A REVIEW ON GLOBAL TRENDS IN HEART FAILURE AND EVOLUTION OF ANGIOTENSIN–NEPRILYSIN INHIBITOR

2020 ◽  
pp. 32-37
Author(s):  
VEERENDRA UPPARA ◽  
SAISEKHAR KODIVANDLA ◽  
ASHIK ALI SHAIK
Keyword(s):  
Heart Failure ◽  
Public Health Problem ◽  
Global Public Health ◽  
Middle Income ◽  
Global Trends ◽  
Middle Income Countries ◽  
Health Loss ◽  
Neprilysin Inhibitor ◽  
Health Related ◽  
Global Public Health Problem

Heart failure (HF) is a major global public health problem irrespective of its causes. It generates an enormous clinical, societal, and economic, health loss burden with an increase in its prevalence reaching an epidemic proportion. The morbidity and mortality associated with heart failure are increasing the health-related burdens worldwide, especially in low- and middle-income countries. This review highlights the trends in HF burden, the clinical spectrum of HF, and the importance of neurohormonal pathways and the evolution of angiotensin receptor neprilysin inhibition in HF with updated clinical practice guidelines.

Suicide among refugees

2021 ◽  
pp. 543-552
Author(s):  
Lakshmi Vijayakumar ◽  
Sujit John ◽  
A.T. Jotheeswaran
Keyword(s):  
Economic Status ◽  
Public Health Problem ◽  
Healthcare Systems ◽  
Global Public Health ◽  
Middle Income ◽  
Middle Income Countries ◽  
Socio Economic Status ◽  
Scant Attention ◽  
Exposure To Trauma ◽  
Global Public Health Problem

Suicide is a global public health problem, with the majority of suicides occurring in low- and middle-income countries. The UNHCR reported that in 2017 there were 25.4 million refugees, with the majority (85%) being hosted by developing countries, which have limited infrastructure, healthcare systems, and are often politically and economically unstable. A review of suicidal behaviour among refugees reveals a prevalence of 3.4–40%. Female sex, higher education and socio-economic status, exposure to trauma, presence of psychological disorders, long stay in detention centres, and rejection of asylum status are associated with increased suicidal risk. Globally, data for rates of suicide among refugee groups are not available and any interventions to reduce suicide among refugees have received scant attention. A theoretical model for understanding suicide risk in refugees is proposed in this chapter and the possible interventions discussed.

scholarly journals Clinical profile of patients with post burn contracture

2018 ◽  
Vol 6 (1) ◽  
pp. 126
Author(s):  
Arnav Tyagi ◽  
Manu Rajan ◽  
Sanjay Dvivedi ◽  
Kinnari A. V. Rawat
Keyword(s):  
Public Health Problem ◽  
Global Public Health ◽  
Medical Sciences ◽  
Middle Income ◽  
Middle Income Countries ◽  
Burn Care ◽  
High Incidence ◽  
East Asia Region ◽  
Flame Burn ◽  
Global Public Health Problem

Background: Burns are a major, global public health problem, resulting in an estimated 195,000 deaths annually. Most burns occur in low-and middle-income countries, with almost half occurring in the south-east Asia region. The reasons for the high incidence include widespread ignorance of fire prevention, the rapid increase of poor socio-economic conditions, and the persistence of old traditions and customs.Methods: The study was carried out in Department of Surgery, Himalayan Institute of Medical Sciences, SRH University, Swami Ram Nagar, Dehradun over a period of 12months. Cases of the post burn contractures attended in the O.P.D were included in the study.Results: A total of 45 patients were included in the study. Of these, 22 (48.8%) were males and 23 (51.2%) were females. Ages ranged from 1 to 55year. Flame burn (20 cases = 44.4%) was the most common type of initial burn insult followed by scald burns (14 cases=31.1%).Conclusions: The pitfalls in initial burn care that lead to contractures in the patients include the failure to institute adequate surgical management of deep burns, the lack of physiotherapy/ROM exercises, and failure to provide proper anti-deformity splint age. There is need to revisit the prevalent acute burn care practices and establish focused preventive strategies.

scholarly journals Antibiotic Dispensation without a Prescription Worldwide: A Systematic Review

