Hazards in anaesthetic practice: body systems and occupational hazards

2017 ◽  
Author(s):  
Alan F. Merry ◽  
Simon J. Mitchell ◽  
Jonathan G. Hardman
Keyword(s):  
Postoperative Cognitive Dysfunction ◽  
International Standards ◽  
High Rate ◽  
World Health ◽  
World Federation ◽  
Middle Income ◽  
Middle Income Countries ◽  
The World ◽  
Health Organization ◽  
Rate Of Failure

“Can’t intubate, can’t oxygenate” crises and aspiration of gastric contents are important hazards in anaesthesia, and may result in the death of relatively young and healthy patients. Airway difficulties may manifest at the end of anaesthesia as well as at induction and are commoner in emergency departments and intensive care settings than during anaesthesia in operating rooms. Elements of poor management characterize the majority of airway complications. Emergency cricothyroidotomy performed by anaesthetists is associated with a high rate of failure. Other important hazards associated with anaesthesia may involve excessive or inadequate levels of oxygen or carbon dioxide in the blood, hypertension or hypotension, hypothermia or hyperthermia (including malignant hyperpyrexia), hypovolaemia, embolism of gas or thrombus, awareness, infection, and injury to the peripheral or central nervous system, or the eyes. Stroke and postoperative cognitive dysfunction may be particularly devastating for patients. These hazards are typically increased in low- and middle-income countries. The World Federation of Societies of Anaesthesiologists and the World Health Organization have endorsed international standards for a safe practice of anaesthesia, which are structured to reflect different levels of resource. The Lifebox Foundation seeks to improve the safety of surgery and anaesthesia in resource-constrained areas, notably by closing the substantial global gap in pulse oximetry. Several hazards are integral to the occupation of anaesthesia, including certain infections, increased rates of suicide, and medico-legal risks. In the end, the best way to mitigate these risks is through focusing on the safety of our patients.

scholarly journals A Symptom-based COVID-19 Diagnostic Tool in case of Limited Testing Facilities

2020 ◽  
pp. 71-75
Author(s):  
Raiiq Ridwan ◽  
Md Robed Amin ◽  
Md Ridwanur Rahman
Keyword(s):  
World Health ◽  
Atypical Pneumonia ◽  
New Disease ◽  
Middle Income ◽  
Middle Income Countries ◽  
The World ◽  
Health Organization ◽  
Transmission Of Disease ◽  
Limited Testing ◽  
Low And Middle Income

Since December 2019, when a cluster of atypical pneumonia cases were identified in Wuhan, China a new disease has spread across the world. COVID-19 has since become the biggest pandemic in a century, touching lives in almost every country in the world. At the outset of COVID-19, the World Health Organization advised for testing to become a priority so that patients with COVID-19 could be quickly identified, isolated and treated to interrupt transmission of disease. However, testing shortages have been an increasing problem in low and middle income countries. Even when tests are available, it has proved time-consuming. Therefore, we propose a symptom-based tool to assist in the diagnosis of COVID-19 management in low and middle income Countries. It is based on the symptoms that have so far been described in the literature and advises the frontline healthcare worker on how to diagnose the likelihood of having COVID-19 and separate the patient into Red (very likely), Yellow (possible) and Green (unlikely) categories. J Bangladesh Coll Phys Surg 2020; 38(0): 71-75

scholarly journals Mental health e-supervision for primary care doctors in Sudan using the WHO mhGAP Intervention Guide

2015 ◽  
Vol 12 (S1) ◽  
pp. S-16-S-19 ◽  
Author(s):  
Anne Aboaja ◽  
Puja Myles ◽  
Peter Hughes
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
World Health ◽  
Middle Income ◽  
Middle Income Countries ◽  
The World ◽  
Health Gap ◽  
Action Programme ◽  
Primary Care Doctors ◽  
Health Organization

This paper describes the evaluation of a pilot e-supervision programme, with a focus on feasibility. The findings suggest that e-supervision in mental health using the World Health Organization (WHO) Mental Health Gap Action Programme (mhGAP) Intervention Guide and case-based discussions is valued by participants and can improve the knowledge, confidence and beliefs of primary care doctors in low- and middle-income countries.

scholarly journals Cervical cancer screening – The challenges of complete pathways of care in low-income countries: Focus on Malawi

2020 ◽  
Vol 16 ◽  
pp. 174550652091480
Author(s):  
Heather A Cubie ◽  
Christine Campbell
Keyword(s):  
Cervical Cancer ◽  
Human Papillomavirus ◽  
World Health ◽  
Middle Income ◽  
Low Resource ◽  
Middle Income Countries ◽  
The World ◽  
Health Organization ◽  
Pathways Of Care ◽  
Low And Middle Income

