After its identification in 1980s,HIV has infected more than 30 million people worldwide.Inthe era of highly active anti-retroviral therapy,anti-retroviral drug resistance results frominsufficient anti-retroviral pres...After its identification in 1980s,HIV has infected more than 30 million people worldwide.Inthe era of highly active anti-retroviral therapy,anti-retroviral drug resistance results frominsufficient anti-retroviral pressure,which may lead to treatment failure.Preliminary studiessupport the idea that anti-retroviral drug resistance has evolved largely as a result of low-adherence of patients to therapy and extensive use of anti-retroviral drugs in the developedworld;however,a highly heterogeneous horde of viral quasi-species are currently circulating indeveloping nations.Thus,the prioritizing of strategies adopted in such two worlds should be quitedifferent considering the varying anti-retroviral drug resistance prevalence.In this article,weexplore differences in anti-retroviral drug resistance patterns between developed and developingcountries,as they represent two distinct ecological niches of HIV from an evolutionary standpoint.展开更多
Geophysical methods are often used to aid in exploration for safe and abundant groundwater. In particular resistivity and seismic refraction methods are helpful in determining depth to bedrock and zones of saturation ...Geophysical methods are often used to aid in exploration for safe and abundant groundwater. In particular resistivity and seismic refraction methods are helpful in determining depth to bedrock and zones of saturation in the subsurface. However the expense of these instruments ($5000 to $20,000) has resulted in their limited use in developing countries. This paper describes how to construct these devices for less than $250 each. The instruments are small, light and robust and are as useful for groundwater exploration as the commercial models for shallow aquifers (less than 35 m deep) where wells can be hand dug, augured or drilled with small portable drill rigs. Data interpretation can be accomplished quickly in the field with free software implemented on a laptop computer. A suite of geophysical instruments and software can therefore be assembled for less than $850. This paper gives the design for these instruments and essential information needed to use them. It is hoped that these inexpensive geophysical instruments can be widely distributed among drillers and aid workers in developing countries, improving the success rate of water wells.展开更多
AIM: To compare the trauma experience gained by a trainee at a United Kingdom major trauma centre and a secondary level hospital in South Africa.METHODS: A profile of inpatient trauma cases during a five-week period i...AIM: To compare the trauma experience gained by a trainee at a United Kingdom major trauma centre and a secondary level hospital in South Africa.METHODS: A profile of inpatient trauma cases during a five-week period in Addenbrooke's Hospital, Cambridge and Somerset Hospital, Cape Town was created. This was achieved by recording various parameters for each patient admitted including age, gender, injury, mechanism of injury and postal/area code. This, together with details of the departments themselves, allows a comparison of the amount and variety of orthopaedic trauma cases experienced by an individual trainee in each setting. RESULTS: The trauma profiles differed significantly. Patients in Cape Town were younger and more likely to be male. In the young, injury in Cape Town was more likely to occur due to assault or being struck by a vehicle, whilst patients in Cambridge were more likely to be injured whilst in a vehicle or in high energy falls. In older patients, trauma at both centres was almost exclusively due to mechanical falls. In a given age group, injuries at the two centres were similar, however the majority of patients admitted to Addenbrooke's were elderly, resulting in less variation in the overall injury profile.CONCLUSION: The trauma profile of a major trauma centre in the United Kingdom is less varied than that of a South African secondary centre, with significantly fewer cases per surgeon. This suggests a more variedtraining experience in the developing world with a greater caseload.展开更多
Endoscopic ultrasonography (EUS) has become a vital diagnostic modality for the evaluation of mediastinal lymphadenopathy, pancreatic cysts and masses, anorectal pathology, subepithelial gastrointestinal lesions, and ...Endoscopic ultrasonography (EUS) has become a vital diagnostic modality for the evaluation of mediastinal lymphadenopathy, pancreatic cysts and masses, anorectal pathology, subepithelial gastrointestinal lesions, and for the staging of many gastrointestinal and pulmonary malignancies. Establishing a EUS program in a developing country presents many challenges. Doing so in Pakistan has led to the identification of the following challenges: initial investment, ongoing costs (particularly fine needle aspiration needle costs), awareness and cytopathology. Endoscopic ultrasonography has revolutionized aspects of the practice of gastroenterology and oncology in the West. This technique is becoming increasingly available in the developing world, where it poses unique challenges to its practice. These challenges include those relating to service initiation and maintenance costs, physician awareness, and onsite cytopathology access. If these issues are anticipated and addressed in ways appropriate to local circumstances, obstacles to the institution of EUS programs can be overcome.展开更多
