scholarly journals Overcoming the Challenges of Epilepsy in Nepal- From Grassroots to Advanced level

2021 ◽  
Vol 1 (1) ◽  
pp. 55-57
Author(s):  
Sharad Hari Gajuryal ◽  
Shreejana Maharjan ◽  
Koji Iida ◽  
Basant Pant
Keyword(s):  
High Rate ◽  
Rural Setting ◽  
Health Concern ◽  
Treatment Gap ◽  
Middle Income ◽  
Advanced Level ◽  
Middle Income Countries ◽  
Care Givers ◽  
Low Middle Income Countries ◽  
The Common

Epilepsy is considered to be one of the common neurological disease with a high public health concern in recent years. The burden of epilepsy is also high affecting the patients and their care givers physically, mentally as well as socio economically. This burden seems very high in low- and middle –income countries with high rate of treatment gap resulting in higher number of morbidity and mortality. There are various challenges in low-middle income countries to overcome the treatment gap. Sustained and coordinated action prioritizing epilepsy from the rural setting to the advance setting can help in tackling the challenges. This article focuses on the challenges of epilepsy treatment in low-middle income country like Nepal and discusses the ways forward to overcome it.

scholarly journals Knowledge of Alzheimer’s Disease Among Medical Students of a Medical College

2018 ◽  
Vol 56 (211) ◽  
pp. 666-669 ◽  
Author(s):  
Rachana Sharma ◽  
Subhash Chandra Sharma ◽  
Sudarshan N Pardhan ◽  
Pratikshya Chalise ◽  
Luna Paudel
Keyword(s):  
Medical Students ◽  
Cross Sectional Study ◽  
Health Concern ◽  
First Year ◽  
Cross Sectional ◽  
Middle Income ◽  
Medical College ◽  
Middle Income Countries ◽  
Medical Study ◽  
Low Middle Income Countries

Introduction:Dementia is a public health concern as the prevalence is increasing worldwide with significant increase being in low-middle income countries. However these countries appear to be less prepared in handling this rise in terms of diagnosis and management. Methods: This cross-sectional study was conducted in Kathmandu medical College, from June 2017 to July 2017. Purposive sampling was done and the medical students who were in their first and final year of study were included in the study after obtaining an informed consent. Results: Total 185 students were included in the study, 80 (43.24%) from first year and 105 (56.75%) from final year of medical study. The mean score of knowledge among the students was 17.44± 2.46; 15.32± 1.22 among first year and 19.06± 1.87 among the final year students. Majority of the students said they have heard about dementia however, only 3 (3.75%) of first year and 43 (41.9%) from final year students have either attended a class or CME on dementia Conclusion:The knowledge about dementia was found to be average among medical students but better among final year medical students in comparison to first year. The knowledge was found to be better statistically among those who had either attended a class or CME on dementia or had exposure through different medias. Keywords:alzheimer`s disease; dementia; knowledge; medical students.

scholarly journals COVID-19 IN CHILDREN AND ADOLESCENT: CHARACTERISTICS AND SPECIFICITIES IN IMMUNOCOMPETENT AND ONCOHEMATOLOGICAL PATIENTS

2022 ◽  
Vol 14 (1) ◽  
pp. e2022009
Author(s):  
Federico Mercolini ◽  
Simone Cesaro
Keyword(s):  
Risk Factors ◽  
Pediatric Population ◽  
Treatment Options ◽  
Attributable Mortality ◽  
Prevention Measures ◽  
Middle Income ◽  
Children And Adolescent ◽  
Middle Income Countries ◽  
Care Givers ◽  
Low Middle Income Countries

SARS-CoV-2 pandemic affected less children and adolescents, morbidity and mortality figures being inferior to that reported for adults. In this review we focused on the clinical course, risk factors for severe COVID-19, mortality, treatment options and prevention measures in the pediatric and adolescent setting with special attention to the pediatric oncohematological patients. In this subgroups of patients, SARS-CoV-2 infection was often asyntomatic but 47 to 68% of patients require hospitalization and 9-10% of those hospitalized needed intensive care with a COVID-19 attributable mortality of about 4%. The multisystem inflammatory syndrome associated to Coronavirus 2019 was less frequent than that reported in the non-oncohematological pediatric population. Noteworthy, the course of COVID-19 was more severe in low-middle income countries. The key measures to prevent SARS-CoV-2 infection are the reduction of patients exposure to the SARS-CoV-2 and vaccination, now available fore care givers and parents and for patients and siblings > 12 years old. The treatment of COVID-19 in pediatric patients was mainly based on supportive care with dexamethasone and heparin prophylaxis for severely ill patients. Other measures, such as convalescent plasma, remdesivir and monoclonal antibodies have been used in limited case or within experimental protocols. Further studies are needed on the risk factors and outcome of SARS-CoV-2 infection in the pediatric immunocompromised patients. 

