Background The conflict in Yemen has devastated the health system, with only 51% of health facilities classified as fully functional and 19.7 million people lacking access to health care. To address the urgent need for primary health care services in rural communities, Save the Children launched an iCCM program in Lahj and Taiz Governorates. A qualitative study was conducted to document the challenges to iCCM service delivery and to aid in developing strategies for overcoming service delivery bottlenecks in conflict-affected rural areas. Methods Qualitative data were collected in Aden City, Lahj Governorate, and Taiz Governorate. Twenty-three IDIs and six FGDs were conducted with iCCM stakeholders at all levels. Results Key findings included: 1) Policy, coordination, and funding were challenged by the fact that iCCM was not integrated into the national health system and was implemented as a short-term emergency program. 2) Villages that received services from a CHW who was based in a different community experienced reduced access to services, especially during times of heightened conflict and insecurity, when CHWs could not travel. 3) Supervision, supply chain, and monitoring were all challenges that were exacerbated by difficulties in travel due to the conflict. Potential solutions to these included the use of mobile technology for supervision and data collection and pre-positioning of buffer stocks in locations closer to CHWs. 4) Travel was seen as the primary threat to the safety of CHWs and supervisors. Measures taken to reduce the risk included limiting travel during periods of heightened insecurity, safety training for CHWs, and use of mobile technology for communication. Conclusions CHWs were able to provide iCCM services in a challenging and insecure context. The challenges in delivery of services were related to both a weak health system and the conflict. Several adaptations to service delivery to overcome the bottlenecks have been identified and should be considered for future community health programs. The closure of the program in Taiz after only 14 months of implementation is a stark illustration of the failure of the current model of short-term humanitarian funding to address long-term needs in protracted emergencies.

Despite the challenging environment of humanitarian emergencies, with focused programmatic attention, demand for quality postabortion care can be created and services delivered while voluntary contraceptive uptake for PAC clients can simultaneously increase substantially, even in settings where the use of contraception after abortion is often stigmatized. Greater representation of long-acting methods, as a proportion of the methods PAC clients chose, occurred in all 3 countries’ method mix, but at different rates.

AIM:To assess the role of hyoscine for polyp detection during colonoscopy. METHODS: Studies (randomized controlled trials orRCTs) that compared the use of hyoscine vs no hyoscine or placebo for polyp detection during colonoscopy were included in our analysis. A search on multiple databases was performed in September 2013 with search terms being "hyoscine and colonoscopy", "hyoscine and polyp", "hyoscine and adenoma", "antispasmotic and colonoscopy", "antispasmotic and adenoma", and "antispasmotic and polyp". Jadad scoring was used to assess the quality of studies. The efficacy of hyoscine was analyzed using Mantel-Haenszel model for polyp and adenoma detection with odds ratio (OR). The I 2 measure of inconsistency was used to assess heterogeneity (P < 0.05 or I 2 > 50%). Statistical analysis was performed by RevMan 5.1. Funnel plots was used to assess publication bias. RESULTS:The search of the electronic databases identified 283 articles. Of these articles, eight published RCTs performed at various locations in Europe, Asia, and Australia were included in our meta-analysis, seven published as manuscripts and one published as an abstract (n = 2307). All the studies included patients with a hyoscine and a no hyoscine/placebo group and were of adequate quality (Jadad score ≥ 2). Eight RCTs assessed the polyp detection rate (PDR) (n = 2307). The use of hyoscine demonstrated no statistically significant difference as compared to no hyoscine or placebo for PDR (OR = 1.06; 95%CI: 0.89-1.25; P = 0.51). FiveRCTs assessed the adenoma detection rate (ADR) (n = 2015). The use of hyoscine demonstrated no statistically significant difference as compared to no hyoscine or placebo for ADR (OR = 1.12; 95%CI: 0.92-1.37; P = 0.25). Furthermore, the timing of hyoscine administration (given at cecal intubation or pre-procedure) demonstrated no differences in PDR compared to no hyoscine or placebo. Publication bias or heterogeneity was not observed for any of the outcomes. CONCLUSION:Hyoscine use in patients undergoing colonoscopy does not appear to significantly increase the detection of polyps or adenomas.© 2014 Baishideng Publishing Group Inc. All rights reserved.Key words: Hyoscine; Antispasmodic; Polyp detection; Colonoscopy Core tip: Hyoscine is used in clinical practice to decrease spasms in the colon during colonoscopy in an effort to improve polyp or adenoma detection. However, this study shows that hyoscine given before the procedure or at time of cecal intubation does not improve polyp or adenoma detection.

Ibrahim (2019) When political solutions for acute conflict in Yemen seem distant, demand for reproductive health services is immediate: a programme model for resilient family planning and post-abortion care services,

An epidemiological study was executed to determine the prevalence of common diseases in camels of Cholistan desert, Pakistan. Starting from Fort Abbas to Rahim Yar Khan, the survey was carried out from May 2010 to April 2011. Epidemiological data was collected from the camel herds of Cholistan (Locally called as Tobbas) and analyzed to interpret current scenario of camel diseases. The overall prevalence of all diseases in camels was 15.8%. The prevalence of trypanosomiasis, pneumonia, mange, and anthrax in camels was recorded as 5.39%, 5.49%, 3.14% and 1.80%, respectively. Considering this baseline information, strategic disease control measures should be develop to combat infectious, parasitic and miscellaneous diseases especially Surra, pneumonia, mange and anthrax. All copyrights reserved to Nexus® academic publishers