Background: Patient access to necessary medical imaging in low- and middle-income countries (LMICs) remains a major obstacle, complicating clinician decision-making and compromising patient outcomes.
Methods: We implemented a longitudinal point-of-care ultrasound (POCUS) training program at a new Family Medicine residency in Zambia and subsequently evaluated residents' perceptions on the impact of POCUS in patient care. Data were documented by the scanning resident via a post-scan survey, which assessed if/how the scan assisted in medical management, and if/how the scan changed that management. The primary endpoint was frequency of scans assisting and changing management. Data were summarized using descriptive statistics.
Results: Over the 1-year study period, 366 patient encounters occurred in which POCUS was utilized, resulting in a total of 542 unique POCUS scans. POCUS assisted in decision-making in 95.6% (350/366) of patient encounters, most commonly by helping to determine a diagnosis. POCUS changed management in 65.8% (235/357) of patient encounters, most commonly leading to a medication change.
Conclusions: Zambian resident physicians perceived POCUS to be very helpful in their clinical decision-making. These data support the need to advance POCUS education at the residency level throughout LMICs, which may be an ideal strategy to promote widespread utilization of POCUS in low-resource settings globally.
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http://dx.doi.org/10.1186/s13089-022-00273-7 | DOI Listing |
Br J Nurs
January 2025
Director, Practice Innovation, Standards and Measurement, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.
Background: Irrespective of where nurses work, they may provide care to individuals with substance use disorders. Unfortunately, some nurses may not understand how to work with these individuals and stigmatisation may occur.
Aim: To explore how to provide effective care for these individuals.
West Afr J Med
September 2024
Department of Internal Medicine, Aga Khan University, Dar es Salaam, Tanzania.
Background And Objectives: Huge clinical and research gaps exist concerning the epidemiology, natural history, availability, and accessibility of care for sleep disorders in sub-Saharan Africa (SSA). This study aimed to profile the characteristics of patients referred for polysomnography and the frequencies of sleep disorders encountered at the new sleep laboratory in Dar es Salaam, Tanzania.
Materials And Methods: This retrospective hospital-based descriptive observational study was conducted at the Aga Khan Hospital Dar es Salaam.
Br J Hosp Med (Lond)
January 2025
Department of Surgery & Cancer, Imperial College London, London, UK.
Predictive algorithms have myriad potential clinical decision-making implications from prognostic counselling to improving clinical trial efficiency. Large observational (or "real world") cohorts are a common data source for the development and evaluation of such tools. There is significant optimism regarding the benefits and use cases for risk-based care, but there is a notable disparity between the volume of clinical prediction models published and implementation into healthcare systems that drive and realise patient benefit.
View Article and Find Full Text PDFPharmaceuticals (Basel)
December 2024
Department of Anesthesiology and Perioperative Medicine, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA 19107, USA.
The last two decades have provided far more options f both patients and their physicians in the treatment of diabetes mellitus. While dipeptidyl peptidase-4 inhibitors (DPP-4is) and glucagon-like peptide 1 receptor agonists (GLP-1RAs) have been approved for nearly two decades, sodium-glucose cotransporter 2 inhibitors (SGLT-2is) are relatively new. Of interest to perioperative physicians, these drugs present specific perioperative concerns, prompting many societies to issue guidelines.
View Article and Find Full Text PDFJ Clin Med
January 2025
Department of Neurosurgery, "Carol Davila" University of Medicine and Pharmacy, 020021 Bucharest, Romania.
Kissing aneurysms, a rare and intriguing cerebrovascular anomaly, challenge even the most advanced neurosurgical techniques. These lesions, characterized by two intimately apposed aneurysms with shared arterial walls, often masquerade as single, irregular aneurysms. This report documents a case of ruptured kissing aneurysms in the M1 segment of the right middle cerebral artery (MCA), complicated by ischemic stroke and pulmonary thromboembolism (PTE)-a convergence of severe complications rarely encountered.
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