Takayasu Arteritis with Isolated Headache and Neck Pain.

Takayasu Arteritis (TA), a chronic inflammatory condition of the aorta and its major branches, causes narrowing and ultimate occlusion of major vessels and may manifest as cerebrovascular insufficiency, organ ischemia, and systemic arterial hypertension (HTN). Herein, we report a case of a 35-year female with the pulseless disease but no other clinical signs except headache and neck pain on exertion despite the fact that three out of four vessels of the aortic arch were occluded. Diagnosis of TA was based on clinical findings, radiological imaging, and doppler studies. This case report highlights the clinical importance of unexplained headaches and absent peripheral pulses in the screening of TA. Key Words: Takayasu arteritis, Unexplained headache, Neck pain.

Effect of Organophasphate poisoning among patients reporting at a tertiary healthcare facility of Sindh Pakistan.

OBJECTIVE: To determine the effect of organophosphate poisoning (OPP) among patients at tertiary healthcare, Pakistan. METHODS: This cohort study was conducted over a six-year period (January 2011 to December 2016) of OPP patients admitted to the intensive care unit of Peoples University of Medical & Health Sciences for Women SBA, Hospital Pakistan and their outcome was determined. RESULTS: Total mortality was 17.39% (84 deaths in 483 patients, excluding those referred to Karachi). Out of these 84 deaths, 65 patients (13.46%) expired due to cardiorespiratory failure, 17 deaths (3.52%) followed due to complication of mechanical ventilation & ICU acquired infection and two deaths (0.41%) occurred due to renal failure. The major cause of poisoning was deliberate self-harm /suicidal intention (93.02%), with gender distribution of female (57.07%) and male (35.95%), followed by unintentional/accidental exposure (6.98%) in males. The intensive supportive treatment, precise and appropriate respiratory care, and adequate amount of atropine and pralidoxime doses are keys to reducing the OPP patient's mortality. CONCLUSION: Organophosphate poisoning (OPP) intoxication is common in female gender. The easy availability of these harmful compounds has resulted in increased mortality either by accidental exposure or most often by the deliberate suicidal attempt.

How nutrition-friendly are agriculture and health policies in Bangladesh?

BACKGROUND: The improvements in nutrition status in Bangladesh, particularly child nutrition outcomes, have been relatively slow, despite remarkable improvements in the country's food situation as well as in the health sector. At present more than 40% of children under 5 years of age are stunted. OBJECTIVE: To examine the specific food, agriculture, and health policies that have existed and currently exist in Bangladesh from the perspective of nutrition and identify gaps in the policy framework for which improvements in nutrition have been slow. METHODS: Policy documents, public financial and budget documents, and related papers were reviewed. Several interviews with former civil servants and bureaucrats were conducted. RESULTS: The approach to achieving food security has been a partial one, with policy provisions focusing excessively on increasing the availability of food, primarily rice. The "accessibility" pillar of food security has received little attention, while the neglect of the "utilization" pillar is conspicuous by the dearth of appropriate policies and laws for ensuring food safety. The efforts in the health sector have largely concentrated on expanding the coverage of primary healthcare, with little consideration of equity and quality. CONCLUSIONS: There exists a wide window of unexplored opportunity to align the remarkable increases in food production and advances in the health sector with nutrition considerations toward an improved nutrition status in Bangladesh.