Intentional burns - A form of gender based violence in Nepal

We truly appreciate your important commentary regarding intentional burns in Nepal. Our study, while the first countrywide population based study on burns in Nepal, has several limitations

Strengthening Surgery Strengthens Health Systems: A New Paradigm and Potential Pathway for Horizontal Development in Low- and Middle-Income Countries

Global health is transitioning toward a focus on building strong and sustainable health systems in developing countries; however, resources, funding, and agendas continue to concentrate on “vertical” (disease-based) improvements in care. Surgical care in low- and middle-income countries (LMICs) requires the development of health systems infrastructure and can be considered an indicator of overall system readiness. Improving surgical care provides a scalable gateway to strengthen health systems in multiple domains. In this position paper by the Society of University Surgeons’ Committee on Global Academic Surgery, we propose that health systems development appropriately falls within the purview of the academic surgeon. Partnerships between academic surgical institutions and societies from high-income and resource-constrained settings are needed to strengthen advocacy and funding efforts and support development of training and research in LMICs

The spatial distribution of injuries in need of surgical intervention in Nepal

Geographic information system modelling can accurately represent the geospatial distribution of disease burdens to inform health service delivery. Given the dramatic topography of Nepal and a high prevalence of unmet surgical needs, we explored the consequences of topography on the prevalence of surgical conditions. The Nepalese Surgeons OverSeas Assessment of Surgical Need (SOSAS) is a validated, countrywide, cluster randomised survey that assesses surgical need in lowand middle-income countries; it was performed in Nepal in 2014. Data on conditions potentially affected by topography (<em>e.g.</em> fractures, hernias, injuries, burns) were extracted from the database. A national digital elevation model was used to determine altitude, aspect, slope steepness and curvature of the SOSAS survey sites. Forward stepwise linear regression was performed with prevalence of each surgical condition as the response variable and topographic data as explanatory variables. The highest correlation coefficient was for models predicting hernias and fractures, both explaining 21% of the variance. The model fitted to death due to fall would become significant when an outlier was excluded (P&lt;0.001; R²=0.27). Excluding the outlier yielded a better-fitted model to burn injury (stepwise regression) without any explanatory variables. Other models trended towards a correlation, but did not have sufficient power to detect a difference. This study identified slight correlation between elevation and the prevalence of hernias and fall injuries. Further investigation on the effects of topography and geography on surgical conditions is needed to help determine if the data would be useful for directing allocation of surgical resources

Proteomic Approaches for Studying the Phases of Wound Healing

© 2009, Springer Berlin Heidelberg. Proteome level information is necessary to understand the function of specific cell types and their roles in health and disease. Proteomics is a rapidly developing field with a wide range of applications in wound healing. The ability to use proteomics to assess the wound healing process would have many benefits, including earlier evidence of healing and better understanding of how different treatments affect the wound at the protein level. The basis of what is known about the chronic wound proteome is based on results from a broad collection of studies utilizing a number of different proteomic techniques on fluids and tissues from wounds with different etiologies. The identification of biomarkers associated with healing or delayed healing in chronic wounds could have great significance in the use of current treatments, as well as in the development of new therapeutic interventions