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surgery in Low and middle income countries

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https://www.readbyqxmd.com/read/29642612/ponseti-technique-for-the-management-of-congenital-talipes-equinovarus-in-a-rural-set-up-in-india-experience-of-356-patients
#1
Rohit Malhotra, Ashutosh Mohapatra, Geetika Arora, Priyam Choudhury, Hitesh Joshi, Pranav Patel
Congenital talipes equinovarus (CTEV), also known as clubfoot, is a complex congenital deformity of the foot that, left untreated, can limit a person's mobility by making it difficult and painful to walk. Worldwide, 80% of children born with clubfoot are in low- and middle-income countries. The management of clubfoot has a long history. Non-operative management did not become popular, as an increasing number of orthopaedists started leaning towards surgical treatment. The late Dr. Ignacio Ponseti developed a method of clubfoot correction that successfully realigns clubfoot in infants without extensive and major surgery...
April 10, 2018: Children
https://www.readbyqxmd.com/read/29624152/barriers-to-participation-in-global-surgery-academic-collaborations-and-possible-solutions-a-qualitative-study
#2
Parisa Nicole Fallah, Mark Bernstein
OBJECTIVE There is a global lack of access to surgical care, and this issue disproportionately affects those in low- and middle-income countries. Global surgery academic collaborations (GSACs) between surgeons in high-income countries and those in low- and middle-income countries are one possible sustainable way to address the global surgical need. The objective of this study was to examine the barriers to participation in GSACs and to suggest ways to increase involvement. METHODS A convenience sample of 86 surgeons, anesthesiologists, other physicians, residents, fellows, and nurses from the US, Canada, and Norway was used...
April 6, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29613935/the-use-of-emergency-physicians-to-deliver-anesthesia-for-orthopaedic-surgery-in-austere-environments-the-expansion-of-the-emergency-physician-s-general-anesthesia-syllabus-to-orthopaedic-surgery
#3
Ogedad Pierre, John F Lovejoy, Robert Stanton, Richard Skupski, Harold Previl, Jerry Bernard, Lia Losonczy, Mark Walsh
BACKGROUND: Five billion people, primarily in low-income and middle-income countries, cannot access safe, affordable surgical and anesthesia care, particularly for orthopaedic trauma. The rate-limiting step for many orthopaedic surgical procedures performed in the developing world is the absence of safe anesthesia. Even surgical mission teams providing surgical care are limited by the availability of anesthesiologists. Emergency physicians, who are already knowledgeable in airway management and procedural sedation, may be able to help to fulfill the need for anesthetists in disaster relief and surgical missions...
April 4, 2018: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29594089/the-need-for-specialized-pediatric-cardiac-critical-care-training-program-in-limited-resource-settings
#4
REVIEW
Indah K Murni, Ndidiamaka L Musa
Congenital heart disease (CHD) is one of the major global health problems with the highest birth prevalence in low- and middle-income countries. In these populous countries, basic health services for the children with CHD, including surgery, are lacking. Even though surgery is performed, outcome after cardiac surgery is influenced by the quality of the postoperative management with a reported high morbidity and mortality. Henceforth, there is an urgent need for comprehensive interventions to provide high quality cardiac intensive care programs to improve the quality of pediatric cardiac surgery services in order to address high morbidity and mortality after cardiac surgery...
2018: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/29574175/developing-process-maps-as-a-tool-for-a-surgical-infection-prevention-quality-improvement-initiative-in-resource-constrained-settings
#5
Jared A Forrester, Luca A Koritsanszky, Demisew Amenu, Alex B Haynes, William R Berry, Seifu Alemu, Fekadu Jiru, Thomas G Weiser
BACKGROUND: Surgical infections cause substantial morbidity and mortality in low-and middle-income countries (LMICs). To improve adherence to critical perioperative infection prevention standards, we developed Clean Cut, a checklist-based quality improvement program to improve compliance with best practices. We hypothesized that process mapping infection prevention activities can help clinicians identify strategies for improving surgical safety. STUDY DESIGN: We introduced Clean Cut at a tertiary hospital in Ethiopia...
