Unique technique of surgery in an unusual variety of Scimitar syndrome: A Case Report

Scimitar syndrome is a rare congenital anomaly characterized by total or partial anomalous pulmonary venous drainage of the right lung to the inferior vena cava. We present a seven year old girl with a systolic murmur who was diagnosed as having a Scimitar syndrome with unusual drainage of the right pulmonary veins. The unique technique of surgery in this patient was appropriate to the unusual, previously not described anatomy

Heart failure in chronic kidney disease: conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference

The incidence and prevalence of heart failure (HF) and chronic kidney disease (CKD) are increasing, and as such a better understanding of the interface between both conditions is imperative for developing optimal strategies for their detection, prevention, diagnosis, and management. To this end, Kidney Disease: Improving Global Outcomes (KDIGO) convened an international, multidisciplinary Controversies Conference titled Heart Failure in CKD. Breakout group discussions included (i) HF with preserved ejection fraction (HFpEF) and nondialysis CKD, (ii) HF with reduced ejection fraction (HFrEF) and nondialysis CKD, (iii) HFpEF and dialysis-dependent CKD, (iv) HFrEF and dialysis-dependent CKD, and (v) HF in kidney transplant patients. The questions that formed the basis of discussions are available on the KDIGO website http://kdigo.org/conferences/heart-failure-in-ckd/, and the deliberations from the conference are summarized her

Coronary artery disease and symptoms of depression in a Kenyan population

Background: Depression and heart disease are replacing the traditional enemies of Africa such as infectious diseases and malnutrition as the increasing causes of disability and premature death. Little is known about the co-morbidity of heart disease and depression in Africa. Objective: To describe the prevalence of depression in Black Africans with and without Coronary Artery Disease as documented on coronary angiography at the Nairobi Hospital. Design: Prospective comparative study. Setting: A private not for Profit 210 bed hospital, catering for fee paying middles class clintele. Results: Of the eighteen patients with an abnormal angiogram, the highest score on the BDI was 9 while the average was 2.11. Of the seven with normal angiograms, the highest BDI was 5, and the average was 1.71. There was no statistical significance in these differences. Conclusion: While African scientists must continue to concentrate on the urgent medical priorities of today (AIDS, malaria, measles, etc), cognisance has to be made of the other emerging epidemic, of the co-morbidity of coronary artery disease and depression. That no significant difference in depression score between the two groups was found could be due to a number of reasons including the small sample size achieved in this first study of its kind in Kenya. East African Medical Journal Vol.81(12) 2004: 611-61

Factors Associated with Non-Participation and Non-Adherence in Directly Observed Mass Drug Administration for Malaria in The Gambia

Introduction: The potential benefits of Mass Drug Administration (MDA) for malaria elimination are being considered in several malaria endemic countries where a decline in malaria transmission has been reported. For this strategy to work, it is important that a large proportion of the target population participates, requiring an in-depth understanding of factors that may affect participation and adherence to MDA programs. Methodology: This social science study was ancillary to a one-round directly observed MDA campaign with dihydroartemisinin-piperaquine, carried out in 12 villages in rural Gambia between June and August 2014. The social science study employed a mixed-methods approach combining qualitative methods (participant observation and in-depth interviewing) and quantitative methods (structured follow-up interviews among non-participating and nonadhering community members). Results: Of 3942 people registered in the study villages, 67.9% adhered to the three consecutive daily doses. For the remaining villagers, 12.6%did not attend the screening, 3.5% was not eligible and 16% did not adhere to the treatment schedule. The main barriers for non-participation and adherence were long and short-term mobility of individuals and specific subgroups, perceived adverse drug reactions and rumors, inconveniences related to the logistics of MDA (e.g. waiting times) and the perceived lack of information about MDA. Conclusion: While, there was no fundamental resistance from the target communities, adherence was 67.9%. This shows the necessity of understanding local perceptions and barriers to increase its effectiveness. Moreover, certain of the constraining factors were socio-spatially clustered which might prove problematic since focal areas of residual malaria transmission may remain allowing malaria to spread to adjacent areas where transmission had been temporarily interrupted