Global economic burden of unmet surgical need for appendicitis

Background There is a substantial gap in provision of adequate surgical care in many low- and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capital approach was applied, focusing on the economic burden resulting from premature death and absenteeism. Results Excess mortality was 4185 per 100 000 cases of appendicitis using approach 1 and 3448 per 100 000 using approach 2. The economic burden of continuing current levels of access and local quality was US $92 492 million using approach 1 and$73 141 million using approach 2. The economic burden of not providing surgical care to the standards of high-income countries was $95 004 million using approach 1 and$75 666 million using approach 2. The largest share of these costs resulted from premature death (97.7 per cent) and lack of access (97.0 per cent) in contrast to lack of quality. Conclusion For a comparatively non-complex emergency condition such as appendicitis, increasing access to care should be prioritized. Although improving quality of care should not be neglected, increasing provision of care at current standards could reduce societal costs substantially

Potential Health Benefits of Anthocyanins in Oxidative Stress Related Disorders

Anthocyanins are naturally occurring water-soluble plant pigments belonging to the flavonoids chemical class. The red, blue and purple colours of leaves, flowers and fruits of plants confirm that they are rich sources of anthocyanins. Many in vivo and in vitro studies reveal that anthocyanins have different health beneficial effects such as antioxidant, antidiabetic, anti-inflammatory, anti-obesity, antihypertensive and anticancer properties. Major benefits of anthocyanin administration are owing to their potent anti-inflammatory and antioxidant activities. Recent investigations have revealed that anti-inflammatory activities of anthocyanins follow the inhibitory pathways of NFкB-mediated decline of inflammatory cytokines production. Inhibition of the anti-inflammatory pathways also influences the modulation of arteriolar disorders and cardiovascular complications due to anthocyanin administration. Moreover, anthocyanins improve diabetes, obesity and cancer pathology by inhibiting NF-кB-mediated inflammatory pathways. However, considerable variations in activities do exist among structurally diverse anthocyanins. This review appraises the recent literature regarding the health benefits of anthocyanins and their molecular mechanisms in various oxidative stress related pathophysiological conditions