scholarly journals Care of People with Epilepsy in Rural Medical Centre of Developing Countries with Limited Resources: During the COVID-19 Pandemic

2020 ◽  
Vol 18 (2) ◽  
pp. 99-101
Author(s):  
A. Verma ◽  
A. Kumar
Keyword(s):  
Developing Countries ◽  
Healthcare Systems ◽  
Limited Resources ◽  
Poor Countries ◽  
Public Health Systems ◽  
Follow Up Care ◽  
Resource Poor ◽  
Chronic Disorders ◽  
Rural Part

Coronavirus disease 2019 (COVID‐19) has become a pandemic disease globally. This extraordinary situation is posing an enormous burden on the healthcare systems worldwide and is reshaping the way in which chronic disorders are managed. Pandemic has made epilepsy care even more demanding in rural part of developing countries. We outline the adverse circumstances in epilepsy care induced by the pandemic; propose emergency management and follow up care of people with epilepsy. There is a requirement for public health systems in resource poor countries to improve awareness, implement proper strategies of triage, acute treatment, telemedicine services and virtual check-ins.

scholarly journals Consensus on Treatment and Follow-Up for Biochemical Recurrence in Castration-Sensitive Prostate Cancer: A Report From the First Global Prostate Cancer Consensus Conference for Developing Countries

2021 ◽  
pp. 538-544
Author(s):  
Fernando S. M. Monteiro ◽  
Fabio A. Schutz ◽  
Igor A. P. Morbeck ◽  
Diogo A. Bastos ◽  
Fernando V. de Padua ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Developing Countries ◽  
Biochemical Recurrence ◽  
Specific Antigen ◽  
Consensus Conference ◽  
Limited Resources ◽  
Response Options ◽  
Recommended Treatment ◽  
Clinical Scenarios

PURPOSE To present a summary of the treatment and follow-up recommendations for the biochemical recurrence in castration-sensitive prostate cancer (PCa) acquired through a questionnaire administered to 99 PCa experts from developing countries during the Prostate Cancer Consensus Conference for Developing Countries. METHODS A total of 27 questions were identified as related to this topic from more than 300 questions. The clinician's responses were tallied and presented in a percentage format. Topics included the use of imaging for staging biochemical recurrence, treatment recommendations for three different clinical scenarios, the field of radiation recommended, and follow-up. Each question had 5-7 relevant response options, including “abstain” and/or “unqualified to answer,” and investigated not only recommendations but also if a limitation in resources would change the recommendation. RESULTS For most questions, a clear majority (> 50%) of clinicians agreed on a recommended treatment for imaging, treatment scenarios, and follow-up, although only a few topics reached a consensus > 75%. Limited resources did affect several areas of treatment, although in many cases, they reinforced more stringent criteria for treatment such as prostate-specific antigen values > 0.2 ng/mL and STAMPEDE inclusion criteria as a basis for recommending treatment. CONCLUSION A majority of clinicians working in developing countries with limited resources use similar cutoff points and selection criteria to manage patients treated for biochemically recurrent castration-sensitive PCa.

scholarly journals INTRAMEDULLARY INTERLOCKING NAILING WITHOUT IMAGE INTENSIFIER AND ORTHO TABLE

2012 ◽  
Vol 19 (03) ◽  
pp. 400-403
Author(s):  
FAYYAZ AHMED ORFI ◽  
SHAHID MAJEED ◽  
MUSHAHID ASLAM ◽  
M Khalid Siddique
Keyword(s):  
Standard Treatment ◽  
Image Intensifier ◽  
Lower Limbs ◽  
Field Hospital ◽  
Poor Countries ◽  
Distal Interlocking ◽  
Resource Poor ◽  
Humerus Fractures ◽  
Study Setting

