Comparison of the International Health Care Systems Through the Consideration of Population Health and Performance Indicators in Canada, Australia and New Zealand: a systematic literature review

A health care system is an organised plan of health services that manage health care to a specified society. Health care system involves a network of organisations, governance, facilities, and health care providers. A successful health care system requires qualified services to all populations whenever and wherever they need. Objective: This article has two main purposes. 1) To ascertain the management of health care system in Canada, Australia and New Zealand, and 2) to discuss the benefits and disadvantages of Universal Health Coverage (UHC) in Canada, Australia and New Zealand. Method: The comparison study is based on the electronic databases such as Scopus, Web of Sciences, PubMed, ProQuest and SAGE. The study was used databases published between 2015-2019, and using OECD and World Bank health data. Results: The Canada, Australia, and New Zealand have similar health care services and pharmaceutical expenses. Although all the similarity in health care services are easy access and comprehensive, the additional purchase of insurance is still required in each country. Conclusion: This study concluded that the Universal Health Coverage is politically achievable and fiscally feasible by considering the depth and scope of its coverage. After comparing the results of the accessibility and quality of health services in Canada, Australia, and New Zealand, the data suggested that the health care systems of these countries are relatively adequate

Apoptosis: Dual role in aetiology and cure

Apoptosis is a programmed cell death which occurs following a variety of stimuli. Physiologically the process is important for morphogenesis of organs and homeostasis of different types of cells. Apoptotic cell death is responsible for a variety of pathologic states such as elimination of cell death in mutated cells, infected cells, tumour cells and transplant rejection well as the pathological atrophy. In this review, there is discussion about the control of apoptosis, detection methods of apoptosis, its association with infectious and non-communicable diseases. Intracellular microorganisms survive through inhibition of host cell apoptosis as well as they destroy the parenchymal cells causing impaired functions. It plays important role in tumourigenesis. There are possible therapeutic roles of drugs that modify apoptosis in human diseases

Immune System in COVID-19: Is It Temporarily Defeated While Conquering?

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is spreading worldwide and becomes a major cause of mortality. In addition to major pathology in lungs such as pneumonia or respiratory failure, multiorgan failure and frequently haematological disorders such as thromboembolic manifestations are leading causes of mortality. This study reviews the interaction of the immune system with target cells, the role of cytokines and other components such as complements encountered in the pathophysiology of major disease processes and possible post-recovery complications. Although there are some clinical effects induced by strong immune reactions, long term immunity against the virus is found in the majority

Suicidal Hanging, is suicide true? A rare case report

Hanging is one of the most common methods of suicide worldwide, and is increased in number of deaths by years. This report describes rare case of hanging which was done by the age of 10 year-girl as suicidal hanging of a child is very uncommon. The investigating officer and forensic team immediately visited the crime scene and checked the possible foul play. Autopsy study supported the suicidal hanging with motive

Pneumaturia and faecaluria: Symptoms leading to a life-saving diagnosis

Colonic diverticulosis is often asymptomatic, but it can complicate bleeding, abscess and stricture. Pneumaturia and faecaluria are unexpected manifestations of colonic diverticulitis complicated by colovesical fistula formation. This case report highlighted a 57-year-old man who presented with lower abdominal pain which was associated with pneumaturia and fecaluria. He was diagnosed with colovesical fistula after being misdiagnosed with other diseases from various clinic visits. Direct fluoroscopy was performed and a diverticular fistula of the sigmoid colon was confirmed by computed tomography of the abdomen. Hartmann’s procedure and resection of the posterior wall of the bladder were resected. Pneumaturia and faecaluria are common but distinct manifestations of complicated diverticular diseases. Attention should be paid to general practitioners to achieve proper referral, hence early treatment and prevention of disease-related complications

Forensic age estimation in living children: how accurate is the Greulich-Pyle method in Sabah, East Malaysia?

