Abdominoplasty procedures are often unsatisfactory in correcting body deformities remaining after massive weight loss. Lateral flanks, hip rolls and buttock ptosis need also to be addressed surgically. To achieve a more noticeable improvement in body contour, a circumferential torsoplasty procedure was performed in 30 patients during the years 1993-1997. Twenty of them had had a gastroplasty procedure before with a mean weight loss of 49.5 kg. Mean operative time was 210 min (range 150-420 min). The total resection weight ranged from 2 to 8.96 kg (mean 4.3 kg). Mean operative blood loss was 635 ml (range 300-1900 min). The mean hospital stay was 12 days. Minor complications occurred in four patients and major complications in one. Both patients and surgeons considered the outcome very satisfactory.

No abstract

Background The rural community in Ethiopia is scattered over a wide geographic area, some regions with difficult mountains, making access to healthcare facilities a great challenge. To overcome geographical barriers and improve access to skilled childbirth care, maternity waiting homes (MWHs), shelters built nearby health facilities, where pregnant women are lodged until labour begins, were introduced decades ago. This study identifies the demand and supply-side determinants of access to MWH services in rural Ethiopia. Methods This descriptive, exploratory study included five focus group discussions and eight in-depth interviews using a semistructured interviewer guide. Field notes were collected, and interviews were audio-recorded. Using Quirkois®, data were coded, transcribed verbatim, translated into English, and analyzed following Penchansky and Thomas’s modified framework of access. Results The study identified several challenges of the implementation of the MWH program in the study area. Subthemes that emerged from the discussions were lack of awareness about the MWH services, geographic inaccessibility, inadequacy of facilities and unaffordability-related issues, substandard and culturally insensitive care at MWHs, and logistic barriers. Most participants rated the MWH quality as poor and requested better MWH services to promote access to skilled birth attendance. Conclusions Several contextual, structural and socio-cultural barriers have been hindering the implementation of MWHs in the study area. To improve women’s access to skilled childbirth, it is crucial to tailor context-based MWH messages, upgrade existing MWHs and ensure that the services are culturally sensitive.

BackgroundMalaria molecular surveillance has great potential to support local national malaria control programs (NMCPs) to inform policy for malaria control and elimination. Molecular markers associated with drug resistance are good predictors of treatment responses. In addition, molecular detection of deletions in hrp2 and hrp3 genes are indicative of potential failure of HRP2-based rapid diagnostic tests. However, there is an urgent need for feasible, cost-effective and fast molecular surveillance tools that NMCPs can implement.MethodsHere we present a new 3-day workflow for targeted resequencing of markers in 13 resistance-associated genes, hrp2&3, a country-specific 28 SNP-barcode for population genetic analysis, and ama1. The assay was applied to control isolates and retrospective samples collected between 2003-2018 in the Loreto region (n = 254) in Peru. Pf AmpliSeq libraries were prepared using a multiplex PCR simultaneously amplifying a high number of targets from dried blood spots and sequenced at high coverage (median 1336, range 20-43795).ResultsThere was no evidence suggesting the emergence of artemisinin resistance in Peru. However, alleles in ubp1 and coronin contributed to recent genetic differentiation of the parasite population. After 2008, predominant parasite lineages in Peru are resistant to sulfadoxine-pyrimethamine (sextuple dhfr/dhps mutant) and chloroquine (SVMNT in crt and NDFCDY in mdr1) and can escape HRP2 based RDTs.ConclusionsThese findings indicate a parasite population under drug pressure, and demonstrates the added value of molecular surveillance systems and offers a highly multiplexed surveillance tool. The targets in the assay can be easily adjusted to suit the needs of other settings.FundingThis work was funded by the Belgium Development Cooperation (DGD) under the Framework Agreement Program between DGD and ITM (FA4 Peru, 2017-2021) and the sample collections in 2018 were supported by VLIR-UOS (project PE2018TEA470A102; University of Antwerp). Funding for the sample collections lead by the U.S. Naval Medical Research Unit 6 (NAMRU-6) in 2011 and 2012 was provided by the Armed Forces Health Surveillance Division (AFHSD) and its Global Emerging Infections Surveillance and Response (GEIS) Section (P0144_20_N6_01, 2020-2021).

The increasing prevalence of non-communicable chronic diseases, particularly in middle-income countries like South Africa, call for physiotherapists in the 21st century to adopt a health promotion approach in patient treatment.