Abdominal Textiloma Mimicking as Left Colic Tumour: A Postoperative Complication Still Common in Low-Income Countries

EMJ Radiology ◽  
2020 ◽  
Keyword(s):  
Low Income ◽  
Early Stage ◽  
Low Income Countries ◽  
Fistula Formation ◽  
Emergency Laparotomy ◽  
Intermittent Fever ◽  
Gastrointestinal Complications ◽  
Surgical Safety ◽  
Surgical Teams ◽  
Safety Rules

Retained foreign bodies have become very rare in countries where the safety rules in the operating theatre are very rigorous and follow precise guidelines. There are low-income countries where hospital structures are precarious, in which the implementation of surgical safety rules has only been effective recently. Surgical teams in these countries are not yet well trained in the observance of the guidelines concerning swab count, meaning that textilomas are not uncommon. Abdominal textiloma may be asymptomatic, or present serious gastrointestinal complications such as bowel obstruction, perforation, or fistula formation because of misdiagnosis. It may mimic abscess formation in the early stage or soft tissue masses in the chronic stage. This case report presents a 27-year-old female who underwent an emergency laparotomy in a rural surgical centre for an ectopic pregnancy. Two months later, a swelling had appeared on the left side of her abdomen, gradually increasing in size, which was not very painful but caused digestive discomfort and asthenia. Intermittent fever was described and treated with antibiotics. The patient was referred to a better equipped centre to benefit from a CT scan. A textiloma was strongly suspected on the CT but a left colic mass was not excluded. Laparotomy confirmed the diagnosis of textiloma and the postoperative course was uneventful. Prevention rules must be strengthened in these countries where patients can hardly bear the costs of iterative surgeries for complications that are avoidable.

Women's Perception of Cervical Cancer and Its Prevention in Rural Laos

2010 ◽  
Vol 20 (5) ◽  
pp. 821-826 ◽  
Author(s):  
Keokedthong Phongsavan ◽  
Alongkone Phengsavanh ◽  
Rolf Wahlström ◽  
Lena Marions
Keyword(s):  
Risk Factors ◽  
Cervical Cancer ◽  
Low Income ◽  
Rural Women ◽  
Screening Program ◽  
Early Stage ◽  
Sociodemographic Factors ◽  
Cross Sectional Study ◽  
Low Income Countries ◽  
Cross Sectional

Background:Cervical cancer is the second most common cancer of women in the world, and it becomes a major cause of cancer mortality in low-income countries. Currently, little is known regarding cervical cancer incidence in Laos, although it is anticipated to be high like in neighboring countries. To be able to develop a screening program in the country, it is essential to explore women's perception of the disease. The purpose of this study was therefore to describe knowledge, awareness, and attitudes regarding cervical cancer among rural women of Laos.Methods:In a descriptive cross-sectional study, women were interviewed using a structured questionnaire covering sociodemographic factors, knowledge of the disease and its risk factors, awareness, and attitudes toward cervical cancer and its prevention.Results:Eight hundred women were included in the study, and 58% claimed to know about cervical cancer. Approximately one third (38%) considered themselves to be at risk, but less than 5% had ever had a Papanicolau test. Sixty-two percent believed it was possible to prevent cervical cancer and that vaccination may be a suitable method, but only 14% know about risk factors. Another method for prevention was frequent vaginal douching, which was suggested by 70% of the women. Symptoms like bleeding and discharge were correctly identified as possible indicators of cervical cancer, but only 57 women (7%) knew that an early stage of the disease could be symptom-free. Lack of subjective symptoms was the main reason for women to refrain from gynecological examinations.Conclusions:This study indicates that rural women in Laos have limited knowledge about cervical cancer and even less about screening and prevention. There is a need to educate the general community about the disease and its prevention.

