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Background: Preventing cancer is better than treating or curing it. Cancer prevention ensures reduced physical, emotional, financial burden to the individual. Methods: The focus of the preventive oncology unit at Healthcare Global (HCG) Enterprise Limited, Bangalore, India, is to increase the understanding of how lifestyle and risk of cancer are related. It also focusses on screening of normal individuals for estimating their risk of developing cancer, which in-turn can lead to earlier detection, improved treatment and outcomes. This unique endeavor started one year back, provides counseling and vaccination services for HPV (Human Papilloma Virus) and HBV (Hepatitis B Virus). Our outreach initiatives in collaboration with the State and City health Departments include screening camps, and awareness sessions focusing on HPV and HBV vaccination. Results: The focus of research is in the areas of cancer epidemiology, prevention, screening, and control. Such research involves a multidisciplinary approach involving the fields of epidemiology, biostatistics, behavioral science, nutrition, and basic science. Conclusion: This novel endeavor at a tertiary cancer hospital in a Developing Country is aimed at preventing the development or progression of the malignant cancer process. [ABSTRACT FROM AUTHOR]

Objectives: To describe the trends and characteristics of the worldwide scientific production on the use of artificial pancreas (AP) in the management of diabetes mellitus (DM). Materials and Methods: Scientific papers published between 2017 and 2022 were retrieved from the Scopus database using relevant keywords. Only original articles, reviews, and short surveys were included. The metadata were exported to the SciVal software for retrieving quantitative data and the main characteristics such as journals, authors, institutions, journal metrics by quartiles, subcategories, and collaborative networks were extracted. Results: A total of 642 articles were included after applying the inclusion/exclusion criteria: original articles, 489; reviews, 151; and short surveys, 2. The most common type of collaboration was at the national level (38.3%; citations per publication: 22.3; field-weighted citation index [FWCI]: 2.2) followed by international collaboration (29.4%; citations per publication: 19.6; FWCI: 1.94). More than 70% of articles in each year were published in journals listed in Q1. Two journals, Diabetes Technology and Therapeutics and Journal of Diabetes Science and Technology, accounted for about 22% of all publications. Six of the top 10 universities were from the United States, with The University of Virginia having the most publications (n = 54; 59 authors; citations per publication: 38.4; FWCI: 3.73). Conclusions: The findings of this study highlight that most research on this topic is published in high-quality journals and has a good citation impact. Notably, most research has been conducted in developed countries, thereby indicating the need for research efforts in this field from developing countries. [ABSTRACT FROM AUTHOR]

Introduction: Dentistry is an ever-evolving branch with extensive resources that have a significant impact on the environment, especially the materials that are inherent to the profession that has contributed to this. In such a situation, it is essential for dentists to embrace environmentally friendly practices or "green dentistry" to change the hazardous practice of dentistry into a sustainable one. Aim: The aim of this paper is to evaluate existing healthcare sustainability principles and to lay out a plan for incorporating the same in regular practice. Methodology: This paper reviews current literature pertaining to green dentistry and its incorporation into daily practice. EBSCOhost and PubMed databases were searched for papers published in the English language for the last 10 years using preset keywords. Conclusion: Using the most recent techniques and processes to reduce waste, preserve energy, and reduce pollution, green dentistry is a cuttingedge approach to dental care that is also economical and time-efficient. Therefore, practicing green dentistry safeguards both the environment and humankind from the dangers of growing urbanization in emerging nations. [ABSTRACT FROM AUTHOR]

Sudden cardiac death (SCD) is a leading cause of mortality worldwide and, in recent years, has become an urgent public health concern in low- and middle-income countries (LMICs). Data from LMICs, however, remains limited. As such, the aim of this article is to systematically review the current literature on the incidence of SCD in LMICs to inform policymakers and identify potential research gaps. A search of PubMed and Embase was utilized to capture the targeted condition, outcome, and setting. Only peer-reviewed cohort studies in LMICs reporting SCD incidence estimates in the general population of individuals aged ≥1 year were eligible for selection. Papers providing incidence data for specific types of SCD, including sudden coronary death or death from sudden cardiac arrest, were also included. After deduplication, 1941 citations were identified and screened. Seven studies representing four countries--Cameroon, China, India, and Iran--met the criteria for inclusion and were considered in our analysis. The crude incidence rate for SCD ranged from 19.9 to 190 cases per 100,000 person-years, while ageadjusted rates ranged from 33.6 to 230 cases per 100,000 person-years. There was notable variability in methods utilized to ascertain SCD cases. These findings suggest that the incidence of all-cause SCD in LMICs and may exceed that of high-income countries; however, observed disparities may be partly attributable to differences in case ascertainment methods. Additional research is needed to better understand the true incidence of SCD in developing countries. It is crucial that future studies across regions utilize standard diagnostic criteria and methodology for identifying SCD, which would provide a framework by which to compare outcomes between settings. [ABSTRACT FROM AUTHOR]

Background: In recent years, information technology has been introduced in the nursing departments of many hospitals to support their daily tasks. Nurses are the largest end user group in Hospital Information Systems (HISs). This study was designed to evaluate data processing in the Nursing Information Systems (NISs) utilized in many university hospitals in Iran. Methods and Materials: This was a cross-sectional study. The population comprised all nurse managers and NIS users of the five training hospitals in Khorramabad city (N = 71). The nursing subset of HIS-Monitor questionnaire was used to collect the data. Data were analyzed by the descriptive-analytical method and the inductive content analysis. Results: The results indicated that the nurses participating in the study did not take a desirable advantage of paper (2.02) and computerized (2.34) information processing tools to perform nursing tasks. Moreover, the less work experience nurses have, the further they utilize computer tools for processing patient discharge information. The "readability of patient information" and "repetitive and time-consuming documentation" were stated as the most important expectations and problems regarding the HIS by the participating nurses, respectively. Conclusions: The nurses participating in the present study used to utilize paper and computerized information processing tools together to perform nursing practices. Therefore, it is recommended that the nursing process redesign coincides with NIS implementation in the health care centers. [ABSTRACT FROM AUTHOR]