March 21, 2018: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/29572215/health-related-quality-of-life-in-congenital-heart-disease-surgery-in-children-and-young-adults-a-systematic-review-and-meta-analysis
#6
Laila Akbar Ladak, Babar Sultan Hasan, Janice Gullick, Robyn Gallagher
BACKGROUND: As survival improves in the congenital heart disease (CHD) population, health-related quality of life (HRQOL) outcomes become increasingly important. While surgery improves survival, poor HRQOL occurs postoperatively and cardiac-related HRQOL outcomes are rarely reported. OBJECTIVE: To conduct a systematic review and meta-analyses of general and cardiac-related HRQOL in CHD surgical children and young adults. METHOD: Medline, CINAHL and EMBASE were searched...
March 23, 2018: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/29547428/global-surgery-system-strengthening-it-is-all-about-the-right-metrics
#7
David A Watters, Glenn D Guest, Viliami Tangi, Mark G Shrime, John G Meara
Progress in achieving "universal access to safe, affordable surgery, and anesthesia care when needed" is dependent on consensus not only about the key messages but also on what metrics should be used to set goals and measure progress. The Lancet Commission on Global Surgery not only achieved consensus on key messages but also recommended 6 key metrics to inform national surgical plans and monitor scale-up toward 2030. These metrics measure access to surgery, as well as its timeliness, safety, and affordability: (1) Two-hour access to the 3 Bellwether procedures (cesarean delivery, emergency laparotomy, and management of an open fracture); (2) Surgeon, Anesthetist, and Obstetrician workforce >20/100,000; (3) Surgical volume of 5000 procedures/100,000; (4) Reporting of perioperative mortality rate; and (5 and 6) Risk rates of catastrophic expenditure and impoverishment when requiring surgery...
April 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29547421/pain-a-neglected-problem-in-the-low-resource-setting
#8
C Roger Goucke, Pongparadee Chaudakshetrin
Approximately 80% of the world's population lives in countries with little or no access to pain management. These countries also have 74% of the world's deaths from cancer and human immunodeficiency virus. Appropriate use of oral opioids can control 80%-90% of cancer pain. However, only 6.7% of the world's medical opioids are available in these low-resource countries. With the Lancet Commission on Global Surgery calling for a significant expansion of surgical services, postoperative pain management will need to be an increasing focus of our attention...
April 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29540407/macroeconomic-costs-of-the-unmet-burden-of-surgical-disease-in-sierra-leone-a-retrospective-economic-analysis
#9
Caris E Grimes, Matthew Quaife, Thaim B Kamara, Christopher B D Lavy, Andy J M Leather, Håkon A Bolkan
OBJECTIVES: The Lancet Commission on Global Surgery estimated that low/middle-income countries will lose an estimated cumulative loss of US$12.3‚ÄČtrillion from gross domestic product (GDP) due to the unmet burden of surgical disease. However, no country-specific data currently exist. We aimed to estimate the costs to the Sierra Leone economy from death and disability which may have been averted by surgical care. DESIGN: We used estimates of total, met and unmet need from two main sources-a cluster randomised, cross-sectional, countrywide survey and a retrospective, nationwide study on surgery in Sierra Leone...
March 14, 2018: BMJ Open
https://www.readbyqxmd.com/read/29505439/surgical-outcomes-of-a-new-low-cost-non-valved-glaucoma-drainage-device-in-refractory-glaucoma-results-at-one-year
#10
Vanita Pathak Ray, Divya P Rao
PURPOSE: To report the early outcomes in terms of efficacy and safety of a new, indigenously manufactured, low-cost non-valved drainage device (Aurolab Aqueous Drainage Implant, AADI) in the management of refractory glaucomas in the Indian population. METHODS: Retrospective review of consecutive patients >12years, who underwent glaucoma drainage device surgery (GDD) via AADI, by a single fellowship-trained surgeon, between January 2014 and December 2016, who had at least 3 months of documented post-op follow-up...
