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1
Heart failure with a reduced ejection fraction (HFrEF) is a condition frequently encountered by healthcare professionals and, in order to achieve the best outcomes for patients, needs to be managed optimally. This guideline document is based on the European Society of Cardiology Guidelines for the t
...
reatment of acute and chronic heart failure published in 2016, and summarises what is considered the best current management of patients with the condition. It provides information on the definition, diagnosis and epidemiology of HFrEF in the African context. The best evidence-based treatments for HFrEF are discussed, including established therapies (beta-blockers, ACE-i/ARBs, mineralocorticoid receptor antagonists (MRAs), diuretics) that form the cornerstone of heart failure management as well as therapies that have only recently entered clinical use (angiotensin receptor-neprilysin inhibitor (ARNI), sodium/glucose cotransporter-2 (SGLT2) inhibitors). Guidance is offered in terms of more invasive therapies (revascularisation, implantable cardioverter defibrillators (ICDs) and cardiac resynchronisation therapy (CRT) by implantation of a biventricular pacemaker with (CRT-D) or without (CRT-P) an ICD, left ventricular assist device (LVAD) use and heart transplantation) in order to ensure efficient use of these expensive treatment modalities in a resourcelimited environment. Furthermore, additional therapies (digoxin, hydralazine and nitrates, ivabradine, iron supplementation) are discussed and advice is provided on general preventive strategies (vaccinations). Sections to discuss conditions that are particularly prevalent in sub-Saharan Africa (HIV-associated cardiomyopathy (CMO), peripartum CMO, rheumatic heart disease, atrial fibrillation) have been added to further improve clinical care for these commonly encountered disease processes.
more
In recent decades, India has witnessed a rapidly exploding epidemic of diabetes.
Indeed, India today has the second largest number of people with diabetes in the
world. The International Diabetes Federation (IDF) estimates that there are 72.9 million people with diabetes in India in 2017, which is
...
projected to rise to 134.3 million by the year 2045. The prevalence of diabetes in urban India, especially in large metropolitan cities has increased from 2% in the 1970s to over 20% at present and the rural areas are also fast catching up.
more
The ICMR type 1 diabetes guidelines come at a time when the SARS-CoV-2 pandemic
has disproportionately affected people with diabetes population, exposing them to a
high risk for severe illness and mortality. Globally, diabetes was responsible for over fourmillion deaths in the year 2019. It was th
...
e leading cause of end-stage kidney disease, adult-onset blindness and cardiovascular diseases. Further, there was a considerable heterogeneity in the prevalence of complications and deaths associated with diabetes across the countries.
more
There is paucity of data on the burden and specific drivers operative in the pathogenesis of chronic obstructive pulmonary disease (COPD) in the African setting and populations. Lack of awareness and inadequate knowledge on the aetio-pathogenesis of the disease together with inadequate capacity for
...
COPD care contributes to preventive and management challenges. Thus, the majority of patients with COPD are misdiagnosed, misclassified and mismanaged or undertreated. With the struggling improvement in the quality of healthcare in Africa, studies conducted over the last 10 years indicates the rising trends in both the risk factors and the burden of COPD. The role of new risk factors such as indoor pollution, infections with human immunodeficiency virus (HIV) and pulmonary tuberculosis (TB), in the pathogenesis of COPD in Africa is increasingly being recognized. This literature review attempts to collect and synthesize information that could be useful in improving COPD care and informing the governments to take appropriate actions for prevention, diagnosis and management of COPD in Africa.
more
Mycetoma: epidemiology, treatment challenges, and progress
Taha, H.; Fahal, A.; Van de Sande, W.
Dovepress open access to scientific and medical research
(2015)
CC
Mycetoma is a specific chronic, granulomatous, inflammatory disease. It usually involves the subcutaneous tissue, most probably after traumatic inoculation of the causative organism. It has a prolonged, progressive, and indolent course, and, if untreated, it ultimately leads to destruction of the de
...
eper tissues and bone, resulting in deformity and disability that may necessitate amputation of the affected parts with all the social and economic implications of this. The disease is characterized by tumefaction, draining sinuses, and the presence of grains.
more
Treating the Patient with Tuberculosis
The report is based on comprehensive information collected at representative sample health facilities all over the country by well-organized and trained teams during May and August 2015. This is a continuation of 2014 Assessment activities and findings also reflect comparison between two consecutive
...
years.
more
In this paper, we review the most significant health and environmental facts and explain why — from a medical perspective — a proper understanding of what nuclear weapons will do invalidates all arguments for continued possession of t
...
hese weapons and requires that they urgently be prohibited and eliminated as the only course of action commensurate with the existential danger they pose.
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