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surgery in Low Resource settings

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https://www.readbyqxmd.com/read/28630690/incidence-and-risk-factors-for-surgical-site-infections-in-obstetric-and-gynecological-surgeries-from-a-teaching-hospital-in-rural-india
#1
Ashish Pathak, Kalpana Mahadik, Manmat B Swami, Pulak K Roy, Megha Sharma, Vijay K Mahadik, Cecilia Stålsby Lundborg
BACKGROUND: Surgical site infections (SSI) are one of the most common healthcare associated infections in the low-middle income countries. Data on incidence and risk factors for SSI following surgeries in general and Obstetric and Gynecological surgeries in particular are scare. This study set out to identify risk factors for SSI in patients undergoing Obstetric and Gynecological surgeries in an Indian rural hospital. METHODS: Patients who underwent a surgical procedure between September 2010 to February 2013 in the 60-bedded ward of Obstetric and Gynecology department were included...
2017: Antimicrobial Resistance and Infection Control
https://www.readbyqxmd.com/read/28588976/the-how-project-understanding-contextual-challenges-to-global-surgical-care-provision-in-low-resource-settings
#2
Nakul P Raykar, Rachel R Yorlets, Charles Liu, Roberta Goldman, Sarah L M Greenberg, Meera Kotagal, Paul E Farmer, John G Meara, Nobhojit Roy, Rowan D Gillies
INTRODUCTION: 5 billion people around the world do not have access to safe, affordable, timely surgical care. This series of qualitative interviews was launched by The Lancet Commission on Global Surgery (LCoGS) with the aim of understanding the contextual challenges-the specific circumstances-faced by surgical care providers in low-resource settings who care for impoverished patients, and how those providers overcome these challenges. METHODS: From January 2014 to February 2015, 20 LCoGS collaborators conducted semistructured interviews with 148 surgical providers in low-resource settings in 21 countries...
November 2016: BMJ Global Health
https://www.readbyqxmd.com/read/28588961/lasting-impact-insights-from-a-surgical-mission-based-mentoring-training-programme-in-the-republic-of-congo
#3
Michelle White, Kristin Close
The global shortage of surgeons, anaesthetists and obstetricians is significant, especially in low and middle income countries (LMICs). A significant amount of LMIC surgical volume is provided by surgical missions and non-governmental organisations (NGOs) who are often well resourced, making them ideal environments for training. However, there are few publications addressing how to train in this setting, or the long-term impact of such training. Mercy Ships operates the largest non-governmental hospital ship in the world, the Africa Mercy, serving LMICs at the invitation of their President by providing free surgery and training for the surgical workforce...
November 2016: BMJ Global Health
https://www.readbyqxmd.com/read/28513193/impact-of-health-literacy-on-time-spent-seeking-hand-care
#4
Aaron Alokozai, David N Bernstein, Nicole Sheikholeslami, Lauren Uhler, David Ring, Robin N Kamal
BACKGROUND: Patients with limited health literacy may have less knowledge and fewer resources for efficient access and navigation of the health care system. We tested the null hypothesis that there is no correlation between health literacy and total time spent seeking hand surgery care. METHODS: New patients visiting a hand surgery clinic at a suburban academic medical center were asked to complete a questionnaire to determine demographics, total time spent seeking hand surgery care, and outcomes...
May 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28497102/use-of-hardware-battery-drill-in-orthopedic-surgery
#5
Bhava R J Satish, Masood Shahdi, Duddupudi Ramarao, Atmakuri V Ranganadham, Sundaresan Kalamegam
Among the power drills (Electrical/Pneumatic/Battery) used in Orthopedic surgery, battery drill has got several advantages. Surgeons in low resource settings could not routinely use Orthopedic battery drills (OBD) due to the prohibitive cost of good drills or poor quality of other drills. "Hardware" or Engineering battery drill (HBD) is a viable alternative to OBD. HBD is easy to procure, rugged in nature, easy to maintain, durable, easily serviceable and 70 to 75 times cheaper than the standard high end OBD...