Background: Conditions that are amenable to surgery are found globally. However, surgery is not easily accessible for most people in low- and middle-income countries due to physical and financial barriers, among others. One-way of mitigating against this situation is through surgical outreach programmes.Patients and Methods: A paediatric surgical outreach in a teaching hospital in the Central Region of Ghana was carried out by a paediatric surgeon from Korle Bu Teaching Hospital. Data on the cases done from June 2011 to June 2014 were analysed.Results: A total of 185 patients had surgery during the study. There were 153 males with the mean age of 4.53 ± 3.67 years. Patients aged 1-5 years represented 51.9% of the patients. Twenty-four (13%) had major surgery and 161 (87%) had minor operations. The most common minor operation performed was inguinal herniotomy representing 47.2% of the cases. None of the patients had any complications.Conclusion: The need for paediatric surgical outreach programme has been shown in this paper as well as its cost-effectiveness. With the current rate of graduation of paediatric surgeons in Ghana, paediatric outreach programmes will be needed in Ghana in the foreseeable future. This outreach should be extended to other regions of the country to cover a larger percentage of children in Ghana. [ABSTRACT FROM AUTHOR]

BACKGROUNDS: Nasoalveolar molding (NAM) application is among presurgical management (PSM) techniques used for infants with cleft lip and palate (CLP). It helps to approximate the palatal cleft and to reshape the nasoalveolar complex prior to primary lip repair. This study aimed to explore types of PSM and the dental speciality provision for infants with CLP in Baghdad. The status of NAM usage and surgeons' perceptions toward NAM usage were assessed. MATERIALS AND METHODS: This is a cross-sectional paper-based questionnaire study that collected responses of surgeons perform primary lip and nose repair regarding PSM. The questionnaire was distributed amongst public and private hospitals in Baghdad. Twenty surgeons were enrolled (only those surgeons who perform primary repair for infants with CLP); two females and eighteen males. RESULTS: The majority of participants' responses suggested that the majority of infants with CLP were provided with baby feeding plates and lip straps. Six surgeons reported that a percentage of their patients who have been provided with NAM. PSM in Baghdad was mostly supplied by orthodontists and plastic surgeons, and the next most likely providers were prosthodontists. 82.35% of the surgeons found that primary surgical repair procedures were easier with NAM than for the other infants. The rest have not perceived any differences. CONCLUSIONS: Orthodontists, surgeons and prosthodontists were involved in providing PSM. Baby feeding plates and lip straps were the most common PSM in Baghdad, although NAM is not uncommon. Most surgeons believe that using NAM made surgical procedures easier and permitted the prediction of surgical outcomes. [ABSTRACT FROM AUTHOR]

Background: Low- and middle-income countries (LMICs) bear the majority of the neurosurgical burden of diseases but lack the resources to meet these needs.Objective: As we increase access to neurosurgical care in LMICs, we must understand patient attitudes toward neurosurgery.Methods and Material: PubMed, LILACS, and African Journals Online databases were searched systematically from inception to January 4, 2020, for studies on neurosurgical patient perceptions in LMICs. The articles found were blindly reviewed with Rayyan by two authors. The two authors resolved conflicts between themselves, and when this was not possible, a third reviewer was consulted. All the articles included were then appraised, and the results were summarized.Results: Six of the 1,175 articles met the inclusion criteria. The studies were set in Brazil, Ethiopia, India, Nigeria, South Korea, and Sub-Saharan Africa. Four of the studies (50%) were phenomenological studies, and the other two were grounded theory and narrative. The studies identified patient attitudes toward neurosurgical practitioners, diseases, and interventions. Ethiopian and Nigerian patients believed cranial diseases to be otherworldly and resorted to traditional medicine or spiritual healing first, whereas Brazilian patients were more comfortable with cranial diseases and even more so if they had had a previous craniotomy. The Indian paper was a recount of a neurosurgeon's experience as a spine patient.Conclusions: There are few studies on neurosurgery patient perception in LMICs. LMIC neurosurgeons should be encouraged to study their patient beliefs concerning neurosurgical diseases and interventions, as this can explain health-seeking behaviors. [ABSTRACT FROM AUTHOR]

Colorectal cancer (CRC) is one of the most common cancers worldwide, CRC is the third furthermost common cancer and the fourth principal reason of cancer-related death. Colorectal cancer incidence varies globally, with developed countries having higher rates than developing countries. Colorectal cancer is associated with a lower socioeconomic status The following databases were searched: PubMed, Science Direct, Web of Science, EBSCO, and the Cochrane Library. Using Rayyan QCRI, included studies were screened by heading and abstract before being subjected to a full-text evaluation. This review investigates the published literature regarding the causes, diagnosis, and management of Colorectal cancer. This study comprised 7 trials with a total of 3,134,223 colorectal cancer patients, Most cases were diagnosed by computed tomography and only one study depended on surgery. The included studies used MRI also. CT defines the staging of CRC as the TNM staging [tumor, nodal, and metastases staging. Understanding the unique gene modifications is widely expected to lead to more accurate and tailored care for persons with polyps and malignancies, driven by molecular characterisation of the individual's colon tumour. [ABSTRACT FROM AUTHOR]

