Hearing loss: an unusual presentation of neurobrucellosis: a case report.

INTRODUCTION: Brucellosis is a zoonotic disease, caused by a Gram-negative coccobacillus of Brucella genus, transmitted to humans by animals, especially cattle. It rarely involves the nervous system (neurobrucellosis); only a few cases present with hearing loss. We report a case of neurobrucellosis, that presented with bilateral sensorineural hearing loss and mild to moderate persistent headache. To the best of our knowledge, this is the first well-documented case from Nepal. CASE PRESENTATION: The patient was a 40-year-old Asian male shepherd from the western mountainous region of Nepal who came to the emergency department of Manipal Teaching Hospital, Pokhara in May, 2018 and did a follow-up for 6 months. He presented with high-grade fever, profuse sweating, headache, myalgia, and bilateral sensorineural hearing loss. His history of consuming raw milk of cattle, symptoms including persistent mild to moderate headache, bilateral hearing loss, and serological findings were suggestive of neurobrucellosis. Following treatment, the symptoms improved, including the complete recovery of hearing loss. CONCLUSION: Hearing loss may be the manifestation of neurobrucellosis. Physicians should know about such presentations in brucella endemic areas.

The plight of COVID-19 pandemic on medical students and residency applicants.

In this pandemic situation, medical students find them in a state of apprehension. With medical institutions closed and switch to online teaching and telehealth, many aspects of medical learning are still compromised, including core clinical rotations, clinical skills evaluation, and exams cancelation. The medical students are distressed about their continuity of education and developing the necessary skill to feel confident enough to practice in the future. The involvement of medical students as frontline workers with inadequate clinical training, the uncertainty of future, lack of knowledge, and access to personal protective equipment have aroused a sense of fear in them. They not only nurture their clinical skills from the clinical rotations but it also helps adapt to their residency program later. With the lack of clinical experience, challenges of online learning, cancelation of conferences, and on-site research, medical students are struggling to make their residency application competitive. Recruiting residents amid the pandemic is a difficult task. The uncertainty in the unprecedented situation has an immense psychological impact on medical students and residency applicants. Despite the hurdles being faced, there are many ways where medical students and residency applicants can use their knowledge to help in fighting the pandemic. They can volunteer in the field of research on COVID-19, as a contact tracer, and provide peer support to the patients through telecommunications. Many avenues are being sought to ensure the continuation of medical education. However, how efficient these methods will prove in the future is yet to be revealed.