RESUMO
PURPOSE: Palghar district, located in the coastal region of the Konkan division of Maharashtra, has a predominantly tribal population. Leptospirosis is a major neglected public health problem and is highly underreported in Palghar district. The study aimed to evaluate the seropositivity of Leptospira infection and its associated epidemiological factors in tribal areas of the Palghar district of Maharashtra. METHODS: The present retrospective study included 94 samples of patients clinically suspected of leptospirosis during a period of one year (2021-2022) tested at Model Rural Health Research Unit (MRHRU) Dahanu. The serum sample testing was done for the presence of specific Leptospira IgM antibodies using the Panbio™ Leptospira IgM ELISA kit. Leptospirosis seropositivity was correlated with various epidemiological risk factors. RESULTS: A total of 12 samples of patients tested positive for specific IgM antibodies by ELISA method, indicating an overall positivity of 12.8%. Among those who tested positive, fever (83.3%), headache (58.3%), myalgia (50%), redness of the eyes (50%), and calf tenderness (16.7%) were the common symptoms observed. Subjects with redness of the eyes were significantly associated with leptospirosis (p = 0.018). The highest positivity (50%) was reported from the Ganjad area of Dahanu taluka. Farmers and animal handlers were most affected by leptospirosis. CONCLUSION: The high proportion of Leptospirosis cases reflects the endemic nature of the disease in the Palghar district. This study shows seasonal trends in leptospirosis incidence over the year. The clinical presentation of leptospirosis may vary from sub-clinical to mild illness to severe and potentially fatal. The findings of this study will be important for achieving the overarching goal of One Health.
RESUMO
Research question: Is there a diurnal variation in salivary progesterone levels during menstrual cycle among Indian women? Design: A longitudinal study was carried out to measure progesterone in saliva among small cross-sectional sample (n = 31) of fertile Indian women of reproductive age comprising young adults (18-25 years, n = 11), adults (26-38 years, n = 9) and middle aged (39-45 years, n = 11). Saliva samples were collected twice daily (morning and evening) across the entire menstrual cycle of 31 women. Results: Mean ages at enrolment and menarche were 30.6 years and 13.6 years respectively. Fifty-five percent of the women were married. The menstrual cycle range was 20-40 days. After controlling for age and menstrual cycle length, statistically significant diurnal variation in progesterone levels was observed across menstrual cycles with high levels in the morning. Conclusions: This is the first report on salivary progesterone in subjects with Indian ethnicity and could have clinical implications for designing point of care kits for menstrual cycle management, fertility and reproduction.
RESUMO
Tumour-induced osteomalacia (TIO), also known as oncogenic osteomalacia, is an uncommon paraneoplastic syndrome which poses a diagnostic challenge. The hallmark feature is severe acquired hypophosphataemic osteomalacia due to renal phosphate wasting because of increased secretion of fibroblast growth factor 23 (FGF-23). A man in his 30s, presented with a 4-year history of severe muscle aches, bone pain and proximal muscle weakness, was referred for evaluation. His laboratory examination revealed severe hypophosphataemia as a result of urinary phosphate wasting, low 1,25-dihydroxyvitamin D, high alkaline phosphatase and elevated FGF-23. We could localise the tumour to his right femur and the biopsy showed a mesenchymal origin. The treatment with pharmacotherapy and radiofrequency ablation helped in the normalisation of blood chemistry and resulted in significant clinical improvement. Hypophosphataemia, phosphaturia, elevated FGF-23 and low 1,25-dihydroxyvitamin D level with severe musculoskeletal pain and muscle weakness necessitate careful evaluation of TIO.
