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surgery in Low and middle income countries

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https://www.readbyqxmd.com/read/29233454/does-radiotherapy-prior-to-surgery-improve-long-term-prognosis-in-pediatric-colorectal-cancer-in-lower-and-upper-middle-income-countries-with-limited-resources-our-experience-and-literature-review
#1
Yacoob Omar Carrim, Luvo Gaxa, Francisca van der Schyff, Nndweleni Meshack Bida, Fareed Omar, Zarina Lockhat
Colorectal carcinoma in children and adolescents is extremely rare, with an annual incidence <0.3 cases per million, most frequently reported in the second decade of life. It accounts for severe morbidity and poor prognosis owing to the low index of suspicion, delayed diagnosis, advanced stage at presentation and the aggressive tumor nature. Patients present with abdominal pain, vomiting, constipation, abdominal distension, rectal tenesmus, iron-deficiency anemia, change in bowel habit and weight loss...
December 7, 2017: Journal of the Egyptian National Cancer Institute
https://www.readbyqxmd.com/read/29225958/overcoming-challenges-in-implementing-the-who-surgical-safety-checklist-lessons-learnt-from-using-a-checklist-training-course-to-facilitate-rapid-scale-up-in-madagascar
#2
REVIEW
Kristin L Close, Linden S Baxter, Vaonandianina A Ravelojaona, Hasiniaina N Rakotoarison, Emily Bruno, Alison Herbert, Vanessa Andean, James Callahan, Hery H Andriamanjato, Michelle C White
The WHO Surgical Safety Checklist was launched in 2009, and appropriate use reduces mortality, surgical site infections and complications after surgery by up to 50%. Implementation across low-income and middle-income countries has been slow; published evidence is restricted to reports from a few single institutions, and significant challenges to successful implementation have been identified and presented. The Mercy Ships Medical Capacity Building team developed a multidisciplinary 3-day Surgical Safety Checklist training programme designed for rapid wide-scale implementation in all regional referral hospitals in Madagascar...
2017: BMJ Global Health
https://www.readbyqxmd.com/read/29225957/limited-sterile-processing-capabilities-for-safe-surgery-in-low-income-and-middle-income-countries-experience-in-the-republic-of-congo-madagascar-and-benin
#3
REVIEW
Olive Fast, Christina Fast, Dan Fast, Suzanne Veltjens, Zouliha Salami, Michelle C White
It is highly difficult to perform safe surgery without sterile instruments, yet the capacity to adequately clean, disinfect and sterilise surgical instruments in low-income and middle-income countries is largely unknown. Sterile Processing Education Charitable Trust developed an assessment tool and, in partnership with Mercy Ships, evaluated the sterile processing capacity in 59 facilities in Madagascar, Benin and the Republic of Congo. This data-driven analysis paper illustrates how lack of sterile processing capacity acts as a barrier to safe surgical care...
2017: BMJ Global Health
https://www.readbyqxmd.com/read/29223665/guidelines-and-checklists-for-short-term-missions-in-global-pediatric-surgery-recommendations-from-the-american-academy-of-pediatrics-delivery-of-surgical-care-global-health-subcommittee-american-pediatric-surgical-association-global-pediatric-surgery-committee
#4
REVIEW
Marilyn Butler, Elizabeth Drum, Faye M Evans, Tamara Fitzgerald, Jason Fraser, Ai-Xuan Holterman, Howard Jen, J Matthew Kynes, Jenny Kreiss, Craig D McClain, Mark Newton, Benedict Nwomeh, James O'Neill, Doruk Ozgediz, George Politis, Henry Rice, David Rothstein, Julie Sanchez, Mark Singleton, Francine S Yudkowitz
INTRODUCTION: Pediatric surgeons, anesthesia providers, and nurses from North America and other high-income countries (HICs) are increasingly engaged in resource-limited areas, with short-term missions (STMs) as the most common form of involvement. However, consensus recommendations currently do not exist for STMs in pediatric general surgery and associated perioperative care. METHODS: The American Academy of Pediatrics (AAP) Delivery of Surgical Care Subcommittee and American Pediatric Surgical Association (APSA) Global Pediatric Surgery Committee, with the American Pediatric Surgical Nurses Association, Inc...
