Global patient outcomes after elective surgery: prospective cohort study in 27 low-, middle- and high-income countries.

BACKGROUND: As global initiatives increase patient access to surgical treatments, there remains a need to understand the adverse effects of surgery and define appropriate levels of perioperative care. METHODS: We designed a prospective international 7-day cohort study of outcomes following elective adult inpatient surgery in 27 countries. The primary outcome was in-hospital complications. Secondary outcomes were death following a complication (failure to rescue) and death in hospital. Process measures were admission to critical care immediately after surgery or to treat a complication and duration of hospital stay. A single definition of critical care was used for all countries. RESULTS: A total of 474 hospitals in 19 high-, 7 middle- and 1 low-income country were included in the primary analysis. Data included 44 814 patients with a median hospital stay of 4 (range 2-7) days. A total of 7508 patients (16.8%) developed one or more postoperative complication and 207 died (0.5%). The overall mortality among patients who developed complications was 2.8%. Mortality following complications ranged from 2.4% for pulmonary embolism to 43.9% for cardiac arrest. A total of 4360 (9.7%) patients were admitted to a critical care unit as routine immediately after surgery, of whom 2198 (50.4%) developed a complication, with 105 (2.4%) deaths. A total of 1233 patients (16.4%) were admitted to a critical care unit to treat complications, with 119 (9.7%) deaths. Despite lower baseline risk, outcomes were similar in low- and middle-income compared with high-income countries. CONCLUSIONS: Poor patient outcomes are common after inpatient surgery. Global initiatives to increase access to surgical treatments should also address the need for safe perioperative care. STUDY REGISTRATION: ISRCTN5181700

Maternal Practices towards Dental Treatment of Primary School Children after the Emergence of Covid 19

<p>Context COVID 19 is a highly contagious viral disease. Dental office has garnered a lot of attention as one of the potential sources of SARS-CoV-2 transmission and dissemination. Due to this, the frequency of dental visits among children and their parents have reduced substantially.Aims To assess maternal practices towards dental treatment of primary school children after the emergence of COVID 19.Settings and Design A school based cross sectional electronic survey, conducted in various schools in Chalakudy town in Kerala.Methods and Material The study was conducted among mothers of primary school children, with a sample size of 709. The data were collected using a validated questionnaire comprised of four parts, part A recorded basic demography, part B mothers' knowledge, part C attitude and part D recorded practices towards dental care and impact covid 19 on dental care.Statistical Analysis Data were analysed using the SPSS version 21. Descriptive measures and chi-square test was conducted separately for each variable. P value was set at < 0.05 level of significance.Results The findings showed that overall knowledge, attitude and practice (KAP) scores of the mothers revealed 81.3% had good KAP score. Among them 95.5% had adequate knowledge while 93.1% had positive attitude whereas a mere 40.7% was translated into practice.Conclusions Knowledge of mothers towards dental treatment of primary school children after the emergence of COVID 19 was adequate but the attitude and the practices were not and this probably due to the fear. Expecting similar pandemics in future, standard operating procedure (SOP) which would ensure absolute infection control in a dental clinic and spreading awareness of such SOP'samong parents can reduce their apprehensions to get dental treatments for their kids.</p><p>Keywords:- COVID 19, Primary School Children, Dental Treatment.</p&gt

Kuluttajabarometri maakunnittain 2000, 2. neljännes

Suomen virallinen tilasto (SVT

Use of failure-to-rescue to identify international variation in postoperative care in low-, middle- and high-income countries: a 7-day cohort study of elective surgery

This was an investigator-initiated study funded by Nestle Health Sciences through an unrestricted research grant and by a National Institute for Health Research (UK) Professorship held by R.P. The study was sponsored by Queen Mary University of London

Genetic studies of African populations: an overview on disease susceptibility and response to vaccines and therapeutics.

Africa is the ultimate source of modern humans and as such harbors more genetic variation than any other continent. For this reason, studies of the patterns of genetic variation in African populations are crucial to understanding how genes affect phenotypic variation, including disease predisposition. In addition, the patterns of extant genetic variation in Africa are important for understanding how genetic variation affects infectious diseases that are a major problem in Africa, such as malaria, tuberculosis, schistosomiasis, and HIV/AIDS. Therefore, elucidating the role that genetic susceptibility to infectious diseases plays is critical to improving the health of people in Africa. It is also of note that recent and ongoing social and cultural changes in sub-Saharan Africa have increased the prevalence of non-communicable diseases that will also require genetic analyses to improve disease prevention and treatment. In this review we give special attention to many of the past and ongoing studies, emphasizing those in Sub-Saharan Africans that address the role of genetic variation in human disease