Antibiotics ◽  
2020 ◽  
Vol 9 (11) ◽  
pp. 786
Author(s):  
Ana Daniela Batista ◽  
Daniela A. Rodrigues ◽  
Adolfo Figueiras ◽  
Maruxa Zapata-Cachafeiro ◽  
Fátima Roque ◽  
...  
Keyword(s):  
Public Health Problem ◽  
Community Pharmacies ◽  
Global Public Health ◽  
Middle Income ◽  
Middle Income Countries ◽  
Development Of Resistance ◽  
Amoxicillin Clavulanic Acid ◽  
Tract Infections ◽  
Administrative Strategies ◽  
Global Public Health Problem

Antibiotic resistance still remains a major global public health problem and the dispensing of antibiotics without a prescription at community pharmacies is an important driver of this. MEDLINE, Pubmed and EMBASE databases were used to search and identify studies reporting the dispensing of non-prescribed antibiotics in community pharmacies or drugstores that sell drugs for human use, by applying pharmacy interviews/questionnaires methods and/or simulated patient methods. Of the 4683 studies retrieved, 85 were included, of which 59 (69.4%) were published in low-and middle-income countries. Most of the papers (83.3%) presented a percentage of antibiotic dispensing without a prescription above 60.0%. Sixty-one studies evaluated the active substance and the most sold antibiotics without a prescription were amoxicillin (86.9%), azithromycin (39.3%), ciprofloxacin (39.3%), and amoxicillin-clavulanic acid (39.3%). Among the 65 articles referencing the diseases/symptoms, this practice was shown to be mostly associated with respiratory system problems (100.0%), diarrhea (40.0%), and Urinary Tract Infections (30.8%). In sum, antibiotics are frequently dispensed without a prescription in many countries and can thus have an important impact on the development of resistance at a global level. Our results indicate the high need to implement educational and/or regulatory/administrative strategies in most countries, aiming to reduce this practice.

scholarly journals Affordability and Availability of Child Restraints in an Under-Served Population in South Africa

2020 ◽  
Vol 17 (6) ◽  
pp. 1979 ◽  
Author(s):  
Prasanthi Puvanachandra ◽  
Aliasgher Janmohammed ◽  
Pumla Mtambeka ◽  
Megan Prinsloo ◽  
Sebastian Van As ◽  
...  
Keyword(s):  
South Africa ◽  
Road Traffic ◽  
Public Health Problem ◽  
Global Public Health ◽  
Injury Death ◽  
Middle Income ◽  
Suitable Alternative ◽  
Middle Income Countries ◽  
Restraint Use ◽  
Child Restraint

Background: Child road traffic injuries are a major global public health problem and the issue is particularly burdensome in middle-income countries such as South Africa where injury death rates are 41 per 100,000 for under 5′s and 24.5 per 100,000 for 5–14-year-old. Despite their known effectiveness in reducing injuries amongst children, the rates of use of child restraint systems (CRS) remains low in South Africa. Little is known about barriers to child restraint use especially in low- and middle-income countries. Methods: We carried out observation studies and parent/carer surveys in 7 suburbs of Cape Town over a three month period to assess usage rates and explore the knowledge and perceptions of parents towards child restraint legislation, ownership and cost; Results: Only 7.8% of child passengers were observed to be properly restrained in a CRS with driver seatbelt use and single child occupancy being associated with higher child restraint use. 92% of survey respondents claimed to have knowledge of current child restraint legislation, however, only 32% of those parents/carers were able to correctly identify the age requirements and penalty. Reasons given for not owning a child seat included high cost and the belief that seatbelts were a suitable alternative. Conclusions: These findings indicate the need for a tighter legislation with an increased fine paired with enhanced enforcement of both adult seatbelt and child restraint use. The provision of low-cost/subsidised CRS or borrowing schemes and targeted social marketing through online fora, well baby clinics, early learning centres would be beneficial in increasing ownership and use of CRS.

scholarly journals Establishment of a road traffic trauma registry for northern Sri Lanka

2020 ◽  
Vol 5 (1) ◽  
pp. e001818 ◽  
Author(s):  
Thayasivam Gobyshanger ◽  
Alison M Bales ◽  
Claire Hardman ◽  
Mary McCarthy
Keyword(s):  
Sri Lanka ◽  
Low Income ◽  
Trauma Registry ◽  
Road Traffic ◽  
Prehospital Care ◽  
Public Health Problem ◽  
Global Public Health ◽  
Middle Income ◽  
Road Traffic Crashes ◽  
Middle Income Countries