March 2, 2018: Journal of Glaucoma
https://www.readbyqxmd.com/read/29490070/temporal-delays-along-the-neurosurgical-care-continuum-for-traumatic-brain-injury-patients-at-a-tertiary-care-hospital-in-kampala-uganda
#11
Silvia D Vaca, Benjamin J Kuo, Joao Ricardo Nickenig Vissoci, Catherine A Staton, Linda W Xu, Michael Muhumuza, Hussein Ssenyonjo, John Mukasa, Joel Kiryabwire, Henry E Rice, Gerald A Grant, Michael M Haglund
BACKGROUND: Significant care continuum delays between acute traumatic brain injury (TBI) and definitive surgery are associated with poor outcomes. Use of the "3 delays" model to evaluate TBI outcomes in low- and middle-income countries has not been performed. OBJECTIVE: To describe the care continuum, using the 3 delays framework, and its association with TBI patient outcomes in Kampala, Uganda. METHODS: Prospective data were collected for 563 TBI patients presenting to a tertiary hospital in Kampala from 1 June to 30 November 2016...
February 26, 2018: Neurosurgery
https://www.readbyqxmd.com/read/29476717/creation-implementation-and-assessment-of-a-general-thoracic-surgery-simulation-course-in-rwanda
#12
Adriana G Ramirez, Nebil Nuradin, Fidele Byiringiro, Robinson Ssebuufu, George J Stukenborg, Georges Ntakiyiruta, Thomas M Daniel
BACKGROUND: The primary objective was to provide proof of concept of conducting thoracic surgical simulation in a low-middle income country (LMIC). Secondary objectives were to accelerate general thoracic surgery skills acquisition by general surgery residents and sustain simulation surgery teaching through a website, simulation models, and teaching of local faculty. METHODS: Five training models were created for use in a LMIC setting and implemented during on-site courses with Rwandan general surgery residents...
February 21, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29469012/nutritional-status-and-postoperative-outcomes-in-patients-with-gastrointestinal-cancer-in-vietnam-a-retrospective-cohort-study
#13
Bui Thi Hong Loan, Shinji Nakahara, Bui An Tho, Tran Ngoc Dang, Le Ngoc Anh, Nguyen Do Huy, Masao Ichikawa
BACKGROUND: Nutritional support for surgical care is crucial because hospital malnutrition is rather common. However, low- and middle-income countries have not adequately addressed nutritional management of surgical patients. To highlight need for nutritional management in surgical patients, the present study aimed to describe preoperative nutritional status in patients who underwent gastrointestinal cancer surgery in Vietnam and to investigate the relationship between preoperative malnutrition and adverse outcomes, such as postoperative complications and prolonged length of hospital stay...
April 2018: Nutrition
https://www.readbyqxmd.com/read/29466408/the-clinical-characteristics-of-adults-with-rheumatic-heart-disease-in-yangon-myanmar-an-observational-study
#14
Nan Phyu Sin Toe Myint, Ne Myo Aung, Myint Soe Win, Thu Ya Htut, Anna P Ralph, David A Cooper, Myo Lwin Nyein, Mar Mar Kyi, Josh Hanson
BACKGROUND: Rheumatic heart disease (RHD) is a major cause of premature death in low and middle-income countries. The greatest barrier to RHD control is neglect of the disease in national health policies and a lack of prevalence data that might inform control efforts. Myanmar is making remarkable progress against many infectious diseases, but there are almost no data to define the clinical burden of RHD in the country. This prospective audit was performed in an adult medical ward of a tertiary-referral hospital in Yangon, to gain an insight into the prevalence of RHD in Myanmar...
