Patterns of wounds in Malawi

In a prospective study conducted at Queen Elizabeth Central Hospital, Blantyre, data from 200 consecutive patients with wounds were collected over a two-week period using a standard proforma. Assaults were the principal cause of wounding (26.5%). Industrial injury and accidental self-injury were also common (17.5% and 12.5% respectively). Lacerations were by far the most common type of wound encountered (67.5%). The most common anatomical site of injury was the hand (23.5%), while the trunk accounted for only 6% of injuries. Males were approximately four times more likely to present with a wound than females. The age of patients affected ranged from 2 to 76 with the commonest group affected the 16-25 year olds. 35% of all wounds occurred in this group. Malawi Medical Journal Vol. 17(2) 2005: 45-4

Tanya jawab buku ajar : Ortopedi dan fraktur sistem apley

x, 99 hal; 14 x 21 c

Tanya jawab buku ajar ortopedi dan faktur sistem apley/ Lavy

x, 99 hal. : ill. ; 22 c

Tanya jawab buku ajar ortopedi dan faktur sistem apley/ Lavy

x, 99 hal. : ill. ; 22 c

Tanya jawab buku ajar ortopedi dan faktur sistem apley/ Lavy

x, 99 hal. : ill. ; 22 c

Geographical Differences in the Forefoot Morphology – A Comparative Radiological Study of Feet in Malawi and UK

Background: Many skeletal morphological differences between populations have been reported with possible but unproven clinical importance. This study was aimed at identifying the normal radiographic findings and measurements seen in patients from Southern Africa and compares them to a European population’s values. Methods: AP foot radiographs of 40 adults from Blantyre, Malawi were compared with those of 40 adults from London, UK. For each patient, measurements were taken of: 1st and 2nd metatarsal lengths, the 1st/2nd intermetatarsal angle, the 1st metatarso-phalangeal angle (the ‘bunion’ angle), and the 2nd metatarsal mortice joint medial and lateral depths. Results : Our results show an increased 1st/2nd metatarsal angle in Malawian feet, but a reduced 'bunion' angle. We also found the second metatarsal length to be longer relative to the first in the Malawian foot, and the 2nd metatarsal base to be significantly more covered by its mortice than in UK feet. Conclusion: This racial anatomical variation may convey more stability and less risk of a Lisfranc dislocation. It is also important to be aware of the normal range of these values when considering the need for forefoot arthroplasty procedures

Systematic review of barriers to surgical care in low-income and middle-income countries

BACKGROUND: There is increasing evidence that lack of facilities, equipment, and expertise in district hospitals across many low- and middle-income countries constitutes a major barrier to accessing surgical care. However, what is less clear, is the extent to which people perceive barriers when trying to access surgical care. METHODS: PubMed and EMBASE were searched using key words ("access" and "surgery," "barrier" and "surgery," "barrier" and "access"), MeSH headings ("health services availability," "developing countries," "rural population"), and the subject heading "health care access." Articles were included if they were qualitative and applied to illnesses where the treatment is primarily surgical. RESULTS: Key barriers included difficulty accessing surgical services due to distance, poor roads, and lack of suitable transport; lack of local resources and expertise; direct and indirect costs related to surgical care; and fear of undergoing surgery and anesthesia. CONCLUSIONS: The significance of cultural, financial, and structural barriers pertinent to surgery and their role in wider health care issues are discussed. Immediate action to improve financial and geographic accessibility along with investment in district hospitals is likely to make a significant impact on overcoming access and barrier issues. Further research is needed to identify issues that need to be addressed to close the gap between the care needed and that provided