Road traffic injuries are a neglected global public health problem. Over 1.25 million people are killed each year, and middle-income countries, which are motorising rapidly, are the hardest hit. Sri Lanka is dealing with an injury-related healthcare crisis, with a recent 85% increase in road traffic fatality rates. Road traffic crashes now account for 25 000 injuries annually and 10 deaths daily. Development of a trauma registry is the foundation for injury control, care and prevention. Five northern Sri Lankan provinces collaborated with Jaffna Teaching Hospital to develop a local electronic registry. The Centre for Clinical Excellence and Research was established to provide organisational leadership, hardware and software were purchased, and data collectors trained. Initial data collection was modified after implementation challenges were resolved. Between 1 June 2017 and 30 September 2017, 1708 injured patients were entered into the registry. Among these patients, 62% were male, 76% were aged 21–50, 71.3% were motorcyclists and 34% were in a collision with another motorcyclist. There were frequent collisions with uncontrolled livestock (12%) and with fixed objects (14%), and most patients were transported by private vehicles without prehospital care. Head (n=315) and lower extremity (n=497) injuries predominated. Establishment of a trauma registry in low-income and middle-income countries is a significant challenge and requires invested local leadership; the most challenging issue is ongoing funding. However, this pilot registry provides a valuable foundation, identifying unique injury mechanisms, establishing priorities for prevention and patient care, and introducing the concept of an organised system to this region.

scholarly journals Chronic heart failure: New challenges and new perspectives

2017 ◽  
Vol 89 (9) ◽  
pp. 4-9 ◽  
Author(s):  
S N Tereshchenko ◽  
I V Zhirov
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Poor Prognosis ◽  
Public Health Problem ◽  
Global Public Health ◽  
Readmission Rates ◽  
Patients With Heart Failure ◽  
Specialized Service ◽  
New Challenges ◽  
Global Public Health Problem

Chronic heart failure is an important global public health problem. This is associated with extremely poor prognosis, high readmission rates, and substantial treatment costs in patients. The paper gives the main aspects of the setting-up of a specialized service to patients with heart failure.

scholarly journals A comparison of publication to TBI burden ratio of low- and middle-income countries versus high-income countries: how can we improve worldwide care of TBI?

2019 ◽  
Vol 47 (5) ◽  
pp. E5 ◽  
Author(s):  
Maria Pia Tropeano ◽  
Riccardo Spaggiari ◽  
Hernán Ileyassoff ◽  
Kee B. Park ◽  
Angelos G. Kolias ◽  
...  
Keyword(s):  
Eastern Mediterranean ◽  
Eastern Mediterranean Region ◽  
Volume Ratio ◽  
Public Health Problem ◽  
Global Public Health ◽  
African Region ◽  
Middle Income ◽  
Middle Income Countries ◽  
Pubmed Database ◽  
Low And Middle Income

OBJECTIVETraumatic brain injury (TBI) is a global public health problem and more than 70% of trauma-related deaths are estimated to occur in low- and middle-income countries (LMICs). Nevertheless, there is a consistent lack of data from these countries. The aim of this work is to estimate the capacity of different and heterogeneous areas of the world to report and publish data on TBI. In addition, we wanted to estimate the countries with the highest and lowest number of publications when taking into account the relative TBI burden.METHODSFirst, a bibliometric analysis of all the publications about TBI available in the PubMed database from January 1, 2008, to December 31, 2018, was performed. These data were tabulated by country and grouped according to each geographical region as indicated by the WHO: African Region (AFR), Region of the Americas (PAH), South-East Asia Region (SEAR), European Region (EUR), Eastern Mediterranean Region (EMR), and Western Pacific Region (WPR). In this analysis, PAH was further subdivided into Latin America (AMR-L) and North America (AMR-US/Can). Then a “publication to TBI volume ratio” was derived to estimate the research interest in TBI with respect to the frequency of this pathology.RESULTSBetween 2008 and 2018 a total of 8144 articles were published and indexed in the PubMed database about TBI. Leading WHO regions in terms of contributions were AMR-US/Can with 4183 articles (51.36%), followed by EUR with 2003 articles (24.60%), WPR with 1507 (18.50%), AMR-L with 141 articles (1.73%), EMR with 135 (1.66%), AFR with 91 articles (1.12%), and SEAR with 84 articles (1.03%). The highest publication to TBI volume ratios were found for AMR-US/Can (90.93) and EUR (21.54), followed by WPR (8.71) and AMR-L (2.43). Almost 90 times lower than the ratio of AMR-US/Can were the ratios for AFR (1.15) and SEAR (0.46).CONCLUSIONSAn important disparity currently exists between countries with a high burden of TBI and those in which most of the research is conducted. A call for improvement of data collection and research outputs along with an increase in international collaboration could quantitatively and qualitatively improve the ability of LMICs to ameliorate TBI care and develop clinical practice guidelines.