For several reasons, cerebral visual impairment (CVI) is emerging as a major cause of visual impairment among children in the developing world and we are seeing an increasing number of such children in our clinics. Owing to lack of early training about CVI and it being a habilitation orientated subject, we need to become equipped to optimally help the affected children. In this paper we have explained our pragmatic approach in addressing children who present with low functioning CVI. Initially we explain briefly, how vision is processed in the brain. We then present what should be specifically looked for in these children in regular clinics as a part of their comprehensive ophthalmic examination. We discuss the process of functional vision evaluation that we follow with the help of videos to explain the procedures, examples of how to convey the conclusions to the family, and how to use our findings to develop intervention guidelines for the child. We explain the difference between passive vision stimulation and vision intervention, provide some common interventions that may be applicable to many children and suggest how to infuse interventions in daily routines of children so that they become relevant and meaningful leading to effective learning experiences. [ABSTRACT FROM AUTHOR]

Background: There is no ideal postoperative pain management. Simple surgeon-delivered local anesthetic (LA) techniques such as wound infiltration and regional nerve blocks can play a significant role in the improvement of postoperative pain relief. Settings and Design: Administered paper questionnaires to delegates attending surgical society conferences. Methods: A 15-point questionnaire was administered to surgical delegates attending general surgey, orthopedic and gynecological conferences at different locations. Results: Response rate was 65.26%. 33% of surgeons used LA regularly, 31% occasionally, and 36% never used LA for postoperative analgesia. 50% of all surgeons used lignocaine for local anesthesia (P < 0.0001) and infiltration (65% of all surgeons) was the most common method (P < 0.0001). Only 30% surgeons knew the correct duration of action of bupivacaine infiltration (P < 0.0001) and only 4% surgeons knew that LAs are antimicrobial (P < 0.0001). 53% of orthopedic surgeons used combination of lignocaine and bupivacaine, while 46% of general and 73% gynecologists surgeons used lignocaine more commonly. Only <5% of all surgeons had used long-acting liposomal bupivacaine and almost 40% more were willing to use the liposomal LA drug only if more evidence is available. Conclusions: Although majority of surgeons were aware of the benefits of LA use for postoperative pain relief, reluctance, lack of knowledge of LA drugs and methods of LA use and fear of infection and wound healing are barriers for effective use of LA drugs for postoperative pain relief. Attending anesthesiologists must develop methods in the operating room to create awareness about the effectiveness of LA use for postoperative pain relief. Single-use vials or ampules of LA must be encouraged to LA use for postoperative analgesia, especially in the third-world countries. [ABSTRACT FROM AUTHOR]

Objectives: The knowledge and behavior of caregivers are playing a significant role in preventing and managing the emergency conditions of disease or disorder suffered by their children. Pediatric asthma is one such severe health disorder, which cripples the child from regular activities and exerts enormous stress on parents if not appropriately managed with adequate knowledge and skills in the initial stage of onset. This research paper, thus, is aimed to appraise the caregivers' knowledge and behavior (n = 250) of asthmatic children admitted to general hospitals in Jazan province, Kingdom of Saudi Arabia, about the cause, prognosis, and therapy of asthma in preventing and handling emergency asthmatic attacks in their children. Materials and Methods: Caregivers were interviewed with the help of a questionnaire (35 items) about pediatric asthma. The questionnaire was adapted from the Chicago Community Asthma Survey. Results: The results revealed that information regarding complications of pediatric asthma, behavioral skills, and knowledge on its management that are required to practice during an emergency was very little among the caregivers of asthmatic children. Lack of proper education, insufficient knowledge of asthma, underprivileged socioeconomic class, and substandard living conditions came out as reasons for poor knowledge and behavior among them. Conclusion: The study recommends that there is an urgent and pressing need to educate caregivers and provide continuous training on the right practice during asthma attacks to take proper and efficient care of their children. [ABSTRACT FROM AUTHOR]

Of the 70 million persons with epilepsy (PWE) worldwide, nearly 12 million PWE are expected to reside in India; which contributes to nearly one-sixth of the global burden. This paper (first of the two part series) provides an in-depth understanding of the epidemiological aspects of epilepsy in India for developing effective public health prevention and control programs. The overall prevalence (3.0-11.9 per 1,000 population) and incidence (0.2-0.6 per 1,000 population per year) data from recent studies in India on general population are comparable to the rates of high-income countries (HICs) despite marked variations in population characteristics and study methodologies. There is a differential distribution of epilepsy among various sociodemographic and economic groups with higher rates reported for the male gender, rural population, and low socioeconomic status. A changing pattern in the age-specific occurrence of epilepsy with preponderance towards the older age group is noticed due to sociodemographic and epidemiological transition. Neuroinfections, neurocysticercosis (NCC), and neurotrauma along with birth injuries have emerged as major risk factors for secondary epilepsy. Despite its varied etiology (unknown and known), majority of the epilepsy are manageable in nature. This paper emphasizes the need for focused and targeted programs based on a life-course perspective and calls for a stronger public health approach based on equity for prevention, control, and management of epilepsy in India. [ABSTRACT FROM AUTHOR]

