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In June, the group of Dr Nzepa gave an interview to the journalists of Rete Sole (central Italy tv/radio broadcasting). In 50minutes was reported the activity undertaken in Djombe Penja together with personnel of Perugia Hospital (doctors and nurses). Dr Vittorio Giuliano during the interview reported the patnership with Developing Medicine to pubblicize the screening activity on the population (600 subjects on hyperetension and diabetes with 1800 measurements). Soon available the mp4 full video.

Major earthquakes are some of the most devastating natural disasters. The epidemiology of earthquake-related injuries and mortality is unique for these disasters. Because earthquakes frequently affect populous urban areas with poor structural standards, they often result in high death rates and mass casualties with many traumatic injuries. These injuries are highly mechanical and often multisystem, requiring intensive curative medical and surgical care at a time when the local and regional medical response capacities have been at least partly disrupted. Many patients surviving blunt and penetrating trauma and crush injuries have subsequent complications that lead to additional morbidity and mortality.

air pollution from mumbai to nairobi, a study confirms that air pollution peaks may contribute to increase the risk of hospitalization for stroke and particulate matter seems to be a significant risk factor, especially for lacunar stroke

strokefocus

 

 

 

 

 

 

 

Seems more and more evident that  levels of air pollution considered safe by health care authorities such as WHO can contribute to higher rates of cognitive decline, stroke, and heart attack, according to many paper recently published.

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Developing Medicine promotes and encourages local activities focusing on new frontiers of health care. Here available the proceedings of the Giornata scienfifica Umbra sulla sclerosi multipla (in Italian) text abstracts and audio mp3 part 1, part 2 part 3. The local event offered a great opportunity to exchange opinions and ideas in MS terapy to local health care personnel (Cascia, Foligno, Perugia, Terni, Trevi Hospitals and Services).

Concentrating on the modern era, ‘War and Medicine’ are considered in the constant evolving relationship between warfare and medicine, beginning with the disasters of the Crimean War and continuing through to today’s conflicts in Afghanistan and Iraq.

This CT scan shows a clear skull fracture due to “arm blanche” beating (see above).

The young (37y old) Bangladesh citizen was working in Tripolis with other houndreds) and attacked during the 2011 summer revolution. Admitted in a local medical centre slowly recovered from a non commotive head trauma. Succeding to cross the Sicily channel on a boat was rescued by Italian Coastal guards. In January while admitted in refugee camp in central Italy suffered of an ischemic stroke (see down).

Alcohol is one of the most diffused intoxicating substances in India (and in the whole world). It has traditionally been drunk in tribal societies, although it has won increasing social acceptance among all social groups, urban males being the main example.

Between 15 and 20 per cent of Indian people consume alcohol and, over the past twenty years, the number of drinkers has increased from one in 300 to one in 20. This translates into about five million people addicted to alcohol. There is a need to increase awareness in the medical community on the topic since less relevant in the western countries where Indian immigrants are now settling. We ll present a case of a 35y Indian old man admitted in our first aid for generalized seizures due to acute alcohol abuse.

The patient underwent to a brain CT scan demonstrating a relevant multiple infarct encephalopathy. Alcoholemia was over 500 mg/ml. I.v. diazepam was administered with fluids. The subject fully recovered and was disharged the next day. Seen the vascular burden an anti epileptic treatment was undertaken with oxcarbazepine 600 bid.

Malaria is the most diffused human parasitic disease, with 300-500 million infected in the world and about 2 million deaths per year. This disease is endemic in tropical and subtropical areas of Africa, Asia, and Central and South America. The disease can be seen almost anywhere, however, as a result of international travel. Malaria is transmitted by mosquitos.

Cerebral malaria is a true medical emergency. In critically ill patients, treatment includes chloroquine, usually given by intramuscular injection, and quinine (or quinidine) given intravenously. In less severe cases, chloroquine alone can be used. If infection occurs in an endemic area of chloroquine-resistant falciparum malaria
(now most areas of the world except parts of Central America, Mexico, the Caribbean, and the Middle East), quinine plus pyrimethamine-sulfadoxine (Fansidar), doxycycline, or clindamycin should be used. In Southeast Asia, where multiple drug resistance occurs, various regimens include quinine plus tetracycline, artesunate (or artemether) plus mefloquine, and mefloquine plus doxycycline. Anticonvulsants should be given to control seizures. Transfusions of whole blood or plasma may be required. Other supportive measures include reduction of fever, fluid and glucose replacement, and respiratory support. Sedation may be necessary in excited or delirious patients. The use of dexamethasone is deleterious in the treatment of cerebral malaria. Mannitol should be used for life-threatening cerebral edema. An infrequent possibly corticosteroid-responsive postmalarial encephalopathy has been described.

Brain injury due to malaria+dengue in a 42y old man leading to permanent comatose state.

An MRI equipment is expensive. 1.5 tesla scanners often cost between US$1 million and US$1.5 million. 3.0 tesla scanners often cost between US$2 million and US$2.3 million. Construction of MRI suites can cost up to US$500,000, or more, depending on project scope. In France, the cost of an MRI exam is approximately 150 Euros. This covers three basic scans including one with an intravenous contrast agent, as well as a consultation with the technician and a written report to the patient’s physician.

MRI provides good imagesbetween the different tissuesof the body, which makes it especially useful in imaging the brain, heart, and tumorscompared with other techniques.

According to the WHO and the Atlas of MS database initiative 6 % of African countries provide MRI machines for their national health care Systems while in eastern Europe the figure is 75% , 95% in western EU, South America 46% and 38% in Central America.

The distribution of MRI machines seems not appropriate with more than 1 MRI per 100,000 inhabitants in US or Italy and less than 0,1 MRI machine per 100, 000 in China or Argentina. LAst update of the database 2009.

…Affluent Arabs used to head to hospitals in the US when they needed treatment. But now, post-Iraq, they are increasingly choosing Germany’s private clinics. With the average foreign patient spending an estimated €80,000 a stay, competition to attract the medical tourists is fierce…. by Monocle 2008…

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