A 22-year-old female presented to clinic for a routine appointment and was incidentally noted to have multiple nummular patches on her upper extremities bilaterally (Figures 1,2). She reported that the lesions have been present for more than two years and their distribution had spread from her arms to her chest and back. She also reported a new “rash” in her hairline that seemed different from these lesions. The patient reported that the lesions on her arms, chest, and back were mildly pruritic when exposed to sun or ocean water but were otherwise asymptomatic.

Purpose: To analyse how effective was the USA, compared to Other Western Countries (OWC) in reducing premature deaths 1989-2015. Design: This population-based study is a cost-effective model of fiscal input into health related to clinical outputs, recognising socio-economic factors influence health outcomes. Using World Bank data for total % GDP-Expenditure-on-Health, and, WHO data for Child (0-4), Adult (55-74) and Age-Standardised-Death-Rates rates per million America is compared with OWC. Cost-Effective Ratios (CEF) are calculated and Confidence Intervals (95%) tests USA against each OWC. `Excess’ deaths are calculated between the most and least expensive health systems.

Despite the global decline in the death rates of Under five children, the risk of a child dying before becoming 5 years of age remains highest in the African Region (90 per 1000 live births), which is approximately seven times higher than that in the European Region (12 per 1000 live births).The purpose of this study was to identify socio-economic, demographic, environmental and nutrition characteristics predictors affecting diarrheal Morbidity of under-five children in Sheka zone, South west Ethiopia. A Community-based cross-sectional study was conducted in Sheka zone, from September 1–September 14, 2018. A Sample of 582 under-five children were selected randomly from Kebeles in the zone constituted the study population. Data were collected using structured and pre-tested questionnaire. Descriptive, Bivariate and multiple binary logistic regressions were employed for data analysis by using SPSS 20. The descriptive results showed that 21.8% of under-five children have experienced diarrhea in the two weeks prior to the time of survey. The remaining 78.2% of under-five children have no experienced diarrhea in the two weeks prior to the time of survey. In multiple logistic regression, the most important determinant factors associated with diarrhea morbidity were stunting, underweight, Child had fever, ever had Vaccination, Employment (working) status of mother, mother education level, source of water supply, and mother underweight. Therefore the Government local health organizations should provide health intervention programs and maternal health awareness (health education for mothers) to reduce under-five children diarrhea morbidity.

This aimed to describe the factors contributed to low enrollments of female in school in South Sudan; these factors are either political reason, cultural reasons. The literature reviewed were from the related information from the prior researchers, their findings has significant to the females’ enrollments, but the failure of their researches was that, they recommended to the government only on the issues on how to reduced poverty. Poverty is not affecting only females, it affect both genders, and cannot be the main factor that cause low enrollment of female. As a result this paper has found it out that, the two mains factors that affect female enrollments was the negative behaviors of the people toward female education and lack of awareness of the South Sudanese communities about the government policies of encouraging females’ education.

Type 2 diabetes is a chronic condition associated with long term complications and premature death. It is a leading cause of non-traumatic amputations, renal failure and blindness. With advances in information technology, diabetes patient data are increasingly collated digitally, however, there is no unifi ed minimal dataset agreed nationally or internationally for data collection. A huge amount of data including patient data, pathology reports, and prescription information is generated by health providers and this information collectively is known as “Big Data.” The Aegle project, A European Union Horizon 2020 funded study, looks at the issue of gathering Big Data, with the aim of harnessing it to help develop personalised therapy to patients with the aim of improving health and optimise outcomes. In this paper, we highlight the potential of the Aegle Project to harness Big Data with real data examples. At the clinical decision support user interface, we show examples where predictive analysis helps stratify patients into risk categories for complications and for therapeutic responses. At the research-oriented user interface, we show how the implementation of this integrated data system has already revealed novel associations that could form the basis for future clinical studies.

