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This paper provides a comprehensive exploration of the current state of gastroparesis management in low and middle-income countries (LMICs), emphasising recent innovations, persistent challenges, and future prospects. Gastroparesis, a condition characterised by delayed stomach emptying, presents debilitating symptoms and is notably linked to neuropathic disorders, including diabetes mellitus. Despite an apparent higher prevalence in LMICs compared to the global average, epidemiological data remains scarce. The paper highlights pioneering research in Pakistan, Brazil, and China, showcasing a transformative shift toward comprehensive studies that delve into nuanced aspects of gastroparesis epidemiology, gender-specific patterns, and innovative therapeutic approaches such as acupuncture. However, challenges impeding clinical management and research in LMICs are identified, encompassing the absence of extensive epidemiological studies, lack of treatment guidelines, and the scarcity of specialised training programs for healthcare professionals. These challenges are intertwined with broader issues such as limited healthcare infrastructure, resource disparities, and healthcare workforce shortages. The paper proposes a multifaceted approach for addressing these challenges, involving international collaboration, capacity building, and the integration of gastroparesis management into primary healthcare services. Strategies to combat brain drain, such as collaborative agreements akin to the UK-South Africa Memorandum of Understanding, are advocated.
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Exploring the landscape of intracranial aneurysms in South America unravels a complex interplay of epidemiological factors, clinical manifestations, and therapeutic challenges. The study methodically conducts a comprehensive literature review spanning the years 2003 to 2023, focusing on English-language articles obtained from diverse databases to elucidate the multifaceted nature of intracranial aneurysms in the region. Results and discussions categorize outcomes into positive domains, emphasizing successful treatments, favorable recoveries, and high survival rates, while also shedding light on negative aspects such as residual aneurysms and complications. The research illuminates significant gaps in pathological typing of intracranial aneurysms and exposes challenges in healthcare accessibility, notably the disparities in neurosurgical resources. Management challenges, including constrained infrastructure access, a neurosurgeon shortage, and gender disparities, are underscored. Transitioning to future prospects, the study advocates for strategic interventions, proposing expanded neurosurgical training, multidisciplinary approaches, improved funding, enhanced access to care, and fostering international collaborations. The study concludes by emphasizing the pivotal role of collaborative efforts, intensified training programs, and global partnerships in propelling intracranial aneurysm management forward in South America, ultimately contributing to enhanced patient outcomes across the region.
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Aneurisma Intracraniano , Humanos , Aneurisma Intracraniano/epidemiologia , Aneurisma Intracraniano/terapia , Aneurisma Intracraniano/cirurgia , América do Sul/epidemiologia , Procedimentos Neurocirúrgicos , Neurocirurgiões , Acessibilidade aos Serviços de SaúdeRESUMO
This paper delves into Renal Denervation Therapy as a promising intervention for resistant hypertension in low- and middle-income countries. With rates of hypertension increasing in LMICs due to lifestyle factors, RDN presents a potentially transformative approach. The methodology involves a comprehensive literature review, focusing on studies in LMICs that unveil proactive developments in standardized guidelines and precision targeting in clinical trials. LMICs actively contribute to research, emphasizing the safety and efficacy of RDN. However, despite these strides, the current landscape reveals challenges, encompassing initial costs, economic disparities, and limitations in healthcare infrastructure. Despite these hurdles, the paper envisions promising future prospects, emphasizing innovative strategies for cost-effective RDN implementation. It advocates for global collaboration and partnerships with international organizations, proposing the expansion of the Global SYMPLICITY Registry to include more LMICs; a testament to a commitment to research advancement. The paper concludes by highlighting comprehensive strategies to overcome challenges, making RDN financially viable in resource-limited settings. It underscores the potential for RDN to enhance global healthcare outcomes, particularly in regions grappling with diverse economic and healthcare challenges.
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Hipertensão , Rim , Humanos , Hipertensão/cirurgia , Hipertensão/tratamento farmacológico , Simpatectomia , Estilo de Vida , Sistema de Registros , Pressão Sanguínea , Resultado do Tratamento , Anti-Hipertensivos/uso terapêuticoRESUMO
Women faced significant barriers to pursue education in the 19th century, yet modern history has witnessed bold women overcoming insurmountable odds in this quest. To this end, Anandi Joshi braved monumental odds to successfully become the first female physician in India. Born in 1865, Anandi was one of 10 children. Her zeal for knowledge was noted early by her father, who ensured that his daughter was well-educated. She married Gopalrao Joshi as a child when she was nine; a practice that was common at the time. Anandi's quest to become a physician stemmed from a traumatic event which saw the death of her child due to the lack of medical care. Despite the numerous prevalent barriers which prevented women from indulging in education, Anandi was determined. She travelled to the United States, where through sheer persistence, she was admitted to the Women's Medical College of Pennsylvania, where she graduated with a Doctor of Medicine (MD) degree in 1886. She subsequently returned to her home country, making her the first female physician in India. Despite her untimely death, Anandi became immortalised as a legend, a beacon of hope, and continues to serve as an inspiration for generations of Indian women.