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surgery in Low Resource settings

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https://www.readbyqxmd.com/read/28087136/global-general-pediatric-surgery-partnership-the-ucla-mozambique-experience
#1
Vanda Amado, Deborah B Martins, Abraar Karan, Brittni Johnson, Shant Shekherdimian, Lee T Miller, Atanasio Taela, Daniel A DeUgarte
BACKGROUND/PURPOSE: There has been increasing recognition of the disparities in surgical care throughout the world. Increasingly, efforts are being made to improve local infrastructure and training of surgeons in low-income settings. The purpose of this study was to review the first 5-years of a global academic pediatric general surgery partnership between UCLA and the Eduardo Mondlane University in Maputo, Mozambique. METHODS: A mixed-methods approach was utilized to perform an ongoing needs assessment...
January 5, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28052574/resource-variation-in-colorectal-surgery-a-national-centre-level-analysis
#2
Thomas M Drake, Matthew J Lee, Asha Senapati, Steven R Brown
BACKGROUND: Delivery of quality colorectal surgery requires adequate resources. We set out to assess the relationship between resources and outcomes in English colorectal units. METHODS: Data was extracted from the ACPGBI resource questionnaire to profile resources. This was correlated with Hospital Episode Statistics (HES) outcome data including 90-day mortality and readmissions. Patient satisfaction measures were extracted from the Cancer Experience Patient Survey (CEPS) and compared at unit level...
January 4, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28025932/thyroid-surgery-in-a-resource-limited-setting
#3
Aria Jafari, David Campbell, Bruce H Campbell, Henry Nono Ngoitsi, Titus M Sisenda, Makaya Denge, Benjamin C James, Susan R Cordes
Objective The present study reviews a series of patients who underwent thyroid surgery in Eldoret, Kenya, to demonstrate the feasibility of conducting long-term (>1 year) outcomes research in a resource-limited setting, impact on the quality of life of the recipient population, and inform future humanitarian collaborations. Study Design Case series with chart review. Setting Tertiary public referral hospital in Eldoret, Kenya. Subjects and Methods Twenty-one patients were enrolled during the study period...
December 1, 2016: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/27986227/global-surgical-ecosystems-a-need-for-systems-strengthening
#4
Catherine R deVries, Jenna S Rosenberg
BACKGROUND: As surgery is gaining recognition as a critical component of universal health care worldwide, surgical communities have come together with unprecedented unity to advocate for systems to support surgical care. This community has long believed that much care could be performed in a cost-effective manner even in low resource settings, despite skepticism voiced by many in public health. To do so will require the development of new systems and re-vamping of old systems that are not effective...
July 2016: Annals of Global Health
https://www.readbyqxmd.com/read/27939204/role-of-glycopyrrolate-in-healing-of-anastomotic-dehiscence-after-primary-repair-of-esophageal-atresia-in-a-low-resource-setting-a-randomized-controlled-study
#5
Mahesh Manilal Vaghela, J K Mahajan, Jegadeesh Sundram, Neerja Bhardwaj, K L N Rao
AIMS: To investigate the role of glycopyrrolate in decreasing oral secretions in patients of esophageal atresia (EA) with anastomotic leak and evaluate its effect on healing of anastomotic dehiscence. METHODS: The study comprised consecutive neonates of esophageal atresia, who had undergone primary surgery and developed anastomotic leak. The patients were randomized into two groups with the observer blinded to the group. The patients in the treatment group were administered glycopyrrolate in the dose of 8 μg/kg 8 hourly, whereas placebo group patients were injected normal saline only...
November 23, 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27904844/cardiothoracic-surgical-experience-in-ghana
#6
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
#7
REVIEW
S Adibul Hasan Rizvi, Sajid Sultan, Mirza Naqi Zafar, Bashir Ahmed, Sadaf Aba Umer, 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...
December 2016: International Journal of Surgery
https://www.readbyqxmd.com/read/27843269/pediatric-adenotonsillectomy-in-a-low-resource-setting-lessons-and-implications
#8
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
#9
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
#10
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
#11
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...
January 2017: 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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
REVIEW
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...
January 2017: Tropical Doctor
https://www.readbyqxmd.com/read/27571911/innovative-non-surgical-management-of-pelvic-and-anterior-vaginal-wall-abscess-following-vaginal-surgery
#18
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...
August 29, 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
#19
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
#20
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
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