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1.
Lancet Glob Health ; 12(3): e522-e529, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-38365422

RESUMEN

In rural settings worldwide, many people live in effective blood deserts without access to any blood transfusion. The traditional system of blood banking is logistically complex and expensive for many resource-restricted settings and demands innovative and multidisciplinary solutions. 17 international experts in medicine, industry, and policy participated in an exploratory process with a 2-day hybrid seminar centred on three promising innovative strategies for blood transfusions in blood deserts: civilian walking blood banks, intraoperative autotransfusion, and drone-based blood delivery. Participant working groups conducted literature reviews and interviews to develop three white papers focused on the current state and knowledge gaps of each innovation. Seminar discussion focused on defining blood deserts and developing innovation-specific implementation agendas with key research and policy priorities for future work. Moving forward, advocates should prioritise the identification of blood deserts and address the context-specific challenges for these innovations to alleviate the ongoing crisis in blood deserts.


Asunto(s)
Bancos de Sangre , Transfusión Sanguínea , Humanos , Políticas , Consenso , Población Rural
2.
Hypertension ; 80(5): 1110-1116, 2023 05.
Artículo en Inglés | MEDLINE | ID: mdl-36912176

RESUMEN

BACKGROUND: To identify and summarize the global research literature on validation of automated noninvasive blood pressure measurement devices (BPMDs) with upper arm cuff, develop a repository of validated BPMDs in compliance with the 2020 World Health Organization technical specifications, and identify challenges and gaps in evidence base on validated BPMDs. METHODS: A scoping review was conducted. Primary research validating BPMDs complying with the 2020 World Health Organization technical specifications (ie, semiautomated/automated noninvasive devices with upper arm cuff), published in English between January 2000 and December 2021, was included. We searched MEDLINE, Web of Science, Scopus, EMBASE, CINAHL, CENTRAL, ProQuest and the dabl website. RESULTS: We included 269 studies validating 251 BPMDs across 89 manufacturers. Omron (29%), Microlife (10%), and A&D Company (8%) were the top 3 manufacturers. The 3 most frequently used validation protocols were the European Society of Hypertension-international protocol 2002 (27%), European Society of Hypertension-international protocol 2010 (25%), and modified British Hypertension Society protocol 1993 (16%), respectively. Nearly 45% of the validated BPMDs were intended for use in clinical settings, 38% were for home or self-measurement use, and 48% were for general adults. Most studies reported that BPMDs passed the validation criteria. There was inadequate reporting across studies, especially pertaining to validation settings. CONCLUSIONS: Most BPMDs fulfilled the validation criteria. However, there are considerable gaps in BPMD research in terms of geographical representation, including specific target populations and diseases/conditions, and a range of arm circumferences. Additionally, a potential strategy is required to accelerate the adoption of the Association for the Advancement of Medical Instrumentation (AAMI)/European Society of Hypertension/International Organization for Standardization Universal Standard (International Organization for Standardization 81060-2:2018) for BPMD validation.


Asunto(s)
Determinación de la Presión Sanguínea , Hipertensión , Adulto , Humanos , Presión Sanguínea , Determinación de la Presión Sanguínea/métodos , Esfigmomanometros , Organización Mundial de la Salud , Monitores de Presión Sanguínea
3.
BMJ Case Rep ; 15(7)2022 Jul 14.
Artículo en Inglés | MEDLINE | ID: mdl-35835482

RESUMEN

A teenage girl presented to our remote rural hospital with history of massive haemoptysis. A CT scan showed a spherical lesion in the right lung. Exploratory thoracotomy was performed with a provisional diagnosis of pulmonary hydatid cyst. Intraoperative findings were consistent with intrapulmonary teratoma and this was confirmed by a histopathological diagnosis of mature teratoma. Four years later, the patient presented again with recurrence of haemoptysis and a right middle lobectomy was performed. We present a report of successful management of this patient with 20-year follow-up since the first surgery, describe the pathology of this rare condition and the procedures used to treat it. We also discuss the social and economic factors that affect decision making in the management of rare conditions in remote rural areas among poor communities that are usually referred to tertiary hospitals and suggest modifications to protocols to provide effective treatment in spite of resource constraints.


Asunto(s)
Neoplasias de los Bronquios , Quiste Dermoide , Teratoma , Adolescente , Quiste Dermoide/cirugía , Femenino , Hemoptisis/etiología , Humanos , Teratoma/complicaciones , Teratoma/diagnóstico por imagen , Teratoma/cirugía , Tomografía Computarizada por Rayos X
4.
BMJ Case Rep ; 14(4)2021 Apr 28.
Artículo en Inglés | MEDLINE | ID: mdl-33910790

RESUMEN

We report a case of right paraduodenal hernia with strangulation of almost the entire small bowel at presentation. Since resection of all bowel of doubtful viability would have resulted in too little residual length to sustain life, a Bogota bag was fashioned using transparent plastic material from an urine drainage bag and the patient monitored intensively for 18 hours. At re-laparotomy, clear demarcation lines had formed with adequate length of viable bowel (100 cm) and resection with anastomosis was done with a good outcome on follow-up, 9 months after surgery. Our description of a rare cause of strangulated intestinal obstruction and a novel method of maximising length of viable bowel is reported for its successful outcome in a low-resource setting.


