Hepatitis C virus infection: an enigma continues

Hepatitis C, caused by hepatitis C virus [HCV], has emerged as a major health problem not only in developing world but also in developed countries. HCV infects approximately 170 million people worldwide. HCV is the most efficiently transmitted through percutaneous exposure to blood, intravenous drug abuse, haemodialysis, nosocomial incidents [colonoscopy], inadequately sterilised medical instruments, high-risk sexual behaviour, body piercing, tattooing and vertical transmission. Most patients with acute HCV infection develop persistent infection and 75-85% patients develop chronic hepatitis. Chronic hepatitis C predisposes patients to progression to fibrosis, cirrhosis and hepatocellular carcinoma. The diagnosis of HCV infection by serological, virological, molecular tools and biopsy is essential in the management of HCV infection. Pegylated interferon a combined with ribavirin has been the mainstay of treatment of HCV infection. Awareness of health care workers and general population is important to curb this silent epidemic. This review is presented as an overview of epidemiology, virology, pathogenesis, clinical manifestations, diagnosis, treatment and prevention of HCV infection

Fatal septicemic melioidosis in young adult

Melioidosis caused by B. pseudomallei remains dormant for months, years and even decades but becomes active when host is immunocompromised by drugs or disease including diabetes mellitus. Patients with diabetes mellitus shows a severe serious presentation of melioidosis. This is a case report of a 26 year old man with diabetes mellitus presented with fever, shortness of breath, left loin pain, dysuria and haematuria. The outcome of this melioidosis case and differential diagnosis are discussed