Solution-focused approach towards improved access to assistive mobility technology and devices in low and middle-income countries: A narrative review

BACKGROUND@#The article focuses on the main challenges for low and middle-income countries (LMICs) and approaches that need to be implemented to achieve assistive mobility devices for all. World Health Organization (WHO) estimates that about one billion (15%) of the world’s population lives with some form of disability, with projections for the same to double by 2050, a significant proportion (approx.840 million) of them residing in low- and middle-income countries. As per WHO, it is estimated that only 5-15% of the people requiring assistive technology have access to it. In low and middle-income countries, the rate of accessibility is expected to be worse due to the high cost of the products, diminished awareness, lack of trained personnel, inadequate availability, and ineffective policy implementation due to lack of funds. The current developments in assistive mobility technologies and devices available at a high cost for consumers in high-income countries have neglected the requirement of persons with disabilities in low and middle-income countries. The improved rehabilitation methods of assistive mobility devices may deliver economic and health benefits to individuals and lessen the financial burden on governments in the future. Therefore, multidisciplinary research is greatly needed to measure and prove the effectiveness of rehabilitation treatment methods and to develop an evidence-based sustainable treatment, particularly in LMICs. Also, a detailed service model assessment can identify the lack of current service provision. The online databases were searched to find relevant articles for the purpose.

Safe leg surgery: the anatomic principles and techniques

The goals of surgical treatment of leg injury are to achieve soft tissue healing, good osseous union and to restore the length of the limb, correct alignment of both bones with their respective joints and normal range of movements of the entire limb at the earliest. Presently, the surgical treatment has been standardised for the tibia fractures for adults and children. Though the surgical progress made in the implants, instruments and techniques, there are considerable surgical complications happening. This article highlights the need of anatomical expertise and safe operative ability for the surgeon.

Hydnora africana Derived Phytochemicals against Acetaldehyde Dehydrogenase of Aeromonas hydrophila Causing Septicemia

For drug discovery it takes approximately 6 years to expose in the market and for commercial uses. There are different procedure to get success in the drug discovery like preliminary phytochemical analysis, structural elucidation of the bioactive compound, preclinical test and clinical test etc. So to optimize the time for invention of new drug molecule, computer aided drug designing and molecular docking analysis is being used as one of the highly effective methodology. The phytochemical extraction of Hydnora africana plant was reported to inhibit the growth of Aeromonas hydrophilawhich cause Septicemia.“Biovia Discovery Studio” molecular docking methods give us opportunity to identify the effective molecule against the microbes. “High positive values of -CDOCKER energy and -CDOCKER interaction energy” recommended that flavone can effectively deactivate the acetaldehyde dehydrogenase enzyme thereby interrupting the life cycle of the organism

Left ventricular dissecting hematoma caused by tissue stabilizer

Abstract Coronary artery bypass grafting is a commonly performed procedure for coronary revascularization. We describe the successful management of left ventricular dissecting hematoma, caused by the tissue stabilizer, while performing off-pump coronary artery bypass graft procedure.

Primary mediastinal hydatid cyst causing diaphragmatic palsy

Abstract Hydatid cystic disease is a significant clinical problem in endemic countries. Hydatid cysts are most commonly located in the liver and lungs. Primary mediastinal hydatid cyst is a rare clinical entity. The diagnosis must be considered in a patient with a mediastinal mass, particularly in endemic regions. Mediastinal hydatid cysts causing paralysis of phrenic and recurrent laryngeal nerves have been rarely reported. We describe a rare case of primary mediastinal hydatid cyst associated with diaphragmatic palsy caused by compression of the left phrenic nerve, which was successfully treated with partial cystectomy and capitonnage with hemidiaphragmatic plication.

