Case Report: Fulminant Infantile Beriberi: A Report of Six Cases

2021 ◽  
Author(s):  
Madhusudan Samprathi ◽  
Faisal Mohammad ◽  
Sridhar M ◽  
Prakash Ramachandra ◽  
Prakash Vemgal
Keyword(s):  
Clinical Presentation ◽  
Clinical Manifestations ◽  
Public Health Problem ◽  
Middle Income ◽  
Middle Income Countries ◽  
Childhood Illnesses ◽  
Important Symptom ◽  
Pulmonary Arterial ◽  
Definition Of ◽  
Severe Pulmonary Arterial Hypertension

Thiamine deficiency disorders are an under-recognized public health problem in low- and middle-income countries. Infantile beriberi, the most important symptom for children, is suspected to significantly contribute to infant mortality and lifelong neurodevelopmental morbidity. Lack of awareness, varied clinical presentation, and lack of a readily available diagnostic marker lead to frequent misdiagnoses. We report six thriving infants who presented with an acute fulminant illness with varied clinical manifestations mimicking common childhood illnesses like pneumonia and sepsis. Four of them presented with the severe cardiovascular form, called Shoshin beriberi, and severe pulmonary arterial hypertension. Empirical intravenous thiamine administered to four of the six infants resulted in dramatic recovery. Awareness of the clinical definition of infantile beriberi and treatment with empirical thiamine can be lifesaving.

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.

Defining Preterm Birth and Stillbirth in the Western Pacific: A Systematic Review

2021 ◽  
pp. 101053952110260
Author(s):  
Mairead Connolly ◽  
Laura Phung ◽  
Elise Farrington ◽  
Michelle J. L. Scoullar ◽  
Alyce N. Wilson ◽  
...  
Keyword(s):  
Preterm Birth ◽  
National Level ◽  
Health Indicators ◽  
Western Pacific ◽  
World Health ◽  
Middle Income ◽  
Middle Income Countries ◽  
Definition Of ◽  
Health Organization ◽  
The Impact

Preterm birth and stillbirth are important global perinatal health indicators. Definitions of these indicators can differ between countries, affecting comparability of preterm birth and stillbirth rates across countries. This study aimed to document national-level adherence to World Health Organization (WHO) definitions of preterm birth and stillbirth in the WHO Western Pacific region. A systematic search of government health websites and 4 electronic databases was conducted. Any official report or published study describing the national definition of preterm birth or stillbirth published between 2000 and 2020 was eligible for inclusion. A total of 58 data sources from 21 countries were identified. There was considerable variation in how preterm birth and stillbirth was defined across the region. The most frequently used lower gestational age threshold for viability of preterm birth was 28 weeks gestation (range 20-28 weeks), and stillbirth was most frequently classified from 20 weeks gestation (range 12-28 weeks). High-income countries more frequently used earlier gestational ages for preterm birth and stillbirth compared with low- to middle-income countries. The findings highlight the importance of clear, standardized, internationally comparable definitions for perinatal indicators. Further research is needed to determine the impact on regional preterm birth and stillbirth rates.

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.

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.

scholarly journals Systematic Review of Tools and Methods to Measure Appetite in Undernourished Children in the Context of Low- and Middle-Income Countries

2018 ◽  
Vol 9 (6) ◽  
pp. 789-812 ◽  
Author(s):  
Scott B Ickes ◽  
Muttaquina Hossain ◽  
Gaelen Ritter ◽  
Monica Lazarus ◽  
Katie Reynolds ◽  
...  
Keyword(s):  
Systematic Review ◽  
Evaluation Method ◽  
Middle Income ◽  
Child Undernutrition ◽  
Middle Income Countries ◽  
Environmental Enteric Dysfunction ◽  
Important Symptom ◽  
Multiple Domains ◽  
Caregiver Report ◽  
Low And Middle Income

