Circular frames without x-ray – lessons learned regarding radiation exposure during tibial deformity correction from Low & Middle Income Countries?

2022 ◽  
pp. 004947552110433
Author(s):  
James Shelton ◽  
Sara Dorman ◽  
Yinna Kim ◽  
Phillipa Thorpe ◽  
Badri Narayan ◽  
...  

Circular frames are a successful way of treating difficult fractures and non-unions. At our institution (CSC) in Phnom Penh, Cambodia, our method differs from developed healthcare systems in that we do not use x-ray to site the frames. A retrospective cohort study was performed between CSC and a UK LRS unit. Demographics, diagnosis, frame type, pre- and post-op deformity, proximal and distal construct alignment comparative to the tibia, and time to union or failure. 70 patients in total were identified and were randomly selected from a hospital in UK. Demographics & deformity were similar and failed to reach significant difference on testing: union rate 70% v. 82%, time to union 9.8 v. 8.5 months, and radiation exposure mean 0 v. 74 cGy/cm2 (range 6.4–326.7). These are startlingly homogenous results considering the differing resources available. We believe that ring fixators are a viable treatment method in austere environments where image intensifiers are unavailable, and demand no unnecessary radiation exposure.

2020 ◽  
Vol 105 ◽  
pp. 198-210 ◽  
Author(s):  
Navarro Ferronato ◽  
Edith Gabriela Guisbert Lizarazu ◽  
Jorge Marcelo Velasco Tudela ◽  
Jimena Karen Blanco Callisaya ◽  
Gianluca Preziosi ◽  
...  

2021 ◽  
Vol 13 (21) ◽  
pp. 11758
Author(s):  
Giulia Oggero ◽  
Louise Puli ◽  
Emma Maria Smith ◽  
Chapal Khasnabis

Global participation at the Paralympic Games has been steadily growing in the past 60 years. However, inequities in relation to geographic representation of Paralympians, sex representation, access to assistive technology, and medal success remain. The objectives of this research are to describe and compare trends in Paralympians’ participation and achievements in the Summer Paralympic Games by income level and sex, including in events requiring assistive products (wheelchairs, hand cycles/trikes, and prostheses). A retrospective secondary analysis of publicly available data was conducted. Participation, sex, and medal tally data were extracted from data available on the International Paralympic Committee website and archives. Data regarding income and population were collected from publicly available data available from the World Bank website. Participation in the Summer Paralympic Games differs significantly by income level (p = 0.000) with high- income countries sending, on average, more Paralympians than low- and middle-income countries. There is a significant difference between male and female participation (p = 0.00), with approximately 29% of all Paralympians being female. High-income countries demonstrate significantly higher achievement than low- and middle-income countries (p = 0.000), including in events requiring assistive products (p = 0.007). Despite growth in overall participation, low- and middle-income countries remain severely underrepresented in both participation and achievement at the Paralympic Games, especially in the events that require high quality assistive products to succeed. More equitable participation and achievement in the Paralympics may be supported by addressing the barriers for females, for people from low- and low-middle income countries, and for those without access to high quality assistive products required.


2020 ◽  
Vol 16 (5) ◽  
pp. 497-502
Author(s):  
Hiba Abbasi ◽  
Noor Abu-Farsakh ◽  
Farah Abuazzam ◽  
Rasha Halaseh ◽  
Othman Alaraj ◽  
...  

Background:: The recent report of The World Health Organization on diabetes has stressed on the burden of diabetes on low/middle income countries. Recent studies advocated the importance of funding more research on diabetes and insulin in these countries. Recently, the European Research Council advocated the importance of gold Open Access (OA) publishing, where the funded research should be immediately accessible. In this study, we aim to assess funding for insulin research, where we will compare the OA status between funded and unfunded research. Methods:: We used Scopus database to assess insulin research published from January 1st, 1999 to December 31st, 2018. Our bibliometric analysis consisted of three main sections: analysis of all publications on insulin, analysis of funded insulin publications, and analysis of unfunded insulin publications. Results:: We found a total of 388,202 publications, of which only 83,180 (21.4%) were funded. USA produced around 30.1% of the total publications, and the National Institute of Health (NIH) was the major funder with 18.6% of all publications. Of the funded publications, 29,143 (35%) were OA publications, compared to 97,347 (31.9%) of the unfunded publications. We didn’t find a significant difference in OA status between funded and unfunded research. Conclusion:: In concordance with the European Research Council’s decision to support gold OA publishing model, we found that only 35% of the funded and 31.9% of the unfunded insulin research were OA. Although the funded research is increasing in China, most of it is produced in high income countries. This highlights the importance of allocating more funds to low/middle income countries.