Uveitis and its complications are more common in the developing world, in which the condition occurs in up to 714 per 100,000 in the population and accounts for up to 25% of all blindness. In India, the ophthalmic sub speciality of uveitis greatly evolved in the last four decades. In the early decades most of the studies were epidemiological studies. In recent years, more research has been published due to tremendous advancements in clinical diagnosis, laboratory investigations and ancillary test and treatment modalities. In this review article, we did a medline search with key words ‘uveitis’ and ‘India’, and selectively incorporated articles showing the evolution of this sub-speciality in India. [ABSTRACT FROM AUTHOR]

Background: Recent disease resurgence in China indicates that corona virus infectious disease is still a pertinent public health problem. We stand at a juncture where we are still unsure about the initial dilemmas regarding its birth, therapies, and the emerging novel strains. Medical literature has focused on the clinical, laboratory, radiological, and therapeutic aspects of disease management. There is paucity of literature on the association between socio‑demographic variables on disease severity and clinical outcome. Materials and Methods: This retrospective observational study analyzing the socio‑demographic variables was performed at a dedicated COVID care center in western Maharashtra, India. Electronic records of all individuals who were admitted to this hospital from July 29 2020, to June 14, 2021, and diagnosed COVID‑19 positive by reverse transcriptase polymerase chain reaction (RT‑PCR) were identified after due institutional ethical clearance. Patients admitted from July 29, 2020, to February 27, 2021, were categorized as patients presenting during the ‘first wave of viral pandemic’. Those admitted from March 01, 2021, to June 14, 2021, have been included as patients admitted during ‘second wave of viral pandemic’. The following outcome parameters were collected (presenting symptoms, duration of symptoms before the individual presented for diagnostic RT‑PCR, total duration of symptoms, severity of disease at onset, duration of hospital stay, the final outcome (discharge/death) and Charlson’s comorbidity index). The linear regression model was used to establish association between socio‑demographic factors and disease severity at onset (mild/moderate/severe/critical). Results: A total of 37033 patients were screened, and the positivity rate with RT‑PCR was 16.99% (n = 6275) during the study period. Out of which 45% (n = 2824) of the patients had mild disease requiring home isolation and the remaining 55% of patients required admission. 1590 patients from the first wave and 910 from the second wave of COVID‑19 were hospitalized and included in the study after exclusion. The mean age of patients in first wave was 49 years and that in second wave was 54 years with 77.6% and 70.6% males in two waves, respectively. The burden of critical cases was higher in second wave as computed to first wave (10% vs 8%). The second wave had more outreach in the rural population as compared to second one (17.8% vs 12.2%). The mean duration from the onset of symptoms to hospitalization was 03 and 04 days, respectively, in two waves. [ABSTRACT FROM AUTHOR]

It has always been argued that countries should not be inactive about the quality of health services. Therefore, a clear policy needs to be created regarding how quality of health services should be. The present scoping review was aimed to identify and map the available evidence regarding the National Quality Policy and Strategy (NQPS) of the health services in health systems of developing countries, graphically and tabularly. We followed the published methodological guidance of the Joanna Briggs Institute reviews. Also, we employed a narrative thematic synthesis integrated with the systematic analysis using the World Health Organization's approach of NQPS, and the multiple-streams framework of Kingdon. We included 33 records that met the inclusion criteria; these records were published between 2010 and 2019. Meanwhile, government documents were the most frequent records (61%). Zimbabwe, Indonesia, and Sudan were the most frequent locations (each one 8%). The Ministry of Health was in charge of the ultimate responsibility for developing the NQPS in all identified countries. Besides, 82% of the countries were in the development phase of NQPS formulation, and convergence of three streams was observed in Indonesia, Sudan, and Tanzania. It seems that the African countries were informed about their quality issues, and the need for having NQPS have been more popular with them. We recommend that future research focuses on examining NQPS in terms of prioritizing in the agenda-setting phase of the policy-making cycle, and also, document analysis of all identified NQPS based on the core eight interdependent elements related to the NQPS approach. [ABSTRACT FROM AUTHOR]

Clinical trials and research studies are being conducted worldwide at a rampant pace leading to generation of large amount of data. However, to reap the benefits of the data generated it is important that this data is shared with the general public without which it can be deemed useless. Despite its importance being known to us, data sharing does not come without its share of problems and it is not as easy to execute as it sounds on-paper. Over the past few years, multiple coveted organizations around the world involved in research activities have come up with their respective guidelines and initiatives to make sure the sharing of research data is smooth and ethical. Developing countries like India have made a few strides in the right direction with some initiatives in-place, but there still seems a long way to go before unanimous data sharing can be a reality. The stakeholders may have to face certain possible repercussions due to data sharing but there is no doubt that if done in the right way, it can lead to universal development. [ABSTRACT FROM AUTHOR]

Background: Epistemic injustice and the so-called "predators" or illegitimate publishers are the challenges of Southern scholarly publishing. Even though open access (OA) publishing is revolutionary in academic publishing, increased compensation from authors in the form of author processing charges (APCs) by commercial publishers has marginalized knowledge creation in the Global South. The purpose of this study was to map the nature and scope of dental journal publishing in India. Methods: We searched databases like Scopus, WoS, DOAJ, and the UGC CARE list for dental journals published in India. Result: There are currently 35 active dental journals, which mostly belong to or are affiliated with non-profit organizations (26, 55.9%) or educational institutions (9, 25.8%). The publication of 25 journals has been outsourced to international commercial publishers, with most of these linked to non-profit organizations. About 39.8% of Indian dental journals are OA and almost half charge APCs. Around 60% of the Indian journals are indexed in Scopus, and slightly less than half (12) are included in the Web of Science (WoS). Discussion: The monopoly of international commercial publishers and the presence of APCs are the real culprits of epistemic injustice in Indian dental journal publishing. Besides, the identification of regional legitimate publishers would help demarcate the term "predatory publishing". Conclusion: The post-colonial world witnessed an emergence in Southern scholarly publishing. However, the hegemony or neoliberal exploitation of international commercial publishers and the prolonged use of "predators" in scholarly debates marginalized the knowledge produced in the Global South. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented in response to a paper by M. Abdollahi et al and S. Kharabaf et al regarding science growth in Iran over the past 35 years.

