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Call for a global breast cancer care pathway. 呼吁建立全球乳腺癌护理途径。
IF 0.6 4区 医学
Tropical Doctor Pub Date : 2025-08-07 DOI: 10.1177/00494755251366343
Sanjay Kumar Yadav, Dhananjaya Sharma
{"title":"Call for a global breast cancer care pathway.","authors":"Sanjay Kumar Yadav, Dhananjaya Sharma","doi":"10.1177/00494755251366343","DOIUrl":"https://doi.org/10.1177/00494755251366343","url":null,"abstract":"<p><p>Breast cancer care in high-income countries has become increasingly standardized and involves a multidisciplinary, evidence-based model with technologically advanced tools. However, this gold standard may not be inaccessible in many low- and middle-income countries, where healthcare infrastructure and financial constraints hinder its implementation. We highlight the frugal, yet effective, breast cancer surgery pathway developed and implemented by us in a tertiary referral center in central India. We have created a context-specific surgical protocol that aligns with the spirit of current standards without relying on expensive technology or consumables. We advocate for a formalized <i>Global Breast Cancer Care Pathway</i> that can be adopted, endorsed, and disseminated by international bodies for use in resource-constrained settings.</p>","PeriodicalId":49415,"journal":{"name":"Tropical Doctor","volume":" ","pages":"494755251366343"},"PeriodicalIF":0.6,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144795922","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
'I-OCD': A bedside protocol for antibiotic stewardship in hospitalised patients. “I-OCD”：住院患者抗生素管理的床边协议。
IF 0.6 4区 医学
Tropical Doctor Pub Date : 2025-08-07 DOI: 10.1177/00494755251362079
Ashok Kumar Pannu
{"title":"'I-OCD': A bedside protocol for antibiotic stewardship in hospitalised patients.","authors":"Ashok Kumar Pannu","doi":"10.1177/00494755251362079","DOIUrl":"https://doi.org/10.1177/00494755251362079","url":null,"abstract":"<p><p>Antimicrobial resistance is a growing public health threat. In hospital settings, antimicrobial decisions must be both prompt and precise. We propose the 'I-OCD' approach, a simple bedside mnemonic to guide daily antibiotic decision-making for hospitalised patients with fever. 'I-OCD' encourages clinicians to: assess evidence of <i>I</i>nfection and determine if antimicrobials are required based on its <i>O</i>rigin and likely <i>O</i>rganisms, obtain appropriate <i>C</i>ultures before initiation, and conduct <i>D</i>aily review of <i>D</i>ose, <i>D</i>uration, and <i>D</i>e-escalation. Empiric therapy should be guided by likely organisms, local antibiograms, and illness severity, rather than defaulting to broad-spectrum coverage. Beyond clinical guidelines, it promotes a behavioural mindset akin to persons with <i>O</i>bsessive-<i>C</i>ompulsive <i>D</i>isorder: clinicians as meticulous 'washers and checkers', committed to hand hygiene and reassessment of antimicrobial need and invasive devices.</p>","PeriodicalId":49415,"journal":{"name":"Tropical Doctor","volume":" ","pages":"494755251362079"},"PeriodicalIF":0.6,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144795923","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
Atypical presentations of cutaneous tuberculosis: A case series of six patients. 皮肤结核的不典型表现：六例患者的病例系列。
IF 0.6 4区 医学
Tropical Doctor Pub Date : 2025-08-04 DOI: 10.1177/00494755251362076
Deepika Rawat, Kiranpreet Malhotra, Himanshu Nirwal, Parul Verma, Urmila Singh, Swastika Suvirya
{"title":"Atypical presentations of cutaneous tuberculosis: A case series of six patients.","authors":"Deepika Rawat, Kiranpreet Malhotra, Himanshu Nirwal, Parul Verma, Urmila Singh, Swastika Suvirya","doi":"10.1177/00494755251362076","DOIUrl":"https://doi.org/10.1177/00494755251362076","url":null,"abstract":"<p><p>Cutaneous tuberculosis (CTB), a rare extrapulmonary manifestation of <i>Mycobacterium tuberculosis</i>, poses a diagnostic challenge owing to its diverse clinical presentations and paucibacillary nature. We present six atypical cases diagnosed between January 2022 and January 2025 at a tertiary care centre in North India. All patients were HIV-negative, with diagnoses confirmed by histopathology, cartridge-based nucleic acid amplification test (CB-NAAT), culture, and imaging studies. Unusual manifestations included scrofuloderma of the hand overlying wrist joint TB, lupus vulgaris with acquired lymphangiectasia, tubercular gumma mimicking inoculation TB in an immunocompetent patient, scrofuloderma secondary to rib osteomyelitis, coexisting papulonecrotic tuberculid with erythema induratum of Bazin, and lupus vulgaris resembling bacillary angiomatosis. Standard anti-tubercular treatment (ATT) resulted in clinical resolution in all cases.