scholarly journals Management and cost of snakebite injuries at a teaching and referral hospital in Western Kenya

F1000Research ◽  
2019 ◽  
Vol 8 ◽  
pp. 1588 ◽  
Author(s):  
Mitchel Otieno Okumu ◽  
Minal Naran Patel ◽  
Foram Rajnkant Bhogayata ◽  
Francis Okumu Ochola ◽  
Irene Awuor Olweny ◽  
...  
Keyword(s):  
Indirect Cost ◽  
Rural Areas ◽  
First Aid ◽  
Continuous Medical Education ◽  
The Body ◽  
Referral Hospital ◽  
Lower Limbs ◽  
Hospital Length Of Stay ◽  
Health Coverage ◽  
The Cost

Background: Data on the cost of snakebite injuries may inform key pillars of universal health coverage including proper planning, allocation, and utility of resources. This study evaluated the injuries, management, and costs resulting from snakebites at Jaramogi Oginga Odinga Teaching and Referral Hospital (JOOTRH) in Kenya.  Methods: In total, medical records of 127 snakebite victims attending JOOTRH between January 2011 and December 2016 were purposely selected and data on the age, gender, type of residence (urban or rural), part of the body bitten, time of bite, injuries, pre-hospital first aid, time to hospital, length of stay, treatment, and costs were collected. Regression analysis was used to predict the total indirect cost of snakebite injuries and p≤ 0.05 was considered significant. Mortality and loss of income of hospitalized victims were considered as direct costs. Results: It was found that 43 victims were 13-24 years of age, 64 were female, 94 were from rural areas, 92 were bitten on the lower limbs, 49 were bitten between 6.00 pm and midnight, 43 attempted pre-hospital first aid, and the median time to hospital was 4.5 hours. Antivenom, supportive therapy, antibiotics, antihistamines, corticosteroids, analgesics, and non-steroidal anti-inflammatory drugs were used. Cellulitis, compartment syndrome, gangrenous foot, psychiatric disorder, and death were the main complications. Most victims spent 1-5 days in hospital and the median cost of treating a snakebite was 2652 KES (~$26). Drugs, ward charges, and nursing procedures were the highest contributors to the total indirect cost. Victims hospitalized for 6-10 days and >10 days incurred 32% and 62% more costs, respectively, compared to those hospitalized for 1-5 days.  Conclusions: The longer snakebite victims are hospitalized, the higher the cost incurred. Continuous medical education on the correct management of snakebites should be encouraged to minimize complications that may increase hospital stays and costs incurred.

scholarly journals The costs of traumatic head injury and associated factors at University of Gondar Specialized Referral Hospital, Northwest Ethiopia

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Yilak Asmamaw ◽  
Mezgebu Yitayal ◽  
Ayal Debie ◽  
Simegnew Handebo
Keyword(s):  
Head Injury ◽  
Length Of Stay ◽  
Medical Cost ◽  
Low Income ◽  
Associated Factors ◽  
Referral Hospital ◽  
Hospital Length Of Stay ◽  
Traumatic Head Injury ◽  
Traumatic Head ◽  
The Cost

