Comparative analysis of open and laparoscopic colectomy for malignancy in a developing country

AIM: To compare the short-term, including oncologic, outcomes of open vs laparoscopic colectomy for cancer in a developing country. METHODS: The records of patients who underwent elective open and laparoscopic colectomies for cancer at the University Hospital of the West Indies between January 2005 and December 2010 were retrospectively reviewed. Demographic(age, gender, Charlson comorbidity index score), peri-operative, post-operative and oncologic data were collected for each patient. Specific oncologic variables included lymph node yield, pathologic stage, grade, proximal, distal and circumferential margin involvement. Fisher's exact, Mann-Whitney, and binary logistic regression tests were used for analysis. Significance level was set atP < 0.05. RESULTS: There were 87 cases for open colectomy(OC) and 17 cases for laparoscopic colectomy(LC). Demographics did not significantly differ between OC and LC groups. Intra-operative blood loss and postoperative analgesic requirements did not significantly differ between groups. There was a trend towards longer operating times in OC group and shorter hospital stay in the LC group. Lymph node yield(14 vs 14, P = 0.619), proximal(10 cm vs 7 cm, P = 0.353) and distal(8 cm vs 8 cm, P = 0.57) resection margin distance and circumferential margin involvement(9 vs 0, P = 0.348) did not significantly differ between groups. Thirty-day morbidity was equivalent between groups(22 vs 6, P = 0.774). There were 6 deaths within 30 d of initial procedure, all in the OC group(6.9%). CONCLUSION: Laparoscopic colectomy in a developing country is oncologically safe and represents a option for colonic malignancies in these regions. Such data encourage the continued laparoscopic development.

The microbial content of unexpired pasteurized milk from selected supermarkets in a developing country

Objective:To determine the presence and levels of microbes in unexpired pasteurized milk from randomly selected supermarkets in Kingston,Jamaica.Methods:The quantitative study used a stratified random sampling technique in the selection of the 20 representative milk samples from six(6) supermarkets.Microbiological tests such as methylene blue reduction,standard plate count(SPC),coliform plate count(CPC),purity plate culture,gram staining and biochemical tests were performed to examine the microbes in purchased unexpired pasteurized milk.Results:One sample(BCr016) had a pH of 4.0.a rancid odour and curdled appearance.It decolourized within one hour during the methylene blue reduction test and was classified as class 4 milk.Seven of the samples were sterile with no microbe growth on the plate count agar and violet red bile salt agar(VRBA).The milk samples that appeared to be safe for consumption were all 10,11,12 and 13 days before expiration.The VRBA sample BCr016,had a colony count of 13 400 CFU/ mL.There was the presence of Escherichia coli in sample LCr021 which had a standard plate count of 1 580 SPC/mL and a coliform count of 500 CFU/mL.Enterobacter sp.was present in colonies from BCr016 and all the other milk samples.Conclusions:Unacceptable levels of Entembacter spp.and Escherichia coli were found in most of the samples.Effective measures to ensure safe milk for human consumption such as the phosphatase test and methylene blue reduction test should be routinely performed on each batch of milk processed by dairy plants.

Nutrition impacts of non-solid cooking fuel adoption on under-five children in developing countries

This paper examines the nutrition impacts of using non-solid cooking fuel on under-five children in developing countries.We draw on data from more than 1.12 million children in 62 developing countries from the Demographic and Health Surveys(DHS).Results from both fixed effects(FE)and instrumental variable(IV)estimates show that using non-solid cooking fuel significantly improves the nutrition outcomes of under-five children.Compared with their peers from households mainly using solid fuel,children from households mainly using non-solid fuel exhibit a lower probability of experiencing stunting(by 5.9 percentage points)and being underweight(by 1.2 percentage points).Our further investigation provides evidence for several underlying mechanisms,such as improved indoor air quality,induced reduction in children’s respiratory symptoms,benefits on maternal health,and reduction in maternal time spent on fuel collection or cooking.Heterogenous analyses suggest that the nutrition benefits of using non-solid cooking fuel are more prominent among boys,children above three years old,and those from households of lower socioeconomic status,rural areas,and Southeast Asia.

