Tropical doctor
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The international standard decision-to-delivery interval (DDI) for emergency Caesarean sections (CSs) is ≤ 30 minutes but there is little evidence to support this recommendation. The aim of this study was to evaluate DDI for emergency CS and its relationship to perinatal outcome. We undertook a prospective observational study of consecutive cases of emergency CS. ⋯ There was a significantly higher risk of poor perinatal outcome for babies with DDI > 60 minutes. The perinatal outcome between DDI of ≤ 30 and 31-60 minutes was statistically not different. However, the ≤ 30 minutes DDI should remain the gold standard.
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We evaluated the cost implications of medical male circumcisions for HIV prevention when performed using re-usable equipment that is sterilized after each use versus using single-use disposal kits. In Uganda, a re-usable circumcision kit results in a net saving of US$7.14-US$12.34 or 46-59%. In resource-limited settings seeking to expand access to medical male circumcision for HIV prevention, substantial cost reductions may be achieved by adopting re-usable circumcision kits.
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The present study aims to assess the different types of costs for treatment of snake bite patients, to quantify household economic impact and to understand the coping mechanisms required to cover the costs for snake bite patients in Bangladesh. The patients admitted to four tertiary level hospitals in Bangladesh were interviewed using structured questionnaires including health-care-related expenditures and the way in which the expenditures were covered. ⋯ Expenditure for venomous snake bite was US$231, which is about seven times higher than non-venomous snake bite (US$34). The treatment imposes a major economic burden on affected families, especially in venomous snake bite cases.
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When it is indicated for surgical procedures below the umbilicus in our low-resource countries, spinal anaesthesia has many advantages: it is simple, cheap, safe and easy to learn and carry out. It reduces nursing load and the risk of aspiration pneumonitis as well as overall postoperative mortality and morbidity. We prospectively carried out a study of 419 patients operated under spinal anaesthesia during our normal surgical activities. ⋯ We had two cases (0.48%) of the rare cauda equina syndrome. In poor-resource countries, the culture of spinal anaesthesia should be better developed and encouraged by the training institutions.
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Traumatic injuries are one of the leading causes of death and disability worldwide and represent a very important public health problem in countries like Ethiopia, where there are insufficient centres of trauma care and where an interest in prevention has only relatively recently been awakened. The aim of this study was to investigate the causes of trauma at St Luke Catholic Hospital. We conducted a one-year retrospective study on 2969 patients who suffered from trauma. ⋯ Half of the 377 admitted patients stay in hospital for more than a week. The 'hit by a stick' disease can be reduced with appropriate public health campaigns on trauma prevention. This is a priority in trauma prevention, especially in the rural areas.