Interlocking nails are the gold standard treatment of fractures of shaft of long bones of lower limbs. It is also frequently performedfor most of the humerus fractures. The procedure is commonly performed using an image intensifier and orthotable. These are expensive andare not readily available in peripheral/field hospitals especially in resource – poor countries. Design: Retrospective study. Setting: FieldHospital Muzaffarabad and Combined Hospital Kharian. Period: Sep 2007 to July 2011. Patients & Methods: 138 consecutive cases offractures of femur, tibia and humerus shafts fixed with I/M I/L Nails in a field hospital. Reduction was achieved by open method in 87 (96.66%)cases of femur, 24 (60%) case of tibia and 5(62.5%) of humerus. Results: There were 34 females and 100 males’ ratio 1:2.94. All the cases wereadults with mean age 38.2 years and range was 16-78 years. Bones fixed were femur (90) 65.21%, tibia (40) 28.21%, and humerus (8) 5.70%.Fracture line was transverse in 104 (75.3%) and communited 10 (7.2%). Fractures were closed 112 (81.2%) and 26 (18.8%) of case. Recentfractures were 122 (88.4%) and old non united 16 (11.6%). Mean follow up period was 06 months - range 3 months to 1 ½ years. Complicationswere failure to achieve distal interlocking 6 cases, infection 3 cases. Union time averaged 3.5 months. Conclusions: It is therefore concludedthat I/M I/L nailing can be done without image and traction table.

scholarly journals Spirometry in Asthma Care: A Review of the Trends and Challenges in Pediatric Practice

2017 ◽  
Vol 11 ◽  
pp. 117955651772067 ◽  
Author(s):  
Adaeze C Ayuk ◽  
Samuel N Uwaezuoke ◽  
Chizalu I Ndukwu ◽  
Ikenna K Ndu ◽  
Kenechukwu K Iloh ◽  
...  
Keyword(s):  
Developing Countries ◽  
Bronchial Asthma ◽  
Care Staff ◽  
Noncommunicable Diseases ◽  
Health Care Staff ◽  
Published Data ◽  
Pediatric Practice ◽  
Poor Countries ◽  
Resource Poor ◽  
Children With Asthma

Background: Given the rising incidence of noncommunicable diseases (NCDs) globally, especially bronchial asthma, there is the need to reduce the associated morbidity and mortality by adopting an objective means of diagnosis and monitoring. Aim: This article aims to review the trends and challenges in the use of spirometry for managing childhood bronchial asthma especially in developing countries. Methods: We conducted a literature search of published data on the use of spirometry for the diagnosis of childhood bronchial asthma with special emphasis resource-poor countries. Results: Guidelines for the diagnosis and treatment of childhood asthma recommend the use of spirometry, but this is currently underused in both tertiary and primary care settings especially in developing countries. Lack of spirometers and proper training in their use and interpretation of findings as well as a dearth of asthma guidelines remains core to the underuse of spirometry in managing children with asthma. Targeting education of health care staff was, however, observed to improve its utility, and practical implementable strategies are highlighted. Conclusions: Spirometry is not frequently used for asthma diagnosis in pediatric practice especially in resource-poor countries where the NCD burden is higher. Strategies to overcome the obstacles are implementable and can make a difference in reducing the burden of NCD.

scholarly journals Consensus on the Treatment and Follow-Up for Metastatic Castration-Resistant Prostate Cancer: A Report From the First Global Prostate Cancer Consensus Conference for Developing Countries (PCCCDC)

2021 ◽  
pp. 559-571
Author(s):  
Fernando Cotait Maluf ◽  
Felipe Moraes Toledo Pereira ◽  
Adriano Gonçalves Silva ◽  
Aldo Lourenço Abbade Dettino ◽  
Ana Paula Garcia Cardoso ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Developing Countries ◽  
Consensus Conference ◽  
Treatment Preference ◽  
Limited Resources ◽  
Castration Resistant Prostate Cancer ◽  
First Line ◽  
Castration Resistant ◽  
Drug Treatments

PURPOSE To present a summary of the recommendations for the treatment and follow-up for metastatic castration-resistant prostate cancer (mCRPC) as acquired through a questionnaire administered to 99 physicians working in the field of prostate cancer in developing countries who attended the Prostate Cancer Consensus Conference for Developing Countries. METHODS A total of 106 questions out of more than 300 questions addressed the use of imaging in staging mCRPC, treatment recommendations across availability and response to prior drug treatments, appropriate drug treatments, and follow-up, and those same scenarios when limited resources needed to be considered. Responses were compiled and the percentages were presented by clinicians to support each response. Most questions had five to seven relevant options for response including abstain and/or unqualified to answer, or in the case of yes or no questions, the option to abstain was offered. RESULTS Most of the recommendations from this panel were in line with prior consensus, including the preference of a new antiandrogen for first-line therapy of mCRPC. Important aspects highlighted in the scenario of limited resources included the option of docetaxel as treatment preference as first-line treatment in several scenarios, docetaxel retreatment, consideration for reduced doses of abiraterone, and alternative schedules of an osteoclast-targeted therapy. CONCLUSION There was wide-ranging consensus in the treatment for men with mCRPC in both optimal and limited resource settings.

