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surgery in Low Resource settings

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https://www.readbyqxmd.com/read/27904844/cardiothoracic-surgical-experience-in-ghana
#1
REVIEW
Mark Tettey, Martin Tamatey, Frank Edwin
Ghana is one of the few low-to-middle-income countries in sub-Saharan Africa able to consistently sustain a cardiothoracic program with locally trained staff for more than two decades. Cardiothoracic surgery practice in Ghana started in 1964 but faltered from a combination of political and the economic problems. In 1989, Dr. Kwabena Frimpong-Boateng, a Ghanaian cardiothoracic surgeon trained in Hannover, rekindled interest in cardiothoracic surgery and in establishing a National Cardiothoracic Centre. His vision and leadership has brought cardiothoracic surgery practice in Ghana to its current high level...
October 2016: Cardiovascular Diagnosis and Therapy
https://www.readbyqxmd.com/read/27865972/paediatric-urolithiasis-in-emerging-economies
#2
REVIEW
S Adibul Hasan Rizvi, Sajid Sultan, Mirza Naqi Zafar, Sadaf Aba Umar, Bashir Ahmed, S A Anwar Naqvi
BACKGROUND: Paediatric urolithiasis remains endemic in low resource countries. This review highlights the epidemiology, causation and management of urolithiasis in an Asian country in the context of emerging economies. METHODS: A literature review of recent articles with key words paediatric urolithiasis, developing countries, endemic stone disease, stone composition, metabolic risk factors, management of paediatric urolithiasis was undertaken and 51 relevant articles were selected with the main focus on experience of this center in managing stone disease in the last two decades...
November 16, 2016: International Journal of Surgery
https://www.readbyqxmd.com/read/27843269/pediatric-adenotonsillectomy-in-a-low-resource-setting-lessons-and-implications
#3
Sanyaolu Alani Ameye, Afolabi Muyiwa Owojuyigbe, Adekunle Adeyemo, Anthony T Adenekan, Sylvia Ouche
OBJECTIVES: To examine the practices related paediatric adenotonsillectomy in our setting especially in relation to blood request and transfusion, routine investigations, post-operative analgesic practice and complications. METHODS: We reviewed the record of paediatric patients who had adenotonsillectomy in our facility over a 5-year period to obtain relevant information to our study. RESULTS: There were 33 males and 19 females with mean age of 3...
July 2016: Nigerian Journal of Surgery: Official Publication of the Nigerian Surgical Research Society
https://www.readbyqxmd.com/read/27837236/effect-of-pre-operative-anaemia-on-post-operative-complications-in-low-resource-settings
#4
Michelle C White, Lydia Longstaff, Peggy S Lai
BACKGROUND: In high-resource settings, even mild anaemia is associated with an increased risk of post-operative complications. Whether this is true in low-resource settings is unclear. We aimed to evaluate the effect of anaemia on surgical outcomes in the Republic of Congo and Madagascar. METHOD: It is a retrospective chart review of 2064 non-pregnant patients undergoing elective surgery with Mercy Ships. Logistic regression was used to determine the association between pre-operative anaemia and pre-defined surgical complications, adjusted for age, gender, surgical specialty, and country...
November 11, 2016: World Journal of Surgery
https://www.readbyqxmd.com/read/27803243/pancreatic-pseudocyst-combined-single-incision-laparoscopic-cystogastrostomy-and-cholecystectomy-in-a-resource-poor-setting
#5
Yardesh Singh, Shamir O Cawich, Leyrone Olivier, Thivy Kuruvilla, Fawwaz Mohammed, Vijay Naraysingh
Laparoscopic cystogastrostomy is a well-accepted minimally invasive modality to treat pancreatic pseudocysts. There has been one prior report of cystogastrostomy via single incision laparoscopic surgery (SILS) in which specialized instrumentation and access platforms were used.We report the challenges encountered in a low resource setting with the SILS approach to drainage using only standard laparoscopic instruments. To the best of our knowledge this is the second report of SILS cystogastrostomy and the first to be performed in a resource poor setting without specialized instruments or platforms...