November 15, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29208832/comparison-of-visual-performance-and-after-cataract-formation-between-two-monofocal-aspheric-intraocular-lenses-following-phacoemulsification-for-senile-cataract-a-randomized-controlled-study
#5
Shikha Yadav, Pranita Sahay, Prafulla K Maharana, Jeewan S Titiyal, Rasik B Vajpayee, Namrata Sharma
PURPOSE: Monofocal aspheric intraocular lenses (IOLs) provide better visual outcome compared to other available IOLs following cataract surgery. However, the imported IOLs are expensive and are not affordable by all subset of patients in low- to middle-income countries like India. The aim of this study is to compare the safety and efficacy of a relatively low cost indigenous IOL (Acriol EC) with an imported aspheric IOL (AcrySof IQ). METHODS: A randomized controlled trial was conducted at a tertiary care centre...
December 2017: Indian Journal of Ophthalmology
https://www.readbyqxmd.com/read/29204198/profile-and-outcome-of-pediatric-brain-tumors-experience-from-a-tertiary-care-pediatric-oncology-unit-in-south-india
#6
Supriya Gujjar Suresh, Arathi Srinivasan, Julius Xavier Scott, Santosh Mohan Rao, Balasubramaniam Chidambaram, Sanjay Chandrasekar
Context: Tumors of the central nervous system (CNS) constitute the second most common pediatric cancers. Unlike leukemia, management of CNS tumors requires a good multidisciplinary team. Higher rates of treatment abandonment are documented in view of complexity of the treatment with long duration, involving neurosurgery, radiation, chemotherapy, and high cost of treatment. Morbidity associated with CNS tumors may be significant in terms of physical deficits as well as neuropsychological and neuroendocrine sequelae...
July 2017: Journal of Pediatric Neurosciences
https://www.readbyqxmd.com/read/29198262/medical-missions-for-the-provision-of-paediatric-cardiac-surgery-in-low-and-middle-income-countries
#7
Frank J Molloy, Nguyenvu Nguyen, Marisa Mize, Gavin Wright, Cecilia St George-Hyslop, Maura O'Callaghan, Emma Scanlan, William M Novick
This review will outline the role of visiting cardiac surgical teams in low- and middle-income countries drawing on the collective experience of the authors in a wide range of locations. Requests for assistance can emerge from local programmes at a beginner or advanced stage. However, in all circumstances, careful pre-trip planning is necessary in conjunction with clinical and non-clinical local partners. The clinical evaluation, surgical procedures, and postoperative care all serve as a template for collaboration and education between the visiting and local teams in every aspect of care...
December 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/29198261/inter-hospital-transport-of-the-child-with-critical-cardiac-disease
#8
Padmanabhan Ramnarayan, Zafurallah Intikhab, Neil Spenceley, Ilias Iliopoulos, Alana Duff, Johnny Millar
Centralisation of services such as cardiology, cardiac surgery, and intensive care in many parts of the world has resulted in the need to safely transport children with critical cardiac disease from local hospitals to specialist centres for diagnostic, surgical, and/or critical care intervention. The transport of this cohort of children, whether locally or internationally, can present specific clinical and logistical challenges. An international group of clinicians with expertise in cardiac care and critical care transport worked together to summarise current clinical practice relating to key areas of transport...
December 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/29198260/management-of-late-presentation-congenital-heart-disease
#9
Parvathi U Iyer, Guillermo E Moreno, Luiz Fernando Caneo, Tahira Faiz, Lara S Shekerdemian, Krishna S Iyer
In many parts of the world, mostly low- and middle-income countries, timely diagnosis and repair of congenital heart diseases (CHDs) is not feasible for a variety of reasons. In these regions, economic growth has enabled the development of cardiac units that manage patients with CHD presenting later than would be ideal, often after the window for early stabilisation - transposition of the great arteries, coarctation of the aorta - or for lower-risk surgery in infancy - left-to-right shunts or cyanotic conditions...
December 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/29198258/perioperative-infections-in-congenital-heart-disease
#10
Indah K Murni, Graeme MacLaren, Debra Morrow, Parvathi Iyer, Trevor Duke
BACKGROUND: Perioperative infections have significant consequences for children with congenital heart disease (CHD), which can manifest as acute or chronic infection followed by poor growth and progressive cardiac failure. The consequences include delayed or higher-risk surgery, and increased postoperative morbidity and mortality. METHODS: A systematic search for studies evaluating the burden and interventions to reduce perioperative infections in children with CHD was undertaken using PubMed...
December 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/29187100/congenital-heart-defects-in-nigerian-children-preliminary-data-from-the-national-pediatric-cardiac-registry
#11
Ekanem N Ekure, Fidelia Bode-Thomas, Wilson E Sadoh, Adeola A Orogade, Barbara E Otaigbe, Fortune Ujunwa, Usman M Sani, Mustafa Asani, Adeola B Animasahun, Oluwatoyin O Ogunkunle
BACKGROUND: Congenital heart defects (CHDs) are common birth defects with significant impact on morbidity and mortality. We aimed to compare regional patterns of CHDs in Nigeria using a registry-based approach. METHODS: Children with echocardiography-confirmed CHDs at 17 medical centers across the country were enrolled in a pilot National Pediatric Cardiac Registry from January to December 2014. RESULTS: A total of 1,296 children (52.9% male; median age 0...