Rares Diseases and Handicap: State of the Medical, Social and Health Policy in Developing Countries. Cameroon case: about One Case: Cushing Disease

2019 ◽  
Author(s):  
Carolle Laure Kpoumie
Keyword(s):  
Developing Countries ◽  
Health System ◽  
Public Health Problem ◽  
Industrialized Countries ◽  
Cushing Disease ◽  
Poor Countries ◽  
The Social ◽  
Set Up ◽  
The Cost

Rare’s diseases and orphan’s diseases, disability (orhandicap) are a reality throughout the world and a real public health problem in developing countries. The great precariousness in which the populations live increases their impact and their gravity by the absence of information, technical platform, means of detection, actual presence of research and clinical studies on these territories, lack of awareness of the detection, diagnosis, without forgetting that the means of care and prevention are sometimes in existent or little known and especially expensive in countries where the populations are poor, without mutual or social security as in industrialized countries .This work will focus on a patient case presenting a rare disease: Cushing's disease. A case that occurred in Cameroon in order to establish in a practical way this major and yet ignored, neglected issue in a health system with poor specialized structures, technical platforms, and without the support of the pharmaceutical laboratories that could with the health system of these poor countries set up a system of refueling in the sense of the social view the cost that requires the monitoring of these long pathologies that make autonomous living almost impossible, also life-threatening.In Cameroon, there have been difficulties in the care and monitoring of this young patient since childhood through the phase of the pubertal transition, adolescence, to adulthood. It is therefore important to organize the follow-up of these patients, by developing specific programs of medical follow-up, psychological care, and social integration programs. Health policies should invest in better support.

scholarly journals Challenges Facing the Shift from the Conventional to Problem-Based Learning Curriculum

2018 ◽  
Vol 8 (1) ◽  
pp. 36 ◽  
Author(s):  
Waleed H AlBuali ◽  
Abdul Sattar Khan
Keyword(s):  
Problem Based Learning ◽  
Limited Resources ◽  
Poor Countries ◽  
Medical Graduates ◽  
Resource Poor ◽  
Staff Cost ◽  
Common Problems ◽  
Different Cultures ◽  
And Training

Tremendous changes have taken place in medical curricula in the last two decades; these changes have arguably created some imbalances in the quality of medical graduates around the globe, which may be partly due to the number of resources often demanded by the design of the newer curricula. Therefore, resource-poor countries are often unable to adopt these newer models of training in their entirety and are thus compelled to follow the so- called “Subject-Based Curriculum”. The authors have discussed and prepared some guidelines to provide direction for the adaptation and implementation of Problem-Based Learning Curriculum (PBLC) in countries with different cultures and limited resources. This article addresses the issues and concerns raised by medical educationists on the implementation of PBLC especially in developing countries. These pointers include practical solutions for such common problems as staff, cost, infrastructure and training. 

scholarly journals Treatment of Localized and Locally Advanced, High-Risk Prostate Cancer: A Report From the First Prostate Cancer Consensus Conference for Developing Countries

2021 ◽  
pp. 530-537
Author(s):  
Raja Khauli ◽  
Robson Ferrigno ◽  
Gustavo Guimarães ◽  
Muhammad Bulbulan ◽  
Pedro Luiz Serrano Uson Junior ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Developing Countries ◽  
High Risk ◽  
Clinical Decision Making ◽  
Locally Advanced ◽  
Consensus Conference ◽  
Limited Resources ◽  
High Risk Prostate Cancer ◽  
Risk Prostate Cancer

PURPOSE To generate and present survey results on important issues relevant to treatment and follow-up of localized and locally advanced, high-risk prostate cancer (PCa) focusing on developing countries. METHODS A panel of 99 PCa experts developed more than 300 survey questions of which 67 questions concern the main areas of interest of this article: treatment and follow-up of localized and locally advanced, high-risk PCa in developing countries. A larger panel of 99 international multidisciplinary cancer experts voted on these questions to create the recommendations for treatment and follow-up of localized and locally advanced, high-risk PCa in areas of limited resources discussed in this article. RESULTS The panel voted publicly but anonymously on the predefined questions. Each question was deemed consensus if 75% or more of the full panel had selected a particular answer. These answers are based on panelist opinion and not on a literature review or meta-analysis. For questions that refer to an area of limited resources, the recommendations considered cost-effectiveness as well as the possible therapies with easier and greater access. Each question had five to seven relevant answers including two nonanswers. Results were tabulated in real time. CONCLUSION The voting results and recommendations presented in this article can guide physicians managing localized and locally advanced, high-risk PCa in areas of limited resources. Individual clinical decision making should be supported by available data; however, as guidelines for treatment of localized and locally advanced, high-risk PCa in developing countries have not been defined, this article will serve as a point of reference when confronted with this disease.