ABSTRACT Child undernutrition has multifactorial causes, ranging from food insecurity to etiologies refractory to conventional nutritional approaches, such as infections, environmental enteric dysfunction, and other conditions that lead to systemic inflammation. Poor appetite may be an important symptom of these causes and may be a useful marker of an undernourished child's ability to recover. We conducted a systematic review to characterize the methods and tools to measure appetite among children <5 y old in low- and middle-income countries. A systematic search of 8 databases identified 23 eligible studies published since 1995. Thirteen described methods based on direct feeding observation or quantification of nutrient intake from caregiver report, 16 described tools that assessed caregiver perceptions of appetite, and 6 reported assessments in both categories. Four studies that gauged caregiver perceptions assessed multiple appetite domains, whereas 12 assessed 1 domain—often with a single question. Only 6 studies reported validation processes, the most common of which compared an observed test meal with daily energy intake. No studies reported the use of a method or tool that was validated in multiple cultural or linguistic contexts. Although dietary intake measures and observed feeding tests have shown validity in some contexts, they are resource intensive. Subjective caregiver questionnaires may offer a more efficient appetite evaluation method, but they have been evaluated less consistently. A rigorously developed and validated tool to rapidly assess child appetite is needed and could be best addressed by a questionnaire that leverages the multiple domains of appetite. The application of interventions that target causes of undernutrition that are not amenable to food-based interventions in clinical or research contexts could be facilitated by an efficient appetite screening tool to identify appetite-related causes of undernutrition and to monitor children's response to such interventions.

scholarly journals Early screening and diagnosis of autism spectrum disorders in Vietnam: A population-based cross-sectional survey

2021 ◽  
Author(s):  
Le Thi Vui ◽  
Duong Minh Duc ◽  
Nguyen Thuy Quynh ◽  
Nguyen Thi Huong Giang ◽  
Vu Thi Thanh Mai ◽  
...  
Keyword(s):  
Autism Spectrum Disorders ◽  
Early Detection ◽  
Public Health Problem ◽  
Population Based ◽  
Autism Spectrum ◽  
Urban Setting ◽  
Cross Sectional ◽  
Middle Income ◽  
Middle Income Countries ◽  
Spectrum Disorders

Background: Early detection of autism spectrum disorders (ASDs) is essential given the under-reported cases in low- and middle-income countries. This first national representative survey was conducted to explore the prevalence of ASDs amongst 18 and 30 months in seven provinces in Vietnam.Design and Method: During 2017- 2018, a national cross-sectional and population-based survey for autism spectrum disorder (ASD) amongst 40,243 children aged 18 to 30 months was conducted in 7 provinces representing the socio-economic regions of Vietnam. M-CHAT was used to screen children and then confirmed by diagnostic assessment using DSM-IV criteria.Results: The prevalence of ASDs amongst children aged 18 and 30 months in Vietnam was high (0.758% or 1 in 132 children). Urban setting, male gender, and hereditable genes were associated with ASD prevalence.Conclusion: ASDs amongst children aged 18 and 30 months in Vietnam tend to be increasing and are similar to this rate in other middle-income countries but lower than that in Western countries. This under-recognized public health problem amongst children should be addressed by early detection and intervention for families with affected children.

scholarly journals A comprehensive capacity assessment tool for non-communicable diseases in low- to middle-income countries: development and results of pilot testing

2016 ◽  
Vol 25 (1) ◽  
pp. 43-53 ◽  
Author(s):  
Isabel Garcia de Quevedo ◽  
Felipe Lobelo ◽  
Loren Cadena ◽  
Madalena Soares ◽  
Michael Pratt
Keyword(s):  
Assessment Tool ◽  
Public Health Problem ◽  
Premature Mortality ◽  
Communicable Diseases ◽  
Middle Income ◽  
Non Communicable Diseases ◽  
Middle Income Countries ◽  
Care Services ◽  
Primary Care Services ◽  
Challenges And Opportunities