Abstract Background Head injuries account for 650,000 annual deaths worldwide. The cost for treating head injury was estimated at US $200 million annually. This contributes to economic impoverishment in low income countries like Ethiopia. Hence, this study was aimed to assess the cost of Traumatic Head Injury (THI) and associated factors in the University of Gondar Specialized Referral Hospital. Method An institution-based cross-sectional study was conducted from March 01 to May 30, 2017. A total of 387 THI patients were included in the study. An interviewer-administered questionnaire was used for data collection. Direct costs and indirect costs were measured by using the bottom-up approach. Data were entered into Epi-Info version 7 and imported to SPSS version 20 for analysis. Simple and multiple linear regression analysis were done to identify factors associated with cost of THI. Results The mean cost of THI per patient was 4673.43 Ethiopian Birr (ETB), 95% CI (4523.6-4823.3), and length of hospital stay averaged 1.73, 95% CI (1.63–1.82). Direct non-medical cost, like transportation fee 1896.19 ETB (±762.56 SD) and medical costs 1101.66 ETB (±534.13 SD) were account for 40.57 and 23.58% of total costs respectively. The indirect cost, loss of income by patient and their attendant due to injury, was 1675.58 ETB (+ 459.26 SD). Patients with moderate and severe levels of injury have 635.167 ETB (Standardized coefficient = 0.173, p < 0.001) and 773.621 ETB (Standardized coefficient = 0. 132, p < 0.001) increased costs, respectively, compared to mild level THI patients. Costs for patients ages 31–45 years were 252.504 ETB (Standardized coefficient = − 0.066, p = 0.046) lower than costs for those 5–14 years old. The cost of THI patients increased by 1022.853 ETB for each additional day of hospital length of stay (Standardized coefficient = 0.648, p < 0.001). Conclusion Most expenses of the THI were from direct non-medical cost. Prior health service use, length of stay, level of injury, and age were significant predictors of cost of THI.

scholarly journals Design and simulation of an equipment for the rehabilitation of people affected by ACV, starting from the subacute stage

2021 ◽  
Vol 12 (3) ◽  
pp. 25-37
Author(s):  
Yuly Jimena González Rodríguez ◽  
◽  
Geraldine Pulido Morales ◽  
Carlos Augusto Toledo Bueno ◽  
◽  
...  
Keyword(s):  
Physical Therapy ◽  
Rural Areas ◽  
Cerebrovascular Accident ◽  
The Body ◽  
Lower Limbs ◽  
Hospital Environment ◽  
High Importance ◽  
Subacute Stage ◽  
Intervening Factors

Cerebrovascular Accident (CVA) or stroke is a disease that results in paralysis of one side of the body. Physical therapy is generally used as a muscular rehabilitation tool that involves different techniques and exercises. For it to be effective, the process must be accompanied by the constancy and discipline with which the routines are performed, which are frequently limited to the hospital environment, causing an interruption in the development of recovery due to the absence of home mechanisms that facilitate its execution in a safe and complete manner. In Colombia, these aspects are enhanced by intervening factors such as: extensive travel from rural areas to care sites, accessibility to specialized centers, among others. That is why this article provides the proposal of an equipment that contributes to CVA rehabilitation from the subacute stage. The design and operation were developed and simulated through Solidworks 2018 Software, involving a series of exercises for upper and lower limbs considered by physiotherapists as of high importance in the treatment of the disease; it means, they can be executed by the patient under ergonomic and safety conditions.

PROVIDING MEDICAL CARE TO PATIENTS WITH BURNS IN AN EMERGENCY

2021 ◽  
pp. 56-59
Author(s):  
Г.А. Турсынбаева ◽  
У.Т. Багысбаева
Keyword(s):  
Medical Care ◽  
First Aid ◽  
The Body ◽  
Clinical Death ◽  
Chemical Burns ◽  
Significant Deterioration ◽  
Respiratory Disorders ◽  
Medical Evacuation ◽  
Reduction Of Mortality ◽  
The Cost

В данной статье рассмотрены основные действия при оказании медицинской помощи больным с ожогами на этапах медицинской эвакуации. Актуальность проблемы обусловлена тем, что своевременное оказание первой помощи пострадавшим предупреждает ухудшение состояния организма, что в значительной степени влияет на снижение летальности, инвалидности и сроков временной утраты трудоспособности больных и пострадавших, существенно снижает расходы на их лечение и реабилитацию [В.И. Хрупкин, 2000; Е.И. Бялик, 2001]. Особенное значение медицинская помощь на догоспитальном этапе приобретает при выраженных нарушениях кровообращения и дыхания, клинической смерти, кровотечении, переломах, термических и химических ожогах, когда неоказание помощи или запаздывание ее быстро приводит к значительному ухудшению состояния организма и даже смерти [В.А. Михайлович, А.Г. Мирошниченко, 2005; С.А. Сумин, 2005]. This article describes the main actions in providing medical care to patients with burns at the stages of medical evacuation. The urgency of the problem is due to the fact that timely first aid to victims prevents the deterioration of the body, which significantly affects the reduction of mortality, disability and the timing of temporary disability of patients and victims, significantly reduces the cost of their treatment and rehabilitation [V. I. Brilkin, 2000; E. I. Bialik, 2001]. Medical care at the prehospital stage is particularly important in cases of severe circulatory and respiratory disorders, clinical death, bleeding, fractures, thermal and chemical burns, when failure to provide assistance or its delay quickly leads to a significant deterioration of the body's condition and even death [V. A. Mikhailovich, A. G. Miroshnichenko, 2005; S. A. Sumin, 2005].

