No abstract

Patients with Chagas cardiomyopathy carry a significant risk of reactivation after heart transplantation. Reactivation of Chagas disease can lead to graft failure or systemic complications such as fulminant central nervous system disease and sepsis. As such, careful screening for Chagas seropositivity prior to transplant is crucial to preventing negative outcomes in the post-transplant setting. One challenge in screening these patients is the variety of laboratory tests available and their differing sensitivities and specificities. In this case report, we present a patient who tested positive by a commercial Trypanosoma cruzi antibody assay and later tested negative by CDC confirmatory serological analysis. After the patient underwent orthotopic heart transplant, he underwent protocol-based polymerase chain reaction surveillance for reactivation as a result of persistent concerns for T. cruzi infection. It was discovered shortly thereafter that the patient had reactivation of Chagas disease, confirming that he did have Chagas cardiomyopathy prior to transplantation, despite negative confirmatory testing. This case illustrates the complexities of serological diagnosis of Chagas disease and the importance of additional testing for T. cruzi when the post-test probability remains high even with a commercial, negative serologic test.

Rubber tapping is a major occupation in Kanya Kumari district and it significantly adds to the economy of the country. There are nearly 126 rubber-based industries recognized by the District Industries Centre (DIC), providing employment to 1874 people'' .This study aims at analyzing the prevalence and risk factors associated with ocular injuries and diseases among rubber tappers in a rural area in Kanya Kumari. AIMS AND OBJECTIVES: 1. To assess the prevalence of ocular diseases and injuries in rubber tappers related to their occupation 2. To evaluate the risk factors associated with ocular diseases and injuries among rubber tappers METHODS: Rubber tappers attending the Ophthalmology Out-Patient department in Sree Mookambika Institute of Medical Sciences between 1.10.2020 to 30.11.2020 were evaluated for ocular injuries and diseases.A detailed history was obtained and ocular complaints were analyzed. After a thorough systemic and ocular examination, data was collected. The collected data were analyzed. RESULTS: The study was conducted for a time period of 2 months. Data was collected from all the rubber tappers attending the ophthalmology OPD in Sree Mookambika Institute of Medical Sciences. A total of 48 patients were evaluated. Among which 17 had foreign body exposure, 4 had corneal abrasion, 1 had fungal corneal ulcer, 16 had cataracts, 7 had refractive error,3 had pterygium. CONCLUSION: Occupation -related injuries are common amidst rubber tappers. The population dependent on this occupation is way too high to be left unattended or their health conditions ignored. The results obtained in this study throws light on the importance of awareness that needs to be advocated among employers and employees involved in rubber plantation and tapping. The use of protective eye goggles and other safety precautions must be propagated among the workers. The rubber tappers must be alerted about the consequences of ignoring safety precautions, specifically how it may lead to severe morbidity, sometimes even loss of vision.They must also be advised to undergo ophthalmic examination whenever necessary and on regular basis,as poor vision due to aging or even physiological refractive errors itself may lead to injuries due to compromised eyesight. After conducting this study,we came to the conclusion that the consciousness of the morbidity that may occur due to poor safety measures at work among the rubber tappers is nearly a flat line. Hence creating awareness and educating them regarding this becomes indispensable.