Extreme Weather Events and Spiraling Debt: A Double Whammy for Bangladeshis Affected by Climate Change.

This study explores how people living in different areas of Bangladesh prone to extreme weather events (EWEs) in the form of floods, cyclones, or droughts perceive climate change, the impacts they suffer in the face of EWEs, and how they cope with their consequences. Qualitative data was collected through in-depth interviews with 73 respondents from three different areas of Bangladesh and subsequently analyzed. The results show that there are similarities and differences between respondents from regions with different vulnerabilities in terms of their views and perceptions about what climate change is its causes, the consequences of EWEs, and the strategies they adopt to cope with their effects. Respondents understood climate change based on their own local experiences of climate change and EWEs. A main finding is that people in all three areas are driven to borrow money in the face of these events as a survival strategy and to be able to continue to support their families. As the climate is set to change rapidly and EWEs to occur more frequently and regularly, it will become routine for those most vulnerable to them to have to cope and live with their impacts. Increased reliance on borrowing risks leading to a debt spiral for already vulnerable people. They are thus subject to a "double whammy": on the one hand the direct effects of climate change and EWEs on their lives and livelihoods and on the other getting caught in a debt spiral sparked by times of crisis.

Double Whammy: A Case of Concurrent Alcohol Use and Hereditary Hemochromatosis Leading to Avascular Necrosis of the Femur.

Avascular necrosis (AVN) of the femur is due to damage to the vasculature of the bone and can include a multitude of causes including medications, alcohol intake, hemoglobinopathies, thrombophilias, and connective tissue disorders, among others. Hereditary hemochromatosis is not a common cause of AVN but should be considered prior to labeling such cases as idiopathic. If a patient has symptoms of persistent hip pain and plain radiography has been unremarkable, one should proceed with magnetic resonance imaging (MRI) of the affected joint due to its sensitivity in detecting osteonecrosis. We present a case report of a 54-year-old male patient with a significant history of alcohol intake and a diagnosis of hereditary hemochromatosis who presented with persistent left hip pain and further imaging revealed the presence of osteonecrosis of the femur.