scholarly journals Medical practitioner’s knowledge on dengue management and clinical practices in Bhutan

PLoS ONE ◽  
2021 ◽  
Vol 16 (7) ◽  
pp. e0254369
Author(s):  
Tsheten Tsheten ◽  
Archie C. A. Clements ◽  
Darren J. Gray ◽  
Kinley Gyeltshen ◽  
Kinley Wangdi
Keyword(s):  
Clinical Management ◽  
Management Practices ◽  
Health Workers ◽  
Public Health Problem ◽  
Fluid Replacement ◽  
Severe Dengue ◽  
Warning Sign ◽  
Major Public Health Problem ◽  
Clinical Practices ◽  
Health Council

Background Dengue has emerged as a major public health problem in Bhutan, with increasing incidence and widening geographic spread over recent years. This study aimed to investigate the knowledge and clinical management of dengue among medical practitioners in Bhutan. Methods We administered a survey questionnaire to all practitioners currently registered under the Bhutan Medical and Health Council. The questionnaire contained items on four domains including transmission, clinical course and presentation, diagnosis and management, and surveillance and prevention of dengue. Participants were able to respond using an online Qualtrics survey, with the invitation and link distributed via email. Results A total of 97 respondents were included in the study (response rate: 12.7%), of which 61.86% were Health Assistants/Clinical Officers (HAs/COs) and 38.14% were medical doctors. The afternoon feeding behaviour of Aedes mosquito was correctly identified by only 24.7% of the respondents, and ~66.0% of them failed to identify lethargy as a warning sign for severe dengue. Knowledge on diagnosis using NS1 antigen and the clinical significance of elevated haematocrit for initial fluid replacement was strikingly low at 47.4% and 27.8% respectively. Despite dengue being a nationally notifiable disease, ~60% of respondents were not knowledgeable on the timing and type of cases to be reported. Respondent’s median score was higher for the surveillance and reporting domain, followed by their knowledge on transmission of dengue. Statistically significant factors associated with higher knowledge included respondents being a medical doctor, working in a hospital and experience of having diagnosed dengue. Conclusion The study revealed major gaps on knowledge and clinical management practices related to dengue in Bhutan. Physicians and health workers working in Basic Health Units need training and regular supervision to improve their knowledge on the care of dengue patients.

Eliminating Hepatitis B from Bangladesh by the Year 2030

2020 ◽  
Vol 38 (3) ◽  
pp. 145-149
Author(s):  
Md Golam Mustafa ◽  
Md Shahinul Alam ◽  
Md Golam Azam ◽  
Md Mahabubul Alam ◽  
Md Saiful Islam ◽  
...  
Keyword(s):  
Hepatitis B ◽  
Health Workers ◽  
Health Sector ◽  
Public Health Problem ◽  
Integrated System ◽  
Hbv Infection ◽  
Diagnosis And Treatment ◽  
Major Public Health Problem ◽  
Medical Institutions ◽  
The Government

Worldwide, hepatitis B virus (HBV) infection is still a major public health problem. Bangladesh having a large burden of HBV infection, should be a major contributor towards it’s elimination by 2030. The country has been making progress in reducing incidence of HBV infection during the past decades. The progresses are mainly due to large vaccination coverage among children and large coverage of timely birthdose vaccine for prevention of mother-to-child transmission of HBV. However, Bangladesh still faces challenges in achieving target of reduction in mortality from HBV. On the basis of targets of the WHO’s Global health sector strategy on viral hepatitis 2016–2021, we highlight priorities for action towards HBV elimination. To attain the target of reduced mortality we propose that, the service coverage targets of diagnosis and treatment should be prioritized along with vaccination. Firstly, improvements are needed in the diagnostic and treatment abilities of medical institutions and health workers. Secondly, the government needs to reduce the costs of health care. Thirdly, better coordination is needed across existing national program and resources to establish an integrated system for prevention, screening, diagnosis and treatment of HBV infection. In this way, we can make progress towards achieving the target of eliminating HBV from Bangladesh by 2030 J Bangladesh Coll Phys Surg 2020; 38(3): 145-149

Severity and costs associated with hospitalization for dengue in public and private hospitals of Surat city, Gujarat, India, 2017–2018

2019 ◽  
Vol 113 (11) ◽  
pp. 661-669 ◽  
Author(s):  
Viral R Bajwala ◽  
Denny John ◽  
T Daniel Rajasekar ◽  
Manoj V Murhekar
Keyword(s):  
Urban Areas ◽  
Tertiary Care ◽  
Public Health Problem ◽  
Warning Signs ◽  
World Health ◽  
Severe Dengue ◽  
Major Public Health Problem ◽  
Private Hospitals ◽  
Government Hospitals ◽  
The Cost