March 2017: Archives of Bone and Joint Surgery
https://www.readbyqxmd.com/read/28492353/laparoscopy-using-room-air-insufflation-in-a-rural-african-jungle-hospital-the-bongolo-hospital-experience-january-2006-to-december-2013
#6
Zachary O'Connor, Marco Faniriko, Keir Thelander, Jennifer O'Connor, David Thompson, Adrian Park
INTRODUCTION: Carbon dioxide is the standard insufflation gas for laparoscopy. However, in many areas of the world, bottled carbon dioxide is not available. Laparoscopy offers advantages over open surgery and has been practiced using filtered room air insufflation since 2006 at Bongolo Hospital in Gabon, Africa. OBJECTIVE: Our primary goal was to evaluate the safety of room air insufflation related to intraoperative and postoperative complications. Our secondary aim was to review the types of cases performed laparoscopically at our institution...
June 2017: Surgical Innovation
https://www.readbyqxmd.com/read/28490566/a-retrospective-cohort-study-of-the-utility-of-the-modified-early-warning-score-for-interfacility-transfer-of-patients-with-traumatic-injury
#7
Kristin Salottolo, Matthew Carrick, Jacob Johnson, Mark Gamber, David Bar-Or
OBJECTIVE: The modified early warning score (MEWS) is a 'track and trigger' score using routine physiological vital signs. The objective is to determine if the pretransfer MEWS can be used for predicting outcomes in trauma patients requiring interfacility transfer to higher levels of care. DESIGN, SETTING AND PARTICIPANTS: Retrospective study of consecutively transferred trauma patients into a level-II trauma centre from 2013 to 2014. INTERVENTIONS: None...
May 9, 2017: BMJ Open
https://www.readbyqxmd.com/read/28458951/cost-effectiveness-of-short-term-neurosurgical-missions-relative-to-other-surgical-specialties
#8
Maria Punchak, Jorge A Lazareff
BACKGROUND: Short-term surgical relief efforts have helped close some gaps in the provision of surgical care in remote settings. We reviewed the published literature on short-term surgical missions to compare their cost-effectiveness across subspecialties. METHODS: PubMed was searched using the algorithm ["cost-effectiveness" AND "surgery" AND ("mission" OR "volunteer")]. Articles detailing the cost-effectiveness of short-term surgical missions in low and middle-income countries (LMIC) were included...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28457932/the-role-of-conventional-myelography-in-the-diagnosis-and-treatment-of-degenerative-spine-diseases-in-low-income-communities-a-prospective-study
#9
David Kitya, Maria Punchak, Francis Bajunirwe
INTRODUCTION: Chronic back pain is a common problem and imaging is crucial for effective diagnosis and treatment. In low-resource settings conventional myelography is a cheap alternative to MRI and CT. This study was conducted to re-examine the diagnostic reliability, effectiveness for surgical decision making and safety of conventional myelography. METHODS: The study was conducted at Tenwek Mission Hospital during June 2009 and March 2010. New patients who presented with features of radiculopathy and/or myelopathy were eligible...
April 27, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28427944/creating-a-global-acute-care-surgery-fellowship-to-meet-international-need
#10
Amina I Merchant, Camila B Walters, Julie Valenzuela, Kelly A McQueen, Addison K May
INTRODUCTION: Existing Acute Care Surgery (ACS) fellowships are positioned to develop well-trained surgeons with specific skills to facilitate improvements in care delivery in Global ACS. Many resident and fellowship programs offer clinical electives that expose trainees to operative experiences, exposing trainees to the needs in resource-challenged settings. However, most lack a focus on long-term development and research designed to enhance the country's local skills, capability, and capacity...