Challenges in the management of paediatric cataract in a developing country

AIM:To review the management of cataract in children in a tertiary hospital in a developing country,and to highlight the challenges therein.· METHODS:The hospital records of children aged 15 years or less that had cataract surgery at University of Nigeria Teaching Hospital,Enugu from 2005 to 2008 were reviewed retrospectively.Information was obtained on bio-data,pre-and post-operative visual acuity(VA),biometry,and type of surgery,use of intraocular lens(IOL) and presence of co-morbidity.SPSS was used for data entry and analysis.· RESULTS:The hospital records of 21 children(26 eyes) were analyzed.There were 12 males(57.1%) and 9 females(42.9%).Pre-operative VA could not be assessed in 11 eyes(42.3%),14 eyes(53.9%) had VA <3/60 and one eye(3.8%) had VA 6/60.Biometry was done in only 5 eyes(19.2%).All eyes had standard extracapsular cataract extraction without primary posterior capsulectomy;12 eyes(46.2%) had posterior chamber intraocular lens(PC-IOL) implant while 13 eyes(50.0%) had no IOL.After 12 weeks of follow up,vision assessment was available in only 15 eyes.With best correction,VA of 6/18 or better was achieved in only 5 eyes(33.3%).· CONCLUSION:Inadequate facilities and inadequate follow up after surgery are some of the challenges in managing paediatric cataract in the developing countries.If these challenges are not addressed,cataract will remain a major cause of childhood blindness and low vision in Africa for many years.There should be collaboration between Paediatric Ophthalmology Centres in industrialized and developing countries to enhance skill transfer.Governmental and International Non-governmental Organizations can go a long way to facilitate this exchange.

Extra-financial Analysis of IFRS Adoption and Application in Developing Country： The Case of Indonesia

This study was aimed to investigate the challenges and impacts of International Financial Reporting Standards （IFRS） adoption and implementation in Indonesia, an emerging country by focusing on extra-financial factors analysis. A series of questionnaires was built up regarding some selected items which have a marginal effect on IFRS adoption and implementation by Indonesian companies, the first part of the questionnaires was designed to gather information relating participants background, the second part of the questionnaire was set to collect participants opinion regarding IFRS adoption and implementation in Indonesia, and the third part of the questionnaire was an open questionnaire to enable the participants to give them suggestion or any additional information they feel can help IFRS adoption and implementation in Indonesia. The findings of this investigation reveal that Indonesia companies have facing several challenges and impacts in their IFRS adoption and implementation such as legal system, taxation system, economy and political ties, accounting education and its infrastructure, and culture structure. To ensure adoption and effective implementation of IFRS, Institute of Indonesia chartered accountants （IAI）, Indonesia government, Indonesia accounting body and academic must work together to reform the consistence of accounting standard for better applicability of IFRS in ensuring transparent information environment.

Profile of Geriatric Trauma in a Developing Country

Geriatric trauma patients require special consideration. They frequently have comorbidities and reduced physiologic reserves, influencing treatment decisions and outcomes. Hence, a comprehensive approach is fundamental to ensure better results. The authors retrospectively evaluated the profile of 332 cases of geriatric trauma over ten years (January 2010-December 2019) at National Orthopaedic Hospital Enugu, in South-East Nigeria. The mean age of patients was 74.78 years (SD = 8.69), with females presenting at a later age than men (76.05 vs 73.69 years), p = 0.013. The commonest mechanism of injury was ground-level fall (47.59%), with proximal femoral fractures being the most common (41.27%). Only 47% of geriatric patients presented to a hospital within 24 hours following injury, and the mean duration of admission was 28 days. Approximately 77% of patients had operative care, and 68.67% expressed satisfaction with the outcome of their management. The mortality rate was 2.11%. In conclusion, most geriatric fractures require surgical intervention and education to facilitate early hospital presentation is needed.

Stakeholders Theory:An Analysis of Eco-Labeling of Commercial Products in A Developing Country(Kenya) Stock Exchange Listed Companies

International environmental organizations propose voluntary eco-labeling as a market incentive to promote industry to operate in an ecologically sustainable and environmentally friendly manner,for instance,with the introduction of ISO 14000.These standards assist organizations to minimize their operations negatively affecting the environment and comply with applicable laws and regulations.Support for eco-labeling has been one of the ways that

Surgical and Anaesthesiology Management of Esophageal Atresia: What Are the Mortality Factors in a Developing Country?

Esophageal atresia is an extreme neonatal surgical emergency whose mortality remains high in our country. We report 8 cases collected over 7 years in a tertiary hospital in Abidjan, C?te d’Ivoire. The purpose of the study is to identify the elements of surgical and anaesthesiological man-agement in our department that influences mortality.