2018: PloS One
https://www.readbyqxmd.com/read/29462500/antifibrinolytic-drugs-for-treating-primary-postpartum-haemorrhage
#15
REVIEW
Haleema Shakur, Danielle Beaumont, Sue Pavord, Angele Gayet-Ageron, Katharine Ker, Hatem A Mousa
BACKGROUND: Postpartum haemorrhage (PPH) - heaving bleeding within the first 24 hours after giving birth - is one of the main causes of death of women after childbirth. Antifibrinolytics, primarily tranexamic acid (TXA), have been shown to reduce bleeding in surgery and safely reduces mortality in trauma patients with bleeding without increasing the risk of adverse events.An earlier Cochrane review on treatments for primary PPH covered all the various available treatments - that review has now been split by types of treatment...
February 20, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29456840/mixed-methods-evaluation-of-the-impact-of-a-short-term-training-program-on-sterile-processing-knowledge-practice-and-attitude-in-three-hospitals-in-benin
#16
Olive Fast, Christina Fast, Dan Fast, Suzanne Veltjens, Zouliha Salami, Michelle White
Background: Proper sterile processing is fundamental to safe surgical practice and optimal patient outcomes. Sterile processing practices in low and middle-income countries often fall short of recommended standards. The impact of education and training on sterile processing practices in low and middle-income countries is unknown. We designed a sterile processing education course, including mentoring, and aimed to evaluate the impact on participants' personal knowledge, skills, and practices...
2018: Antimicrobial Resistance and Infection Control
https://www.readbyqxmd.com/read/29454115/traumatic-spinal-injury-global-epidemiology-and-worldwide-volume
#17
Ramesh Kumar, Jaims Lim, Rania A Mekary, Abbas Rattani, Michael C Dewan, Salman Y Sharif, Enrique Osorio-Fonseca, Kee B Park
BACKGROUND: Traumatic spinal injury (TSI) results from injury to bony, ligamentous and/or neurological structures of the spinal column and can cause significant morbidity and mortality. The global burden of TSI is poorly understood, so we performed a systematic review and meta-analysis to estimate the global volume of TSI. METHODS: We performed a systematic review through PubMed, Embase and Cochrane Databases on TSI studies published from 2000 to 2016. Collected data were used to perform a meta-analysis to estimate the annual incidence of TSI across World Health Organization (WHO) regions and World Bank income groups using random effect models...
February 14, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29452941/surgical-site-infection-after-gastrointestinal-surgery-in-high-income-middle-income-and-low-income-countries-a-prospective-international-multicentre-cohort-study
#18
(no author information available yet)
BACKGROUND: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. METHODS: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country...
February 13, 2018: Lancet Infectious Diseases
https://www.readbyqxmd.com/read/29448900/provision-of-surgical-care-in-ethiopia-challenges-and-solutions
#19
Caitrin M Kelly, Nichole Starr, Nakul P Raykar, Rachel R Yorlets, Charles Liu, Miliard Derbew
With the lowest measured rate of surgery in the world, Ethiopia is faced with a number of challenges in providing surgical care. The aim of this study was to elucidate challenges in providing safe surgical care in Ethiopia, and solutions providers have created to overcome them. Semi-structured interviews were conducted with 10 practicing surgeons in Ethiopia. Following de-identification and immersion into field notes, topical coding was completed with an existing coding manual. Codes were adapted and expanded as necessary, and the primary data analyst confirmed reproducibility with a secondary analyst...
February 15, 2018: Global Public Health
https://www.readbyqxmd.com/read/29441407/disability-weights-for-pediatric-surgical-procedures-a-systematic-review-and-analysis
#20
REVIEW
Emily R Smith, Tessa Concepcion, Stephanie Lim, Sam Sadler, Dan Poenaru, Anthony T Saxton, Mark Shrime, Emmanuel Ameh, Henry E Rice
BACKGROUND: Metrics to measure the burden of surgical conditions, such as disability weights (DWs), are poorly defined, particularly for pediatric conditions. To summarize the literature on DWs of children's surgical conditions, we performed a systematic review of disability weights of pediatric surgical conditions in low- and middle-income countries (LMICs). METHOD: For this systematic review, we searched MEDLINE for pediatric surgery cost-effectiveness studies in LMICs, published between January 1, 1996, and April 1, 2017...
February 13, 2018: World Journal of Surgery
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