scholarly journals RETINOPATHY OF PREMATURITY, AN IMPORTANT PUBLIC HEALTH PROBLEM IN PAKISTAN: A REVIEW

2021 ◽  
Vol 3 (2) ◽  
pp. 457-466
Keyword(s):  
Health Care Providers ◽  
Retinopathy Of Prematurity ◽  
Preventive Measures ◽  
Public Health Problem ◽  
High Rate ◽  
Care Providers ◽  
Middle Income ◽  
Screening Programs ◽  
Middle Income Countries ◽  
Low Middle Income Countries

Introduction: Retinopathy of Prematurity (ROP) is the significant cause of blindness in children globally. Although the incidence of ROP is greater in premature infants worldwide, statistics show that it is more common in low-middle-income countries. Multiple causes and complications of ROP in low middle-income countries have been reported therefore the purpose of this literature review was to review the findings from literature about the burden, causes, outcomes, and important preventive measures of ROP for low middle-income countries, especially in Pakistan. Methods: A comprehensive review of the literature was conducted from published articles. Research studies were selected that included risk factors of ROP, screening, and diagnosis of ROP, treatment of ROP, and prevention of ROP.Results The cause of the high rate of ROP in Low-middle income countries (LMICs) includes a high rate of preterm babies, lack of awareness regarding ROP, financial instability, and insufficient treatment and screening programs at the newborn units. ROP is found to be the significant cause of preventable blindness in South Asia. There are three different levels of prevention aimed at reducing the burden of ROP in LMICs. Primary prevention aims at reduction in preterm births, secondary prevention aims at early diagnosis of the disease and tertiary prevention aims at reducing deterioration of conditions due to disease. Conclusion: The emphasis on preventive measures especially primary and secondary level prevention can help in decreasing the burden of ROP. This requires a multidisciplinary approach at all levels including at the level of policymaking, program implementation, health care providers, and community level.

The Impact of Covid 19 on Pregnant Women and Child Health

2020 ◽  
Vol 11 (SPL1) ◽  
pp. 1367-1373
Author(s):  
Nikhil Sanjay Mujbaile ◽  
Smita Damke
Keyword(s):  
Social Issues ◽  
Middle Income ◽  
Web Based ◽  
Middle Income Countries ◽  
Low Middle Income Countries ◽  
The Social ◽  
Social Separation ◽  
The Impact ◽  
And Child Health ◽  
General Wellbeing

The Covid illness (COVID-19) pandemic has spread rapidly all through the world and has had a drawn-out impact. The Pandemic has done incredible damage to society and made genuine mental injury to numerous individuals. Mental emergencies frequently cause youngsters to deliver sentiments of relinquishment, despondency, insufficiency, and fatigue and even raise the danger of self-destruction. Youngsters with psychological instabilities are particularly powerless during the isolate and colonial removing period. Convenient and proper assurances are expected to forestall the event of mental and social issues. The rising advanced applications and wellbeing administrations, for example, telehealth, web-based media, versatile wellbeing, and far off intuitive online instruction can connect the social separation and backing mental and conduct wellbeing for youngsters. Because of the mental advancement qualities of youngsters, this investigation additionally outlines intercessions on the mental effect of the COVID-19 Pandemic. Further difficulties in Low Middle-Income Countries incorporate the failure to actualize successful general wellbeing estimates, for example, social separating, hand cleanliness, definitive distinguishing proof of contaminated individuals with self-disconnection and widespread utilization of covers The aberrant impacts of the Pandemic on youngster wellbeing are of extensive concern, including expanding neediness levels, upset tutoring, absence of admittance to the class taking care of plans, decreased admittance to wellbeing offices and breaks in inoculation and other kid wellbeing programs. Kept tutoring is critical for kids in Low Middle-Income Countries. Arrangement of safe situations is mainly testing in packed asset obliged schools. 