Cervical cancer is the fourth most common cancer among women globally, with approximately 580,000 new diagnoses in 2018. Approximately, 90% of deaths from this disease occur in low- and middle-income countries, especially in areas of high HIV prevalence, and largely due to limited prevention and screening opportunities and scarce treatment options. In this overview, we describe the opportunities and challenges faced in many low- and middle-income countries in delivery of cervical cancer detection, treatment and complete pathways of care. In particular, drawing on our experience and that of colleagues, we describe cervical screening and pathways of care provision in Malawi, as a case study of a low-resource country with high incidence and mortality rates of cervical cancer. Screening methods such as cytology – although widely used in high-income countries – have limited relevance in many low-resource settings. The World Health Organization recommends screening using human papillomavirus testing wherever possible; however, although human papillomavirus primary testing is more sensitive and detects precancers and cancers earlier than cytology, there are currently costs, infrastructure considerations and specificity issues that limit its use in low- and middle-income countries. The World Health Organization accepts the alternative screening approach of visual inspection with acetic acid as part of ‘screen and treat’ programmes as a simple and inexpensive test that can be undertaken by trained health workers and hence give wider screening coverage; however, subjectivity and variability in interpretation of findings between providers raise issues of false positives and overtreatment. Cryotherapy using either nitrous oxide or carbon dioxide is an established treatment for precancerous lesions within ‘screen and treat’ programmes; more recently, thermal ablation has been recognized as suitable to low-resource settings due to lightweight equipment, short treatment times, and hand-held battery-operated and solar-powered models. For larger lesions and cancers, complete clinical pathways (including loop excision, surgery, radiotherapy, chemotherapy and palliative care) are required for optimal care of women. However, provision of each of these components of cancer control is often limited due to limited infrastructure and lack of trained personnel. Hence, global initiatives to reduce cervical mortality need to adopt a holistic approach to health systems strengthening.

scholarly journals The cross-national epidemiology of specific phobia in the World Mental Health Surveys

2017 ◽  
Vol 47 (10) ◽  
pp. 1744-1760 ◽  
Author(s):  
K. J. Wardenaar ◽  
C. C. W. Lim ◽  
A. O. Al-Hamzawi ◽  
J. Alonso ◽  
L. H. Andrade ◽  
...  
Keyword(s):  
Mental Disorders ◽  
Epidemiological Data ◽  
Specific Phobia ◽  
World Health ◽  
Middle Income ◽  
Middle Income Countries ◽  
Co Morbidity ◽  
The World ◽  
Health Organization ◽  
Cross National

BackgroundAlthough specific phobia is highly prevalent, associated with impairment, and an important risk factor for the development of other mental disorders, cross-national epidemiological data are scarce, especially from low- and middle-income countries. This paper presents epidemiological data from 22 low-, lower-middle-, upper-middle- and high-income countries.MethodData came from 25 representative population-based surveys conducted in 22 countries (2001–2011) as part of the World Health Organization World Mental Health Surveys initiative (n = 124 902). The presence of specific phobia as defined by the Diagnostic and Statistical Manual of Mental Disorders, fourth edition was evaluated using the World Health Organization Composite International Diagnostic Interview.ResultsThe cross-national lifetime and 12-month prevalence rates of specific phobia were, respectively, 7.4% and 5.5%, being higher in females (9.8 and 7.7%) than in males (4.9% and 3.3%) and higher in high- and higher-middle-income countries than in low-/lower-middle-income countries. The median age of onset was young (8 years). Of the 12-month patients, 18.7% reported severe role impairment (13.3–21.9% across income groups) and 23.1% reported any treatment (9.6–30.1% across income groups). Lifetime co-morbidity was observed in 60.5% of those with lifetime specific phobia, with the onset of specific phobia preceding the other disorder in most cases (72.6%). Interestingly, rates of impairment, treatment use and co-morbidity increased with the number of fear subtypes.ConclusionsSpecific phobia is common and associated with impairment in a considerable percentage of cases. Importantly, specific phobia often precedes the onset of other mental disorders, making it a possible early-life indicator of psychopathology vulnerability.

scholarly journals The Global Neurosurgery and the WFNS

2021 ◽  
Vol 1 (1) ◽  
pp. 13-14
Author(s):  
Franco Servadei ◽  
Maria Pia Tropetano
Keyword(s):  
Surgical Care ◽  
Critical Factor ◽  
World Health ◽  
Easy Access ◽  
World Federation ◽  
Middle Income ◽  
Global Improvement ◽  
Surgical Workforce ◽  
The World ◽  
Health Organization