November 1, 2016: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/27793460/the-use-of-the-submental-island-flap-in-reconstructing-palatal-and-facial-defects-in-a-surgical-camp-in-east-africa
#6
Kate Clancy, Camille Huwyler, Shawn Li, Jeffrey Otiti, Chad A Zender
BACKGROUND: The goals of successful reconstructive surgery are to restore function and cosmesis; however, limitation of resources can become an important consideration in low-middle income countries. METHODS: We describe our experience using the submental island flap in two cases during a short-term surgical camp in East Africa. RESULTS: The submental island flap was utilized as an excellent alternative to a free flap to reconstruct a subtotal maxillectomy and a parotidectomy defect in two patients...
September 28, 2016: American Journal of Otolaryngology
https://www.readbyqxmd.com/read/27788172/retrospective-review-of-the-anaesthetic-management-of-maxillectomies-and-mandibulectomies-for-benign-tumours-in-sub-saharan-africa
#7
Michelle C White, Katherine C Horner, Peggy S Lai
BACKGROUND: Safe anaesthesia is a crucial component of safe surgical care, yet anaesthetic complications are common in resource-limited settings. We describe differences in anaesthetic needs for Mandibulectomy vs. Maxillectomy in three sub-Saharan African countries. MATERIALS AND METHODS: Retrospective review of patients undergoing minor Mandibulectomy, major Mandibulectomy, or Maxillectomy in Togo, Guinea and Republic of the Congo. Surgeries were performed on the Africa Mercy, an international non-governmental hospital ship...
2016: PloS One
https://www.readbyqxmd.com/read/27774923/development-and-validation-of-a-low-cost-microsurgery-ear-trainer-for-low-resource-settings
#8
M P A Clark, B D Westerberg, J E Mitchell
OBJECTIVE: Chronic suppurative otitis media is a neglected condition affecting up to 330 million people worldwide, with the burden of the disease in impoverished countries. The need for non-governmental organisations to hardwire training into their programmes has been highlighted. An ear surgery simulator appropriate for training in resource-poor settings was developed, and its effectiveness in facilitating the acquisition of headlight and microsurgical skills necessary to safely perform procedures via the ear canal was investigated...
October 2016: Journal of Laryngology and Otology
https://www.readbyqxmd.com/read/27738719/burden-of-first-osteoporotic-hip-fracture-in-spain-a-prospective-12-month-observational-study
#9
Jose Ramón Caeiro, Agustí Bartra, Manuel Mesa-Ramos, Íñigo Etxebarría, Jorge Montejo, Pedro Carpintero, Francesc Sorio, Sonia Gatell, Andrea Farré, Laura Canals
The purpose of this study was to estimate the burden of osteoporotic fractures beyond the hospitalization period covering up to the first year after the fracture. This was a prospective, 12-month, observational study including patients aged ≥65 years hospitalized due to a first low-trauma hip fracture, in six Spanish regions. Health resource utilization (HRU), quality of life (QoL) and autonomy were collected and total costs calculated. Four hundred and eighty seven patients (mean ± SD age 83 ± 7 years, 77 % women) were included...
October 14, 2016: Calcified Tissue International
https://www.readbyqxmd.com/read/27716155/specialty-preferences-among-final-year-medical-students-in-medical-schools-of-southeast-nigeria-need-for-career-guidance
#10
Edmund Ndudi Ossai, Kenechi Anderson Uwakwe, Uchenna Chidi Anyanwagu, Ntat Charles Ibiok, Benedict Ndubueze Azuogu, Ngozi Ekeke
BACKGROUND: In resource-poor settings with low doctor-population ratio, there is need for equitable distribution of healthcare workforce. The specialty preferences of medical students determine the future composition of physician workforce hence its relevance in career guidance, healthcare planning and policy formulation. This study was aimed at determining the specialty preferences of final year medical students in medical schools of southeast Nigeria, the gender differences in choice of specialty and the availability of career guidance to the students during the period of training...