Risk Factors of Mortality Among Patients with Stroke in Low Middle-Income Countries:  A Series of 180 Patients

2020 ◽  
Author(s):  
Larrey Kamabu ◽  
Hervé Monka Lekuya ◽  
Bienvenu Muhindo Kasusula ◽  
Nicole Kavugho Mutimani ◽  
Louange Maha Kathaka ◽  
...  
Keyword(s):  
Risk Factors ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low Middle Income Countries

scholarly journals Triaging and adaptations of surveillance of cancer services in the COVID pandemic

2020 ◽  
pp. 1-3
Author(s):  
Shirley Lewis ◽  
Lavanya Gurram ◽  
Umesh Velu ◽  
Krishna Sharan
Keyword(s):  
Cancer Patients ◽  
Clinical Examination ◽  
Cancer Care ◽  
Middle Income ◽  
Face To Face ◽  
Middle Income Countries ◽  
Cancer Services ◽  
Low Middle Income Countries

Abstract Introduction: Coronavirus disease (COVID-19) has significantly challenged the access to cancer care and follow-up for a patient with cancer. Methods: Based on published literature and our experiences, it is reasonable to presume that clinical examination and follow-up visits have been significantly curtailed worldwide in order to adhere to the new norms during the pandemic. Although telephonic and telemedicine consultations may help bridge a few gaps, completely dispensing with in-person consultation has its challenges, especially in low middle-income countries. Telephonic consultations could facilitate triaging of ambulatory cancer patients and allocation of face-to-face consultations for high priority patients. Conclusions: We propose a telephonic consultation-based triaging approach for ambulatory cancer patients in order to identify those needing in-hospital consultations.

scholarly journals Exploration of recovery of people living with severe mental illness (SMI) in low/middle-income countries (LMICs): a scoping review

BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e045005
Author(s):  
Fadia Gamieldien ◽  
Roshan Galvaan ◽  
Bronwyn Myers ◽  
Zarina Syed ◽  
Katherine Sorsdahl
Keyword(s):  
Mental Illness ◽  
Severe Mental Illness ◽  
Scoping Review ◽  
Data Extraction ◽  
Flow Diagram ◽  
Personal Recovery ◽  
Middle Income ◽  
Middle Income Countries ◽  
Provider Perspectives ◽  
Low Middle Income Countries

ObjectiveTo examine the literature on how recovery of people with severe mental illness (SMI) is conceptualised in low/middle-income countries (LMICs), and in particular what factors are thought to facilitate recovery.DesignScoping review.Data sources and eligibilityWe searched 14 electronic databases, hand searched citations and consulted with experts during the period May–December 2019. Eligible studies were independently screened for inclusion and exclusion by two reviewers. Unresolved discrepancies were referred to a third reviewer.Data extraction and synthesisAll bibliographical data and study characteristics were extracted using a data charting form. Selected studies were analysed through a thematic analysis emerging from extracted data.ResultsThe Preferred Reporting Items for Systematic Reviews and Meta-Analyses flow diagram offers a summary of the results: 4201 titles, 1530 abstracts and 109 full-text articles were screened. Ten articles were selected for inclusion: two from Turkey, two from India, and one each from China, Swaziland, Indonesia, Egypt, South Africa and Vietnam. Although most studies used qualitative methods, data collection and sampling methods were heterogeneous. One study reported on service provider perspectives while the rest provided perspectives from a combination of service users and caregivers. Three themes emerged from the data analysis. First, studies frame recovery as a personal journey occurring along a continuum. Second, there was an emphasis on social relationships as a facilitator of recovery. Third, spirituality emerged as both a facilitator and an indicator of recovery. These themes were not mutually exclusive and some overlap exists.ConclusionAlthough there were commonalities with how high-income countries describe recovery, we also found differences in conceptualisation. These differences in how recovery was understood reflect the importance of framing the personal recovery concept in relation to local needs and contextual issues found in LMICs. This review highlighted the current sparse evidence base and the need to better understand recovery from SMI in LMICs.

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