This article reviews the current status of cardiovascular disease(CVD) on the international scale.Presently viewed as an epidemic that has migrated from westernized societies to developing countries,several important ...This article reviews the current status of cardiovascular disease(CVD) on the international scale.Presently viewed as an epidemic that has migrated from westernized societies to developing countries,several important issues are elaborated upon.They include the basis for the increasing prevalence of CVD and the associated societal implications.The challenges related to lack of resources and infrastructure support may also impede successful implementation of proven strategies to reduce CVD.In addition to traditional risk factors such as cigarette smoking,hypertension,obesity,hyperlipidemia,diabetes mellitus and insulin resistance,many developing countries must also contend with other risk biomarkers.Included in this grouping are human immunodeficiency virus/acquired immunodeficiency syndrome and other infectious/inflammatory processes as well as nutritional and vitamin deficiencies that make preventive measures more difficult to prioritize.Taken together,greater partnering between local governments,affiliated hospitals and international societies is needed to enhance and facilitate efforts aimed at optimizing standard of care measures in developing countries in order to reduce cardiovascular risk.展开更多
Poor wastewater management coupled with lack of sanitation facilities has aggravated the sanitation challenges in developing countries.?This study was aimed at providing information on the current state of sanitation ...Poor wastewater management coupled with lack of sanitation facilities has aggravated the sanitation challenges in developing countries.?This study was aimed at providing information on the current state of sanitation in Cotonou City through surveys. The most common sanitation facilities in the city were septic tanks, latrines and soakaway pits. Mechanical desulging was mainly used (94%) for desludging latrines and septic tanks with a frequency of less than once a year for 73% of the houses;manual desludging was most common for soakaway pits. 84% of sullage generated is disposed without treatment. The only existing stabilization pond plant, managed by a private company SIBEAU, is overloaded;the effluent is poor (up to 2250mg/l BOD5) and does not meet any quality standards. 96% of survey respondents recognise that the sanitation situation in the city is not good;it has to be improved by providing an appropriate and sustainable sanitation management system.展开更多
The constantly expanding world wide mobility and globalization within the pediatric community puts new demands on pediatric surgical health care systems worldwide. Forcing carers to pay attention not only on their bes...The constantly expanding world wide mobility and globalization within the pediatric community puts new demands on pediatric surgical health care systems worldwide. Forcing carers to pay attention not only on their best surgical and medical performance like in the past. In contrary, they are forced to pay much more attention on psycho-medical aspects like finance, rehabilitation, socialization and integration, culture, management and logistics, health edu-cation and language skills. Then, according to our opinion these aspects should be considered as Post Traumatic Stress Disorder (PTSD)-like syndrome and treated accordingly. Then handling this problem succesfully, would be essential for the future survival of any health care system.展开更多
基金Supported by Tehran University of Medical Sciences(grant55/10848)
文摘After its identification in 1980s,HIV has infected more than 30 million people worldwide.Inthe era of highly active anti-retroviral therapy,anti-retroviral drug resistance results frominsufficient anti-retroviral pressure,which may lead to treatment failure.Preliminary studiessupport the idea that anti-retroviral drug resistance has evolved largely as a result of low-adherence of patients to therapy and extensive use of anti-retroviral drugs in the developedworld;however,a highly heterogeneous horde of viral quasi-species are currently circulating indeveloping nations.Thus,the prioritizing of strategies adopted in such two worlds should be quitedifferent considering the varying anti-retroviral drug resistance prevalence.In this article,weexplore differences in anti-retroviral drug resistance patterns between developed and developingcountries,as they represent two distinct ecological niches of HIV from an evolutionary standpoint.
文摘Geophysical methods are often used to aid in exploration for safe and abundant groundwater. In particular resistivity and seismic refraction methods are helpful in determining depth to bedrock and zones of saturation in the subsurface. However the expense of these instruments ($5000 to $20,000) has resulted in their limited use in developing countries. This paper describes how to construct these devices for less than $250 each. The instruments are small, light and robust and are as useful for groundwater exploration as the commercial models for shallow aquifers (less than 35 m deep) where wells can be hand dug, augured or drilled with small portable drill rigs. Data interpretation can be accomplished quickly in the field with free software implemented on a laptop computer. A suite of geophysical instruments and software can therefore be assembled for less than $850. This paper gives the design for these instruments and essential information needed to use them. It is hoped that these inexpensive geophysical instruments can be widely distributed among drillers and aid workers in developing countries, improving the success rate of water wells.