October 4, 2016: BMC Medical Education
https://www.readbyqxmd.com/read/27709055/pendulum-exercises-after-hip-arthroscopy-a-video-technique
#11
Ryan Sauber, George Saborio, Beth M Nickel, Benjamin R Kivlan, John J Christoforetti
Advanced hip joint-preserving arthroscopic techniques have been shown to improve patient-reported functional outcomes with low rates of postoperative complications. Prior work has shown that formation of adhesive scar is a potential source of persistent pain and cause for revision surgery. As resources for postoperative in-studio physical therapy become scarce, a home-based strategy to avoid scar formation without adding formal therapy cost may be beneficial. The purpose of this technical note is to introduce a patient-centered educational video technique for home-caregiver delivery of manual hip pendulum exercises in the postoperative setting...
August 2016: Arthroscopy Techniques
https://www.readbyqxmd.com/read/27578856/training-responsibly-to-improve-global-surgical-and-anaesthesia-capacity-through-institutional-health-partnerships-a-case-study
#12
Laura Macpherson, Maggie Collins
BACKGROUND: Urgent investment in human resources for surgical and anaesthesia care is needed globally. Responsible training and education is required to ensure healthcare providers are confident and skilled in the delivery of this care in both the rural and the urban setting. The Tropical Health and Education Trust (THET), a UK-based specialist global health organisation, is working with health training institutions, health professionals, Ministries of Health and Health Partnerships or 'links' between healthcare institutions in the UK and low- or middle-income country (LMIC) counterparts...
August 30, 2016: Tropical Doctor
https://www.readbyqxmd.com/read/27571911/innovative-non-surgical-management-of-pelvic-and-anterior-vaginal-wall-abscess-following-vaginal-surgery
#13
Nisha Singh, Neha Negi, Namrata Kumar
Surgical site infections remain a common cause of morbidity following gynaecological surgery. The widespread implementation of antibiotic prophylaxis prior to surgery, as well as cognizance of modifiable risk factors for postoperative infection, has led to a significant reduction in postoperative infection rates. However, in low resource settings where sepsis and infections are common, surgical site infections following vaginal hysterectomy are sometimes encountered. It is a challenge to treat these infections with minimal intervention avoiding repeat surgery...
2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27541442/interventions-to-promote-follow-up-after-trabeculectomy-surgery-in-rural-southern-china-a-randomized-clinical-trial
#14
Ke Yang, Ling Jin, Li Li, Siming Zeng, Ruqian Wei, Guirong Li, Pingyi Man, Nathan Congdon
Importance: Follow-up after trabeculectomy surgery is important to surgical success, but little is known about the effect of interventions on improving follow-up in low-resource areas. Objective: To examine whether text message reminders and free eye medications improve follow-up after trabeculectomy in rural southern China. Design, Setting, and Participants: This randomized clinical trial studied 222 consecutive patients undergoing trabeculectomy from October 1, 2014, through November 31, 2015, at 4 rural hospitals in Guangdong and Guangxi Provinces, China...
October 1, 2016: JAMA Ophthalmology
https://www.readbyqxmd.com/read/27530439/obstacles-to-implementation-of-an-intervention-to-improve-surgical-services-in-an-ethiopian-hospital-a-qualitative-study-of-an-international-health-partnership-project
#15
Emma-Louise Aveling, Desalegn Tegabu Zegeye, Michael Silverman
BACKGROUND: Access to safe surgical care represents a critical gap in healthcare delivery and development in many low- and middle-income countries, including Ethiopia. Quality improvement (QI) initiatives at hospital level may contribute to closing this gap. Many such quality improvement initiatives are carried out through international health partnerships. Better understanding of how to optimise quality improvement in low-income settings is needed, including through partnership-based approaches...
