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Wernicke's encephalopathy in exclusive breastfed infants

World Journal of Pediatrics 2017年第5期13卷 485-488页

作者： Javeed Iqbal Bhat Qazi Iqbal Ahmed Ambreen ali ahangar Bashir Ahmed Charoo Mushtao Ahmad Sheikh Wajid ali Syed Department of Pediatrics Sher-I-Kashmir Institute of Medical SciencesSrinagarJammu&KashmirIndia Registrar Department of Anesthesiology and Critical Care GMC SrinagarJammu&KashmirIndia

Background:Kashmir has a population that largely consumes polished rice which is deficient in ***,lactating women in this region are prone to severe thiamine deficiency because of their traditional food avoidance *** beriberi is common in exclusively breastfed infants of thiamine deficient mothers in ***:This was a one year prospective hospitalbased *** included 50 exclusively breastfed infants in our *** patients were evaluated as per unit protocol including complete septic workup and metabolic *** of our patients belonged to low and middle income group families,and mothers were on customary dietary *** and anthropometric data were collected from all the study *** addition,data regarding the treatments received by the study population and overall mortality were ***:The mean age,male:female ratio,and mean weight of the study population were 3.15±0.97 months,1.5∶1,and 5.1±1.1 kg,*** food avoidance practices were followed by 80% of the *** was observed in 40 (80%) *** was observed in 30 (60%).Septic workup including cerebro spinal fluid analysis was normal in all *** magnetic resonance imaging finding was bilateral basal ganglia *** blood thiamine diphosphate levels showed a drastic decrease (10-49 nmol/L).Ten percent of the study infants ***:In exclusively breasffed infants,we observed acute infantile encephalopathy with epidemiological,clinical,biochemical,and radiological features suggestive of infantile Wernicke's encephalopathy and a favourable therapeutic response to thiamine supplementation during the acute stage.

关键词： basal ganglia hyperintensity polished rice Wernicke's encephalopathy

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Why Are Risk-Pooling and Risk-Sharing Arrangements Necessary for Financing Healthcare and Improving Health Outcomes in Low and Lower Middle-Income Countries

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Health 2018年第1期10卷 122-131页

作者： ali ahangar ali Mohammad Ahmadi Amir Hossein Mozayani Mozayani Sajjad Faraji Dizaji School of Economics and Management Tarbiat Modarres University (TMU) Tehran Iran Economic Research Center (ERC) Tarbiat Modarres University (TMU) Tehran Iran Department of Economic Development and Planning School of Economics and Management Tarbiat Modarres University (TMU) Tehran Iran

Health is important to economic development, and economic development has an important impact on health outcomes. Health Expenditure makes up a substantial part of the global economy. In the world, the costs of healthcare are increasing;patients are compelled to pay more for treatment, and that makes a lot of people faced to Catastrophic Health Expenditures (CHE) and in long run fall below the poverty line. One of the most urgent and vexing challenges faced by many low- and middle-income countries is how to provide health care for the more than two billion poor people who live in these areas (developing countries). As much as more than 65% (in 2014) of total private health care expenditure in low-income countries comes from out-of-pocket payment by patients. In addition, according to World Bank report (2007), in low and lower middle-income countries was speared nearly 13% of global health spending with 87% the global disease burden. The WHO considers health financing models with high risk pooled, such as health insurance and prepaid schemes, a promising means for achieving universal health-care coverage and promotion health care. A crucial concept in health financing is that of pooling. The WHO defines risk-pooling as the “accumulation and management of revenues in such a way as to ensure that the risk of having to pay for health care is borne by all members of the pool and not by each contributor individually”. The larger degree of pooling, the less people will have to bear the health financial risks. Furthermore, adopting and operating financing policies based on greeter risk pooling/sharing (prepayments) are recommended to all countries (especially in low and lower-middle income countries). It means risk sharing/pooling plays a key role in all financing systems for achieving effectiveness and efficiency health systems.

关键词： Risk Pooling Risk Sharing Health Care Financing Health Economics Low and Middle Income

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