Many underdeveloped countries still struggle with the public health issue of acute illnesses, especially with the emergence of injuries as a major category of acute diseases. Control of the acute disease is challenging particularly when it occurs as an outbreak, either in isolation or as part of a wider epidemic. This narrative review summarizes the definition, epidemiologic transition, pattern and modes of spread, classification, epidemiologic measures, community burden, prevention, control, and future challenges of acute disease. This review is to provide a reference for epidemiologists, clinicians, researchers, and policymakers. [ABSTRACT FROM AUTHOR]

An acquired brain injury (ABI) is an injury to the brain, which is not hereditary, congenital, degenerative, or induced by birth trauma. In India, rapid urbanization, economic growth and changes in lifestyle have led to a tremendous increase in the incidence of ABI, so much so that it is being referred to as a ‘silent epidemic'. Unlike developed countries, there is no well-established system for collecting and managing information on various diseases in India. Thus it is a daunting task to obtain reliable information about acquired brain injury. In the course of conducting a systematic review on the epidemiology of ABI in India, we recognized several challenges which hampered our effort. Inadequate case definition, lack of centralized reporting mechanisms, lack of population based studies, absence of standardized survey protocols and inadequate mortality statistics are some of the major obstacles. Following a standard case definition, linking multiple hospital-based registries, initiating a state or nationwide population-based registry, conducting population-based studies that are methodologically robust and introducing centralized, standard reporting mechanisms for ABI, are some of the strategies that could help facilitate a thorough investigation into the epidemiology and understanding of ABI. This may help improve policies on prevention and management of acquired brain injury in India. [ABSTRACT FROM AUTHOR]

Introduction: Enhanced recovery after surgery (ERAS) principles is an evidence-based surgical management approach that requires cooperation across various medical specialties. In this study, we applied ERAS principles in total laparoscopic hysterectomy (TLH) and the post-operative outcomes like post-operative pain, nausea and vomiting, opioid requirement, day of discharge, and any other complaints were studied. Methods: The study was conducted in a private healthcare setup in Jodhpur, Rajasthan, India. In this non-randomised controlled study 103 patients who underwent TLH over a period of 1 year were alternatively allocated to the study group and the control group. There were 51 patients in the study group in whom ERAS principles were applied and 52 patients in control group in whom traditional post-operative care was given. Results: Post-operative nausea and vomiting and opioid requirement were significantly reduced in the study group (P < 0.05). The post-operative pain was similar in both groups. The majority of patients in study group were discharged within 24 h as compared to the routine discharge after 48 h. Conclusion: Following ERAS principles in TLH results in decrease in post-operative nausea and vomiting, post-operative opioid requirement and hospital stay. Hence, the ERAS principles should be the standard practice in TLH even in a developing country setup. [ABSTRACT FROM AUTHOR]

Objective: Stroke is relatively rare in children, but it can lead to significant morbidity and mortality. Understanding the risk factors related to stroke will optimize the outcomes in children. Published cohorts of children with stroke recurrence rates are variable. This study has been done to determine the risk factors, clinical features, and outcomes of recurrent pediatric stroke in a developing country. Materials and Methods: We enrolled 98 children with stroke: 16 children were excluded due to incomplete investigations and were lost to follow-up. This study was conducted in a tertiary care hospital in Dhaka, Bangladesh from January 2017 to December 2019. Detailed investigations regarding stroke, physical examination, and targeted investigations were done. Results: We studied 82 patients: Among them, 52 had their 1st attack, and 30 had recurrent attacks of stroke. The age range of onset of stroke was 4.78 ± 3.90 and 5.30 ± 4.25 in the first and recurrent stroke, respectively. In this study, 36.5% of the enrolled children presented with a recurrence of stroke, whereas the rest presented with the first episode of stroke. The most common cause of recurrent stroke was intracranial vasculopathy, with the most common being vascular narrowing and moya moya disease (MMD). Protein C deficiency was observed more frequently in recurrent stroke. No significant difference was found in the risk factors of the first and recurrent stroke. During follow-up, patients with recurrent stroke developed cognitive decline, epilepsy, and speech disorder more frequently. Conclusion: In children with recurrent stroke vasculopathy, particularly MMD and protein C deficiency were observed more frequently. Moreover, in this group, sequelae-like cognitive dysfunction, speech disorder, and epilepsy were observed more frequently. [ABSTRACT FROM AUTHOR]

Context: The first stage of Universal Health Coverage (UHC) was founded Iran to achieve better access to needed health services. Aims: The aim of present study was to illustrate the prevalence rate of malnutrition's subtypes in under 5-year old children after UHC in comparison with before that. Settings and Design: In a cross-sectional study in 2018, anthropometric indices of 970 under 5 years old children in rural and small towns of Isfahan province were gathered from their health files by cluster randomized sampling method. Methods: Children whose weight for age, height for age, and weight for height were lower than -2SD based on Z score, were marked as underweight, stunting, and wasting, respectively. Children, whose weight for age was upper than +2SD, were marked as overweight. Statistical Analysis Used: The T-test, Chi-square, and logistic regression tests were used for determination of association between malnutrition's subtypes and demographic variables. Results: A total of 78 (8.04%) of under 5 years old children were wasting, 74 (7.63%) were underweight, and 82 (8.45%) were stunting. Also, 12 (1.23%) of the children from the same group were overweight. Conclusions: The prevalence rate of underweight and stunting in under 5 years old children were less than before UHC implementation period. The prevalence rate of overweight children below 5 in Isfahan province's villages and small towns was low. [ABSTRACT FROM AUTHOR]

