Diarrheal diseases due to infection constitute a major burden of disease. Dehydration resulting from diarrhea can be fatal. It is the cause of approximately 1.8 million deaths every year. The vast majority of these deaths are of children under five years of age living in low-and middle-income countries. Interventions to prevent diarrhea include provision of safe water, hand washing, the use of sanitation facilities, exclusive breastfeeding of infants and rotavirus vaccination. Diagnosis is guided by symptoms into one of three categories: acute watery diarrhea, dysentery or bloody diarrhea, or persistent diarrhea of longer than 2 weeks in duration. Treatment of diarrhea in children includes oral rehydration with a pre-formulated solution or with fluids that can be prepared and administered in the home. Zinc supplementation is recommended. Only in certain circumstances are antibiotics advised and anti-motility agents are discouraged. The lives of many children could be saved with proper case management of diarrhea. With immediate and sustained actions to decrease both the incidence and mortality attributed to diarrhea, the burden of this prominent public health threat could be dramatically reduced. Escherichia coliE. coli are a varied group of organisms including both pathogenic and harmless strains. The infectious types are grouped according to factors that characterize their pathogenic mechanism. Enterotoxigenic E. coliEnterotoxigenic E. coli (ETEC) is a common cause of diarrhea in infants and children in developing countries and the most common cause of traveler's diarrhea [47,48]. The infectious dose required for ETEC infection is quite large

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Inguinal hernia is the most common general surgical condition in the world. Although task sharing of surgical care with nonsurgeons represents one method to increase access to essential surgery, the safety and outcomes of this strategy are not well described for hernia repair.OBJECTIVE To compare outcomes after inguinal hernia repair with mesh performed by medical doctors and surgeons in Ghana.

Groin hernia is a common condition in men in this east Ugandan cohort and the annual surgical correction rate is low. Investment is needed to increase surgical capacity in this healthcare system.

Key Points Question Did the treatment of colorectal cancer in Stockholm, Sweden, change during the COVID-19 pandemic? Findings In this cohort study of 1140 patients with colorectal cancer from the Swedish Colorectal Cancer Registry, the proportion of patients with colon cancer treated with ostomy almost doubled, from 17% in March to August 2019 to 30% in March to August 2020; short-term complications and time to surgery remained unchanged. Meaning These findings suggest that changes in surgical behavior occurred during the COVID-19 pandemic, most likely aiming to reduce complications and intensive care unit care.

BackgroundDiarrhoea is the second leading cause of death in children under five accounting for 1.8 million deaths yearly. Despite global efforts to reduce diarrhoea mortality through promotion of proper case management, there is still room for ample improvement. In order to seek options for such improvements this study explored the knowledge and practices of diarrhoea case management among health care providers at health centres and drug shops in Uganda.MethodsRecords were reviewed for case management and structured interviews concerning knowledge and practices were conducted with the staff at all health centres and at all identified drug shops in the rural district of Namutumba, Uganda.ResultsThere was a significant gap between knowledge and documented practices among staff. Antibiotics, antimalarials and antipyretics were prescribed or recommended as frequently as Oral Rehydration Solution (ORS). In almost a third of the health facilities, ORS was out of stock. 81% of staff in health centres and 87% of staff in drug shops stated that they prescribed antibiotics for common diarrhoea. Zinc was not prescribed or recommended in any case.ConclusionsThe findings indicate that many children presenting with diarrhoea are inadequately treated. As a result they may not get the rehydration they need and are at risk of potential side effects from unjustified usage of antibiotics. Practices must be improved at health centres and drug shops in order to reduce childhood mortality due to diarrhoeal diseases.

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