November 2017: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/29185018/evaluation-of-resources-necessary-for-provision-of-trauma-care-in-botswana-an-initiative-for-a-local-system
#12
Michael B Mwandri, Timothy C Hardcastle
BACKGROUND: Developing countries face the highest incidence of trauma, and on the other hand, they do not have resources for mitigating the scourge of these injuries. The World Health Organization through the Essential Trauma Care (ETC) project provides recommendations for improving management of the injured and building up of systems that are effective in low-middle-income countries (LMICs). This study uses ETC project recommendations and other trauma-care guidelines to evaluate the current status of the resources and organizational structures necessary for optimal trauma care in Botswana; an African country with relatively good health facilities network, subsidized public hospital care and a functioning Motor Vehicle Accident fund covering road traffic collision victims...
November 28, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/29184597/the-impact-and-cost-effectiveness-of-the-amref-health-africa-smile-train-cleft-lip-and-palate-surgical-repair-programme-in-eastern-and-central-africa
#13
Hasan Hamze, Asrat Mengiste, Jane Carter
Introduction: Cleft lip with or without cleft palate (CLP) is a congenital malformation that causes significant morbidity in low and middle income countries. Amref Health Africa has partnered with Smile Train to provide CLP surgeries since 2006. Methods: We analyzed anonymized data of 37,274 CLP patients from the Smile Train database operated on in eastern and central Africa between 2006 and 2014. Cases were analyzed by age, gender, country and surgery type. The impact of cleft surgery was determined by measuring averted Disability-Adjusted Life Years (DALYs) and delayed averted DALYs...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/29179954/universal-health-coverage-and-intersectoral-action-for-health-key-messages-from-disease-control-priorities-3rd-edition
#14
REVIEW
Dean T Jamison, Ala Alwan, Charles N Mock, Rachel Nugent, David Watkins, Olusoji Adeyi, Shuchi Anand, Rifat Atun, Stefano Bertozzi, Zulfiqar Bhutta, Agnes Binagwaho, Robert Black, Mark Blecher, Barry R Bloom, Elizabeth Brouwer, Donald A P Bundy, Dan Chisholm, Alarcos Cieza, Mark Cullen, Kristen Danforth, Nilanthi de Silva, Haile T Debas, Peter Donkor, Tarun Dua, Kenneth A Fleming, Mark Gallivan, Patricia J Garcia, Atul Gawande, Thomas Gaziano, Hellen Gelband, Roger Glass, Amanda Glassman, Glenda Gray, Demissie Habte, King K Holmes, Susan Horton, Guy Hutton, Prabhat Jha, Felicia M Knaul, Olive Kobusingye, Eric L Krakauer, Margaret E Kruk, Peter Lachmann, Ramanan Laxminarayan, Carol Levin, Lai Meng Looi, Nita Madhav, Adel Mahmoud, Jean Claude Mbanya, Anthony Measham, María Elena Medina-Mora, Carol Medlin, Anne Mills, Jody-Anne Mills, Jaime Montoya, Ole Norheim, Zachary Olson, Folashade Omokhodion, Ben Oppenheim, Toby Ord, Vikram Patel, George C Patton, John Peabody, Dorairaj Prabhakaran, Jinyuan Qi, Teri Reynolds, Sevket Ruacan, Rengaswamy Sankaranarayanan, Jaime Sepúlveda, Richard Skolnik, Kirk R Smith, Marleen Temmerman, Stephen Tollman, Stéphane Verguet, Damian G Walker, Neff Walker, Yangfeng Wu, Kun Zhao
The World Bank is publishing nine volumes of Disease Control Priorities, 3rd edition (DCP3) between 2015 and 2018. Volume 9, Improving Health and Reducing Poverty, summarises the main messages from all the volumes and contains cross-cutting analyses. This Review draws on all nine volumes to convey conclusions. The analysis in DCP3 is built around 21 essential packages that were developed in the nine volumes. Each essential package addresses the concerns of a major professional community (eg, child health or surgery) and contains a mix of intersectoral policies and health-sector interventions...