Background: The prevalence of childhood blindness is 0.3/1000 children in industrialized countries, 1.2/1000 children in developing countries and 0.17% in India. The visually impaired face difficulty in learning as they depend on speech and touch to orient themselves, making it challenging for the dentist to manage them. In such patients, there are limitations of moving around in different surroundings and performing basic activities due to which managing them becomes a challenging task for pediatric dentists. Therefore, there is a need to treat and train the visually impaired individuals with the aid of modified behavior management techniques so that the outcome of the treatment could be perceived at its best. Case Presentation: This case report aims to demonstrate successful full-mouth rehabilitation, in a 5-year-old boy with visual impairment using "Audio-tactile Performance (ATP) technique" and "Tell-Feel-Do technique." ATP is a multisensory health education method, specially designed for training visually impaired children. "Tell-feeldo" technique can be used instead of "tell show-do" to demonstrate the ongoing procedures to the patient. This case report emphasizes the successful treatment of a visually impaired child using these techniques. With the introduction of ATP, it has become easier for both the dentist and the child to get along with each other, and also the dentist can easily convey all the procedures to be done in the child. Clinical significance: A case of visually impaired child with "Tell- Feel-Do" and ATP. [ABSTRACT FROM AUTHOR]

Context: Data from the Western countries suggest that obsessive-compulsive disorder (OCD) in children and adolescents is associated with male preponderance, comorbid neurodevelopmental disorders, and high family loading. However, data are limited from the developing countries with respect to the demographic and clinical characteristics of OCD in children and adolescents. Aims: To study the demographic and clinical characteristics of children and adolescents (age ≤18 years) with OCD. Setting and Design: This was a cross‑sectional study, conducted in outpatient treatment setting, across six centers in India. Materials and Methods: Participants were assessed using a semi‑structured pro forma for sociodemographic information, clinical characteristics, the Children’s Yale Brown Obsessive Compulsive Scale (CYBOCS), Structured Clinical Interview for Diagnostic and Statistical Manual, 5th Edition Research Version, Children’s Depression Rating Scale, and Family Interview for Genetic Studies. Results: The sample was largely male with a moderate illness severity. Nearly 75% of the sample had illness onset before the age of 14 years. Aggressive, contamination‑related obsessions and washing, checking, and repeating compulsions were the most common symptoms. CYBOCS assessment revealed that >2/3rd of children and adolescents endorsed avoidance, pathological doubting, overvalued sense of responsibility, pervasive slowness, and indecisiveness. Family history and comorbidity rates were low. OC‑related disorders were present in about 10% of the sample. Conclusions: This study suggests that the clinical characteristics of OCD in children and adolescents in developing countries differ on certain aspects as reported from developed countries. [ABSTRACT FROM AUTHOR]

BACKGROUND: Suicide is a public health problem, and the number of paraphenylenediamine (PPD)-containing hair dye poisoning with suicidal intentions is increasing in developing countries. In order to better understand this situation, we aimed to conduct a systematic review and meta-analysis to estimate the prevalence and complications associated with hair dye poisoning in developing countries. METHODS: We conducted a systematic review of epidemiological studies using MeSh terms and text keywords to identify studies from the inception to March 2016 about hair dye poisoning with suicidal intentions in developing countries. A meta-analysis was used to calculate the pooled prevalence proportion of hair dye poisoning and its major complications. Data extraction, data analysis, and risk of bias assessment were performed. RESULTS: Thirty-two studies were included in the systematic review and 29 of these studies containing 5,559 subjects covering six countries were included in the meta-analysis. The pooled prevalence proportion of hair dye poisoning with suicidal intentions was 93.5% (95% confidence interval [CI] = 91.6-95.4) with a mortality rate of 14.5% (95% CI = 11.1-17.9). Of these, 73.8% were female, and 26.2% were male (sex ratio: 2.7:1). The occurrence of angioneurotic edema in hair poisoning patients was 67.1% (95% CI = 56.6-77.6), and tracheostomy intervention was considered in 47.9% (95% CI = 22.7-73.2) patients with respiratory distress. Acute renal failure was noticed in 54.7% (95% CI = 34.5-74.9) of the pooled samples and mortality rates were 14.5% (95% CI = 11.1-17.9). The pooled rate of the population studied from Asia and Africa showed 94.6% (95% CI = 92.5-96.7) and 82.9% (95% CI = 70.6-95.3), respectively, ingested hair dye with suicidal intentions. Further, studies carried out in Africa showed slightly higher mortality of 15.1% (95% CI = 6.56-23.7) than the Asians 14.3% (95% CI = 10.5-18.1). CONCLUSION: This meta-analysis provided clear evidence of the prevalence of hair dye poisoning among individuals with suicidal intentions and had given robust evidence for policy making to curtail emerging PPD-containing hair dye poisoning in developing countries. [ABSTRACT FROM AUTHOR]