April 17, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28345398/challenges-in-the-surgical-management-of-ectopic-pregnancy-in-a-low-resource-setting-mpilo-central-hospital-bulawayo-zimbabwe
#11
Solwayo Ngwenya
Background Ectopic pregnancy contributes to maternal morbidity and mortality, especially in low-resourced countries with limited facilities for early diagnosis and treatment. It is a very challenging condition to diagnose. Patients may collapse and die while undergoing investigation. Aims To assess surgical treatment given to patients presenting at Mpilo Central Hospital, the challenges that are faced and the outcomes; and also to document how women survive this dangerous condition in a setting challenged by low resources...
January 1, 2017: Tropical Doctor
https://www.readbyqxmd.com/read/28321296/improving-surgical-and-anaesthesia-practice-review-of-the-use-of-the-who-safe-surgery-checklist-in-felege-hiwot-referral-hospital-ethiopia
#12
Ryan Ellis, Ahmad Izzuddin Mohamad Nor, Iona Pimentil, Zebenaye Bitew, Jolene Moore
Development of surgical and anaesthetic care globally has been consistently reported as being inadequate. The Lancet Commission on Global Surgery highlights the need for action to address this deficit. One such action to improve global surgical safety is the introduction of the WHO Surgical Checklist to Operating Rooms (OR) around the world. The checklist has a growing body of evidence supporting its ability to assist in the delivery of safe anaesthesia and surgical care. Here we report the introduction of the Checklist to a major Ethiopian referral hospital and low-resource setting and highlight the success and challenges of its implementation over a one year period...
2017: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/28274969/cohort-analysis-of-outcomes-in-69%C3%A2-490-emergency-general-surgical-admissions-across-an-international-benchmarking-collaborative
#13
Prem Chana, Mark Joy, Neil Casey, David Chang, Elaine M Burns, Sonal Arora, Ara W Darzi, Omar D Faiz, Carol J Peden
OBJECTIVE: This study aims to use the Dr Foster Global Comparators Network (GC) database to examine differences in outcomes following high-risk emergency general surgery (EGS) admissions in participating centres across 3 countries and to determine whether hospital infrastructure factors can be linked to the delivery of high-quality care. DESIGN: A retrospective cohort analysis of high-risk EGS admissions using GC's international administrative data set. SETTING: 23 large hospitals in Australia, England and the USA...
March 8, 2017: BMJ Open
https://www.readbyqxmd.com/read/28259351/surgical-volume-and-postoperative-mortality-rate-at-a-referral-hospital-in-western-uganda-measuring-the-lancet-commission-on-global-surgery-indicators-in-low-resource-settings
#14
Geoffrey A Anderson, Lenka Ilcisin, Lenard Abesiga, Ronald Mayanja, Noralis Portal Benetiz, Joseph Ngonzi, Peter Kayima, Mark G Shrime
BACKGROUND: The Lancet Commission on Global Surgery recommends that every country report its surgical volume and postoperative mortality rate. Little is known, however, about the numbers of operations performed and the associated postoperative mortality rate in low-income countries or how to best collect these data. METHODS: For one month, every patient who underwent an operation at a referral hospital in western Uganda was observed. These patients and their outcomes were followed until discharge...
March 1, 2017: Surgery
https://www.readbyqxmd.com/read/28257319/contextual-challenges-to-safe-surgery-in-a-resource-limited-setting-a-multicenter-multiprofessional-qualitative-study
#15
John W Scott, Yihan Lin, Georges Ntakiyiruta, Zeta A Mutabazi, William Austin Davis, Megan A Morris, Douglas S Smink, Robert Riviello, Steven Yule
OBJECTIVES: Safe surgery should be available to all patients, no matter the setting. The purpose of this study was to explore the contextual-specific challenges to safe surgical care encountered by surgeons and surgical teams in many in low- and middle-income countries (LMICs), and to understand the ways in which surgical teams overcome them. BACKGROUND: Optimal surgical performance is highly complex and requires providers to integrate and communicate information regarding the patient, task, team, and environment to coordinate team-based care that is timely, effective, and safe...