Aspergillus Spondylodiscitis After Spinal Stenosis Surgery: A Case Report

2020 ◽  
Vol 5 (3 And 4) ◽  
pp. 155-160
Author(s):  
Mohsen Aghapoor ◽  
◽  
Babak Alijani Alijani ◽  
Mahsa Pakseresht-Mogharab ◽  
◽  
...  
Keyword(s):  
Antifungal Drugs ◽  
The Body ◽  
Lower Limbs ◽  
Lumbar Pain ◽  
Case Presentation ◽  
Delay In Diagnosis ◽  
Death Case ◽  
Therapeutic Results ◽  
History Of ◽  
Probable Diagnosis

Background and Importance: Spondylodiscitis is an inflammatory disease of the body of one or more vertebrae and intervertebral disc. The fungal etiology of this disease is rare, particularly in patients without immunodeficiency. Delay in diagnosis and treatment of this disease can lead to complications and even death. Case Presentation: A 63-year-old diabetic female patient, who had a history of spinal surgery and complaining radicular lumbar pain in both lower limbs with a probable diagnosis of spondylodiscitis, underwent partial L2 and complete L3 and L4 corpectomy and fusion. As a result of pathology from tissue biopsy specimen, Aspergillus fungi were observed. There was no evidence of immunodeficiency in the patient. The patient was treated with Itraconazole 100 mg twice a day for two months. Pain, neurological symptom, and laboratory tests improved. Conclusion: The debridement surgery coupled with antifungal drugs can lead to the best therapeutic results.

The Experience in Organizing and Conducting the Analysis of Data on Nutrition of School-Aged Children in the Sverdlovsk Region within the Federal Public Health Promotion Project

2020 ◽  
pp. 10-17
Author(s):  
NA Moiseeva ◽  
IL Kholstinina ◽  
MF Knyazeva ◽  
TV Mazhaeva ◽  
OL Malykh ◽  
...  
Keyword(s):  
Public Health ◽  
Health Promotion ◽  
Rural Areas ◽  
Nutritional Value ◽  
School Meals ◽  
School Aged Children ◽  
Healthy Nutrition ◽  
Urban And Rural Areas ◽  
The Cost ◽  
Public Health Promotion

Introduction: Implementation of the Federal Public Health Promotion Project should raise awareness and develop skills of healthy nutrition in children, thus contributing to disease prevention. Our objective was to evaluate the results of pilot nutrition monitoring in school-aged children of the Sverdlovsk Region as part of the Federal Public Health Promotion Project and the National Demography Project. Results: We established that school meals were generally satisfactory: the rations complied with physiological needs of children in terms of their nutritional value, basic nutrients, energy, and distribution of calories by main meals. We noted differences in the cost and nutritional value of meals and the variety of dishes and foodstuffs used between urban and rural areas. As a rule, pupils have one or two school meals a day. Outside of school, their consumption of dairy products and fruit is limited. Conclusions: Our findings may promote the elaboration of municipal programs aimed, inter alia, at changing the amount of sugar and salt used in the manufacture of public catering products, the cost of dishes with a high content of sugar, saturated fats, and salt, and subsidies on healthy nutrition.