Issues related to the management of pleural effusion in India are unique. With high incidence of tuberculosis and malignancy, managing patients with pleural effusion may not be the same between patients. Decisions on intercostal chest drain insertion, volume of fluid to be removed during therapeutic thoracentesis, and further diagnostic imaging and investigations are often taken with difficulty in low‑resource settings. Pleural manometry can help resolve these issues and help in the management of such patients. Pleural manometry has been advocated as a valuable tool to characterize underlying lung behavior during thoracentesis and has been proposed to be useful in diagnosing unexpandable lung, predicting the success of pleurodesis, and preventing the development of excessively negative pleural pressures which in turn may lead to the development of reexpansion pulmonary edema. There is very little literature on pleural manometry from India and other developing countries. In this article, the utility of pleural manometry in managing patients with malignant pleural effusion is discussed. [ABSTRACT FROM AUTHOR]

Introduction: Antibiotic-resistant infections have become increasingly prevalent nowadays. As a result, it is essential to examine the key socioeconomic and political factors which contribute to the rise in the prevalence of antibiotic resistance in developing and developed nations. This study aims to identify the various contributors to the development of antibiotic resistance in each type of nation. Methods: PUBMED was used to identify primary research, systematic reviews, and narrative reviews published before Jan 2017. Search terms included antibiotic resistance, antimicrobial resistance, superbugs, multidrug-resistant organisms, developing countries, developed countries. Publications from different countries were included to ensure generalizability. Publications were excluded if they didn't mention factors causing resistance, focused on the molecular basis of resistance, or if they were case reports. Publicly available reports from national and international health agencies were used. Results: In developing countries, key contributors identified included: (1) Lack of surveillance of resistance development, (2) poor quality of available antibiotics, (3) clinical misuse, and (4) ease of availability of antibiotics. In developed countries, poor hospital-level regulation and excessive antibiotic use in food-producing animals play a major role in leading to antibiotic resistance. Finally, research on novel antibiotics is slow ing down due to the lack of economic incentives for antibiotic research. Conclusion: Overall, multiple factors, which are distinct for developing and developed countries, contribute to the increase in the prevalence of antibiotic resistance globally. The results highlight the need to improve the regulatory framework for antibiotic use and research globally. [ABSTRACT FROM AUTHOR]

Background: After nearly four decades of testing an innovative model for training health workers for marginalized communities, the evidence base for the impact of University of the Philippines Manila-School of Health Sciences (UPM-SHS) medical program needs to address important gaps. Has it succeeded in contributing toward socially accountable medical education where medical schools will be evaluated in terms of their contribution to society's health outcomes? To answer this question, this study examined human resources for health (HRH) inequity in the Philippines and reviewed the medical school's performance in terms of addressing HRH distribution. Methods: The evaluation of the school's performance was done through two phases. Phase 1 involved generating HRH inequity metrics for the Philippines through secondary data. Phase 2 involved gathering primary data and generating performance metrics for UPM-SHS. Results: We found challenges that UPM-SHS needs to address based on the analysis of its student admissions from 1976 to 2011: targeting the right underserved communities, especially at the municipal level; addressing issues of high leakage and undercoverage rates in the program; ensuring mechanisms for return service are in place at the community level; and tracking and measuring program outputs and impact on community health outcomes. Discussion: Given this study on the performance of UPM-SHS to produce a broad range of health workforce to address the needs of marginalized communities in the Philippines and in similarly situated countries, there is a need to reassess its HRH development strategy. If it wants to build a critical mass of transformational health leaders to meet the needs of poor communities as part of its social accountability mandate, it needs to accelerate this development process. [ABSTRACT FROM AUTHOR]

Background: In the year 2014, Android smartphones accounted for one-third of mobile connections globally but are predicted to increase to two-thirds by 2020. In developing countries, where teleconsultations can benefit health-care providers most, the ratio is even higher. This study compared the use of two Android phones, an 8 megapixel (MP) and a 16 MP phone, for capturing microscopic images. Method: The Android phones were used to capture images and videos of a gastrointestinal biopsy teaching set of referred cases from the Armed Forces Institute of Pathology (AFIP). The acquired images and videos were reviewed online by two pathologists for image quality, adequacy for diagnosis, usefulness of video overviews, and confidence in diagnosis, on a 5-point Likert scale. Results: The results show higher means in a 5-point Likert scale for the 8 MP versus the 16 MP phone that were statistically significant in adequacy of images (4.0 vs. 3.75) for rendering diagnosis and for agreement with the reference diagnosis (2.33 vs. 2.07). Although the quality of images was found higher in the 16 MP phone (3.8 vs. 3.65), these were not statistically significant. Adding video images of the entire specimen was found to be useful for evaluating the slides (combined mean, 4.0). Conclusion: For telepathology and other image dependent practices in developing countries, Android phones could be a useful tool for capturing images. [ABSTRACT FROM AUTHOR]

Background: There is limited scientific evidence on the relationship of job stress with quality of life (QoL). Purpose: This study aims to explore different domains of job stress affecting IT/ITES professionals and estimate the levels of stress that these professionals endure to reach positive levels of QoL given that other determinants operating between these two variables are accounted for. Materials and Methods: We estimated levels of stress that software professionals would have endured to reach positive levels of QoL considering that other factors operating between these two variables are accounted for. The study participants comprised 1071 software professionals who were recruited using a mixed sampling method. Participants answered a self-administered questionnaire containing questions on job stress, QoL, and confounders. Results: All the domains (physical, psychological, social, and environmental) of QoL showed statistically significant positive associations with increasing stress domains of autonomy, physical infrastructure, work environment, and emotional factors. Conclusions: The respondents clearly found the trade-off of higher stress to be acceptable for the improved QoL they enjoyed. It is also possible that stress might actually be responsible for improvements in QoL either directly or through mediation of variables such as personal values and aspirations. "Yerkes-Dodson law" and stress appraisal models of Folkman and Lazarus may explain the plausible positive association. [ABSTRACT FROM AUTHOR]