Abstract Background Dengue is major public health problem in India, especially in urban areas. We conducted a study to estimate the severity and costs of treatment among hospitalized dengue patients in Surat city, Gujarat, India. Methods We reviewed the medical records of dengue patients hospitalized in five tertiary care facilities (private [n=2], semi-government [n=2] and government [n=1]) between April 2017 and March 2018. We used the World Health Organization 2009 classification to classify the severity of dengue. A resource utilization approach was used to estimate the cost of illness in US dollars (US$) (inflation adjusted to 2018) from a quasi-societal perspective (excluding non-medical cost) for dengue hospitalization. Results Of the 732 hospitalized dengue patients, 44.7% had no warning symptoms, 39.5% had warning signs and 15.8% had severe dengue. The mean cost of hospitalization was US$86.9±170.7. The cost of hospitalization was 28.8 times higher in private hospitals compared with government hospitals. Consultant charges in private hospitals, laboratory investigations in semi-government hospitals and registration with admission charges in government hospitals accounted for 27.3%, 39.4% and 53% of the direct cost in these facilities, respectively. Conclusions A better triage system for hospitalization, subsidizing costs in the public sector and cost capping in the private sector can help to reduce the cost of hospitalization due to dengue so as to ensure affordability for larger portion of the society for universal health coverage.

scholarly journals Diagnostic, Prognostic, and Therapeutic Value of Circulating miRNAs in Heart Failure Patients Associated with Oxidative Stress

2016 ◽  
Vol 2016 ◽  
pp. 1-13 ◽  
Author(s):  
Md Sayed Ali Sheikh ◽  
Umme Salma ◽  
Baohai Zhang ◽  
Jimei Chen ◽  
Jian Zhuang ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Heart Failure ◽  
Brain Natriuretic Peptide ◽  
Natriuretic Peptide ◽  
Clinical Management ◽  
Treatment Strategies ◽  
Public Health Problem ◽  
Major Public Health Problem ◽  
Circulating Mirnas ◽  
Heart Failure Patients

Heart failure is a major public health problem especially in the aging population (≥65 years old), affecting nearly 5 million Americans and 15 million European people. Effective management of heart failure (HF) depends on a correct and rapid diagnosis. Presently, BNP (brain natriuretic peptide) or N-terminal pro-brain natriuretic peptide (NT-proBNP) assay is generally accepted by the international community for diagnostic evaluation and risk stratification of patients with HF. However, regardless of its widespread clinical use, BNP is still encumbered by reduced specificity. As a result, diagnosis of heart failure remains challenging. Although significant improvement happened in the clinical management of HF over the last 2 decades, traditional treatments are ultimately ineffective in many patients who progress to advanced HF. Therefore, a novel diagnostic, prognostic biomarker and new therapeutic approach are required for clinical management of HF patients. Circulating miRNAs seem to be the right choice for novel noninvasive biomarkers as well as new treatment strategies for HF. In this review, we briefly discuss the diagnostic, prognostic, and therapeutic role of circulating miRNAs in heart failure patients. We also mentioned our own technique of extraction of RNA and detection of circulating miRNAs from human plasma and oxidative stress associated miRNAs with HF.

scholarly journals Assessment of Public Health Units’ Capacity to Manage Under-Five Malnutrition: A Case Study of Kamuli District, Uganda

2018 ◽  
Vol 3 (3) ◽  
pp. 100
Author(s):  
Benon Musasizi ◽  
Elizabeth Ekirapa Kiracho ◽  
Saul Kamukama ◽  
Geoffrey Babughirana
Keyword(s):  
Public Health ◽  
Human Resource Development ◽  
Quantitative Methods ◽  
Health Workers ◽  
Public Health Problem ◽  
Building Blocks ◽  
Health Facilities ◽  
Major Public Health Problem ◽  
Cross Sectional ◽  
Under Five

Malnutrition is a major public-health problem throughout the developing world and is an underlying factor in over 50% of the 10-11 million children under 5 years of age who die each year of preventable causes. Uganda loses US$310 million worth of productivity per year due to the high levels of stunting, iodine-deficiency disorders, iron deficiency, low birth weight, and malnutrition contributes to a loss of about 4.1% of the gross domestic product per year. This paper provides the findings of an assessment conducted in Kamuli district to determine the capacity of public health units to manage under-five malnutrition focusing on the six building blocks of the health system. This was a descriptive cross sectional study that employed both qualitative and quantitative methods of data collection, analysis and presentation. This involved interviewing health workers using a semi structured questionnaire and checklist for health facilities. Supplement qualitative data was collected using key informant interviews (KIIs). Results indicate that the capacity of health facilities to manage under-five malnutrition in Kamuli district was found to be low at 36.6% only. Capacity of health facilities was based on; Nutrition leadership and human resource development, health worker knowledge, availability of equipment and supplies, physical infrastructure, availability of infant and young child nutrition policy guidelines and planning and budgeting at health facility level.