November 24, 2017: Lancet
https://www.readbyqxmd.com/read/29159605/outcomes-of-emergency-laparotomy-el-care-protocol-at-tertiary-care-center-from-low-middle-income-country-lmic
#15
Nitin Vashistha, Dinesh Singhal, Sandeep Budhiraja, Bharat Aggarwal, Raj Tobin, Kamal Fotedar
BACKGROUND: Emergency laparotomy mortality ranges between 10 and 20% in best of Western healthcare systems and is currently a major focus for quality improvement programs. In contrast, emergency surgery scenario in LMIC is largely undefined, often neglected and complex (large burden of diseases but only limited capacity for adequate treatment). We evaluated the efficacy of 'EL care protocol' aimed at cost-effective optimal utilization of best available local expertise and infrastructure...
November 20, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/29149877/key-bottlenecks-to-the-provision-of-safe-obstetric-anaesthesia-in-low-income-countries-a-cross-sectional-survey-of-64-hospitals-in-uganda
#16
Isabella Epiu, Agnes Wabule, Andrew Kambugu, Harriet Mayanja-Kizza, Jossy Verel Bahe Tindimwebwa, Gerald Dubowitz
BACKGROUND: Despite recent advances in surgery and anaesthesia which significantly improve safety, many health facilities in low-and middle-income countries (LMICs) remain chronically under-resourced with inability to cope effectively with serious obstetric complications (Knight et al., PLoS One 8:e63846, 2013). As a result many of these countries still have unacceptably high maternal and neonatal mortality rates. Recent data at the national referral hospitals in East Africa reported that none of the national referral hospitals met the World Federation of Societies of Anesthesiologists (WFSA) international standards required to provide safe obstetric anaesthesia (Epiu I: Challenges of Anesthesia in Low-and Middle-Income Countries...
November 17, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29147893/high-elective-surgery-cancellation-rate-in-malawi-primarily-due-to-infrastructural-limitations
#17
Meghan Prin, Jessica Eaton, Onias Mtalimanja, Anthony Charles
BACKGROUND: The provision of safe and timely surgical care is essential to global health care. Low- and middle-income countries have a disproportionate share of the global surgical disease burden and struggle to provide care with the given resources. Surgery cancellation worldwide occurs for many reasons, which are likely to differ between high-income and low-income settings. We sought to evaluate the proportion of elective surgery that is cancelled and the associated reasons for cancellation at a tertiary hospital in Malawi...
November 16, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/29143091/risk-of-catastrophic-health-expenditure-in-rwandan-surgical-patients-with-peritonitis
#18
J L Rickard, C Ngarambe, L Ndayizeye, B Smart, J P Majyambere, R Riviello
BACKGROUND: Surgical procedures are cost-effective compared with various medical and public health interventions. While peritonitis often requires surgery, little is known regarding the associated costs, particularly in low- and middle-income countries. The aim of this study was to determine in-hospital charges for patients with peritonitis and if patients are at risk of catastrophic health expenditure. METHODS: As part of a larger study examining the epidemiology and outcomes of patients with peritonitis at a referral hospital in Rwanda, patients undergoing operation for peritonitis were enrolled and hospital charges were examined...
November 15, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/29119547/interventions-to-improve-access-to-cataract-surgical-services-and-their-impact-on-equity-in-low-and-middle-income-countries
#19
REVIEW
Jacqueline Ramke, Jennifer Petkovic, Vivian Welch, Ilse Blignault, Clare Gilbert, Karl Blanchet, Robin Christensen, Anthony B Zwi, Peter Tugwell
BACKGROUND: Cataract is the leading cause of blindness in low- and middle-income countries (LMICs), and the prevalence is inequitably distributed between and within countries. Interventions have been undertaken to improve cataract surgical services, however, the effectiveness of these interventions on promoting equity is not known. OBJECTIVES: To assess the effects on equity of interventions to improve access to cataract services for populations with cataract blindness (and visual impairment) in LMICs...
November 9, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29074364/improving-surgical-safety-and-nontechnical-skills-in-variable-resource-contexts-a-novel-educational-curriculum
#20
Yihan Lin, John W Scott, Sojung Yi, Kathryn K Taylor, Georges Ntakiyiruta, Faustin Ntirenganya, Paulin Banguti, Steven Yule, Robert Riviello
OBJECTIVE: A substantial proportion of adverse intraoperative events are attributed to failures in nontechnical skills. To strengthen these skills and improve surgical safety, the Non-Technical Skills for Surgeons (NOTSS) taxonomy was developed as a common framework. The NOTSS taxonomy was adapted for low- and middle-income countries, where variable resources pose a significant challenge to safe surgery. The NOTSS for variable-resource contexts (VRC) curriculum was developed and implemented in Rwanda, with the aim of enhancing knowledge and attitudes about nontechnical skills and promoting surgical safety...
October 23, 2017: Journal of Surgical Education
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