Correction of Posture Deviations in the Sagittal Plane Using the Pilates Method

2019 ◽  
pp. 3-13
Author(s):  
Alexandru Cîtea ◽  
George-Sebastian Iacob
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Postural Control ◽  
Human Body ◽  
Sagittal Plane ◽  
The Body ◽  
Lower Limbs ◽  
Low Back ◽  
Pilates Method ◽  
The Relationship

Posture is commonly perceived as the relationship between the segments of the human body upright. Certain parts of the body such as the cephalic extremity, neck, torso, upper and lower limbs are involved in the final posture of the body. Musculoskeletal instabilities and reduced postural control lead to the installation of nonstructural posture deviations in all 3 anatomical planes. When we talk about the sagittal plane, it was concluded that there are 4 main types of posture deviation: hyperlordotic posture, kyphotic posture, rectitude and "sway-back" posture.Pilates method has become in the last decade a much more popular formof exercise used in rehabilitation. The Pilates method is frequently prescribed to people with low back pain due to their orientation on the stabilizing muscles of the pelvis. Pilates exercise is thus theorized to help reactivate the muscles and, by doingso, increases lumbar support, reduces pain, and improves body alignment.

scholarly journals The failure of community-based health insurance schemes in Tanzania: opening the black box of the implementation process

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ramadhani Kigume ◽  
Stephen Maluka
Keyword(s):  
Health Insurance ◽  
Community Health ◽  
Rural Areas ◽  
Health Coverage ◽  
Access To Health Services ◽  
Community Based ◽  
Community Based Health Insurance ◽  
Urban Districts ◽  
Health Fund ◽  
The Government

Abstract Background Globally, there is increased advocacy for community-based health insurance (CBHI) schemes. Like other low and middle-income countries (LMICs), Tanzania officially established the Community Health Fund (CHF) in 2001 for rural areas; and Tiba Kwa Kadi (TIKA) for urban population since 2009. This study investigated the implementation of TIKA scheme in urban districts of Tanzania. Methods A descriptive qualitative case study was conducted in four urban districts in Tanzania in 2019. Data were collected using semi-structured interviews, focus group discussions and review of documents. A thematic approach was used to analyse the data. Results While TIKA scheme was important in increasing access to health services for the poor and other disadvantaged groups, it faced many challenges which hindered its performance. The challenges included frequent stock-out of drugs and medical supplies, which frustrated TIKA members and hence contributed to non-renewal of membership. In addition, the scheme was affected by poor collections and management of the revenue collected from TIKA members, limited benefit packages and low awareness of the community. Conclusions Similar to rural-based Community Health Fund, the TIKA scheme faced structural and operational challenges which subsequently resulted into low uptake of the schemes. In order to achieve universal health coverage, the government should consider integrating or merging Community-Based Health Insurance schemes into a single national pool with decentralised arms to win national support while also maintaining local accountability.

scholarly journals Urban Sustainability at the Cost of Rural Unsustainability

2021 ◽  
Vol 13 (10) ◽  
pp. 5466
Author(s):  
Guangwei Huang
Keyword(s):  
Urban Sprawl ◽  
Rural Areas ◽  
Urban Sustainability ◽  
Negative Externalities ◽  
Large Cities ◽  
Rural Sustainability ◽  
Use Of Resources ◽  
The Cost ◽  
New Framework ◽  
Japan And China

Urban sustainability refers to building and maintaining cities that can continue to function without running out of resources. However, growing cities require more land and urban sprawl has transformed surrounding rural areas into urbanized settlements. Furthermore, the prosperity of large cities depends on the supply of both natural and human resources from rural areas, either nearby or remote. On the other hand, the use of resources of rural areas by cities may cause negative externalities to rural areas, affecting their sustainability. Therefore, a critical, but very much neglected issue, is how unban sustainability should be pursued without affecting rural sustainability. In this study, cases in Japan and China were analyzed from resources and population migration perspectives to provide evidence for the possibility that urban sustainability might have been pursued at the cost of rural unsustainability. It was intended to develop a better understanding of urban sustainability through the lens of externalities. Based on the analysis, a new framework for urban sustainability study was proposed, which consists of three new pillars. Namely, externality, vulnerability, and population instability.

scholarly journals Development of unmanned aerial vehicle (UAV) networks delivering early defibrillation for out-of-hospital cardiac arrests (OHCA) in areas lacking timely access to emergency medical services (EMS) in Germany: a comparative economic study

