deepti B Sharma, Alok Deshmukh, Ravikant Mahant, Chandan Tiwari, Pawan Agarawal, Dhananjaya Sharma
{"title":"Intravenous hypertonic dextrose in conservatively managed adhesive small bowel obstruction: An exploratory observational study.","authors":"Deepti B Sharma, Alok Deshmukh, Ravikant Mahant, Chandan Tiwari, Pawan Agarawal, Dhananjaya Sharma","doi":"10.1177/00494755261449090","DOIUrl":"10.1177/00494755261449090","url":null,"abstract":"<p><p>Adhesive small bowel obstruction (ASBO) is commonly managed conservatively, with adjuncts such as CT scan with per-oral water-soluble contrast, which are diagnostic and in some cases therapeutic. However, these may not be consistently available in low-resource settings. Hypertonic solutions have been shown to influence intestinal oedema and function, but the role of intravenous hypertonic dextrose is unclear. We describe an observational experience of adjunctive 25% dextrose (40 mL daily for 3 days) in selected patients with ASBO managed non-operatively at a tertiary centre in central India.</p>","PeriodicalId":49415,"journal":{"name":"Tropical Doctor","volume":" ","pages":"662-664"},"PeriodicalIF":0.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845104","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Richter's hernia through a missed traumatic abdominal wall defect: A rare cause of early postoperative obstruction after trauma laparotomy. 通过外伤性腹壁缺损漏诊的里希特疝：创伤剖腹手术后早期梗阻的罕见原因。
IF 0.6 4区 医学
Tropical Doctor Pub Date : 2026-10-01 Epub Date: 2026-04-25 DOI: 10.1177/00494755261445183
Harpyar Singh, Megha Tandon, Avinash Ranga, Ayush Badolia
{"title":"Richter's hernia through a missed traumatic abdominal wall defect: A rare cause of early postoperative obstruction after trauma laparotomy.","authors":"Harpyar Singh, Megha Tandon, Avinash Ranga, Ayush Badolia","doi":"10.1177/00494755261445183","DOIUrl":"10.1177/00494755261445183","url":null,"abstract":"<p><p>A young man with multiple stab wounds underwent emergency trauma laparotomy for penetrating abdominal injury. Initial exploration revealed only an omental tear. The postoperative course, however, was complicated by early intestinal obstruction. Re-exploration revealed a Richter's hernia through a missed traumatic abdominal wall defect. This case highlights a rare but important cause of postoperative obstruction following trauma laparotomy.</p>","PeriodicalId":49415,"journal":{"name":"Tropical Doctor","volume":" ","pages":"755-756"},"PeriodicalIF":0.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147787277","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Atrial fibrillation as the initial presentation of hyperthyroidism: Two cases: Graves' thyroid storm and toxic adenoma. 以甲亢为首发表现的心房颤动：Graves甲状腺风暴和中毒性腺瘤2例。
IF 0.6 4区 医学
Tropical Doctor Pub Date : 2026-10-01 Epub Date: 2026-05-22 DOI: 10.1177/00494755261454455
Ram Arvind Viswanathan, Manokaran Chinnusamy
{"title":"Atrial fibrillation as the initial presentation of hyperthyroidism: Two cases: Graves' thyroid storm and toxic adenoma.","authors":"Ram Arvind Viswanathan, Manokaran Chinnusamy","doi":"10.1177/00494755261454455","DOIUrl":"10.1177/00494755261454455","url":null,"abstract":"<p><p>Atrial fibrillation (AF) is a recognised but potentially reversible manifestation of hyperthyroidism and may occasionally precede classic thyrotoxic symptoms. We report two cases in which AF was the initial presentation of hyperthyroidism with distinct aetiology and clinical severity. The first had rapid AF from Graves' disease, and the second had new-onset AF due to a solitary toxic adenoma. These cases emphasise the importance of routine thyroid evaluation in patients presenting with new-onset AF.</p>","PeriodicalId":49415,"journal":{"name":"Tropical Doctor","volume":" ","pages":"727-729"},"PeriodicalIF":0.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148007205","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Cryptosporidiosis presenting as reversible acute allograft dysfunction mimicking rejection in a renal transplant recipient. 隐孢子虫病在肾移植受者中表现为可逆性急性同种异体移植物功能障碍模拟排斥反应。
IF 0.6 4区 医学
Tropical Doctor Pub Date : 2026-10-01 Epub Date: 2026-06-03 DOI: 10.1177/00494755261456910
Surya Prakash Thotanolla, Jeeja Jaya Janardhanan, Namesh Kamat
{"title":"Cryptosporidiosis presenting as reversible acute allograft dysfunction mimicking rejection in a renal transplant recipient.","authors":"Surya Prakash Thotanolla, Jeeja Jaya Janardhanan, Namesh Kamat","doi":"10.1177/00494755261456910","DOIUrl":"10.1177/00494755261456910","url":null,"abstract":"<p><p>Diarrhoeal illnesses in renal transplant recipients are common in tropical regions but may have significant implications beyond gastro-intestinal morbidity. Cryptosporidiosis, although common in tropical settings, may present as acute allograft dysfunction through a haemodynamic mechanism, closely mimicking rejection. Recognition of this reversible cause is essential to avoid unnecessary escalation of immuno-suppression and to ensure timely management. Gastro-intestinal infections are often considered benign and self-limiting, but their systemic consequences in immunosuppressed hosts are frequently under-recognised.</p>","PeriodicalId":49415,"journal":{"name":"Tropical Doctor","volume":" ","pages":"807-808"},"PeriodicalIF":0.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148150990","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Beyond the stoma: Exteriorized ileal loop without ostomy as a simple, feasible alternative to defunctioning loop ileostomy. 在造口之外：不造口的外化回肠袢是一种简单可行的替代功能性回肠袢造口术的方法。