Prognosis of Breast Cancer Patients Underwent Surgery in a Developing Country

Background: We aim to review different factors associated with the relapse and the mortality in breast cancer patients in restricted-resource settings over a five-year period. Method: A retrospective cohort study including 133 women underwent breast cancer surgery was performed at the Surgical Oncology Unit of the Conakry University Hospital in Guinea. Socio-demographical characteristics, clinical information, treatment and data on relapse and survival were retrieved from medical files. Predictor factors of relapse were analyzed by using univariate and multivariate logistic regression. Factors associated with mortality were analyzed by Kaplan Meier survival and Cox models. Results: Breast cancer surgery was conservative in 13 cases (9.8%) and radical in 120 cases (90.2%). Five-year relapse was 33.8% ± 8.0% and the predictor factors of this relapse were age and stage III (p = 0.005). The overall 5-year mortality was 42.1% and the risk factors independently associated with death were body mass index (p = 0.01), origin of patients (p = 0.02), radiotherapy (p = 0.01) and cancer relapse (p = 0.001). Conclusion: The proportions of relapse and death were higher in breast cancer patients. The age and the stage of cancer at the time of surgery were the predictor factors of relapse. Body mass index, origin of patients, radiotherapy and cancer relapse were associated with death.

Primary Results of Late Surgical Treatment in Children with Tetralogy of Fallot from a Developing Country

Objectives: The purpose was to show how important is to operate on the Senegalese African children presenting with Tetralogy of Fallot (TOF) regardless of their age. Methods: It is a retrospective, descriptive analysis of data from the Department of Pediatric Cardiology, University Hospital of Tuebingen’s data base which was searched for all cases of TOF in foreign patients younger than 15 years between 05/2004-10/2016. Results: 16 children from Senegal with TOF were referred for treatment. Mean age of patients was 7.0 years (range 0.9 - 14.8 years). Primary corrective surgery was performed in 13/16 patients. A primary shunt procedure was required in 3/16 patients. All patients were discharged in good condition with a median 13 postoperative days. We did not register any deaths. All became asymptomatic with pulse oximetry oxygen saturations greater than 95%. The right ventricular outflow tract (RVOT) gradient was less than 30 mmHg in all patients and 2 patients had moderate pulmonary valvular insufficiency. Conclusions: It was still necessary to operate Senegalese children presenting with TOF irrespective of their age.

How to Implement Change in Asthma Management in a Developing Country

The goal of asthma management is to control symptoms, reduce the need for short acting beta agonist, and maintain optimal pulmonary function, and normal physical activities. Uncontrolled asthma can lead to obesity, suboptimal pulmonary function, poor quality of life and mortality. Children with bronchial asthma in River State University Teaching Hospital were just receiving acute care in the emergency room with no concrete plan for a follow up care for their chronic asthma;as a result most of the patients had uncontrolled asthma. In the hospital, the situation led to increased emergency hospitalization, resulting in decreased bed availability, increased burden on manpower and health resource utilization thereby putting more pressure on the limited health resources. Using the Kotter’s model for change management, transformational and situational leadership style, the change in the desired quality and scope of health service rendered to asthmatic patients was successfully implemented;as a result there was a decrease in emergency room visit for acute asthma by 57.5% and an increase in the uptake of scheduled clinic visits for asthma control services. The effect of these changes was an improvement in the control of asthma and quality of life of our patient cohort. Implementation of change in health service delivery is a delicate process that needs a stepwise approach in order to successfully implement and sustain the desired change.

Construction of a Small Scale Laboratory for Solar Collectors and Solar Cells in a Developing Country

In the field of renewable energy, self-provided research in developing countries is barely present, but most welcomed. The creation of know-how and self-development of technologies should reduce the dependence on industrialized countries for both materials and knowledge. This work presents technological and social issues related to the construction of a low budget solar laboratory in Mozambique. The goal is to demonstrate that scientific level research can be carried out in developing countries by using affordable solutions without sacrificing quality of the results. For this investigation, a solar laboratory was built in 2011 at Universidade Eduardo Mondlane of Maputo. The laboratory enables measurements?to evaluate solar?thermal and?photovoltaic-thermal?hybrid collectors.?Thanks to the?flexibility of the system,?students and teaching staff can?add/remove equipment and develop customised local research programs. In addition, a course on the principles of solar energy and collector simulation for local students was taught. The needed data acquisition devices usually used in Europe were compared with cheaper and easy-maintenance ones. Calibration and estimation of the uncertainty were successfully performed. Approximately 9% of inaccuracy in the measurement was introduced by the cheaper equipment, but the investment cost was reduced by more than 90%. Other issues, results and future recommendations are shown.