文摘AIM: To compare the trauma experience gained by a trainee at a United Kingdom major trauma centre and a secondary level hospital in South Africa.METHODS: A profile of inpatient trauma cases during a five-week period in Addenbrooke's Hospital, Cambridge and Somerset Hospital, Cape Town was created. This was achieved by recording various parameters for each patient admitted including age, gender, injury, mechanism of injury and postal/area code. This, together with details of the departments themselves, allows a comparison of the amount and variety of orthopaedic trauma cases experienced by an individual trainee in each setting. RESULTS: The trauma profiles differed significantly. Patients in Cape Town were younger and more likely to be male. In the young, injury in Cape Town was more likely to occur due to assault or being struck by a vehicle, whilst patients in Cambridge were more likely to be injured whilst in a vehicle or in high energy falls. In older patients, trauma at both centres was almost exclusively due to mechanical falls. In a given age group, injuries at the two centres were similar, however the majority of patients admitted to Addenbrooke's were elderly, resulting in less variation in the overall injury profile.CONCLUSION: The trauma profile of a major trauma centre in the United Kingdom is less varied than that of a South African secondary centre, with significantly fewer cases per surgeon. This suggests a more variedtraining experience in the developing world with a greater caseload.
文摘Endoscopic ultrasonography (EUS) has become a vital diagnostic modality for the evaluation of mediastinal lymphadenopathy, pancreatic cysts and masses, anorectal pathology, subepithelial gastrointestinal lesions, and for the staging of many gastrointestinal and pulmonary malignancies. Establishing a EUS program in a developing country presents many challenges. Doing so in Pakistan has led to the identification of the following challenges: initial investment, ongoing costs (particularly fine needle aspiration needle costs), awareness and cytopathology. Endoscopic ultrasonography has revolutionized aspects of the practice of gastroenterology and oncology in the West. This technique is becoming increasingly available in the developing world, where it poses unique challenges to its practice. These challenges include those relating to service initiation and maintenance costs, physician awareness, and onsite cytopathology access. If these issues are anticipated and addressed in ways appropriate to local circumstances, obstacles to the institution of EUS programs can be overcome.
文摘This article reviews the current status of cardiovascular disease(CVD) on the international scale.Presently viewed as an epidemic that has migrated from westernized societies to developing countries,several important issues are elaborated upon.They include the basis for the increasing prevalence of CVD and the associated societal implications.The challenges related to lack of resources and infrastructure support may also impede successful implementation of proven strategies to reduce CVD.In addition to traditional risk factors such as cigarette smoking,hypertension,obesity,hyperlipidemia,diabetes mellitus and insulin resistance,many developing countries must also contend with other risk biomarkers.Included in this grouping are human immunodeficiency virus/acquired immunodeficiency syndrome and other infectious/inflammatory processes as well as nutritional and vitamin deficiencies that make preventive measures more difficult to prioritize.Taken together,greater partnering between local governments,affiliated hospitals and international societies is needed to enhance and facilitate efforts aimed at optimizing standard of care measures in developing countries in order to reduce cardiovascular risk.
文摘Poor wastewater management coupled with lack of sanitation facilities has aggravated the sanitation challenges in developing countries.?This study was aimed at providing information on the current state of sanitation in Cotonou City through surveys. The most common sanitation facilities in the city were septic tanks, latrines and soakaway pits. Mechanical desulging was mainly used (94%) for desludging latrines and septic tanks with a frequency of less than once a year for 73% of the houses;manual desludging was most common for soakaway pits. 84% of sullage generated is disposed without treatment. The only existing stabilization pond plant, managed by a private company SIBEAU, is overloaded;the effluent is poor (up to 2250mg/l BOD5) and does not meet any quality standards. 96% of survey respondents recognise that the sanitation situation in the city is not good;it has to be improved by providing an appropriate and sustainable sanitation management system.
文摘The constantly expanding world wide mobility and globalization within the pediatric community puts new demands on pediatric surgical health care systems worldwide. Forcing carers to pay attention not only on their best surgical and medical performance like in the past. In contrary, they are forced to pay much more attention on psycho-medical aspects like finance, rehabilitation, socialization and integration, culture, management and logistics, health edu-cation and language skills. Then, according to our opinion these aspects should be considered as Post Traumatic Stress Disorder (PTSD)-like syndrome and treated accordingly. Then handling this problem succesfully, would be essential for the future survival of any health care system.
