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surgery in Low and middle income countries

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https://www.readbyqxmd.com/read/29448900/provision-of-surgical-care-in-ethiopia-challenges-and-solutions
#1
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
#2
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
https://www.readbyqxmd.com/read/29436708/nursing-wound-care-practices-in-haiti-facilitators-and-barriers-to-quality-care
#3
B A Timmins, C Thomas Riché, M W Saint-Jean, J Tuck, L Merry
AIM: To describe the facilitators and barriers for nurses to perform quality wound care in three surgical wards of a hospital in Port-au-Prince, Haiti. BACKGROUND: Up to a quarter of patients in low- and middle-income countries may acquire at least one infection while hospitalized. There is a paucity of research investigating nursing wound care practices in low- and middle-income countries regarding the prevention of hospital-acquired infections. METHODS: The design was qualitative descriptive...
February 13, 2018: International Nursing Review
https://www.readbyqxmd.com/read/29433865/electricity-and-generator-availability-in-lmic-hospitals-improving-access-to-safe-surgery
#4
Sagar Chawla, Shaheen Kurani, Sherry M Wren, Barclay Stewart, Gilbert Burnham, Adam Kushner, Thomas McIntyre
BACKGROUND: Access to reliable energy has been identified as a global priority and codified within United Nations Sustainable Goal 7 and the Electrify Africa Act of 2015. Reliable hospital access to electricity is necessary to provide safe surgical care. The current state of electrical availability in hospitals in low- and middle-income countries (LMICs) throughout the world is not well known. This study aimed to review the surgical capacity literature and document the availability of electricity and generators...
March 2018: Journal of Surgical Research
https://www.readbyqxmd.com/read/29433385/intravenous-lidocaine-as-adjuvant-to-general-anesthesia-in-renal-surgery
#5
Mohamed Said Nakhli, Mohamed Kahloul, Taieb Guizani, Chekib Zedini, Ajmi Chaouch, Walid Naija
The role of intraoperative intravenous lidocaine infusion has been previously evaluated for pain relief, inflammatory response, and post-operative recovery, particularly in abdominal surgery. The present study is a randomized double-blinded trial in which we evaluated whether IV lidocaine infusion reduces isoflurane requirement, intraoperative remifentanil consumption and time to post-operative recovery in non-laparoscopic renal surgery. Sixty patients scheduled to undergo elective non-laparoscopic renal surgery under general anesthesia were enrolled to receive either systemic lidocaine infusion (group L: bolus 1...
December 2018: Libyan Journal of Medicine
https://www.readbyqxmd.com/read/29411073/demand-and-capacity-to-integrate-pelvic-organ-prolapse-and-genital-fistula-services-in-low-resource-settings
#6
Vandana Tripathi, Sohier Elneil, Lauri Romanzi
INTRODUCTION AND HYPOTHESIS: There is a need for expanded access to safe surgical care in low- and middle-income countries (LMICs) as illustrated by the report of the 2015 Lancet Commission on Global Surgery. Packages of closely-related surgical procedures may create platforms of capacity that maximize impact in LMIC. Pelvic organ prolapse (POP) and genital fistula care provide an example. Although POP affects many more women in LMICs than fistula, donor support for fistula treatment in LMICs has been underway for decades, whereas treatment for POP is usually limited to hysterectomy-based surgical treatment, occurring with little to no donor support...
February 6, 2018: International Urogynecology Journal
https://www.readbyqxmd.com/read/29411066/how-much-data-are-good-enough-using-simulation-to-determine-the-reliability-of-estimating-pomr-for-resource-constrained-settings
#7
Isobel H Marks, Zhi Ven Fong, Sahael M Stapleton, Ya-Ching Hung, Yanik J Bababekov, David C Chang
INTRODUCTION: Perioperative mortality rate (POMR) is a suggested indicator for surgical quality worldwide. Currently, POMR is often sampled by convenience; a data-driven approach for calculating sample size has not previously been attempted. We proposed a novel application of a bootstrapping sampling technique to estimate how much data are needed to be collected to reasonably estimate POMR in low-resource countries where 100% data capture is not possible. MATERIAL AND METHODS: Six common procedures in low- and middle-income countries were analysed by using population database in New York and California...
February 6, 2018: World Journal of Surgery
https://www.readbyqxmd.com/read/29387297/smile-train-making-the-grade-in-global-cleft-care
#8
REVIEW
Matthew Louis, Ryan M Dickey, Larry H Hollier
The global medical and psychological burden of cleft lip and palate is large, especially in low- and middle-income countries. For decades, medical missions have sought to alleviate this burden; however, there are significant barriers to providing sustainable, high-quality cleft care using the mission model. Smile Train, an international children's charity founded in 1999, has developed a scalable model which provides support to local partner hospitals and surgeons around the world. Smile Train partners with hospitals to support cleft care treatment across the developing world...
March 2018: Craniomaxillofacial Trauma & Reconstruction
https://www.readbyqxmd.com/read/29368076/the-socioeconomic-impact-of-a-pediatric-ostomy-in-uganda-a-pilot-study
#9
Arlene Muzira, Nasser Kakembo, Phyllis Kisa, Monica Langer, John Sekabira, Doruk Ozgediz, Tamara N Fitzgerald
INTRODUCTION: Multiple pediatric surgical conditions require ostomies in low-middle-income countries. Delayed presentations increase the numbers of ostomies. Patients may live with an ostomy for a prolonged time due to the high backlog of cases with insufficient surgical capacity. In caring for these patients in Uganda, we frequently witnessed substantial socioeconomic impact of their surgical conditions. METHODS: The operative log at the only pediatric surgery referral center in Uganda was reviewed to assess the numbers of children receiving ostomies over a 3-year period...