March 2, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28217724/quality-of-life-among-female-cancer-survivors-in-africa-an-integrative-literature-review
#16
REVIEW
Rhoda Suubi Muliira, Anna Santos Salas, Beverley O'Brien
Quality of life (QOL) has been studied extensively among cancer populations in high income countries where cancer care resources are available to many. Little is known concerning the QOL of cancer groups residing in Africa where resources can be scarce. The integrative review of the literature explored and critically examined studies that had addressed QOL in female cancer survivors in Africa. The extent to which QOL studies incorporated a cultural perspective was also examined. Research studies published between 2005 and 2015 were retrieved from five databases: CINAHL, MEDLINE, SCOPUS, ProQuest dissertations and Theses full text, and GlobalHealth...
January 2017: Asia-Pacific Journal of Oncology Nursing
https://www.readbyqxmd.com/read/28216396/estimating-the-cost-of-neurosurgical-procedures-in-a-low-income-setting-an-observational-economic-analysis
#17
Jihad Abdelgadir, Tu Tran, Alex Muhindo, Doomwin Obiga, John Mukasa, Hussein Ssenyonjo, Michael Muhumza, Joel Kiryabwire, Michael M Haglund, Frank A Sloan
BACKGROUND: There are no data on cost of neurosurgery in low-income and middle-income countries. The objective of this study was to estimate the cost of neurosurgical procedures in a low-resource setting to better inform resource allocation and health sector planning. METHODS: In this observational economic analysis, microcosting was used to estimate the direct and indirect costs of neurosurgical procedures at Mulago National Referral Hospital (Kampala, Uganda)...
May 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28215195/tetanus-a-potential-public-health-threat-in-times-of-disaster
#18
Paige Finkelstein, Laura Teisch, Casey J Allen, Gabriel Ruiz
BACKGROUND: Tetanus is a potentially fatal condition that is rare in urban environments but is seen in developing countries and post-natural-disaster. Therefore, the purpose of this report was to review the epidemiology, pathogenesis, and management of tetanus in the trauma patient. METHODS: A thorough literature review was conducted to look for the most current and thorough guidelines on the prophylaxis and treatment of tetanus. PUBMED (National Center for Biotechnology Information, National Institutes of Health; Bethesda, Maryland USA), MEDLINE (US National Library of Medicine, National Institutes of Health; Bethesda, Maryland USA), and Cochrane Library (The Cochrane Collaboration; Oxford, United Kingdom) databases were searched for articles in English, published from 2005 to 2015, using the keywords "Tetanus," "Trauma/Surgery," and "Disaster...
February 20, 2017: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/28179175/-to-operate-versus-not-to-operate-in-low-resource-settings-example-of-aneurysm-surgery-in-rural-iran-and-impact-of-mastery-of-neurosurgical-anatomy
#19
Dylan Griswold, Arnau Benet, Halima Tabani, Michael T Lawton, Ali Tayebi Meybodi
BACKGROUND: Subarachnoid hemorrhage (SAH) has a global incidence of 9/100,000. In low-resource settings, where neurosurgical capacity is diminished through fewer human and technological resources, neurosurgeons may not be prepared to operate on aneurysm cases in emergent situations. We report a patient presented with aneurysmal SAH in rural Iran, creating the dilemma of the will for the neurosurgeon. We discuss the impact of the knowledge of neurosurgical anatomy on the resolution of this dilemma...
April 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28168717/cervical-cancer-prevention-and-treatment-in-latin-america
#20
REVIEW
Melissa S Lopez, Ellen S Baker, Mauricio Maza, Georgia Fontes-Cintra, Aldo Lopez, Juan M Carvajal, Fernanda Nozar, Veronica Fiol, Kathleen M Schmeler
Cervical cancer is a preventable disease with a known etiology (human papillomavirus), effective preventive vaccines, excellent screening methods, and a treatable pre-invasive phase. Surgery is the primary treatment for pre-invasive and early-stage disease and can safely be performed in many low-resource settings. However, cervical cancer rates remain high in many areas of Latin America. This article presents a number of evidence-based strategies being implemented to improve cervical cancer outcomes in Latin America...
April 2017: Journal of Surgical Oncology
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