Chapter 10 of Pediatric Surgery: This chapter provides an overview of some of the challenges when providing anaesthesia care for children in Africa. The chapter reviews
the cardiac, respiratory, and renal differences of children in comparison to adults. Additionally, it addresses preoperative asses...sment, including guidelines for nothing by mouth (NPO, or nil per os), general and regional anaesthesia, intraoperative monitoring, airway management, and postoperative care
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Journal of Child Psychology and Psychiatry60:5 (2019), pp 500–515
Mood disorders
Chapter E.4
2018 edition
Standard Treatment Guideline
Mood disorders
Chapter E.3
2016 edition
The Zimbabwe National Pharmacovigilance Policy Handbook, 2nd Edition updates the November 2013 version to indicate the Zimbabwe National Pharmacovigilance (PV) Centre’s compliance with the WHO Pharmacovigilance Indicators Handbook 2015.
This statement aims to provide guidance and recommendation to African Union Member States in responding to the following questions:
What should countries do when announcing identification of a herbal remedy or medicine?
What are the implications for the rest of the continent?
This comprehensive book has established itself as the most useful text for the medical practitioner in poor-resource settings who is obliged to manage surgical cases. It is particularly adapted for those whose surgical experience is basic or minimal. Importantly, it has extensive advice about pitfal...ls to avoid, and what to do if things go wrong. It is written in simple style, particularly for those whose mother tongue is not English. It is not a text which discusses the latest up-to-date technology, but it is not out-of-date being a synthesis of the best advice from a myriad of surgeons practicing for many years in low- and middle-income countries.
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For patients on NIPPV or HFNO with persistent hypoxaemia or respiratory distress:
• Check the equipment: inspect the exterior of the machine, the tubing (circuit), the mask for any sign of mechanical damage, confirm it fits securely without leak (if CPAP/BiPAP) and the filters are in place. Ensur...e the settings are appropriate and flow is maximized.
• Check the oxygen source: there is sufficient oxygen available and flowing through the device. If FiO2 > 50% of oxygen is needed, the ventilator must have a blender.
• Check there is no obstruction with secretions: patients with COVID-19 may have very thick secretions which may block small and large airways and cause sudden respiratory deterioration.
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Trustworthy, evidence-based health guidelines form the basis of national policies affecting both patients and health-care workers. Emphasizing the link between robust evidence and people’s trust in their health systems, Dr Hans Henri P. Kluge, WHO Regional Director for Europe said at the launch ev...ent, “Trust and transformation are key words for us, especially when we talk about improving and strengthening our health systems. Transformation should first and foremost serve the interests of patients and health-care workers”.
While it is not always easy to demonstrate the immediate effect of guidelines on people’s health, there is no viable alternative to utilizing guidelines based on the best available evidence.
Yet, developing robust guidelines remains a challenge for most countries. “Guidelines need to be both simple to use and timely, they need to address people’s real needs, especially at the local level, and should ultimately reflect the resources available,” said Dr Natasha Azzopardi-Muscat, Director, Country Health Policies and Systems, WHO/Europe. “This means that any successful guideline needs to be adjusted and adapted to local contexts and realities.”
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Patients with diabetes are at increased risk of developing cardiovascular disease (CVD) with its manifestations of coronary artery disease (CAD), heart failure (HF), atrial fibrillation (AF), and stroke, as well as aortic and peripheral artery diseases. In addition, diabetes is a major risk factor f...or developing chronic kidney disease (CKD), which in itself is associated with developing CVD. The combination of diabetes with these cardio-renal comorbidities enhances the risk not only for cardiovascular (CV) events but also for CV and all-cause mortality. The current European Society of Cardiology (ESC) Guidelines on the management of cardiovascular disease in patients with diabetes are designed to guide prevention and management of the manifestations of CVD in patients with diabetes based on data published until end of January 2023. Over the last decade, the results of various large cardiovascular outcome trials (CVOTs) in patients with diabetes at high CV risk with novel glucose- lowering agents, such as sodium–glucose co-transporter-2 (SGLT2) inhibitors and glucagon-like peptide-1 (GLP-1) receptor agonists (RAs), but also novel non-steroidal mineralocorticoid receptor antagonists (MRAs), such as finerenone have substantially expanded available therapeutic op-
tions, leading to numerous evidence-based recommendations for the management of this patient population.
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