scholarly journals An Overview of Pain Management

2005 ◽  
Vol 91 (2) ◽  
pp. 20-30
Author(s):  
June L. Dahl
Keyword(s):  
Pain Management ◽  
Pain Assessment ◽  
Management Practices ◽  
Public Health Problem ◽  
The United States ◽  
Basic Knowledge ◽  
Rational Approach ◽  
Major Public Health Problem ◽  
Pharmacologic Treatments ◽  
Control Pain

ABSTRACT In spite of major advances in pain management practices, the undertreatment of pain remains a major public health problem in the United States. A basic knowledge of pain assessment and management is critical to removing the barriers that are responsible for poor pain control. Pain assessment is the essential first step in the management of any type of pain as it guides the development of a rational approach to treatment. Pharmacologic therapies are often essential to successful pain management. Three major classes of pain medications are available: non-opioids, opioids, and adjuvant analgesics for special pain problems. This paper provides an overview of the various drugs in each of these classes as well as recommendations to guide their use. The goal of therapy is to reduce pain and improve function. A comprehensive approach to pain management should be based on the use of multimodal therapy, rational combinations of pharmacologic and non-pharmacologic treatments.

scholarly journals Clinical management of cUTI, cIAI, and HABP/VABP attributable to carbapenem-resistant Gram-negative infections in Spain

2021 ◽  
Author(s):  
Ricard Ferrer ◽  
María Carmen Fariñas ◽  
Emilio Maseda ◽  
Miguel Salavert ◽  
German Bou ◽  
...  
Keyword(s):  
Clinical Management ◽  
Bacterial Pneumonia ◽  
Chart Review ◽  
Complicated Urinary Tract Infection ◽  
Public Health Problem ◽  
Major Public Health Problem ◽  
Post Discharge ◽  
Gram Negative ◽  
Carbapenem Resistant ◽  
Healthcare Associated

Introduction. Carbapenem-resistant Gram-negative (CRGN) infections are a major public health problem in Spain, often implicated in complicated, healthcare-associated infections that require the use of potentially toxic antibacterial agents of last resort. The objective of this study was to assess the clinical management of complicated infections caused by CRGN bacteria in Spanish hospitals. Methods. The study included: 1) a survey assessing the GN infection and antibacterial susceptibility profile in five participating Spanish hospitals and 2) a non-interventional, retrospective single cohort chart review of 100 patients with complicated urinary tract infection (cUTI), complicated intra-abdominal infection (cIAI), or hospital-acquired bacterial pneumonia/ventilator-associated bacterial pneumonia (HABP/VABP) attributable to CRGN pathogens. Results. In the participating hospitals CRGN prevalence was 9.3% amongst complicated infections. In the retrospective cohort, 92% of infections were healthcare-associated, and Klebsiella pneumoniae and Pseudomonas aeruginosa were the most common pathogens. OXA was the most frequently detected carbapenemase type (71.4%). We found that carbapenems were frequently used to treat cUTI, cIAI, HABP/VABP caused by CRGN pathogens. Carbapenem use, particularly in combination with other agents, persisted after confirmation of carbapenem resistance. Clinical cure was 66.0%, mortality during hospitalization 35.0%, mortality at the time of chart review 62.0%, and 6-months-post-discharge readmission 47.7%. Conclusion. Our results reflect the high burden and unmet needs associated with the management of complicated infections attributable to CRGN pathogens in Spain and highlight the urgent need for enhanced clinical management of these difficult-to-treat infections.

scholarly journals Dengue Fever in Pregnancy Mimicking Obstetric Hemorrhage

2011 ◽  
Vol 3 (1) ◽  
pp. 40-41
Author(s):  
Meghana Narendrabhai Mehta ◽  
Jitesh Mafatlal Shah ◽  
Ashvin Dayalal Vachhani ◽  
Archish Ishvarbhai Desai
Keyword(s):  
Dengue Fever ◽  
Rna Virus ◽  
Vital Signs ◽  
Public Health Problem ◽  
Fetal Distress ◽  
Fluid Replacement ◽  
Intrauterine Fetal Death ◽  
Major Public Health Problem ◽  
Maternal Complications ◽  
Fetal Complications

ABSTRACT Dengue is a major public health problem in the tropical and subtropical area. Dengue fever is caused by one of the four dengue virus serotypes of the genus Flavivirus, family flaviviridae, RNA virus.1-3 Dengue is transmitted to humans by the mosquito Aedes aegypti. The principal maternal complications are abortion, premature labor, retroplacental hematoma leading to antepartum hemorrhage and hemorrhage during and after delivery. Fetal complications are prematurity, intrauterine fetal death (IUFD), acute fetal distress in labor, maternal-fetal (vertical) transmission and neonatal death. Management of dengue fever is conservative with intravenous fluid replacement and close observation of vital signs and bleeding.