IF 0.6 4区 医学
Tropical Doctor Pub Date : 2026-10-01 Epub Date: 2026-04-21 DOI: 10.1177/00494755261443667
Thangavel Prabhakar, Vineet Dwivedi, Yogendra Singh Wadiwa, Pawan Agarwal, Dhananjaya Sharma
{"title":"Beyond the stoma: Exteriorized ileal loop without ostomy as a simple, feasible alternative to defunctioning loop ileostomy.","authors":"Thangavel Prabhakar, Vineet Dwivedi, Yogendra Singh Wadiwa, Pawan Agarwal, Dhananjaya Sharma","doi":"10.1177/00494755261443667","DOIUrl":"10.1177/00494755261443667","url":null,"abstract":"<p><p>A defunctioning loop ileostomy is widely used to protect distal bowel repair and anastomoses, but is associated with significant stoma-related morbidity and the obvious need for a second procedure for closure. We therefore evaluated the creation of an unopened exteriorized (covering) ileal loop without ostomy as a simple, feasible alternative. In our prospective interventional study, 26 patients undergoing emergency surgery for ileal perforation or distal intestinal obstruction underwent this procedure, with an option for bedside conversion to ileostomy if required. Stoma conversion was required in only four patients, while the remainder avoided ileostomy and underwent loop repositioning without complication. This technique appears simple and safe, avoids stoma-related morbidity, and eliminates the need for a second surgery in the majority of patients.</p>","PeriodicalId":49415,"journal":{"name":"Tropical Doctor","volume":" ","pages":"665-669"},"PeriodicalIF":0.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147787343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Dermatofibrosarcoma protuberans in a resource-limited setting: Diagnostic delays and surgical management in a 10-patient institutional series. 资源有限的隆突性皮肤纤维肉瘤：10例机构系列患者的诊断延误和手术治疗。
IF 0.6 4区 医学
Tropical Doctor Pub Date : 2026-10-01 Epub Date: 2026-05-04 DOI: 10.1177/00494755261447946
Harpyar Singh, Raj Kumar Chejara, Sahib Sarangal, Shivanand Hosamani, Sushila Choudhary
{"title":"Dermatofibrosarcoma protuberans in a resource-limited setting: Diagnostic delays and surgical management in a 10-patient institutional series.","authors":"Harpyar Singh, Raj Kumar Chejara, Sahib Sarangal, Shivanand Hosamani, Sushila Choudhary","doi":"10.1177/00494755261447946","DOIUrl":"10.1177/00494755261447946","url":null,"abstract":"<p><p>Delayed diagnosis of dermatofibrosarcoma protuberans (DFSP) remains a challenge in low- and middle-income settings, often leading to large tumours or inadequate primary excisions. Our case series describes ten patients with histologically confirmed DFSP treated at a tertiary care centre in India between 2022 and 2024. All patients underwent wide local excision, with reconstruction using split-thickness skin grafts, local or regional flaps, or mesh reinforcement for abdominal wall defects. Adjuvant radiotherapy was used in selected high-risk cases.</p>","PeriodicalId":49415,"journal":{"name":"Tropical Doctor","volume":" ","pages":"738-740"},"PeriodicalIF":0.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Decompressive fasciotomy as a limb-sparing intervention for gas-forming soft tissue infection of the lower limb in diabetic patients: A prospective cohort study of 20 cases from Dakar, Senegal. 减压筋膜切开术作为保肢干预糖尿病患者下肢气体形成软组织感染：一项来自塞内加尔达喀尔的20例前瞻性队列研究
IF 0.6 4区 医学
Tropical Doctor Pub Date : 2026-10-01 Epub Date: 2026-04-30 DOI: 10.1177/00494755261446119
Seye Yacine, Gueye Mohamadou Lamine, Diop Mouhamadou Laye, Touré Alpha Oumar, Seck Mamadou, Dieng Madieng
{"title":"Decompressive fasciotomy as a limb-sparing intervention for gas-forming soft tissue infection of the lower limb in diabetic patients: A prospective cohort study of 20 cases from Dakar, Senegal.","authors":"Seye Yacine, Gueye Mohamadou Lamine, Diop Mouhamadou Laye, Touré Alpha Oumar, Seck Mamadou, Dieng Madieng","doi":"10.1177/00494755261446119","DOIUrl":"10.1177/00494755261446119","url":null,"abstract":"<p><p>Major amputation remains the default response to gas-forming soft tissue infection of the lower limb in diabetic patients across Sub-Saharan Africa, despite its devastating functional and economic consequences in settings with minimal prosthetic services. We report a prospective cohort study of 20 such patients who underwent primary decompressive fasciotomy at a tertiary centre in Dakar, Senegal. Overall limb salvage was achieved in 75% (15/20), and in-hospital mortality was zero. Among nine patients ultimately requiring amputation, the planned level was downstaged in 78%, including one patient initially assessed for hip disarticulation who underwent lower leg amputation. Preoperative vascular status was the decisive predictor: salvage reached 91% with good arterial perfusion versus 0% in mediacalcosis (Mönckeberg's arteriosclerosis) (<i>p</i> < 0.01). Therefore, decompressive fasciotomy, being a less invasive, inexpensive, and technically accessible procedure, should precede amputation in every diabetic patient with gas-forming lower limb infection and preserved arterial flow.</p>","PeriodicalId":49415,"journal":{"name":"Tropical Doctor","volume":" ","pages":"655-661"},"PeriodicalIF":0.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147822868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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