Mixed Connective Tissue Disease Presenting As Quadriparesis In A Female

Mixed connective tissue disease (MCTD), or overlap syndrome, is a multisystem autoimmune disease characterized by a combination of clinical features similar to those of polymyositis, systemic sclerosis, and rheumatoid arthritis. MCTD patients present with a distinct rise (high titers) of anti-U1 ribonucleoprotein antibody in serum. Here, we present the case of a 45-year-old female who presented with subacute onset weakness on all four limbs and later on diagnosed as overlap syndrome with severe myositis

Use of autologous umbilical cord blood transfusion in neonates undergoing surgical correction of congenital cardiac defects: A pilot study

Background: Blood transfusion requirement during neonatal open heart surgeries is universal. Homologous blood transfusion (HBT) in pediatric cardiac surgery is used most commonly for priming of cardiopulmonary bypass (CPB) system and for postoperative transfusion. To avoid the risks associated with HBT in neonates undergoing cardiac surgery, use of autologous umbilical cord blood (AUCB) transfusion has been described. We present our experience with the use of AUCB for neonatal cardiac surgery. Designs and Methods: Consecutive neonates scheduled to undergo cardiac surgery for various cardiac diseases who had a prenatal diagnosis made on the basis of a fetal echocardiography were included in this prospective observational study. After a vaginal delivery or a cesarean section, UCB was collected from the placenta in a 150-mL bag containing 5 mL of citrate–phosphate–dextrose–adenine-1 solution. The collected bag with 70–75 mL cord blood was stored at 2°C–6°C and tested for blood grouping and infections after proper labeling. The neonate's autologous cord blood was used for postcardiac surgery blood transfusion to replace postoperative blood loss. Results: AUCB has been used so far at our institute in 10 neonates undergoing cardiac surgery. The donor exposure in age and type of cardiac surgery-matched controls showed that the neonates not receiving autologous cord blood had a donor exposure to 5 donors (2 packed red blood cells [PRBCs], including 1 for CPB prime and 1 for postoperative loss, 1 fresh frozen plasma, 1 cryoprecipitate, and 1 platelet concentrate) compared to 1 donor for the AUCB neonate (1 PRBC for the CPB prime). Postoperative blood loss was similar in both the groups of matched controls and study group. Values of hemoglobin, total leukocyte count, platelet counts, and blood gas parameters were also similar. Conclusions: Use of AUCB for replacement of postoperative blood loss after neonatal cardiac surgery is feasible and reduces donor exposure to the neonate. Its use, however, requires a prenatal diagnosis of a cardiac defect by fetal echo and adequate logistic and psychological support from involved clinicians and the blood bank.

Surgical repair of D-TGA with an aortopulmonary window and ventricular septal defects / Correção cirúrgica da transposição das grandes artérias com janela aortopulmonar e defeitos do septo ventricular

D-Transposition of great arteries with an aortopulmonary window is a rare congenital anomaly. We describe a case of D-Transposition of great arteries with an aortopulmonary window and multiple ventricular septal defects in a 5-month boy who underwent successful surgical repair.

A transposição das grandes artérias com uma janela aortopulmonar é uma anomalia congênita rara. Descrevemos um caso de transposição das grandes artérias com janela aortopulmonar e múltiplos defeitos do septo ventricular em um menino de 5 meses submetido a tratamento cirúrgico com sucesso.

Inflammatory pseudotumor of the omentum.

Inflammatory pseudotumor is an unusual quasineoplastic lesion, of uncertain natural history and etiopathogenesis, which consists of inflammatory cells and myofibroblastic spindle cells; and is usually found in children and young adults. Clinical manifestations and radiological feature of this rare entity, can be indistinguishable from a malignant sarcomatous or lymphoproliferative disorders. Here, a case of surgically proven inflammatory pseudotumor of the omentum in a child and its review of literature is presented. Conservative surgery is curative in most cases of inflammatory pseudotumors. Awareness of this lesion is essential for clinicians, radiologists and pathologists, as pre-operative recognition may spare the child from unnecessary radical surgery or harmful chemoradiotherapy.

CT virtual bronchoscopy: new non invasive tool in pediatric patients with foreign body aspiration.

A 2-year-old girl presented with recurrent cough, wheese and breathing difficulty. Her imaging (CT and virtual bronchoscopy) revealed a foreign body in tracheobronchial tree, that was removed by rigid bronchoscopy.