Chronic Diarrhea in a Drinker: A Breakthrough Case of Pellagra in the US South.

The triad of diarrhea, dementia, and dermatitis constitutes the clinical diagnosis of pellagra. However, most reported cases of pellagra have occurred without all components of the triad. Pellagra was declared eradicated in the United States after an outbreak in the 1920s, and is now considered to be an exceedingly rare diagnosis in developed countries. In this article, we present a case of a 56-year-old man who presented with a significant history of alcohol use and chronic diarrhea. Pellagra was clinically diagnosed based on the triad of diarrhea, cognitive dysfunction, and dermatitis in this malnourished, alcoholic patient. The patient was treated and clinically improved with resolution of his diarrhea and cognitive dysfunction.

Initial program evaluation of the Ponseti method in Nigeria.

The Ponseti method for correcting clubfoot is a safe, effective, and low-cost treatment that has recently been implemented in Nigeria. This study evaluates the initial impact of the Ponseti method and the unique challenges to its diffusion among practitioners and patients. Information was obtained by traveling to Ponseti clinics to interview or give questionnaires to the Ponseti method practitioners and the parents of children with clubfoot. The challenges identified among the practitioners were: 1) an inadequate amount of information; 2) inadequate resources; 3) insufficient training programs; and 4) a lack of funding. The challenges among parents were: 1) a deficit in knowledge about clubfoot and its treatment; 2) financial constraints; 3) culture and religious practices, and 4) difficulties with treatment compliance. Information from this study can be used to implement specific strategies to improve the dissemination and implementation of the Ponseti method for treating clubfoot in Nigeria and throughout West African nations that share cultural and socioeconomic commonalities.