Post-transplant Diabetes Mellitus: What Physicians Need to Know

Monkeypox was a zoonotic infection, first detected in parts of northern Africa in the 1970s. Monkeypoxvirus, the causative agent of monkeypox, is a species of genus Orthopoxvirus and is closely related to long-eradicated smallpox caused by variola virus. Outbreaks in the West (in USA, UK, and Ireland) along with periodic re-emergence of the disease in parts of Africa have generated concern among global health bodies due to the existent deficiency of guidelines for management of the disease. Genetic variations and altered mechanisms favoring better survival of the virus have made early identification of the disease during screening difficult, particularly in resource-limited settings like rural areas of Africa. Through evidences gathered from experimental studies conducted after these outbreaks, the virus is known to be transmitted from several animal reservoirs along with human-to-human contact of blood, body fluids, or aerosol. Early diagnosis through immunoassays and polymerase chain reaction (PCR) tests, although not very specific, allows early treatment and subsequently better patient survival and recovery. Presence of lymphadenopathy along with fever, sore throat, and a vesiculopustular rash is diagnostic. The virus affects the gastrointestinal, hematological, ocular, and respiratory systems, in like manner producing afflictions of the specific system. Treatment, through experimental data, has been preferred to be symptomatic, with the aim to prevent superinfections. Antivirals like cidofovir and tecovirimat have been studied upon and used in clinical trials with favorable outcomes. Antiviral immunoglobulins have also been used with success in certain patients for postexposure prophylaxis.

Childhood Lupus with Microangiopathic Antiphospholipid Syndrome and Pulmonary Hemorrhage.

Background: Concurrent thrombotic and hemorrhagic manifestations are uncommon in patients with Antiphospholipid Syndrome. Case characteristics: A 10-year-old girl with fever, edema, rash and joint pains, who later developed deep venous thrombosis (DVT), stroke, thrombotic microangiopathic hemolytic anemia and pulmonary hemorrhage. Investigations confirmed Antiphospholipid syndrome associated with systemic lupus erythematosus. Outcome: She went into complete remission with intravenous immunoglobulins, plasmapheresis, immunosuppression and anticoagulation. Message: Thrombotic microangiopathic hemolytic anemia and anti-phospholipid syndrome can be the presenting manifestations of systemic lupus erythematosus..