Medical device landscape for communicable and noncommunicable diseases in low-income countries

Abstract Background This study characterized the landscape of commercially available medical devices specifically designed for use in low-income countries (LICs). Methods A state-of-the-art review of peer-reviewed publications, patents, global health databases, and online resources was performed. The criteria established for a health technology’s inclusion in the study were: it met the definition of a medical device; it was designed and developed to address one of the top ten causes of death in LICs, Millennium Development Goal (MDG) 4, or MDG 5; and there was evidence of its commercialization. Results Analysis identified 134 commercialized devices exclusively designed for use in LICs. More than 85% of devices were designed to address infectious diseases or child or maternal health (MDG 4 or 5, respectively). None of the identified devices addressed prevention of noncommunicable diseases (NCDs). Only 8% of devices were designed for use in primary health facilities by non-physician health providers. Conclusion There is a significant mismatch between the projected global burden of disease due to NCDs and the relevant number of commercialized medical devices designed specifically for use in LICs. A limited number of commercialized devices were designed for use by non-physician health providers. These findings suggest the need for medical devices targeting NCDs in LICs and design processes that consider the broader context of design and engage stakeholders throughout all phases of design.https://deepblue.lib.umich.edu/bitstream/2027.42/144540/1/12992_2018_Article_355.pd

Age, sex ratio, spawning season, gonadosomatic index, and fecundity of Cobitis faridpaki (Actinopterygii, Cobitidae) from the Siahrud River in the southeastern Caspian Sea basin

Cobitis faridpaki Cobitis faridpaki (Mousavi-Sabet, Vasil'eva, Vatandoust and Vasil'ev, 2011) is found in streams of the Siahrud River in the southeastern Caspian Sea basin, and this is the first report on reproductive parameters of the newly described endemic loach. Reproductive conditions are key parameters of fish populations, and their assessment is very important for endemic fishes. To study reproduction biology of this fish, sampling was done at monthly intervals throughout the year and 258 individuals of Cobitis faridpaki, were caught from Siahrud River in the southeastern Caspian Sea basin, in the north of Iran. Age, sex ratio, fecundity, oocytes diameter and gonadosomatic index were estimated. A regression analysis was used to find relationships between fecundity and fish size (length and weight), gonad weight and age. Sex ratio differed significantly from unity and was biased to females. The mature females and males were longer than 40 and 30 mm in total length, and +2 and +1 in age, respectively. The average egg diameter was 0.578 mm. Spawning took place from beginning of May to late July when water temperature was between 19.4 to 25.1 °C. Average GSI value at the beginning of the reproduction period was 9.12% and ranged between 2% to 20% in ripe mature females. The averages of absolute and relative fecundity were calculated as 1366 and 508, respectively. The absolute fecundity was significantly related to body weight and gonad weight. Based on the pattern of gonadosomatic index, it was concluded that this fish has a prolonged active reproduction period, which is a type of adaptation of short-lived small fishes to environmental conditions

Migration of Epithelium During Phenytoin-Dependent Gingival Overgrowth in Mice

A small cavity was made in the mesiopalatal area of the maxillary first molar adjacent to the gingiva. Mice were maintained on 40 mg/kg phenytoin (or on diluent for control) by daily intraperitoneal injections. After 9 weeks, light microscopic observations revealed that in experimental mice, epithelial cells migrated towards the cavity and covered it. In controls, epithelial cell migration towards the cavity did not occur. For scanning electron microscopic (SEM) studies, specimens were fixed in 4% glutaraldehyde in 0.1 M phosphate buffer, pH 7.2, for 2 hours, dehydrated, critical point dried and coated with gold. The surface of the outer gingival epithelium of experimental and of control mice showed a honeycomb arrangement of the microridges suggesting their keratinized nature. Epithelial cells lining the cavity showed well marked macroridges along their borders. Parallel microridges were observed on the upper surface of these cells suggesting that they were non-keratinized. It was concluded that the migrating epithelial cells, that covered the cavity during phenytoin-dependent gingival overgrowth, were of the non-keratinized type

Screening and diagnostic assessment of neurodevelopmental disorders in a male prison

Purpose The purpose of this paper is to identify neurodevelopmental disorders and difficulties (NDD) in a male prison. The study used standardised tools to carry out screening and diagnostic assessment of the attention deficit hyperactivity disorder (ADHD), autism spectrum disorder (ASD) and intellectual disability (ID). Design/methodology/approach The ADHD self-report scale, 20-item autism quotient and the Learning Disability Screening Questionnaire were used to screen 240 male prisoners. Prisoners who screened positive on one or more of these scales or self-reported a diagnosis of ADHD, ASD or ID were further assessed using the diagnostic interview for ADHD in adults, adapted Autism Diagnostic Observation Schedule and the Quick Test. Findings Of the 87 prisoners who screened positive for NDD and were further assessed, 70 met the study’s diagnostic criteria for ADHD, ASD or ID. Most of those with NDD (51 per cent) had previously gone unrecognised and a high proportion (51 per cent) were identified through staff- or self-referral to the study. Originality/value The study demonstrated that improving awareness and providing access to skilled, standardised assessment within a male prison can result in increased recognition and identification of NDD