State-Contingent Debt Instruments for Sovereigns

Policy Papers ◽  
2017 ◽  
Vol 17 (23) ◽  
Author(s):  
Keyword(s):  
Low Income ◽  
Sovereign Debt ◽  
Risk Sharing ◽  
Early Stage ◽  
Low Income Countries ◽  
Liquidity Premium ◽  
Sovereign State ◽  
Market Participants ◽  
Fiscal Space ◽  
Excessive Risk

Background. The case for sovereign state-contingent debt instruments (SCDIs) as a countercyclical and risk-sharing tool has been around for some time and remains appealing; but take-up has been limited. Earlier staff work had advocated the use of growth-indexed bonds in emerging markets and contingent financial instruments in low-income countries. In light of recent renewed interest among academics, policymakers, and market participants—staff has analyzed the conceptual and practical issues SCDIs raise with a view to accelerate the development of self-sustaining markets in these instruments. The analysis has benefited from broad consultations with both private market participants and policymakers. The economic case for SCDIs. By linking debt service to a measure of the sovereign’s capacity to pay, SCDIs can increase fiscal space, and thus allow greater policy flexibility in bad times. They can also broaden the sovereign’s investor base, open opportunities for risk diversification for investors, and enhance the resilience of the international financial system. Should SCDI issuance rise to account for a large share of public debt, it could also significantly reduce the incidence and cost of sovereign debt crises. Some potential complications require mitigation: a high novelty and liquidity premium demanded by investors in the early stage of market development; adverse selection and moral hazard risks; undesirable pricing effects on conventional debt; pro-cyclical investor demand; migration of excessive risk to the private sector; and adverse political economy incentives.

Mental health of refugees in primary care

2021 ◽  
pp. 431-438
Author(s):  
Edvard Hauff ◽  
Reidun Brunvatne
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Low Income ◽  
Mental Health Problems ◽  
Early Stage ◽  
Healthcare Services ◽  
Low Income Countries ◽  
Torture Survivors ◽  
Early Screening ◽  
Vulnerable Patients

Primary health care is usually the first level of formal health services that refugees meet in the country of resettlement. Providing culture-sensitive, accessible, and equitable services is a major challenge in high-income countries but even more so in middle- and low-income countries, where there are fewer resources. Presenting complaints are often multiple and complex. Early screening for mental health problems is controversial, and the priority is to establish a good working alliance and trust at an early stage. Vulnerable patients who may have limited or no social support or social capital due to split families; women and children exposed to sexual violence or trafficking; and torture survivors need special care and attention. Healthcare services are often fragmented making it difficult for people to traverse these services. Furthermore, there is a general need for competency building. The organization of primary mental health care for refugees in Norway is described as an example and a lesson for other countries who are facing similar problems.

scholarly journals Screening for Depression in Adolescents in Gokarneshwor Municipality-4, Kathmandu

2019 ◽  
Vol 21 (1) ◽  
pp. 70-73 ◽  
Author(s):  
Niraj Shrestha ◽  
S Pandey
Keyword(s):  
Low Income ◽  
Early Stage ◽  
Severe Depression ◽  
Low Income Countries ◽  
Age Group ◽  
Late Adolescent ◽  
Systematic Random Sampling ◽  
Simple Set ◽  
Patient Health ◽  
Self Harm

Depression which is characterized by hopelessness and loss of interest in social activities is common during adolescence. However it is often unrecognized and the burden is even more in low income countries. It also increases the risk of suicide in future. Hence in a developing country like Nepal it is important that such cases are detected at the early stage preventing further worsening of the condition. A simple set of questionnaires like Patient Health Questionnaire (PHQ) 9 can be used to screen for depression. Using this questionnaire screening for depression was carried out in adolescents of Gokarneshwor municipality, ward 4. Four hundred and twenty participants were selected by the process of systematic random sampling. Based on answers to nine questions score was given and adolescents categorized as having no, mild, moderate or severe depression. The PHQ 9 score suggested that 13.1% were suffering from depression, out of which 23.6% from moderate to severe depression which required psychiatric consultation. Out of those shown to have some form of depression 40.0% said they had thought of self harm in last 2 weeks. Late adolescence was significantly associated with depression. Thoughts related to self harm were also six times more in late adolescent age group than the early adolescent age group.

scholarly journals The Role of Childhood Cancer Civil Society on Cancer Control on Low-Income Countries

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 136s-136s
Author(s):  
A. Manirakiza
Keyword(s):  
Childhood Cancer ◽  
Low Income ◽  
Health Workers ◽  
Early Stage ◽  
Cancer Control ◽  
Low Income Countries ◽  
Childhood Cancers ◽  
Cancer Awareness ◽  
Community Needs ◽  
High Standards

