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EDITORIAL

Tropical pediatrics and clinician professionalism in medical education

Introduction

Definition of professionalism

Principles of professionalism

Background

Table 1. Professionalism milestones

Level 1

Level 2

Level 3

Level 4

Level 5

Teaching professionalism in tropical pediatrics

Formative assessment

Training the evaluators

Workshops to prepare residents

Remediation

Conclusion

References

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Cardiology and tropical climates

Abstract

Introduction

Heart sounds and murmurs

Innocent murmurs

Table 1. Innocent murmurs

Pathologic findings

Pathologic murmurs

Cardiology testing in heart murmur evaluation

Congenital heart disease in developing countries

Congestive heart failure

Table 2. Ross classification of pediatric heart failure

Treatment of congestive heart failure

Refractory heart failure

Endomyocardial fibrosis

Rheumatic fever and rheumatic heart disease

Table 3. Causes of congestive heart failure in pediatrics

Table 4. Jones criteria for rheumatic fever

Kawasaki disease

Table 5. Diagnostic criteria for Kawasaki syndrome

Table 6. Risk factors for cardiac sequelae in Kawasaki disease

Management

Nutritional issues

Syncope

Table 7. Causes of syncope

Table 8. Syncope history

Table 9. Syncope warning symptoms – Refer for further work-up

Table 10. Evaluation of syncope

Chest pain

SBE prophylaxis

Table 11. Endocarditis antibiotic choice

General pediatric care of children with complex heart disease

Nutritional issues

Infectious diseases in patients with complex cardiac disorders

Conclusion

References

Pediatric neurology unique to tropical regions

Abstract

Introduction

Viral meningo-encephalitis in the tropics

Table 1. General findings in infective cerebrospinal fluid (CSF) analysis

Nipah virus and Hendra virus

Lymphocytic choriomeningitis virus (LCMV)

Poliomyelitis

CNS involvement in Dengue fever

Diagnosis

Management

Rabies and Lyssa viruses

Diagnosis

Management

Table 2. WHO recommended post-exposure prophylaxis (PEP) for rabies infection

Neurologic complications of measles

Acute measles encephalitis

Acute disseminated encephalomyelitis (ADEM)

Subacute sclerosing panencephalitis (SSPE)

Blindness

Management

Neurologic involvement of the human immunodeficiency virus (HIV)

Table 3. Neuropsychiatric disease in children with HIV

CNS co-infections in HIV in the tropics

Tropical spastic paraparesis and HTLV-1-associated myelopathy (TSP/HAM)

Bacterial meningo-encephalitis in the tropics

Tropical pyomyositis (myositis tropicans)

Table 4. Three clinically apparent stages of disease in Myositis Tropicans

Diagnosis

Management

Leprosy

Table 5. Ridley-Jopling System: Types of Leprosy and Prognosis

Table 6. Summary of Immune-mediated lepra reactions can:

Diagnosis

Management

Table 7. World Health Organization recommended treatment regimens for childhood leprosy

Lessons from leprosy for the future

CNS tuberculosis

Parasites in the CNS in the tropics

Management

CNS trypanosomal disease

Diagnosis

River blindness

Nodding syndrome – An enigmatic epidemic epilepsy

Management

CNS malaria

Diagnosis of cerebral malaria

Table 8.

Management of cerebral malaria

Neurotoxins and nutritional aspects of tropical pediatric neurology

Konzo

Neurolathyrism

Tropical Ataxic Neuropathy (TAN)

Management of TAN

Cretinism

Conclusion

References

Nephrology and the tropics

Abstract

Introduction

Clinical syndromes

Malaria and kidney disease

Plasmodium falciparum

Treatment of falciparum induced acute kidney injury

Plasmodium malariae

Schistosomiasis

Lower urinary tract schistosomiasis: Schistosoma haematobium

Glomerular disease and schistosomiasis

Schistosomiasis and the kidney: treatment

Empiric treatment of proteinuria with uncertain diagnosis

Conclusion

References

Surgical care in tropical countries

Abstract

Introduction

Common abdominal conditions

Pathogenesis

Clinical presentations

Diagnosis of schistosomiasis

Treatment of Schistosomiasis

Management of portal hypertension

Surgical treatment for genitourinary schistosomiasis

Amebiasis

Pathogenesis

Clinical presentation

Diagnosis of amebiasis

Treatment of intestinal amebiasis

Amebic liver abscess

Pathogenesis

Clinical presentation

Treatment

Hydatidosis

Pathogenesis

Clinical presentation

Diagnosis

Treatment

Chagas’ disease

Pathogenesis

Clinical presentations

Diagnosis of Chagas’ achalasia

Management

Chagas’ megacolon

Tropical spleen

Treatment

Complications of splenectomy

Splenic abscess

Presentation

Treatment

Splenic trauma

Surgical thyroid disorders

Treatment of thyroid conditions

Cutaneous malignancy

Diagnosis

Treatment

Conclusion

References

Pediatrics and human immunodeficiency virus

Abstract

Introduction

The history of HIV

Pathogenesis

Presentation

Table 1. Presenting symptoms of pediatric HIV infection (8, 13)

Diagnosis

Table 2. Clinical categories of HIV for children less than 13 years of age (13)

Transmission

Treatment

Table 3. Approved antiretroviral agents in the United States (17)

Medication side-effects

Medication compliance

Immunizations

Challenges to care

Prevention

Progress

Future

Table 4. Millennium development goals relating to HIV/AIDS(3)

Conclusion

References