Called many names, the abolitionists tore the nation apart in order to create a more perfect union. Men and women, black and white, Northerners and Southerners, poor and wealthy, these passionate anti-slavery activists fought body and soul in the most important civil rights crusade in American history"--Container.
Tuberculosis is endemic in many developing nations of the world. However, with the epidemic of AIDS, the disease has re-emerged in advanced countries as well.
Tuberculosis presenting as pyrexia of unknown origin is well known and can affect any organ in the body. Two patients presented with pyrexia of unknown origin and on evaluation splenic lesions were discovered which proved to be splenic tuberculosis after fine needle aspiration.
Both patients were HIV negative. Splenic abscesses could be one of the complications of bacterial Endocarditis and in the past splenectomy used to be the treatment of choice.
After the demonstration of acid-fast bacilli both patients improved after therapy with antitubercular treatment. Clinical description and literature review is described in this brief report. TuberculosisHIVDiabetes mellitusFever of unknown origin Introduction Isolated splenic tuberculosis is extremely rare, particularly in the immunocompetent persons.
Splenic tuberculosis, however, can be part of military tuberculosis in immunocompromised patients. Tuberculosis spleen invariably presents in the form of an abscess.
The risk factors for splenic abscess described in the literature are sickle cell disease, hemoglobinopathies, splenic trauma endocarditis or tuberculosis elsewhere in an immunocompetent patient. Although rare cases of splenic tuberculosis in immunocompetent patients have been described in the past.
With re-emergence of tuberculosis due to AIDS and use of immunosuppressive medications around the globe, it is very important to bear this rare clinical condition while evaluating pyrexia of unknown origin in a given case.
Case 1 A year-old male vet nary doctor by profession presented with the history of off and on fever of 8 weeks duration.
The fever was low grade, intermittent and was associated with weight loss of 4 kilograms. There was no evening rise of temp and no sweating.
The patient denied any history of a cough, urinary symptoms or diarrhoea. There was no history of travel or contact with sick people. He had been type II diabetic for last 12 years controlled on oral hypoglycemic agents and had no history of acute or chronic complications.
There was no history of tuberculosis in the past or in close contacts. He was non-alcoholic and denied any high-risk behaviour. The clinical examination revealed an average built person who was conscious oriented and had stable vitals.
There was no jaundice or lymphadenopathy. Abdominal examination revealed moderate splenomegaly. The liver was not palpable and there was no ascites. Respiratory and cardiovascular systems were normal. During the hospitalisation temp.
ESR was 88mm for the first hour. The tests on kidney and liver functions were normal. An echocardiogram was done to rule out any features of subacute bacterial endocarditis. All the valves of his heart were normal and no feature of endocarditis was noted. The patient had normal ejection fraction and the pericardial cavity was normal too.
Blood cultures and urine cultures were found to be sterile. A hour collection of urine showed no evidence of albuminuria and funduscopic examination ruled out retinopathy. Keeping in view splenic abscesses CT guided fine needle aspiration was done and acid-fast bacillus were demonstrated by Zeal-Neilson s stain and the patient was put on antitubercular treatment.
The culture of the aspirate a few weeks later turned out to be positive for Mycobacterium tuberculosis. His HIV serology was negative. The patient continued standard four-drug regimen for two months followed by two drug regimen for another seven months.
Patients fever settled after two weeks of treatment and followed our clinic till completion of his treatment. CASE 2 A year-old female student presented with the history of off and on fever of 5 weeks duration. The fever was low grade intermittent and not associated with sweating She also complained of loss of appetite and weight loss of 3 kilogrammes over a period of 2months She denied any history of a cough, urinary symptoms.
The patient had no history of contact with sick persons or travel. She had no co morbid illness. On examination she was conscious oriented and had mild pallor, no lymphadenopathy or jaundice was noted.The book was part biography, part novel, part nonfictional account of Juan Facundo Quiroga, a gaucho leader, and its political impact was tremendous.
Sarmiento became his country's most important citizen, and when he ran for president after a life in exile, the vote easily placed him in office (74).
List of figures List of tables Notes on contributors Acknowledgements 1 Introduction: the worlds of environmental justice Ryan Holifield, Jayajit Chakraborty and Gordon Walker Part I: SITUATING, ANALYSING AND THEORISING ENVIRONMENTAL JUSTICE 2 Historicizing the personal and the political: evolving racial formations and the environmental justice.
Page 1 Page 2 Essays Page 3 Page 4 Page 5 Page 6 Page 7 Page 8 Page 9 his first chapter he reports having covered "aspects of Dominican history and culture of In this essay, I will attempt to show how The Diaries conveys.
Clinical Studies—Part 1, Paolo Bellavite, Riccardo Ortolani, Francesco Pontarollo, Valeria Piasere, Giovanni Benato, and Anita Conforti Evidence-Based Complementary and Alternative Medicine Volume 3 (), Issue 3, Pages Bios & Profiles - Faculty - CUNY Bios & Profiles.
Anita Desai Revision For Chapter 1 Part 2 “Village by the sea” Essay Sample Published by admin on April 19, The poorness of the lila’s household is really apparent in the Hagiographas of Desai.