Mycetoma is a chronic infection of underlying fungal (eumycetoma) or bacterial (actinomycetoma) origin. It is characterised by a clinical triad of tumour-like swelling, actively draining sinuses and macroscopic grains of characteristic colours.We the case of a 66-year-old woman on immunosuppressive therapy presenting with eumycetoma of the foot (Madura foot). The fungal organism cultured was Acrophialophora fusisporaThis case was managed with a combination of extensive surgical debridement, and packing with calcium sulfate (Stimulan) beads impregnated with vancomycin and voriconazole. As far as the authors are aware, this is a novel adjunct to the surgical treatment of deep fungal infection in the foot.Eumycetoma treated with surgery and oral antifungal therapy leads to cure rates of 25%-35%. This novel treatment seems to bear further investigation for the potential to improve cure rates. At 8 months follow-up, our patient appears to be making good progress with no current signs of recurrence.

Nicaraguans have migrated internally and internationally for centuries due to economic, political and sociocultural factors. Deficiencies in the country\'s health care system have produced inequities in people\'s access to health care and medicines. Remittances have become an important source of income, partly invested in health.
The overall aim of the study was to analyse migration-health relations in contemporary Nicaragua within a broader context of socio-economic transformations.
The study uses a mixed-methods approach, combining qualitative interview data and quantitative survey data.
The findings show that migration is commonly practised as a strategy for making a living and is related to the struggle for a better life. Health concerns are indirectly embedded in people\'s mobile livelihoods, but also directly influence migration motives. Furthermore, migration involves both advantages and disadvantages for health. Physical and sexual violence can come to an end for migrating women, health care and medicine can become more accessible for internal migrants, and vulnerabilities caused by environmental disasters can be avoided by moving. Moreover, remittances can improve people\'s everyday life and health. Yet migration can also be a stressful and health-damaging event. International migrants, particularly the undocumented, can have problems accessing health care, and also experience much danger at border crossings. Transnational families can suffer emotionally as well as physically due to separation. Findings from the survey show that family members of migrants do not rate their physical health as good as often as non-migrating families.
The Nicaraguan population is not guaranteed its social rights of citizenship. This results in mobile livelihoods and the need for translocal social support (e.g. remittances). Migration can have both positive and negative effects on health for migrants and their family members; geographical distance and social differences are key to the outcome.

Chinese immigrants in the Netherlands are less likely than other ethnic groups to utilize mainstream mental health care services. This study investigated the experiences of Chinese with mental health problems, to inform measures to make services more responsive to the needs of this group. Qualitative methods of analysis were applied to interview data in order to explore ways of finding help, barriers to accessing mainstream mental health care, experiences in care, factors jeopardizing the quality of care, and views on mental health services among Chinese migrants in the Netherlands. Rather than recruiting individuals with mental health problems, an indirect method was used in which ethnic Chinese participants were invited to tell us about one or more Chinese individuals in their social environment whom they regarded as having (had) mental health problems (Symbol: see text). Although most Chinese regarded mainstream Dutch care as the appropriate resource for dealing with mental health problems, many barriers to access and threats to care quality were reported. In contrast to the widely accepted view that cultural differences in health beliefs underlie the low utilization of mental health services by Chinese in the West, the main obstacles identified in this study concerned practical issues such as communication problems and lack of knowledge of the health system. Respondents also described concerns about entitlement to care and discrimination (actual or anticipated). Measures suggested by respondents for improving care included increased use of interpreters and cultural mediators, encouraging migrants to increase their language proficiency, and better dissemination of information about the health system. The article concludes with a discussion of the policy implications of these findings.