Background: The Greulich and Pyle’s Radiographic Atlas of Skeletal Development of the Hand and Wrist (GP Atlas) is the most widely used method of determining the bone age (BA) of a child. It is also a widely accepted method for forensic age determination. As there is limited local bone age data for forensic age estimation, the purpose of this study was to assess the accuracy of the GP Atlas for forensic age determination in living Sabahan children. Method: This study recruited 182 children between the ages of 9 years to 18 years. BA estimation of the left-hand anteroposterior radiographs were performed by two experienced radiologists using the Greulich-Pyle method. Results: The BA estimates from two radiologists had very high interobserver reliability (ICC 0.937) and a strong positive interobserver correlation (r > 0.90). The GP method, significantly and consistently underestimated chronological age (CA) by 0.7, 0.6 and 0.7 years in overall children, boys and girls respectively with minimal errors. Mean absolute error and root of mean squared error for overall children was 1.5 and 2.2 years respectively, while mean absolute percentage error was 11.6%. This underestimation was consistent across all age groups but was statistically significant only at 13–13.9 and 17–18.9 years old age groups. Conclusion: Despite high interobserver reliability of BA estimation using the GP Atlas, this method consistently underestimates the age of the child in all children to a significant degree, for both boys and girls across all age groups, with an acceptably low level of error metrics. Our findings suggest that locally validated GP Atlas or other type of assessments (artificial intelligence or machine learning) are needed for assessment of BA to accurately predict CA, since current GP Atlas standards significantly underestimated chronological age with minimal error for children in Sabah. A larger population-based study would be necessary for establishing a validated atlas of a bone age in Malaysia

Treatment of hypertension-should we be more aggressive?

In 2014 approximately one billion adults or 22 % of the world population have hypertension (HTN), with 9.4 million deaths in 2010.The rates of HTN in children and adolescents have increased in the last 20 years in the United States. Lowest rates of HTN in the rural India and highest in Poland. HTN results from a complex interaction of genes and environments factors. HTN is classified as primary or essential, is due to lifestyle and genetic factors, and secondary HTN is due to identifiable cause e.g., chronic kidney disease, narrowing of the kidney arteries and endocrine disorder. Several environmental factors influence HTN. High salt intake, lack of exercise, obesity, and depression. Role of caffeine and vitamin D deficiency are less clear. Frequent symptoms include headaches, lightheadedness, vertigo, tinnitus, and altered vision. Severely elevated blood pressure equal or greater than a systolic 180 or diastolic 110 is considered as HTN emergency. HTN in gestation occurs in approximately 8-10% of pregnancies. Ambulatory blood pressure monitoring over 12 to 24 hours is the most accurate method to confirm diagnosis. Goal of blood pressure control a target below the range of 140-160/90- 100 mmHg, and change in lifestyle. First line of medications for HTN include thiazide-diuretics, calcium channel blockers, angiotensin converting enzyme inhibitors and angiotensin receptor blockers. Prevention of HTN include maintain normal body weight, reduce dietary salt intake, regular exercise, effective lifestyle change, limit alcohol consumption, and diet rich in fruit and vegetables

Skeletal manifestations of congenital syphilis: rare but clinically relevant

Congenital syphilis occurs as a result of maternal transmission of treponema pallidum in utero. This condition is mainly diagnosed by treponemal and non–treponemal serologic tests. However, both maternal nontreponemal and treponemal IgG antibodies can be transferred through the placenta to the fetus, thus complicating its interpretation soon after birth. We report a case of a neonate with congenital syphilis whose mother became infected after the first trimester of pregnancy. We report how skeletal radiographs expedite the clinical decision-making process and direct further management of neonates. This case also highlights the need for repeated syphilis screening in the latter part of pregnancy

Mentor-mentee program with Medical Students: A successful program with ethical considerations

Background: Mentoring is the relationship of a guide or a teacher with another person/student augmenting his/her carrier growth, knowledge, skills, and experiences implemented by caring, sharing and helping hands. The aim of this paper is to highlight the mentoring, type of mentoring, how important of matching and consideration of ethical issue in mentoring program. Not missing these significant points, mentoring program could be successful in universities including medical faculty. Methods: The SMART principles of specific, measurable, attainable, relevant, and time-bound are essential to structure the matching between mentor and mentee. The rule of etiquette and ethical issues are crucial and beneficial for mentor-mentee relationship. Clinical mentoring programs help to develop students’ clinical skills and can increase interest in under-subscribed specialties. Positive mentoring plays a part in reversing the decline of academic medicine, by sparking interest through early research experiences. Results: There is the short term goal which is to introduce an immediate support network for incoming students and the long term goal is to cultivate a mentoring culture to engage all strata of medical students and every faculty member. Medical students expressed that mentoring program is to provide counselling, develop professionalism, increase students' interest in research, and support them in their personal growth. Conclusion: The goal of mentorship is to provide additional support to student or mentee by steering of the academic needs or social prerequisites to accelerate the personal and professional development of mentee with advice, guide and feed backs from the mentor