The challenges of running magnetic resonance imaging services in the tertiary health centers of Nigeria

The field of diagnostic radiology has emerged and expanded to become an integral part of healthcare worldwide. Nigeria, as a country is keeping pace with the global trend. Magnetic resonance imaging (MRI) is now becoming standard clinical care in many tertiary health centers of Nigeria. The technique has great advantages and some setbacks in a country likeNigeria. Here, we review some of the challenges involved in the practice of MRI, including recommendations on the way forwardfor overall advancementof MRI services in the country.Method: Literature search were done using keywords described above on Medline, PubMed, HINARI and Advanced Google search. Relevant articles were pooled and information wasextracted and appropriately referenced. Books and Journal hardcopies were also obtained from the Library of Usmanu Danfodiyo University Teaching Hospital, Sokoto. These were referenced accordingly. Results: The introduction of MRI as a radiological modality in Nigeria revolutionized the field of medicine. MRI gives different, reliable, safer and superior information when compared with Xrays (radiography) and computed tomography (CT) scans especially as regards soft tissue differentiation. The foremost challenges of MRI in Nigeria are; high economic cost, poor power supply issues and technical maintenance. Conclusion: We recommend a multi stakeholder approach in areas of procurement, installation, training and maintenance of MRI machine. The national health insurance scheme and other hospital based welfare schemes should be expanded to significantly accommodate high cost investigations like the MRI

An analysis of climate change and health hazards: results from an international study

Purpose: The interconnections between climate change and health are well studied. However, there is a perceived need for studies that examine how responses to health hazards (e.g. cardiovascular diseases, ozone layer effects, allergens, mental health and vector-borne diseases) may assist in reducing their impacts. The purpose of this paper is to review the evidence on health responses to climate hazards and list some measures to address them. Design/methodology/approach: A mixed literature review, bibliometric analysis and an original online survey were undertaken on 140 participants from 55 countries spread across all geographical regions. Findings: The bibliometric analysis identified that most climate-related health hazards are associated with extreme weather events. However, only one-third of the investigated papers specifically analysed the connections between climate change and health hazards, revealing a thematic gap. Also, although Africa is highly affected by climate change, only 5% of the assessed studies focused on this continent. Many respondents to the survey indicated “heat distress” as a significant vulnerability. The survey also identified social determinants relevant to climate-induced health vulnerabilities, such as socioeconomic and environmental factors, infrastructure and pre-existing health conditions. Most respondents agree that policies and regulations are the most effective adaptation tools to address the public health hazards triggered by climate change. This paper presents some suggestions for optimising public health responses to health hazards associated with climate change, such as the inclusion of climate-related components in public health policies, setting up monitoring systems to assess the extent to which specific climate events may pose a health threat, establishing plans to cope with the health implications of heatwaves, increased measures to protect vulnerable groups and education and awareness-raising initiatives to reduce the overall vulnerability of the population to climate-related health hazards. These measures may assist the ongoing global efforts to understand better – and cope with – the impacts of climate change on health. Originality/value: The combination of a literature review, bibliometric analysis and an original world survey identified and presented a wide range of responses

Alzheimer's disease: A review of recent developments

Alzheimer's disease (AD) is the most common type of dementia in aging adults, and a substantial burden to patients, caregivers, and the healthcare system. It is an increasingly significant public health issue; with the number of people living with AD projected to increase dramatically over the next few decades, making the search for treatments and tools to measure disease progression increasingly urgent. This review is based on a search of Medline, the Cochrane Database of Systemic Reviews, and citation lists of relevant publications. The subject headings and keywords used were Alzheimer's disease, dementia, primary neuronal degeneration and senile plagues. Only the articles written in English were included. The diagnosis is still primarily made based on history and physical and neurologic examinations. Approved treatments are few and of limited efficacy, serving mostly to slow or delay progression and not to cure the disease, despite significant research by pharmaceutical industries. Cholinesterase inhibitors offer some help in treating cognitive and global functioning, as well as behavioral abnormalities in patients with mild-, moderate-, or severe-stage disease. The N-methyl-d-aspartate (NMDA) antagonist, memantine, is similarly effective alone or in combination with cholinesterase inhibitors in moderate to severe stages of the disease. Recent insights into the pathophysiology of AD have led to promising investigational therapies, including the development of γ- and β-secretase inhibitors as well as active and passive immunization against the amyloid β-protein.DOI: 10.4103/1596-3519.8205