CHINA’S COUNTRY IDENTITY AND BUILDING A NEW MODE OF RELATIONSHIP WITH DEVELOPING COUNTRIES

For a long time, China has adhered to the identity of a developing country and made strengthening solidarity and cooperation with developing countries an important part of its foreign policy. Since the late 1990s, China’s relations with developing countries have become increasingly diverse and added many new elements. The report of the 19th National Congress of the Communist Party of China used partnerships to guide China to build positive relations with various types of countries and stressed that China has expanded the way for developing countries to modernize.

Challenges to establishing and maintaining kidney transplantation programs in developing countries:What are the coping strategies?

Kidney transplantation(KT)is the optimal form of renal replacement therapy for patients with end-stage renal diseases.However,this health service is not available to all patients,especially in developing countries.The deceased donor KT programs are mostly absent,and the living donor KT centers are scarce.Single-center studies presenting experiences from developing countries usually report a variety of challenges.This review addresses these challenges and the opposing strategies by reviewing the single-center experiences of developing countries.The financial challenges hamper the infrastructural and material availability,coverage of transplant costs,and qualification of medical personnel.The sociocultural challenges influence organ donation,equity of beneficence,and regular follow-up work.Low interests and motives for transplantation may result from high medicolegal responsibilities in KT practice,intense potential psychosocial burdens,complex qualification protocols,and low productivity or compensation for KT practice.Low medical literacy about KT advantages is prevalent among clinicians,patients,and the public.The inefficient organizational and regulatory oversight is translated into inefficient healthcare systems,absent national KT programs and registries,uncoordinated job descriptions and qualification protocols,uncoordinated on-site investigations with regulatory constraints,and the prevalence of commercial KT practices.These challenges resulted in noticeable differences between KT services in developed and developing countries.The coping strategies can be summarized in two main mechanisms:The first mechanism is maximizing the available resources by increasing the rates of living kidney donation,promoting the expertise of medical personnel,reducing material consumption,and supporting the establishment and maintenance of KT programs.The latter warrants the expansion of the public sector and the elimination of non-ethical KT practices.The second mechanism is recruiting external resources,including financial,experience,and training agreements.

Food Security in Developing Countries: Factors and Mitigation

Since 1976, eradicating hunger has become one of the priority objectives of the United Nations, which is included in the Charter of Human Rights;the right to get adequate food. The qualification of food security in time and space must analyze not only the three components it covers but also the relationships that these three components maintain. Climate change contributes to food insecurity, but it is not the only factor. To address food insecurity in various forms, greater food security must be combined with improved sustainable agricultural practices with minimal strain on the environment. This review of literature insists on the principles of food security, which in particular allows a better understanding of food insecurity in developing countries and favors a greater contribution of agriculture and food systems in general to nutritional progress.

Research on Developing an Assessment Scale for Tourism Experience Elements of Ancient Shu Road Heritage Trail

Cultural ancient roads,known in Chinese as gudao,serve as heritage trails that carry historical exchanges across various regions in China.Due to their extensive preservation,wide geographical distribution,diverse thematic variations,and considerable tourist appeal,these paths have emerged as representative heritage trails,increasingly transforming into a novel tourism product experience that is highly favored by tourists and recognized by government authorities.However,research on ancient roads for tourism in China currently lacks a systematic theoretical framework,as well as relevant policies,regulations,and standards to guide their practical development.Therefore,there is a pressing need to draw upon international best practices and conduct foundational research to develop an experience element system that aligns with the perceptions,behaviors,and consumption characteristics of Chinese tourists,thereby advancing theoretical exploration in this field.This study focuses on the representative Ancient Shu Road as a case study and employs a mixed-method approach that integrates qualitative and quantitative research.It aims to construct a tourist-centric scale for the experience elements of ancient road tourism while analyzing the interactive relationship between these experience elements and tourist needs.This study addresses a significant gap in the development of indicator systems for domestic studies of ancient road tourism experiences.Ultimately,the study establishes a comprehensive scale that encompasses three core categories—trail resources and environment,facilities and services,and modes of tourism activities—along with eight primary dimensions:core resources,surrounding cultural environment,surrounding natural environment,tourism reception facilities and services,infrastructure and support services,information facilities and information services,and outdoor and recreational activities.This scale consists of thirty-two specific items,providing a robust reference for future research endeavors.Additionally,the study proposes specific development strategies related to key mechanisms,spatial configuration,and facility construction to enhance the overall development of ancient road tourism.