2020 ◽  
Vol 11 (SPL1) ◽  
pp. 1367-1373
Author(s):  
Nikhil Sanjay Mujbaile ◽  
Smita Damke

The Covid illness (COVID-19) pandemic has spread rapidly all through the world and has had a drawn-out impact. The Pandemic has done incredible damage to society and made genuine mental injury to numerous individuals. Mental emergencies frequently cause youngsters to deliver sentiments of relinquishment, despondency, insufficiency, and fatigue and even raise the danger of self-destruction. Youngsters with psychological instabilities are particularly powerless during the isolate and colonial removing period. Convenient and proper assurances are expected to forestall the event of mental and social issues. The rising advanced applications and wellbeing administrations, for example, telehealth, web-based media, versatile wellbeing, and far off intuitive online instruction can connect the social separation and backing mental and conduct wellbeing for youngsters. Because of the mental advancement qualities of youngsters, this investigation additionally outlines intercessions on the mental effect of the COVID-19 Pandemic. Further difficulties in Low Middle-Income Countries incorporate the failure to actualize successful general wellbeing estimates, for example, social separating, hand cleanliness, definitive distinguishing proof of contaminated individuals with self-disconnection and widespread utilization of covers The aberrant impacts of the Pandemic on youngster wellbeing are of extensive concern, including expanding neediness levels, upset tutoring, absence of admittance to the class taking care of plans, decreased admittance to wellbeing offices and breaks in inoculation and other kid wellbeing programs. Kept tutoring is critical for kids in Low Middle-Income Countries. Arrangement of safe situations is mainly testing in packed asset obliged schools. 


2020 ◽  
Author(s):  
Larrey Kamabu ◽  
Hervé Monka Lekuya ◽  
Bienvenu Muhindo Kasusula ◽  
Nicole Kavugho Mutimani ◽  
Louange Maha Kathaka ◽  
...  

Author(s):  
Shirley Lewis ◽  
Lavanya Gurram ◽  
Umesh Velu ◽  
Krishna Sharan

Abstract Introduction: Coronavirus disease (COVID-19) has significantly challenged the access to cancer care and follow-up for a patient with cancer. Methods: Based on published literature and our experiences, it is reasonable to presume that clinical examination and follow-up visits have been significantly curtailed worldwide in order to adhere to the new norms during the pandemic. Although telephonic and telemedicine consultations may help bridge a few gaps, completely dispensing with in-person consultation has its challenges, especially in low middle-income countries. Telephonic consultations could facilitate triaging of ambulatory cancer patients and allocation of face-to-face consultations for high priority patients. Conclusions: We propose a telephonic consultation-based triaging approach for ambulatory cancer patients in order to identify those needing in-hospital consultations.


BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e045005
Author(s):  
Fadia Gamieldien ◽  
Roshan Galvaan ◽  
Bronwyn Myers ◽  
Zarina Syed ◽  
Katherine Sorsdahl

ObjectiveTo examine the literature on how recovery of people with severe mental illness (SMI) is conceptualised in low/middle-income countries (LMICs), and in particular what factors are thought to facilitate recovery.DesignScoping review.Data sources and eligibilityWe searched 14 electronic databases, hand searched citations and consulted with experts during the period May–December 2019. Eligible studies were independently screened for inclusion and exclusion by two reviewers. Unresolved discrepancies were referred to a third reviewer.Data extraction and synthesisAll bibliographical data and study characteristics were extracted using a data charting form. Selected studies were analysed through a thematic analysis emerging from extracted data.ResultsThe Preferred Reporting Items for Systematic Reviews and Meta-Analyses flow diagram offers a summary of the results: 4201 titles, 1530 abstracts and 109 full-text articles were screened. Ten articles were selected for inclusion: two from Turkey, two from India, and one each from China, Swaziland, Indonesia, Egypt, South Africa and Vietnam. Although most studies used qualitative methods, data collection and sampling methods were heterogeneous. One study reported on service provider perspectives while the rest provided perspectives from a combination of service users and caregivers. Three themes emerged from the data analysis. First, studies frame recovery as a personal journey occurring along a continuum. Second, there was an emphasis on social relationships as a facilitator of recovery. Third, spirituality emerged as both a facilitator and an indicator of recovery. These themes were not mutually exclusive and some overlap exists.ConclusionAlthough there were commonalities with how high-income countries describe recovery, we also found differences in conceptualisation. These differences in how recovery was understood reflect the importance of framing the personal recovery concept in relation to local needs and contextual issues found in LMICs. This review highlighted the current sparse evidence base and the need to better understand recovery from SMI in LMICs.


2021 ◽  
Vol 5 (1) ◽  
pp. e000976
Author(s):  
Ayanda Gina ◽  
Nadja F Bednarczuk ◽  
Asitha Jayawardena ◽  
Peter Rea ◽  
Qadeer Arshad ◽  
...  

Hearing screening for newborn babies is an established protocol in many high-income countries. Implementing such screening has yielded significant socioeconomic advantages at both an individual and societal level. This has yet to permeate low/middle-income countries (LMIC). Here, we illustrate how newborn hearing screening needs to be contextually adapted for effective utilisation and implementation in an LMIC. Specifically, this advocates the use of auditory brainstem testing as the first-line approach. We propose that such adaptation serves to maximise clinical efficacy and community participation at a reduced cost.


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