2016 Issue

Rapidly deteriorating mobility in a young man: Case description and possible differential diagnoses

doi:10.7244/cmj.2016.06.001
V Srirangam

A 32 year old gentleman, presenting initially with a ‘dragging’ foot, rapidly progressed to become paraplegic within a year. Here, a case summary is presented initially, followed by the differential diagnosis for the clinical presentation. Investigations primarily showed combined central and peripheral demyelination which could have been secondary to the anti-CRMP5 antibodies found in his serum. Such antibodies are highly associated with malignancy and, as a consequence, our patient was extensively investigated for an occult neoplasm (which was not found). While the central and peripheral demyelination may have been secondary to an antibody-mediated paraneoplastic syndrome, other differentials such as autoimmune combined demyelination must also be considered.

Integrating Care for Communicable Disease and Non-Communicable Disease

Credit: Penn State, flickr

doi:10.7244/cmj.2016.05.002
A Yang

Although communicable disease (CD) and non-communicable disease (NCD) are often thought of as separate, competing entities particularly when it comes to funding pipelines and interventions, the two classes of disease are in fact intimately related. Medical anthropologists and sociologists have long recognized that social determinants such as poverty serve as a common breeding ground for CDs and NCDs, but the relationship between the two kinds of diseases can be even more direct. This article explores the intimate symbiosis between CDs and NCDs through a range of illustrative examples. In some CD-NCD pairs, the CD causes or is etiologically associated with an NCD, illustrating that NCD interventions are sometimes more effective when coupled with CD interventions, such as vaccination programs. In others, the relationship is better characterized as bidirectional, each worsening the outcomes of the other. From a broader perspective, these relationships also connect with each other in a larger web of various CD-NCD interactions. Because of these reinforcing relationships, screening for and treating CDs and related NCDs together rather than separately can more effectively reduce the suffering they cause. Hence, integrating interventions against CDs and NCDs can produce better clinical results than addressing them separately, and given the increasing overlap between the burdens of NCDs and CDs across the world, integration is now as crucial as ever.

Dengue in India: The importance of child education

doi:10.7244/cmj.2016.05.001
M Roshen

Dengue is an important mosquito-borne viral disease and constitutes a major public health concern throughout tropical and subtropical regions. Its global incidence has increased 30-fold in the past half century and the World Health Organisation (WHO) estimates that there are up to 100 million new infections annually, with 40% of the world’s population at risk.

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