Asunto(s)
Gangrena , Obstrucción Intestinal , Colombia , Gangrena/cirugía , Hernia , Humanos , Obstrucción Intestinal/diagnóstico por imagen , Obstrucción Intestinal/etiología , Obstrucción Intestinal/cirugía , Intestino Delgado/diagnóstico por imagen , Intestino Delgado/cirugía , Hernia Paraduodenal
5.
Ann N Y Acad Sci ; 1498(1): 96-107, 2021 08.
Artículo en Inglés | MEDLINE | ID: mdl-33385182

RESUMEN

In this article, we report the different presentations of thiamine deficiency disorders seen at a remote rural mission hospital in Northeast India, including investigations, treatment, and recovery. Two case studies, one of an infant with cardiac beriberi and the other of a nonalcoholic adult presenting with peripheral neuropathy, cardiomyopathy, and metabolic acidosis and responding to thiamine supplementation, are described in detail. We share our experience with these clinical entities over the past two decades, including recent research and lessons learned, and suggest ways forward to identify at-risk populations in Northeast India, improve early diagnosis and treatment, and promote preventive public health strategies.


Asunto(s)
Susceptibilidad a Enfermedades , Hospitales , Población Rural , Deficiencia de Tiamina/epidemiología , Deficiencia de Tiamina/etiología , Beriberi/complicaciones , Beriberi/diagnóstico , Beriberi/epidemiología , Beriberi/etiología , Humanos , India/epidemiología , Vigilancia en Salud Pública , Tiamina , Deficiencia de Tiamina/complicaciones , Deficiencia de Tiamina/diagnóstico
6.
F1000Res ; 9: 683, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33500775

RESUMEN

Background: Maternal and perinatal Health Research collaboration, India (MaatHRI) is a research platform that aims to improve evidence-based pregnancy care and outcomes for mothers and babies in India, a country with the second highest burden of maternal and perinatal deaths. The objective of this paper is to describe the methods used to establish and standardise the platform and the results of the process. Methods: MaatHRI is a hospital-based collaborative research platform. It is adapted from the UK Obstetric Surveillance System (UKOSS) and built on a pilot model (IndOSS-Assam), which has been extensively standardised using the following methods: (i) establishing a network of hospitals; (ii) setting up a secure system for data collection, storage and transfer; (iii) developing a standardised laboratory infrastructure; and (iv) developing and implementing regulatory systems. Results: MaatHRI was established in September 2018. Fourteen hospitals participate across four states in India - Assam, Meghalaya, Uttar Pradesh and Maharashtra. The research team includes 20 nurses, a project manager, 16 obstetricians, two pathologists, a public health specialist, a general physician and a paediatrician. MaatHRI has advanced standardisation of data and laboratory parameters, real-time monitoring of data and participant safety, and secure transfer of data. Four observational epidemiological studies are presently being undertaken through the platform. MaatHRI has enabled bi-directional capacity building. It is overseen by a steering committee and a data safety and monitoring board, a process that is not normally used, but was found to be highly effective in ensuring data safety and equitable partnerships in the context of low and middle income countries (LMICs). Conclusion: MaatHRI is the first prototype of UKOSS and other similar platforms in a LMIC setting. The model is built on existing methods but applies new standardisation processes to develop a collaborative research platform that can be replicated in other LMICs.


Asunto(s)
Servicios de Salud del Niño , Países en Desarrollo , Servicios de Salud Materna , Mejoramiento de la Calidad , Medicina Basada en la Evidencia , Familia , Femenino , Hospitales , Humanos , India , Lactante , Estudios Observacionales como Asunto , Embarazo , Atención Prenatal
7.
Biodivers Data J ; (5): e10294, 2017.
Artículo en Inglés | MEDLINE | ID: mdl-28325974

RESUMEN

BACKGROUND: The genus Platythomisus Doleschall, 1859 presently comprises 13 valid species, nine known from Africa and four from Asia. All Platythomisus species are known from females only, except P. jucundus Thorell, 1894 and P. sudeepi Biswas, 1977 from both sexes and P. quadrimaculatus from juvenile. Only, P. sudeepi was reported from India. NEW INFORMATION: Platythomisus octomaculatus (C. L. Koch, 1845) is recorded after 120 years of its last report; newly recorded from Assam, India which extends its distribution from the previously known localities, Java and Sumatra. Platythomisus sudeepi is newly recorded from the Maharashtra State. The variation in the number of abdominal spots on juvenile, sub-adult and adult of P. octomaculatus observed during rearing is reported. Although, the species name 'octomaculatus' suggests eight spots, we observed that the anterior pair of abdominal spots is fused in adults.

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