Natl Med J India
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Nephrogenic systemic fibrosis is an idiopathic, sclerosing condition that occurs only in patients who have impaired renal function. Although its most conspicuous manifestation is in the skin, the condition involves multiple organ systems and is potentially fatal. ⋯ The progressive systemic fibrosing process involves multiple organs and contributes to the morbidity and the increased mortality. Appropriate preventive action, prompt recognition and timely reporting of cases may enable better management of this condition.
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Cryptosporidium spp. are a major cause of diarrhoea in developing countries mainly affecting children and HIV-infected individuals with low CD4 counts. The infection is self-limiting in immunocompetent hosts, but can be severe and persistent in the immunocompromised and malnourished. Treatment is less than optimal and no vaccine is currently available. ⋯ Using these methods, the common cryptosporidial species reported to affect both HIV-infected adults and children in India are C. hominis and C. parvum. With easier access to antiretroviral therapy for Indian patients with HIV, the effect on the prevalence of cryptosporidiosis and aetiology of HIV-related diarrhoea remains to be seen. Therefore, data from different parts of India form a necessary baseline against which the effect of antiretroviral therapy can be evaluated.
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Viral hepatitis is a major public health problem in India, which is hyperendemic for HAV and HEV. Seroprevalence studies reveal that 90%-100% of the population acquires anti-HAV antibody and becomes immune by adolescence. Many epidemics of HEV have been reported from India. ⋯ HDV infection is infrequent in India and is present about 5%-10% of patients with HBV-related liver disease. HCC appears to be less common in India than would be expected from the prevalence rates of HBV and HCV. The high disease burden of viral hepatitis and related CLD in India, calls for the setting up of a hepatitis registry and formulation of government-supported prevention and control strategies.
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There is an ever-increasing gap between the number of donors and those waiting for organ grafts, resulting in increased waiting times and mortality on transplant waiting lists. Consequently, every potential donor must be considered for possible transplantation even if they are outside the conventional donor criteria. ⋯ There is a potential to transmit infections and, to a lesser extent, malignancy from the donor organ to the immunosuppressed recipient, and this may also have an effect on subsequent organ function in the recipient. Thus, transmission of infections from organ donors to recipients represents low but serious potential risks that must be weighed against a candidate's risk of dying before a transplant becomes available.