January 24, 2018: Pediatric Surgery International
https://www.readbyqxmd.com/read/29366998/the-role-of-neurosurgery-in-countries-with-limited-facilities-facts-and-challenges
#10
Franco Servadei, Zefferino Rossini, Federico Nicolosi, Carlotta Morselli, Kee B Park
The Lancet Commission on Global Surgery has recently focused the attention on the lack of surgical care worldwide. Like other surgical subspecialties, neurosurgical care needs to be better distributed around the world, with a major attention to the low-middle income countries. Neurosurgical diseases like hydrocephalus, traumatic brain injury and brain tumours have a high impact on families, individual quality of life and cost for the society. Implementation of neurosurgical care in poor settings is not easy...
January 20, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29363608/implementation-of-a-colour-coded-universal-protocol-safety-initiative-in-guatemala
#11
Brad M Taicher, Shannon Tew, Ligia Figueroa, Fausto Hernandez, Sherry S Ross, Henry E Rice
BACKGROUND: Universal protocol implementation can be challenging in low-income or middle-income countries, particularly when providers work together across language barriers. The aim of this quality improvement initiative was to test the implementation of a colour-coded universal protocol in a Guatemalan hospital staffed by US and Guatemalan providers. METHODS: From 2013 to 2016, a US and Guatemalan team implemented a universal protocol at a Guatemalan surgical centre for children undergoing general surgical or urologic procedures...
January 23, 2018: BMJ Quality & Safety
https://www.readbyqxmd.com/read/29322309/the-global-spine-care-initiative-a-summary-of-guidelines-on-invasive-interventions-for-the-management-of-persistent-and-disabling-spinal-pain-in-low-and-middle-income-communities
#12
REVIEW
Emre Acaroğlu, Margareta Nordin, Kristi Randhawa, Roger Chou, Pierre Côté, Tiro Mmopelwa, Scott Haldeman
PURPOSE: The purpose of this study was to synthesize recommendations on the use of common elective surgical and interventional procedures for individuals with persistent and disabling non-radicular/axial with or without myelopathy, radicular back pain, cervical myelopathy, symptomatic spinal stenosis, and fractures due to osteoporosis. This review was to inform a clinical care pathway on the patient presentations where surgical interventions could reasonably be considered. METHODS: We synthesized recommendations from six evidence-based clinical practice guidelines and one appropriate use criteria guidance for the surgical and interventional management of persistent and disabling spine pain...
January 10, 2018: European Spine Journal
https://www.readbyqxmd.com/read/29290072/operations-for-suspected-neoplasms-in-a-resource-limited-setting-experience-and-challenges-in-the-eastern-democratic-of-congo
#13
Luc Malemo Kalisya, Jacques Fadhili Bake, Richard Bigabwa, David H Rothstein, Sarah B Cairo
INTRODUCTION: Surgery is an essential component of a functional health system, with surgical conditions accounting for nearly 11-15% of world disability. While communicable diseases continue to burden low- and low-middle-income countries, non-communicable diseases, such as cancer, are an important cause of morbidity and mortality worldwide. Preliminary data on malignancies in low- and middle-income countries, specifically in Africa, suggest a higher mortality compared to other regions of the world, a difference partially explained by limited availability of screening and early detection systems as well as poorer access to treatment...
December 31, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/29282513/international-study-of-the-epidemiology-of-paediatric-trauma-papsa-research-study
#14
Catherine J Bradshaw, Ashwath S Bandi, Zahid Muktar, Muhammad A Hasan, Tanvir K Chowdhury, Tahmina Banu, Mesay Hailemariam, Florence Ngu, David Croaker, Rouma Bankolé, Tunde Sholadoye, Oluwole Olaomi, Emmanuel Ameh, Antonio Di Cesare, Ernesto Leva, Yona Ringo, Lukman Abdur-Rahman, Ramy Salama, Essam Elhalaby, Helen Perera, Christopher Parsons, Stewart Cleeve, Alp Numanoglu, Sebastian Van As, Shilpa Sharma, Kokila Lakhoo
OBJECTIVES: Trauma is a significant cause of morbidity and mortality worldwide. The literature on paediatric trauma epidemiology in low- and middle-income countries (LMICs) is limited. This study aims to gather epidemiological data on paediatric trauma. METHODS: This is a multicentre prospective cohort study of paediatric trauma admissions, over 1 month, from 15 paediatric surgery centres in 11 countries. Epidemiology, mechanism of injury, injuries sustained, management, morbidity and mortality data were recorded...
December 28, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/29261548/prospective-observational-study-of-intraoperative-anesthetic-events-in-district-hospitals-in-namibia
#15
Andrew J Ottaway, Leonard Kabongo
BACKGROUND: Access to safe surgery and anesthesia care is grossly inadequate in low- and middle-income countries, with a shortage of anesthesia providers contributing to this crisis. In Namibia, medical officers typically receive no >3 months of informal training in anesthesia. This study sought to determine the prevalence, currently unknown, of intraoperative adverse anesthetic events in this setting. Further, we assessed surgical volume, complications, and mortality outcomes at the district hospital level...
December 19, 2017: Anesthesia and Analgesia
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
#16
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 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
#17
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
#18
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
#19
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
#20
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
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