4H-1,3-Benzothiazin-4-one a Promising Class Against MDR/XDR-TB

2019 ◽  
Vol 19 (8) ◽  
pp. 567-578 ◽  
Author(s):  
Marcus Vinicius Nora de Souza ◽  
Thais Cristina Mendonça Nogueira
Keyword(s):  
Treatment Time ◽  
Public Health Problem ◽  
New Drugs ◽  
Global Public Health ◽  
Synthesis Mechanism ◽  
Highly Active ◽  
Latent Disease ◽  
Resistant Strains ◽  
Chemical Class ◽  
Global Public Health Problem

Nowadays, tuberculosis (TB) is an important global public health problem, being responsible for millions of TB-related deaths worldwide. Due to the increased number of cases and resistance of Mycobacterium tuberculosis to all drugs used for the treatment of this disease, we desperately need new drugs and strategies that could reduce treatment time with fewer side effects, reduced cost and highly active drugs against resistant strains and latent disease. Considering that, 4H-1,3-benzothiazin-4-one is a promising class of antimycobacterial agents in special against TB-resistant strains being the aim of this review the discussion of different aspects of this chemical class such as synthesis, mechanism of action, medicinal chemistry and combination with other drugs.

Health research capacity in Nepal: Analysis of the trend and the role of local researchers

2021 ◽  
pp. 004947552098277
Author(s):  
Madhu Kharel ◽  
Alpha Pokharel ◽  
Krishna P Sapkota ◽  
Prasant V Shahi ◽  
Pratisha Shakya ◽  
...  
Keyword(s):  
Health Research ◽  
Fold Increase ◽  
Research Capacity ◽  
Rapid Review ◽  
Evidence Based ◽  
Middle Income ◽  
Middle Income Countries ◽  
Health Related ◽  
Evidence Based Decision Making

Evidence-based decision-making is less common in low- and middle-income countries where the research capacity remains low. Nepal, a lower-middle-income country in Asia, is not an exception. We conducted a rapid review to identify the trend of health research in Nepal and found more than seven-fold increase in the number of published health-related articles between 2000 and 2018. The proportion of articles with Nepalese researchers as the first authors has also risen over the years, though they are still only in two-thirds of the articles in 2018.

scholarly journals A Fatal and Rare Case of Hydatid Cyst in the Pouch of Douglas

2021 ◽  
Author(s):  
Ritu Asnani ◽  
Sunil Kumar Yeshvanth ◽  
Lancelot Lobo ◽  
Shipra Sonkusare
Keyword(s):  
Hydatid Cyst ◽  
Rare Case ◽  
Frozen Section ◽  
Public Health Problem ◽  
Zoonotic Infection ◽  
Middle Income ◽  
Middle Income Countries ◽  
Significant Public Health Problem ◽  
Significant Public Health ◽  
Pouch Of Douglas

Abstract Hydatid cyst is a zoonotic infection and a significant public health problem in low- and middle-income countries. A 79-year-old female patient was presented to the gynecology outpatient department with complaints of pain in the abdomen and difficulty in micturition, with a mass palpable per speculum. The ultrasound was suggestive of an ovarian cystadenocarcinoma, whereas computed tomography of the abdomen favored hydatid cyst with adnexal neoplasm as a differential diagnosis. Considering the contradictory findings, a frozen section was sent to confirm the diagnosis, which showed hooklets of Echinococcus granulosus/hydatid cyst under the microscope. This was a rare case of pelvic hydatid cyst mimicking ovarian malignancy and was associated with a less-preferred mode of investigation (frozen section). This article focuses on how a frozen section, despite its limitations and being expensive, can still be considered for accurate patient management.

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