Fuzzy-based approach to quantify the downtime of buildings in developing countries

Earthquake is one of the natural disasters that affects the buildings and communities in developing countries.It causes different levels of damages to the buildings,making them uninhabitable for a period of time,called downtime(DT).This paper proposes a Fuzzy Logic hierarchical method to estimate the downtime of residential buildings in developing countries after an earthquake.The use of expert-based systems allows quantifying the indicators involved in the model using descriptive knowledge instead of hard data,accounting also for the un-certainties that may affect the analysis.The applicability of the methodology is illustrated using the information gathered after the 2015 Gorkha,Nepal,earthquake as a case study.On April 25,2015,Nepal was hit by the Mw 7.8 Gorkha earthquake,which damaged and destroyed more than 500.000 residential buildings.Information obtained from a Rapid Visual Damage Assessment(RVDA)is used through a hierarchical scheme to evaluate the building damageability.Sensitivity analysis based on Sobol method is implemented to evaluate the impor-tance of parameters gathered in the RVDA for building damage estimation.The findings of this work may be used to estimate the restoration time of damaged buildings in developing countries and to plan preventive safety measures.

Morphological and Molecular Characterizations of Country Bean (Lablab purpureus L.) Genotypes for Drought Tolerance

Country bean, Lablab purpureus (L.) is considered one of the most important leguminous crops, but their cultivation under drought stress condition encounters challenges. In this study, an experiment has been conducted among 30 genotypes under drought condition to explore morphological diversity of qualitative and quantitative, biochemical, molecular analysis. The study identified significant variations in eight traits among the genotypes examined, with phenotypic variance exceeding genotypic variance, indicating both genetic and environmental influences. High heritability and genetic advance were observed in primary, secondary, and tertiary branch lengths, suggesting these traits are likely controlled by additive gene effects, making them effective targets for selection. Principal component analysis identified three components that made a substantial contribution, accounting for approximately 73.06% of the overall quantitative variations. Among the quantitative traits, the highest coefficient of variation (CV%) has been found in number of flowers (55.05%). While number of primary branches, primary branch length, number of secondary branches, secondary branch length, number of tertiary branches, tertiary branch length has individually more than 20% of CV%. The genotypes have been grouped into three clusters based on quantitative traits. Analysis of protein reveals that the genotypes of DS28 and DS29 have higher protein content than other genotypes. Dehydrogenase responsive genotypes have been found on DS28 and DS29 from the molecular analysis. The results suggest that the genotypes DS28 and DS29 could contribute as genetic resource of high protein content and DREB responsive, and the eight quantitative traits of 30 genotypes could be used for further breeding programme.

Pitfalls in an International Development (ID) Project Implementation: A Case Study in a Developing Country

Literature review noted that donor funded projects and programs are sometimes referred to as International Development: ID projects. ID projects and programs are often being provided for the developing countries like an emerging, developing or least developed country. Such projects and programs are under public sector development specifically designed for economic and social needs of developing countries. These projects or programs are either implemented by recipient governments under a bilateral (or multilateral) agreement with the donor country or through an 'implementing partner' of the donor, frequently a non-governmental organization or professional contractor. The operating environment and culture of the host country also make ID projects different from traditional business projects and make traditional project management tools in the developed world less appropriate (Blunt and Jones, 1992). This sometimes provides big challenges to various project teams. The paper through a Case study approach evaluates an ID Chinese Government funding construction project and its pitfalls through qualitative research approach. Qualitative data was presented and discussed to provide an insight into major challenges in the implementation of ID project of such scale.

Informing policy makers in developing countries:Practices and limitations of geriatric home medication review in Malaysia-A qualitative inquiry

Objective:To explore existing practices and challenges in the delivery of geriatric home medication review(HMR).The study was part of a larger study aimed to offer solution to expand the range of geriatric HMR.Methods:This study employed qualitative exploratory design through semi-structured individual in-depth interviews with the public pharmacists involved in the delivery of geriatric HMR at public hospitals.The purpose of the interviews was to explore challenges faced by them in the delivery of geriatric HMR.Results:Based on the emerging themes from the qualitative data,the study reveals that geriatric HMR in Malaysia is integrated as part of multidisciplinary home care visits,encompassing a diverse patient population with various healthcare needs.However,it faces challenges such as the lack of outcome monitoring,formal training,and workforce constraints.Despite these hurdles,there is a pressing need for the expansion of this service to better serve the community,and collaboration with community pharmacists holds potential to broaden its scope.Ultimately,the findings suggest that pharmacist-led HMR is both warranted and feasible within the Malaysian healthcare context.In order to optimize medicine-use among older people living in the community,approaches for expanding geriatric HMR services in Malaysia must be developed.Conclusions:This study holds profound implications as it attempts to illuminate policy makers in developing countries,enabling them to formulate effective HMR plans.By considering the challenges highlighted within this research,policy makers can design a comprehensive HMR service that caters adeptly to the healthcare needs of the mass population.