In 2015, the Lancet Commission on Global Surgery highlighted surgical care disparities worldwide [1]. No one could ever imagine that Global Neurosurgery would become a real movement, a source of inspiration for others surgical specialties [2]. Over the years, Global Neurosurgery allowed the realization of a collective awareness of surgery as a global health priority. The Neurosurgical community accepted the challenge of delivering timely, safe, and affordable neurosurgical care to all who need it. Multiple efforts have been made to address this need to promote national surgical policies, improve surgical education and training, build quality research, and advocate for the surgical workforce. The critical factor has been the relationship between the World Health Organization (WHO) and the World Federation of Neurosurgical Societies (WFNS). Since 1955, the WFNS has promoted global improvement in neurosurgical care, building neurosurgical capacity through education, training, technology, and research. The goals are ambitious. By creating international partnerships, the WFNS has established multiple training programs in neurosurgical centers in Africa and other countries with limited facilities, allowing residents to work first in the host countries to learn and improve their skills and return to their country of origin [3,4,5]. Furthermore, the WFNS is working on sustainable surgical programs within Low-and Middle-income countries (LMICs) using digital technology [6]. Internet availability allows fast and easy access to digital resources, and digital education has become an emerging tool to bridge the gap between surgeons from High-Income Countries (HICs) and LMICs.

scholarly journals Feasibility Study of the World Health Organization Health Care Facility-Based Antimicrobial Stewardship Toolkit for Low- and Middle-Income Countries

Antibiotics ◽  
2020 ◽  
Vol 9 (9) ◽  
pp. 556
Author(s):  
Gina Maki ◽  
Ingrid Smith ◽  
Sarah Paulin ◽  
Linda Kaljee ◽  
Watipaso Kasambara ◽  
...  
Keyword(s):  
Health Care ◽  
World Health Organization ◽  
Feasibility Study ◽  
Care Facility ◽  
Health Care Facility ◽  
World Health ◽  
Middle Income ◽  
Middle Income Countries ◽  
The World ◽  
Health Organization

Antimicrobial stewardship (AMS) has emerged as a systematic approach to optimize antimicrobial use and reduce antimicrobial resistance. To support the implementation of AMS programs, the World Health Organization developed a draft toolkit for health care facility AMS programs in low- and middle-income countries. A feasibility study was conducted in Bhutan, the Federated States of Micronesia, Malawi, and Nepal to obtain local input on toolkit content and implementation of AMS programs. This descriptive qualitative study included semi-structured interviews with national- and facility-level stakeholders. Respondents identified AMS as a priority and perceived the draft toolkit as a much-needed document to further AMS program implementation. Facilitators for implementing AMS included strong national and facility leadership and clinical staff engagement. Barriers included lack of human and financial resources, inadequate regulations for prescription antibiotic sales, and insufficient AMS training. Action items for AMS implementation included improved laboratory surveillance, establishment of a stepwise approach for implementation, and mechanisms for reporting and feedback. Recommendations to improve the AMS toolkit’s content included additional guidance on defining the responsibilities of the committees and how to prioritize AMS programming based on local context. The AMS toolkit was perceived to be an important asset as countries and health care facilities move forward to implement AMS programs.

scholarly journals Introduction

2021 ◽  
pp. 1-2
Author(s):  
Mahmoud Aljurf ◽  
Navneet S. Majhail ◽  
Mickey B. C. Koh ◽  
Mohamed A. Kharfan-Dabaja ◽  
Nelson J. Chao
Keyword(s):  
World Health ◽  
International Agency ◽  
Cancer Death ◽  
Middle Income ◽  
Death Rates ◽  
Middle Income Countries ◽  
Global Age ◽  
The World ◽  
Significant Public Health ◽  
Health Organization

AbstractCancer is a growing healthcare problem worldwide with significant public health and economic burden to both developed and developing countries. According to the World Health Organization, cancer is the second leading cause of death globally, with an estimated 20 million new cancer cases and 10 million cancer deaths in 2020. The International Agency for Cancer Research (IARC) estimates that globally one in five people will develop cancer in their lifetime. Low- and middle-income countries have been disproportionately affected by the rise of cancer incidence and account for approximately 70% of global cancer deaths. At the same time, substantial innovations in screening, diagnosis, and treatment of cancer have improved patient outcomes; global age-standardized cancer death rates showed a 17% decline from 1990 to 2016.

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