Kartagener syndrome with renal amyloidosis: a case report

Kartagener syndrome is a rare disorder caused by defective ciliary function. It is described as a triad of cystic bronchiectasis, chronic sinusitis, and situs invertus. Renal involvement, although uncommon, is reported. The available evidence in literature consists of case reports and series, which describe various patterns of renal involvement. We hereby describe a case of a young female who presented with advanced renal failure and hypertension requiring urgent hemodialysis. On evaluation, she was found to have the classic triad of bronchiectasis, chronic sinusitis, and situs invertus leading to the diagnosis of Kartagener syndrome. On workup for the cause of renal failure, we found membranoproliferative glomerulonephritis due to amyloidosis secondary to bronchiectasis. This is a rare association and only 1 case has been reported in the available literature. There are no consensus guidelines regarding treatment of this condition, due to paucity of available data and because of rarity of the condition. This disease should be reported to augment the available literature

A pilot study to evaluate home-based screening for the common non-communicable diseases by a dedicated cadre of community health workers in a rural setting in India

Abstract Background Population-based screening for the common non-communicable diseases (NCD) is recommended but is difficult to implement in the hard-to-reach areas of low resourced countries. The objective of our pilot study was to evaluate the feasibility and the efficacy of delivering NCD screening services at home by trained community health workers (CHWs). Men and women aged 30-60 years residing in rural areas of India were targeted for screening. Methods The CHWs made home visits to educate the participants about healthy lifestyles and symptoms of common cancers and counsel the tobacco/alcohol users to quit. They measured height, weight, blood pressure (BP) and random blood sugar for all and performed oral visual examination (OVE) to screen the tobacco/alcohol users for oral cancer. For cervical cancer screening, the women themselves provided self-collected vaginal samples that the CHWs delivered to the laboratory for high-risk Human Papillomavirus (HPV) detection. The women were not screened for breast cancer but were made aware of the common symptoms and the importance of early diagnosis. Further assessment of the screen-positive individuals and the women with breast symptoms was arranged at the nearest primary health center (PHC). Results The CHWs screened 1998 men and 4997 women from 20 villages within 6 months; the refusal rate was less than 10%. High BP and sugar were detected in 32.6% and 7.5% participants respectively; hypertension and diabetes were confirmed in 42.3% and 35% respectively among those undergoing follow-up. Obesity prevalence was only 2.4%. More than 50% men were tobacco chewers. Of the total participants, 2.6% were positive on OVE, though no oral cancer was detected among them. HPV test was positive in 8.6% women and they were triaged with visual inspection after application of acetic acid (VIA) test for treatment either by thermal ablation (same visit) or by loop excision. VIA was positive in 14% of the HPV-positive women and 56.5% of them received same day ablative treatment. The VIA-negative women were advised follow up after 1 year. No breast cancer was detected among the 0.6% women complaining of breast symptoms. Conclusions Delivery of NCD screening services at home by trained CHWs is feasible and well-accepted by our study population