Background and context: Over 250,000 new pediatric cancer cases are diagnosed yearly worldwide. In the developing countries, the childhood cancer burden is estimated to increase even more. Rwanda Children's Cancer Relief (RCCR) is a nonprofit organization with a mission to ensure that children with cancers access high standards of treatment and support. After realizing that majority in our community lack information on childhood cancers, our efforts since 2014 has been concentrated on raising awareness of childhood cancers. Aim: Raise awareness on childhood cancer among community members. Strategy/Tactics: During a massive walk, trained volunteers with informative brochures, posters in both local and international languages comprising information on early symptoms of childhood cancers, ways to navigate referral system among others are used during community outreaches. These activities are aired on national radios and TVs, newspapers and social media are also used to spread information. Program/Policy process: Many activities are carried out in September during the RCCR Annual Childhood Cancers Awareness Month. We involve community health workers, private sectors and academic institutions. We focus on talks, community outreaches and childhood cancers awareness activities. Outcomes: 2017 campaign included the aforementioned activities and was concluded by a walk dubbed (#KidsCancerWalk2016) which attracted more than 600 participants. Two local TVs, 6 radios and 7 online diaries covered the campaign in its different phases. More than 1000 posters, 1100 brochures and 500 flyers were distributed followed by intensive online campaign with more than 100 Facebook posts, 350 Tweets, and 700 Retweets. Strong partnerships with private, public sectors were created and Ministry of Health approved September as the national childhood cancer awareness month following RCCR campaigns. What was learned: Childhood cancers are fatal when left untreated but treatable when they are detected at an early stage. Activities that RCCR carry out on annual basis increase the general population knowledge about childhood cancers. Civil societies like RCCR play a crucial role in addressing the growing burden of childhood cancers and the disparities in access to and quality of care. They can also influence policy changes and address the specific patients' and community needs.

Three Cases of Joubert Syndrome in a Consanguineous Syrian Family and a Interesting Case of Multinational Collaboration

2021 ◽  
Author(s):  
Davor Petrović ◽  
Vida Čulić ◽  
Zofia Swinderek-Alsayed
Keyword(s):  
Low Income ◽  
Autosomal Recessive ◽  
Autosomal Recessive Disorder ◽  
Joubert Syndrome ◽  
Interesting Case ◽  
Low Income Countries ◽  
Ocular Motor ◽  
Quality Health Care ◽  
Quality Health ◽  
Motor Apraxia

AbstractJoubert syndrome (JS) is a rare congenital, autosomal recessive disorder characterized by a distinctive brain malformation, developmental delay, ocular motor apraxia, breathing abnormalities, and high clinical and genetic heterogeneity. We are reporting three siblings with JS from consanguineous parents in Syria. Two of them had the same homozygous c.2172delA (p.Trp725Glyfs*) AHI1 mutation and the third was diagnosed prenatally with magnetic resonance imaging. This pathogenic variant is very rare and described in only a few cases in the literature. Multinational collaboration could be of benefit for the patients from undeveloped, low-income countries that have a low-quality health care system, especially for the diagnosis of rare diseases.

Reviewing the Development of Rural Finance in Vietnam

2013 ◽  
pp. 121-136
Author(s):  
Duong Pham Bao
Keyword(s):  
Low Income ◽  
Financial System ◽  
Low Income Countries ◽  
Supply Side ◽  
New Paradigm ◽  
Rural Finance ◽  
Market Mechanisms ◽  
Rural Credit ◽  
Rural Organizations ◽  
Doi Moi

The objective of this article is to review the development of the rural financial system in Vietnam in recent years, especially, after Doi moi. There are two opposite schools of thought in the literature on rural credit policies in developing countries. One is the conventional supply-side (government-led) approach while the other is called “a new paradigm” that emphasizes the importance of the viability of financial providers and the well functioning of rural credit markets. Conventional theories of rural finance contend that rural finance in low-income countries is generally accompanied by many failures. Contrary to these theories, rural finance in Vietnam does not encounter the above-mentioned failures so far. Up to the present time, it is progressing well. Using a supply-side approach, methodologically, this study reviews the development of the rural financial system in Vietnam. The significance of this study is to challenge the extreme view of dichotomizing between the old and the new credit paradigms. Analysis in this study contends that a rural financial market that, (1) is initiated and spurred by government; (2) operates principally under market mechanisms; and (3) is strongly supported by rural organizations (semi-formal/informal institutions) can progress stably and well. Therefore, the extremely dichotomizing approach must be avoided.

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