scholarly journals Lesson From Other Discipline’s Decision in Managing Giant Haemangioma Of The Hemithorax : Case Report

1970 ◽  
Vol 1 (1) ◽  
Author(s):  
Shelly M Djaprie ◽  
Gentur Sudjatmiko
Keyword(s):  
Developing Countries ◽  
Case Report ◽  
Pediatric Surgery ◽  
Surgical Excision ◽  
Limited Resources ◽  
Moderate Size ◽  
The Right ◽  
Giant Size ◽  
Infantile Haemangiomas

The management of the giant and moderate size infantile haemangiomas are challenging problems, especially in health systems with limited resources in developing countries. The aim of presenting this case is to take a lesson from another discipline’s decision in managing haemangioma.The author provide information based on clinical examination and surgical records of the patient with giant hemangioma which was consulted to plastic surgery team. A four month year old boy was consulted by pediatric surgery team with a giant size haemangioma on the right hemithorax.The treatment option for each haemangioma are different based on the case itself. Especially for this case, it seems better to be treated conservatively due to several reason, such as the phase of hemangioma, the location of the mass, the size, the donor morbidity. Early surgical excision of a moderate size infantile haemangioma may be justified especially when there is dificulty of follow-up. This approach will prevent growth deformation, impact on nearby vital organs and psychological problems.

2199Cardiovascular risk behaviour is an emerging health issue in developing countries

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
L Negesa ◽  
J Magarey ◽  
P Rasmussen ◽  
J Hendriks
Keyword(s):  
Physical Activity ◽  
Developing Countries ◽  
Physical Inactivity ◽  
Total Population ◽  
Vegetable Consumption ◽  
Risk Behaviours ◽  
Unhealthy Lifestyle ◽  
Increased Risk ◽  
Follow Up Care

Abstract Background Previously, cardiovascular disease (CVD) was considered the “Disease of the Rich”, however nowadays also populations with low socioeconomic status have been identified at increased risk of developing CVD. The global progress in CVD prevention is scarce particularly in developing countries, which are facing a high burden of CVD whilst there is limited availability of resources and evidence to educate and modify lifestyle behaviours in the population. Moreover, there is a lack of infrastructure and policy making in these countries. Purpose The goal of the study was to quantify the prevalence of different cardiovascular risk behaviours among patients with known cardiovascular conditions in a developing countries. Methods A hospital based cross-sectional survey was conducted in two referral hospitals in Ethiopia. Outpatient unit patients who had a confirmed diagnosis of CVD were eligible for participation in the study. Data were collected through face-to-face interviews with patients using validated tools; WHO STEPs instrument and international physical activity questionnaire. Results A total of 287 CVD patients were recruited, 56% were females and 90% were urban residents. All patients had inadequate consumption of fruit and vegetables, 20% were current khat chewers, 19% were current alcohol drinkers and only 1% were current smokers. The prevalence of low physical activity (defined as less than 600 MET-minutes per week) in the total population was 51.6% for both sexes; more than half of the total population were physically inactive. Moreover, females had a significantly higher prevalence of physical inactivity as compared to males, 58% vs 43.2%, P=0.017. Approximately one-third (30%) of patients had only one of these risk behaviours, more than half (52%) had two, 18% had three or more risk behaviours. The majority (70%) of the patients had multiple risk behaviours (Table 1), the prevalence of these did not significantly vary with sex, residence and educational level (p>0.05). Conclusion Patients with CVD maintain unhealthy lifestyles even though attending follow up care with a specific focus on risk management. The findings of this study demonstrate a high prevalence of physical inactivity, alcohol consumption and inadequate fruit and vegetable consumption in developing countries. The emerging increase of CVD and the continuation of unhealthy lifestyle in patients is somewhat comparable with western countries, demonstrating an emerging global problem. Moreover, this study shows the existing follow-up care is ineffective and provides evidence for policy makers that health services reform is required. Implementation of lifestyle support programs should be considered for the disease prevention policy agenda in developing countries.

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