African journal of health sciences
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In recent times, the phrase " traditional medicine" has become a catchword among the peoples in all countries in Africa. This has been due partly because the use of herbal remedies has gained popularity worldwide and the exploitation of these remedies has become a multimillion industry. The term "African traditional medicine" is not synonymous with "Alternative and complimentary medicine" which is a misnomer which is sometimes used. ⋯ All the stakeholders stand to gain a great deal in the development and promotion of African traditional medicine. In particular, all the practitioners in the present allopathic health care system will gain professionally as well as economically as they will have access to an additional culture-friendly system with which to provide services to the people. All the stakeholders must join hands in the effort to institutionalize the appropriate African traditional medicine in the health care systems in order to provide the health services that are urgently needed in the communities.
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Major and minor surgery is a service of great importance both for the people in need and for health workers and managers trying to develop a comprehensive primary health care service. While in highly industrialized countries some 5000-9000 major operations are performed per 100,000 people per year, the rates in East Africa in the early 1990s were in the range of 70-500. In our study all surgical operations performed at hospitals and clinics in Meru district during 12 months in 1990-1991 were listed on record forms including age, sex and home address of patients, and type of operation. ⋯ The smaller clinics did on average only 1.8-6.4 minor operations per month. The basic need for minor surgery in these areas has not been estimated, so the unmet need must be considered unknown. Further research is recommended in the following areas: epidemiological estimates of surgical service need in eastern Africa, critical review of the health information systems with regard to surgery, quality of major and minor surgery services especially in rural areas, and reasons for low surgical output at small clinics; possible remedies.
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The currently available evidence suggest that diuretics and/or low dose dopamine increases renal blood flow (RBF), glomerular filtration rate (GFR) and natriuresis in experimental animals, and limits ATP utilisation and oxygen needs in nephron segments at high risk of ischaemic injury, actions that could potentially limit renal injury and accelerate recovery in acute renal failure (ARF). These effects have indeed been confirmed in most experimental animals while using mannitol or low dose dopanime. ⋯ Most clinical studies have failed to demonstrate convincingly that low dose dopamine either prevents ARF in high risk patients or improves renal function or outcome in patients with established ARF. This confusing scenario is further complicated by the fact that both diuretics and low dose dopamine can result in severe metabolic and cardiovascular complications in critically ill patients.
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Africa continues to face enormous challenges in her efforts to provide health care and to control diseases, particularly in the face of dwindling financial resources, inadequate facilities and supplies, and increased demand for health services. The situation is further compounded by new challenges created by the emergence of new infections, re-emergence of diseases hitherto thought to have been put under control, changes in epidemiological patterns and manifestations of existing diseases. All these factors have an overall effect of increasing disease incidences, morbidity and mortality, thus, hindering efforts to control disease in the continent. ⋯ Such initiatives will complement the efforts of health care agencies and the country health care institutions. In this issue, Magambo et al (pp149-156) have attempted to look at health problems of people living in southern Sudan, an area that has, for along time, experienced civil turmoil. Understanding of health problems of southern Sudan will not only provide a basis for instituting diseases control measures in this region, but will also provide a basis for instituting preventing measures within the affected country, and in the neighboring regions.
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The HIV/AIDS pandemic can truly be described as an infectious disease that has recently emerged and judging from its rapid global spread, it leaves no doubt that it is one of the greatest health threats mankind has to contend with. This pandemic has alerted and stimulated the international scientific community to seriously reflect oa other recent episodes of emerging and re-emerging infections. The examples that have recently been observed and addressed include new emerging infectious diseases, unusual manifestations of previously known diseases and unusual eruption of known diseases in unusual geographic foci or unusual altitudes. ⋯ Setting up rapid reaction forces to respond to specific outbreak situations in order to control the spread of an emerging infectious disease. In this area of rapid trans not continental travel, the world is viewed as a "global village" and the relevance of the current International Sanitary Regulations requires a re-appraisal. Global sensitisation of the international community to the importance of this programme will ease and facilitate efforts at mobilisation resources needed and the training of the manpower required to make the above activities operational on a global scale.