scholarly journals Attitudes and Practices in the Prevention of Purulent Ophthalmia Neonatal in Senegalese Hospital

2020 ◽  
Vol 4 (2) ◽  
Keyword(s):  
Health Workers ◽  
Public Health Problem ◽  
World Health ◽  
Major Public Health Problem ◽  
Eye Drops ◽  
Eye Care ◽  
Attitudes And Practices ◽  
Care Workers ◽  
Multicenter Prospective Study ◽  
Health Organization

Introduction: Ophthalmia or neonatal conjunctivitis is a major public health problem in developing countries. Recommendations have been issued by the World Health Organization (WHO) and the Ministry of Health of Senegal for the prevention of this scourge. The objective of the work was to assess the level of knowledge and practice of these recommendations by health workers. Methodology: This was a multicenter, prospective study conducted from March 1st to June 30th, 2013 in nine (9) health structures at the four (4) districts of Dakar. All agents who performed care at birth were included. Results: We interviewed 108 health care workers in the nine targeted structures. More than half of the respondents (54.6%) interviewed were in a maternity ward with midwives (41.7%) who were clearly in the majority. As far as knowledge is concerned, the practice of neonatal eye care was systematic for 88% of the nursing staff at birth. Regarding attitudes and practices, the majority of caregivers cleaned (67.6%) the eyes before instillation of eye drops. More than eighty-four percent (84.3%) of the caregivers surveyed routinely practiced eye care in the newborn at birth. The majority of the agents prescribed Rifamycin (47.2%) as a single dose in each eye. Paediatricians recommended one day of treatment while midwives and general practitioners recommended 7 days. Conclusion: Overall, the recommendations are not well implemented by caregivers. It would then be necessary to improve the level of information for harmonization and application of the recommendations.

Trend and Predictive Analytics of Dengue Prevalence in Administrative Region

2020 ◽  
pp. 236-262
Author(s):  
Kannimuthu Subramanian ◽  
Swathypriyadharsini P. ◽  
Gunavathi C. ◽  
Premalatha K.
Keyword(s):  
Machine Learning ◽  
Urban Areas ◽  
Goodness Of Fit ◽  
Predictive Analytics ◽  
Learning Algorithms ◽  
Public Health Problem ◽  
Viral Disease ◽  
Machine Learning Algorithms ◽  
Severe Dengue ◽  
Major Public Health Problem

Dengue is fast emerging pandemic-prone viral disease in many parts of the world. Dengue flourishes in urban areas, suburbs, and the countryside, but also affects more affluent neighborhoods in tropical and subtropical countries. Dengue is a mosquito-borne viral infection causing a severe flu-like illness and sometimes causing a potentially deadly complication called severe dengue. It is a major public health problem in India. Accurate and timely forecasts of dengue incidence in India are still lacking. In this chapter, the state-of-the-art machine learning algorithms are used to develop an accurate predictive model of dengue. Several machine learning algorithms are used as candidate models to predict dengue incidence. Performance and goodness of fit of the models were assessed, and it is found that the optimized SVR gives minimal RMSE 0.25. The classifiers are applied, and experiment results show that the extreme boost and random forest gives 93.65% accuracy.

scholarly journals Clinical Manifestations and Distribution of Cutaneous Leishmaniasis in Pakistan

2011 ◽  
Vol 2011 ◽  
pp. 1-8 ◽  
Author(s):  
Abaseen Khan Afghan ◽  
Masoom Kassi ◽  
Pashtoon Murtaza Kasi ◽  
Adil Ayub ◽  
Niamatullah Kakar ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Cutaneous Leishmaniasis ◽  
Primary Care Physicians ◽  
Health Workers ◽  
Clinical Manifestations ◽  
Public Health Problem ◽  
Skin Lesions ◽  
Major Public Health Problem ◽  
Local Health

Cutaneous leishmaniasis (CL) is a rising epidemic in Pakistan. It is a major public health problem in the country especially alongside regions bordering the neighboring Afghanistan and cities that have had the maximum influx of refugees. The purpose of our paper is to highlight the diverse clinical manifestations of the disease seen along with the geographic areas affected, where the hosts are particularly susceptible. This would also be helpful in presenting the broad spectrum of the disease for training of health care workers and help in surveillance of CL in the region. The increased clinical diversity and the spectrum of phenotypic manifestations noted underscore the fact that the diagnosis of CL should be not only considered when dealing with common skin lesions, but also highly suspected by dermatologists and even primary care physicians even when encountering uncommon pathologies. Hence, we would strongly advocate that since most of these patients present to local health care centers and hospitals, primary care practitioners and even lady health workers (LHWs) should be trained in identification of at least the common presentations of CL.

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