The Pan African medical journal
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In resource-poor settings, the modified Blalock-Taussig shunt (MBTS) is often performed for symptomatic relief of Fallot's tetralogy. From September 2011, we adopted the strictly posterior thoracotomy (SPOT), a minimal-access technique for the MBTS and report the cosmetic advantages in this communication. ⋯ The SPOT approach represents a safe and cosmetically superior alternative to the standard posterolateral thoracotomy, the scar being imperceptible to the patient. The excellent cosmetic appeal and preservation of body image makes this approach particularly attractive in children and young adults.
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Maternal mortality for Kenya was 488/100,000 live births in 2009. Maternal mortality estimate for Central Province is unknown. We retrospectively reviewed data between 1st July 2009 and 30th June 2010 to estimate the hospital based maternal mortality ratio, characterize deaths by time, place and person and describe possible causes of deaths in Central province, Kenya. ⋯ Maternal mortality is of public health importance in the region. Most deaths occurred within 24 hours after admission. Third delay was important. Bleeding and Eclampsia were the main causes of death. A third (34%) of notified deaths were not reviewed.
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Universal Health Coverage (UHC) has been a global concern for a long time and even more nowadays. While a number of publications are almost unanimous that Rwanda is not far from UHC, very few have focused on its financial sustainability and on its extreme external financial dependency. The objectives of this study are: (i) To assess Rwanda UHC based mainly on Community-Based Health Insurance (CBHI) from 2000 to 2012; (ii) to inform policy makers about observed gaps for a better way forward. ⋯ Rwanda UHC is not a dream but a reality if we consider all convincing results issued of the seven metrics.
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Thrombotic Thrombocytopenic Purpura-Haemolytic Uremic Syndrome (TTP-HUS) is a rare pregnancy and postpartum complication that may simulate the more common obstetric complications, preeclampsia and the syndrome of haemolysis, elevated liver functions tests, low platelets (HELLP). We describe a 26 years old patient who presented with peri-partum TTP-HUSand was initially treated as a case of HELLP syndrome without any improvement. A brief review of the current TTP-HUS treatment options in pregnancy is also presented.
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Tube thoracostomy (TT) is widely used to resolve a number of pleural conditions. Few data are available on the complications of TT performed for non-traumatic conditions, especially in low income setting. The aim of this study is to analyse the indications and complications of TT performed for both traumatic and non-traumatic conditions of the chest in a low-income environment. ⋯ TT is a safe and efficient procedure to drain pleural collections of both traumatic and non-traumatic origins, even in low-income settings. The incidence of complications could be reduced by a better training of general practitioners on this procedure.