Gestational diabetes mellitus (GDM) is a type of glucose intolerance which is often identified first time in pregnancy. It is important to assess whether in Uttar Pradesh (a largest state of India with one of the highest rate of the infant and maternal mortality rate has also higher chances of future Diabetes Mellitus (FDM) in mothers which may attribute it to GDM uncontrolled in pregnancy. The Primary objective of this study was to be determine whether the future Diabetes Mellitus in women is associated with GDM degree of control and can the GDM Management in Pregnancy Improves future Diabetes Mellitus via a Prospective study approach. A prospective cohort study was done for 2 and half years from October 1, 2016, to March 31, 2019, at 900 GDM screening units as a part of the Gestational Diabetes Prevention and Control Project, Uttar Pradesh approved by the Indian Government in the state of Uttar Pradesh, India. A total of 515532 pregnant women were screened during their 16–32th weeks of pregnancy by impaired oral glucose test (OGTT) as per NHM Guidelines for GDM, 12784 GDM & 7287 Non GDM for maternal and perinatal outcomes were followed up in both GDM and non GDM categories in the 2 years and 6 months (2016-2019) after blood sugar management. The Pregnant women were recruited at 900 healthcare facilities, 515532 Pregnant Women have been screened at 16-20 Weeks & 24th-28 weeks of pregnancy as per Guidelines of National health Mission, GOI Guideline. There were not only Significant( p< 0.0001) Perinatal deaths(597)4.6% in GDM category as compared to Non GDM category139(1.9%). There were also more future Diabetics in women in GDM cases, with High Birth weight Babies specially in less Control of Blood Sugar levels during Pregnancy. The Overall incidence of future Diabetes in women cases were only 15.9% in GDM Cases at 140-160 mg/dl at GDM Diagnosis,but as the blood sugar levels increased the Incidence of future diabetes in women increased to high level[>160-200mg/dl (36%)]. So there was a significant association between GDM in Mothers and women developing Diabetes after delivery early with poor perinatal & neonatal outcomes, which suggests GDM Management is Crucial in pregnancy for reducing burden of prospective diabetes in Indian women.

Adverse drug reactions (ADRs) cause considerable mortality and morbidity. Its importance becomes greater in relation to the current increase in the use of drugs and multimorbidity. Premarketing studies do not allow a complete knowledge of the safety of a medicine. Many ADRs occurring in the outpatient setting, but there is a significant lack of information regarding the epidemiology of ADRs in this level of health care. Thus, guidance on how to direct attention to effective targets for improvement of medication safety in ambulatory care settings is missing. In this scenario, the general practitioner (GP) is in a rare, special position in the health system, which allows him to combine the clinical tasks of diagnosis and treatment on individuals with epidemiological and public health tasks on communities, including a important role in the study of ADRs’s epidemiology. Among the methods aimed at identifying and quantifying the ADRs, in the GP consultation, we have: 1) Data derived from pure clinical observation; 2) Voluntary spontaneous notification systems; 3) Effective local initiatives for improving the collection of reports on ADRs; 4) Careful epidemiological studies, which may include descriptive studies (cross-sectional), retrospective (case-control), prospective (cohort), clinical trials, and single-case studies, seasonal variations, longitudinal studies, etc.; 5) Patient reporting of ADRs; 6) The use of algorithms for the diagnostic of ADRs; 7) Intensive telephone surveillance; 8) Collaborative work with Pharmacists working in the community; 9) From the position of the GP (where the entire medical care process begins and ends) the incidence rate of ADRs caused by hospital prescribed drugs can also be observed and collected from discharge of the hospital admissions; And 10) Genetics and electronic health records can go together to identify heritable traits to predisposition to ADRs.

Background: Self-medication is an important public health problem in developed and developing countries, with antimicrobial resistance increasing over time as a result of antimicrobial abuse. The aim of this study was to determine the prevalence of antimicrobial self-medication as well as associated factors among outpatient consultations of two hospitals within the Buea Health District, Cameroon.