BMJ Open ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. e043791
Author(s):  
Jan Bauer ◽  
Dieter Moormann ◽  
Reinhard Strametz ◽  
David A Groneberg
Keyword(s):  
Cost Effectiveness ◽  
Emergency Medical Services ◽  
Rural Areas ◽  
Medical Services ◽  
Secondary Outcome ◽  
Annual Average ◽  
Emergency Medical ◽  
Life Years ◽  
Timely Access ◽  
The Cost

ObjectivesThis study wants to assess the cost-effectiveness of unmanned aerial vehicles (UAV) equipped with automated external defibrillators (AED) in out-of-hospital cardiac arrests (OHCA). Especially in rural areas with longer response times of emergency medical services (EMS) early lay defibrillation could lead to a significant higher survival in OHCA.Participants3296 emergency medical stations in Germany.SettingRural areas in Germany.Primary and secondary outcome measuresThree UAV networks providing 80%, 90% or 100% coverage for rural areas lacking timely access to EMS (ie, time-to-defibrillation: >10 min) were developed using a location allocation analysis. For each UAV network, primary outcome was the cost-effectiveness using the incremental cost-effectiveness ratio (ICER) calculated by the ratio of financial costs to additional life years gained compared with current EMS.ResultsCurrent EMS with 3926 emergency stations was able to gain 1224 life years on annual average in the study area. The UAV network providing 100% coverage consisted of 1933 UAV with average annual costs of €43.5 million and 1845 additional life years gained on annual average (ICER: €23 568). The UAV network providing 90% coverage consisted of 1074 UAV with average annual costs of €24.2 million and 1661 additional life years gained on annual average (ICER: €14 548). The UAV network providing 80% coverage consisted of 798 UAV with average annual costs of €18.0 million and 1477 additional life years gained on annual average (ICER: €12 158).ConclusionThese results reveal the relevant life-saving potential of all modelled UAV networks. Furthermore, all analysed UAV networks could be deemed cost-effective. However, real-life applications are needed to validate the findings.

scholarly journals A Feasibility Study of Kinematic Characteristics on the Upper Body According to the Shooting of Elite Disabled Archery Athletes

2021 ◽  
Vol 18 (6) ◽  
pp. 2962
Author(s):  
Tae-Whan Kim ◽  
Jae-Won Lee ◽  
Seoung-Ki Kang ◽  
Kyu-Yeon Chae ◽  
Sang-Hyup Choi ◽  
...  
Keyword(s):  
The Body ◽  
Lower Limbs ◽  
Upper Body ◽  
Movement Trajectory ◽  
Phase 2 ◽  
Kinematic Characteristics ◽  
Significant Difference ◽  
Athletes With Disabilities ◽  
Body Center ◽  
Time Required

The purpose of this study is to compare and analyze the kinematic characteristics of the upper limb segments during the archery shooting of Paralympic Wheelchair Class archers (ARW2—second wheelchair class—paraplegia or comparable disability) and Paralympic Standing Class archers (ARST—standing archery class—loss of 25 points in the upper limbs or lower limbs), where archers are classified according to their disability grade among elite disabled archers. The participants of this study were selected as seven elite athletes with disabilities by the ARW2 (n = 4) and ARST (n = 3). The analysis variables were (1) the time required for each phase, (2) the angle of inclination of the body center, (3) the change of trajectory of body center, and (4) the change of the movement trajectory of the bow center by phase when performing six shots in total. The ARW2 group (drawing phase; M = 2.228 s, p < 0.05, holding phase; M = 4.414 s, p < 0.05) showed a longer time than the ARST group (drawing phase; M = 0.985 s, holding phase; M = 3.042 s), and the angle of the body did not show a significant difference between the two groups. Additionally, in the direction of the anteroposterior axis in the drawing phase, the change in the movement trajectory of the body center showed a more significant amount of change in the ARW2 group than in the ARST group, and the change in the movement trajectory of the bow center did not show a significant difference between the two groups.

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