Non-communicable diseases (NCDs) are the leading causes of death worldwide, with higher rates of premature mortality in low- and middle-income countries (LMICs). This places a high economic burden on these countries, which usually have limited capacity to address this public health problem. We developed a guided self-assessment tool for describing national capacity for NCD prevention and control. The purpose of this tool was to assist countries in identifying key opportunities and gaps in NCD capacity. It was piloted in three countries between 2012 and 2013: Mozambique, Colombia, and the Dominican Republic. The tool includes details about NCD burden; health system infrastructure and primary care services; workforce capacity; surveillance; planning, policy, and program management; and partnerships. In the three pilot countries, the tool helped to identify differences in capacity needs pertaining to staff, training, and surveillance, but similarities were also found related to NCD challenges and opportunities. The NCD tool increased our understanding of needs and critical capacity elements for addressing NCDs in the three pilot countries. This tool can be used by other LMICs to map their efforts toward addressing NCD goals and defining priorities.

Stillbirth as the primary manifestation of disseminated tuberculosis in a young immunocompetent mother with multiple perforations of the ileum

2021 ◽  
Vol 14 (2) ◽  
pp. e239386
Author(s):  
Deepak Rajput ◽  
Amit Gupta ◽  
Ravi Roshan ◽  
Arvind Kumar
Keyword(s):  
Weight Loss ◽  
Pregnancy Loss ◽  
Clinical Presentation ◽  
Delayed Presentation ◽  
Female Reproductive System ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low Middle Income Countries ◽  
Mother And Child ◽  
In Pregnancy

Tuberculosis (TB), a significant cause of morbidity and mortality worldwide, is particularly relevant in low/middle-income countries like India, where the disease is endemic. The female reproductive system is very vulnerable to this infection with, the clinical presentation being utterly silent in most patients. Symptoms of TB in pregnancy may initially be attributed to the gravidity itself besides temporary concealment of associated weight loss by the normally occurring weight gain during the pregnancy. Untreated TB may cause pregnancy loss by either placental damage or direct harm to both the mother and child. We report a case of latent disseminated TB in a young immunocompetent female that was revealed in the postpartum state (after full-term stillbirth delivery at home) as 20 ileal perforations secondary to intestinal TB. Due to ongoing sepsis and delayed presentation to the hospital, the patient could not be salvaged despite the best possible efforts.

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 Antiparasitic phytotherapy perspectives, scope and current development

Infectio ◽  
2019 ◽  
Vol 23 (2) ◽  
pp. 189 ◽  
Author(s):  
Jhon Carlos Castaño Osorio ◽  
Alejandra María Giraldo García
Keyword(s):  
Low Income ◽  
Public Health Problem ◽  
Cost Effective ◽  
Prolonged Treatment ◽  
Major Public Health Problem ◽  
Middle Income ◽  
Middle Income Countries ◽  
Commercial Markets ◽  
Health And Economic Development ◽  
New Treatments

Tropical protozoan diseases are currently a major public health problem throughout the world and are strongly linked with poverty, this combined with a lack of commercial markets for potential drugs has created a large burden on the health and economic development of low-income and middle-income countries in Africa, Asia, and the Americas. Due to the low research interest and the high increase of resistance against the existing treatments, as well as increasing inefficiency, toxicity, prolonged treatment schedules and costs, there is an urgent need for cost-effective, safe and easy-to-administer, new effective compounds with novel mechanisms of action. Several studies of crude plant extracts have already identified potential compounds to treat Chagas’ disease, Leishmaniasis, Toxoplasmosis, Giardiasis, and Malaria among other protozoan parasites. Natural compounds of medicinal plants have shown lower toxicity together with higher specificity, creating an optimistic view of new treatments for diseases. Out of 1010 new active substances approved as drugs for medical conditions by regulatory agencies during the past 25 years, 490(48.5%) were from a natural origin.

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