August 17, 2016: BMC Health Services Research
https://www.readbyqxmd.com/read/27512994/a-cost-effectiveness-tool-to-guide-the-prioritization-of-interventions-for-rheumatic-fever-and-rheumatic-heart-disease-control-in-african-nations
#16
David Watkins, Solomon J Lubinga, Bongani Mayosi, Joseph B Babigumira
BACKGROUND: Rheumatic heart disease (RHD) prevalence and mortality rates remain especially high in many parts of Africa. While effective prevention and treatment exist, coverage rates of the various interventions are low. Little is known about the comparative cost-effectiveness of different RHD interventions in limited resource settings. We developed an economic evaluation tool to assist ministries of health in allocating resources and planning RHD control programs. METHODOLOGY/PRINCIPAL FINDINGS: We constructed a Markov model of the natural history of acute rheumatic fever (ARF) and RHD, taking transition probabilities and intervention effectiveness data from previously published studies and expert opinion...
August 2016: PLoS Neglected Tropical Diseases
https://www.readbyqxmd.com/read/27509992/challenges-in-the-management-of-breast-cancer-in-a-low-resource-setting-in-south-east-asia
#17
P Ley, C Hong, J Varughese, L Camp, Sok Bouy, E Maling
BACKGROUND: Breast cancer is the second most common cancer in women in Cambodia, a low income country in SouthEast Asia. The Sihanouk Hospital Centre of Hope (SHCH) is a charity hospital set up by an international nongovernmental organisation, HOPE Worldwide. In 2008, SHCH partnered with AmeriCares, a global health organisation to set up and deliver a breast cancer programme to provide education, diagnosis and treatment for women with breast cancer. The objective of this study is to characterise the presentation, diagnosis, treatment and outcomes of women treated under this program...
2016: Asian Pacific Journal of Cancer Prevention: APJCP
https://www.readbyqxmd.com/read/27506407/barriers-to-neurosurgical-training-in-sub-saharan-africa-the-need-for-a-phased-approach-to-global-surgery-efforts-to-improve-neurosurgical-care
#18
Elie Sader, Philip Yee, Mojgan Hodaie
BACKGROUND: Neurosurgery in low-income countries is faced with multiple challenges. While the most common challenges include infrastructure and physical resource deficits, an underemphasized barrier relates to the methods and components of surgical training. The role of important aspects including didactic surgical training, surgical decision-making, workshops, conferences, and assessment methods have not been duly studied. Knowledge of these issues is a crucial step to move closer to strengthening surgical capacity in low income countries...
August 6, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27486275/types-and-outcome-of-fetal-urinary-anomalies-in-low-resource-setting-countries-a-retrospective-study
#19
Hend Shalaby, Reda Hemida, Hanan Nabil, Mohammad Ibrahim
BACKGROUND: Congenital anomalies of the kidney and urinary tract in the developing countries have a poor prognosis due to limited experience in antenatal and postnatal management. PATIENTS AND METHODS: A 3-year retrospective study was carried out from January 2011 to December 2013. The following data were collected and analyzed: maternal age, gravidity, parity, gestational age at diagnosis, and ultrasonography findings. Final diagnosis after birth, the performed surgeries, follow-up data, as well as survival at one year were also analyzed...
October 2016: Journal of Obstetrics and Gynaecology of India
https://www.readbyqxmd.com/read/27427933/remote-digital-preoperative-assessments-for-cleft-lip-and-palate-may-improve-clinical-and-economic-impact-in-global-plastic-surgery
#20
Christopher Hughes, Jacob Campbell, Swagoto Mukhopadhyay, Susan McCormack, Richard Silverman, Janice Lalikos, Alan Babigian, Charles Castiglione
OBJECTIVE: Reconstructive surgical care can play a vital role in the resource-poor settings of low- and middle-income countries. Telemedicine platforms can improve the efficiency and effectiveness of surgical care. The purpose of this study is to determine whether remote digital video evaluations are reliable in the context of a short-term plastic surgical intervention. SETTING: The setting for this study was a district hospital located in Latacunga, Ecuador. PATIENTS: Participants were 27 consecutive patients who presented for operative repair of cleft lip and palate...
July 18, 2016: Cleft Palate-craniofacial Journal
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