</p>","PeriodicalId":49415,"journal":{"name":"Tropical Doctor","volume":" ","pages":"494755251362076"},"PeriodicalIF":0.6,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144776741","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
Pelvic organ prolapse and cervical adenocarcinoma in a postmenopausal woman: A case report. 绝经后妇女盆腔器官脱垂和宫颈腺癌1例报告。
IF 0.6 4区 医学
Tropical Doctor Pub Date : 2025-08-01 DOI: 10.1177/00494755251362934
Meenakshi Pandey, Deepa Shanmugham, Ramya Palani, Prithiviraj Nagarajan
{"title":"Pelvic organ prolapse and cervical adenocarcinoma in a postmenopausal woman: A case report.","authors":"Meenakshi Pandey, Deepa Shanmugham, Ramya Palani, Prithiviraj Nagarajan","doi":"10.1177/00494755251362934","DOIUrl":"https://doi.org/10.1177/00494755251362934","url":null,"abstract":"<p><p>The simultaneous occurrence of pelvic organ prolapse and cervical adenocarcinoma is rare and can pose diagnostic challenges owing to overlapping symptoms. We present the case of a 60-year old multiparous, postmenopausal woman with a six month history of vaginal prolapse involving a mass. After undergoing vaginal hysterectomy with pelvic floor repair, histopathological examination revealed the presence of stage 1A<sub>2</sub> endocervical adenocarcinoma. Post-operative imaging showed no metastasis or lymph node involvement.</p>","PeriodicalId":49415,"journal":{"name":"Tropical Doctor","volume":" ","pages":"494755251362934"},"PeriodicalIF":0.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144762097","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
Standard operating protocol for Scrub typhus diagnosis and treatment. 恙虫病诊断和治疗标准操作规程。
IF 0.6 4区 医学
Tropical Doctor Pub Date : 2025-08-01 DOI: 10.1177/00494755251362933
Ashok Kumar Pannu
{"title":"Standard operating protocol for Scrub typhus diagnosis and treatment.","authors":"Ashok Kumar Pannu","doi":"10.1177/00494755251362933","DOIUrl":"https://doi.org/10.1177/00494755251362933","url":null,"abstract":"<p><p>Scrub typhus is increasingly recognised as a common cause of acute febrile illness in South and Southeast Asia. A lack of clinical suspicion and delayed diagnosis contribute to a mortality rate of ∼10%. A clinical diagnosis based on seasonal epidemiology, presence of eschar or rash, thrombocytopenia, hepatic or splenic involvement, and multiorgan dysfunction warrants prompt empirical treatment with doxycycline or azithromycin. IgM enzyme-linked immunosorbent assay remains the diagnostic mainstay. Treatment is stratified by severity; dual therapy is recommended in severe, confirmed cases. Most patients respond within 48 h of antibiotic initiation.</p>","PeriodicalId":49415,"journal":{"name":"Tropical Doctor","volume":" ","pages":"494755251362933"},"PeriodicalIF":0.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144762098","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
Standard operating protocol for influenza testing, treatment and prophylaxis. 流感检测、治疗和预防的标准操作规程。
IF 0.6 4区 医学
Tropical Doctor Pub Date : 2025-07-31 DOI: 10.1177/00494755251362937
Ashok Kumar Pannu
{"title":"Standard operating protocol for influenza testing, treatment and prophylaxis.","authors":"Ashok Kumar Pannu","doi":"10.1177/00494755251362937","DOIUrl":"https://doi.org/10.1177/00494755251362937","url":null,"abstract":"<p><p>Effective influenza management requires early testing to guide time-sensitive antiviral therapy, the indiscriminate use of which may promote drug resistance. Reverse transcriptase polymerase chain reaction (RT-PCR) testing is constrained by laboratory infrastructure needs and a turnaround time of several hours. Point-of-care nucleic acid amplification tests (NAATs) and digital immunoassays (DIAs), though rapid, remain costly and are not widely available in low- and middle-income countries (LMICs). This standard operating protocol provides practical guidance for managing seasonal and zoonotic (avian) influenza, primarily based on WHO recommendations. Oseltamivir is reserved for severe influenza, with empirical use permitted only if RT-PCR results are delayed beyond 24 h. For non-severe illness, Baloxavir is recommended in patients at high risk of hospitalisation, but only after a positive NAAT or DIA; however, its access and affordability remain limited in LMICs. Post-exposure prophylaxis is reserved for specific high-risk exposures.