Background: Knowledge of community medicine is essential for health care professionals to function as efficient primary health care physicians. Medical students learning Community Medicine as a subject are expected to be competent in critical thinking and generic skills so as to analyze community health problems better. However, current teaching by didactic lectures fails to develop these essential skills. Problem-based learning (PBL) could be an effective strategy in this respect. This study was hence done to compare the academic performance of students who were taught Community Medicine by the PBL method with that of students taught by traditional methods, to assess the generic skills of students taught in a PBL environment and to assess the perception of students toward PBL methodology. Materials and Methods: This study was conducted among seventh-semester final-year medical students between June and November 2014. PBL was introduced to a randomly chosen group of students, and their performance in an assessment exam at the end of postings was compared with that of the remaining students. Generic skills and perception toward PBL were also assessed using standardized questionnaires. Results: A total of 77 students took part in the brainstorming session of PBL. The correlation between self-assigned scores of the participants and those assigned by the tutor in the brainstorming session of PBL was significant (r = 0.266, P = 0.05). Out of 54 students who took part in the presentation session, almost all 53 (98.1%) had good perception toward PBL. Demotivational scores were found to be significantly higher among males (P = 0.024). The academic performance of students (P < 0.001) and success rates (P = 0.05) in the examination were higher among students who took part in PBL compared to controls. Conclusion: PBL helped improve knowledge of students in comparison to those exposed only to didactic lectures. As PBL enabled students to identify the gaps in their knowledge and enhanced their group functioning and generic skills, we recommend PBL sessions: They would help optimize the training in Community Medicine at medical schools. Good correlation of tutor and self-assessment scores of participants in the brainstorming session suggests that the role of tutors could be restricted to assessment in presentation sessions alone. Demotivation, which hinders group performance in PBL, needs to be corrected by counselling and timely feedback by the tutors. [ABSTRACT FROM AUTHOR]

Background: A small proportion of physicians adhere to tuberculosis (TB) notification regulations, particularly in the private sector. In most developing countries, the private sector has dominance over delivering services in big cities. In such circumstances deviation from the TB treatment protocol is frequently happening. This study sought to estimate TB notification in the private sector and settle on determinants of TB notification by private sector physicians. Methods: A population-based study has been conducted; private physicians at their clinics were interviewed. The total number of 443 private sectors' physicians has been chosen by the stratified random sampling method. Appropriate descriptive analysis was used to describe the study's participants. Logistic regression was used for bivariable and multivariable analysis. Results: The response rate of the study was 90.06 (399%). Among responders, who had stated that they were suspicious of TB over the recent year, 62 (16.45%) stated that they reported cases of TB at least once during the same period. Having reporting requirements and the number of visited patients was significantly related to TB suspicious (odds ratio = 2.84, confidence interval: 1.62--5, P < 0.01). Workplace and access to relevant resources are associated with TB notification (P < 0.05). Conclusions: In poor resource settings with a high burden of TB, the public health administration can promote notification activities in the private sector by simple and quick interventions. It seems that a considerable fraction of private sector physicians, not all of them, will notify TB if they are provided with primary information and primary resources. To optimize the TB notification, however, intersectoral interventions are more likely to be successful. [ABSTRACT FROM AUTHOR]

The article presents a developing nations' perspective Tele-child neurology in the era of Covid 19 pandemic. Topics include rapid pace of progression of the pandemic has forced many nations to institute strict containment measures; and examine the potential of the emerging tele‑child‑neurology practices in meeting the brisk demands in developing countries.

The article discusses a study focusing on teledermatology research publication between 1975 and 2017 and its bibliometric evaluation. Topics discussed include the use of data from Thomson Reuters Web of Science in this study; the use of teledermatology keyword in the research; and the publication of teledermatology research in the U.S. and Great Britain.

Background: The nature of community-based participatory research (CBPR) poses distinctive ethical challenges. In the absence of organized guidelines, a remarkable amount of researchers' time and energy will be spent tackling these ethical challenges. The study aimed to explore ethical issues and principles potentially arising when conducting CBPR. Methods: This qualitative study conducted in CBPR Center of Tehran University of Medical Sciences. Required data were gathered through systematic literature review and semi-structured interviews. Representatives of community, academia, and nongovernmental organizations (NGOs) participated in our study. Ten interviews with representatives of partner organizations, four group interviews with academic staff, and four with representatives of community were conducted. Repeated thematic analysis was used to elicit ethics-related overarching themes from transcribed interviews. As recommendations, these themes were then organized into a set of CBPR-related ethical issues and principles. Results: Four CBPR ethical guidelines (including 173 articles) were selected from a systematic review. Overarching themes relating to ethical principles which emerged from interviews were as follows: Trust, transparency and accountability, equity and inclusion, power imbalance, tolerance and conflict management, and attention to cultural sensitivity. Practical principles that emerged included: Consensus rather than informed consent, ownership of data and research achievements, and sustainability and maintenance of relationships. According to findings and in comparison to international guidelines, the present study put more emphasis on cultural sensitivity and sustainability as CBPR ethical tangles. Conclusions: Community-based participatory research ethical challenges are of the same kind in most parts of the world. However, some discrepancies exist that calls for local scrutiny. Future use and critic of current explored ethical issues and principles are highly encouraged. [ABSTRACT FROM AUTHOR]