Comment: Kidney exchange to overcome financial barriers to kidney transplantation

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The use of social networking technology in the promotion and scaling up of complex global health initiatives

Western medicine has a long tradition of humanitarian service in low resource countries and in crisis and disaster situations. However, advances in social network technology have dramatically changed the manner in which global health services are delivered. A new generation of healthcare professionals, modeled as social entrepreneurs, utilizing collaborative and nonprofit models is establishing relationships with healthcare professionals in host countries, to actively track early disease detection, scaling up of services and research. Oftentimes, technology allows healthcare professionals to contribute to these efforts remotely and without detracting from their routine clinical work as well as facilitating more flexible pathways for global health training in postgraduate education. This paper examines the limitations and opportunities for the utilization of social networking technology, including health care workers as social entrepreneurs, in early disease detection and in scaling up of services and research. Key words: global healthcare entrepreneurs, global burden of disease, social network technology, low resource countries, scaling up, capacity building, social enterpris

Efficacy of Anxiolytic and Preoperative Counseling on Preoperative Anxiety Reduction: A Randomized Comparison Study

Background: The incidence of preoperative anxiety is high. Anxiolytic agents have been used to reduce preoperative anxiety for many years. Recently the role of non-pharmacological interventions like preoperative information through interviews, counseling, and verbal reassurance for the reduction in preoperative anxiety has been established. But, the efficacy of these non-pharmacological interventions and the anxiolytic agent has not been compared previously. In this study, we compared the effectiveness of oral alprazolam and preoperative counseling by an anesthesiologist for the reduction of preoperative anxiety. Materials and Methods: A total of 110 patients were randomly divided into two groups. Group A received 0.5 mg oral Alprazolam tablets, the night before surgery. Group C received counseling from an anesthesiologist with a fixed protocol the night before surgery. Anxiety was assessed with a state-trait anxiety inventory (STAI) scale, and scores were assessed in the pre-anesthetic assessment room, at night before surgery before giving study interventions, and on the day of surgery before shifting to the operation room. Hemodynamic parameters and respiratory rate were monitored along with anxiety scores. Data were analyzed using an independent t-test, Chi-square test, and repeated variance analysis measures (ANOVA). Results: Anxiety scores and hemodynamic parameters were comparable between the groups at all times of measurement. Anxiety scores in the alprazolam group were less than counseling group on the day of surgery, but this difference was not statistically significant. Conclusion: Although treatment with Alprazolam resulted in lesser anxiety scores, overall, both the methods were ineffective in reducing preoperative anxiety