</p>","PeriodicalId":49415,"journal":{"name":"Tropical Doctor","volume":" ","pages":"494755251362937"},"PeriodicalIF":0.6,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144754998","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
How (not) to practice global health: A field guide for the distinguished global south expert. 如何（不）实践全球健康：为杰出的全球南方专家提供的实地指南。
IF 0.6 4区 医学
Tropical Doctor Pub Date : 2025-07-31 DOI: 10.1177/00494755251362275
Dhananjaya Sharma
{"title":"How (not) to practice global health: A field guide for the distinguished global south expert.","authors":"Dhananjaya Sharma","doi":"10.1177/00494755251362275","DOIUrl":"https://doi.org/10.1177/00494755251362275","url":null,"abstract":"","PeriodicalId":49415,"journal":{"name":"Tropical Doctor","volume":" ","pages":"494755251362275"},"PeriodicalIF":0.6,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144754996","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
Geriatric Tuberculosis in India: Emerging challenges and practical perspectives. 印度老年结核病：新出现的挑战和实际观点。
IF 0.6 4区 医学
Tropical Doctor Pub Date : 2025-07-31 DOI: 10.1177/00494755251362095
Ashok Kumar Pannu
{"title":"Geriatric Tuberculosis in India: Emerging challenges and practical perspectives.","authors":"Ashok Kumar Pannu","doi":"10.1177/00494755251362095","DOIUrl":"https://doi.org/10.1177/00494755251362095","url":null,"abstract":"<p><p>Geriatric tuberculosis (TB) is an emerging but under-recognized challenge in India. Older adults often present with atypical or advanced disease, leading to delayed diagnosis, treatment complications, and increased mortality. While pulmonary TB is common, extrapulmonary and disseminated forms are also frequent. Diagnosis is hindered by non-specific symptoms and reduced microbiological yield, and treatment is complicated by co-morbidity, polypharmacy, and poor adherence. Despite elevated risk, older adults are not prioritized under current TB preventive strategies. This review highlights the unique clinical features, diagnostic limitations, and management challenges of TB in older adults, emphasizing the need for age-responsive TB control strategies.</p>","PeriodicalId":49415,"journal":{"name":"Tropical Doctor","volume":" ","pages":"494755251362095"},"PeriodicalIF":0.6,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144754995","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
Rethinking postgraduate research in low- and middle-income countries: From box-ticking to capacity building. 重新思考中低收入国家的研究生研究：从打勾到能力建设。
IF 0.6 4区 医学
Tropical Doctor Pub Date : 2025-07-31 DOI: 10.1177/00494755251361075
Dhananjaya Sharma, Michael Cotton
{"title":"Rethinking postgraduate research in low- and middle-income countries: From box-ticking to capacity building.","authors":"Dhananjaya Sharma, Michael Cotton","doi":"10.1177/00494755251361075","DOIUrl":"https://doi.org/10.1177/00494755251361075","url":null,"abstract":"","PeriodicalId":49415,"journal":{"name":"Tropical Doctor","volume":" ","pages":"494755251361075"},"PeriodicalIF":0.6,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144754997","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
Mycobacterium meets malignancy: A curious clinical convergence. 分枝杆菌遇到恶性肿瘤：一个奇怪的临床趋同。
IF 0.5 4区 医学
Tropical Doctor Pub Date : 2025-07-22 DOI: 10.1177/00494755251360301
Seema Rao, Md Ali Osama, Sonia Badwal, Nitin Gupta
{"title":"<i>Mycobacterium</i> meets malignancy: A curious clinical convergence.","authors":"Seema Rao, Md Ali Osama, Sonia Badwal, Nitin Gupta","doi":"10.1177/00494755251360301","DOIUrl":"https://doi.org/10.1177/00494755251360301","url":null,"abstract":"","PeriodicalId":49415,"journal":{"name":"Tropical Doctor","volume":" ","pages":"494755251360301"},"PeriodicalIF":0.5,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144683477","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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