Mit nyaya health april 22 2011
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Nyaya Health is a non-profit organization that started a hospital in rural Achham district of Nepal where there was previously no access to medical care. The organization was founded in 2006 and opened Bayalpata Hospital in 2007, which has since expanded services and now provides outpatient and emergency care, birthing services, inpatient care, testing and treatment for diseases, and community health outreach. Nyaya Health aims to prioritize the most marginalized populations and works collaboratively with the Nepali government. It relies on volunteers and donations to continue improving healthcare in the region.
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AIESEC in Nepal saw tremendous growth in its GCDP program from July 2013 to June 2014. The number of trainees increased by over 2800% for some roles. The number of trainees and interns also grew substantially. Customer satisfaction as measured by NPS increased over time, reaching a high of 42 in June 2014. The GCDP program was financially profitable and had several months of reserves. Match and conversion rates for opportunities were over 90% and 1.1 respectively, showing fast and focused results. As of mid-2014, AIESEC in Nepal had achieved over a quarter of its goals for the year in its GCDP program.
Nepal - Current Situation in Control Strategies and Health Systems in Asia
Nepal - Current Situation in Control Strategies and Health Systems in AsiaThalassaemia International Federation
Current Situation in Control Strategies and Health Systems in Asia - Nepal by DR AJIT RAYAMAJHI of the KANTI CHILDREN’S HOSPITAL, KATHMANDUOverview of National Health Policy and Public Health Program in Nepal : For ...
This document summarizes the key policies and strategies of Nepal's health sector. It discusses Nepal's progress in health over the last several decades, despite challenges of poverty and conflict. The constitution establishes health as a fundamental right. National health policies focus on universal access to basic health services, developing human resources, traditional and modern medical systems, supply of medicines and self-reliance in production. Current priorities include strengthening primary health care networks, increasing private sector participation, and controlling infectious diseases. The document outlines continued efforts to improve quality and ensure equitable access to health services.
Importance of planning, monitoring, evaluation and
This document discusses the importance of planning, monitoring, evaluation and follow up in managing entrepreneurship development programs and competition. It outlines the key steps in planning including defining tasks, identifying resources, considering alternatives and creating and working the plan. It also discusses the importance of monitoring, evaluating, and following up on programs to ensure goals are achieved and problems addressed. Finally, it describes phases of entrepreneurship development programs including pre-training, training, and post-training phases aimed at developing entrepreneurial skills and supporting new businesses.
Brief history of development of health system in nepal
Nepalese history is divided into three eras: Ancient (1st century to 879 AD), Medieval (879 AD to 1768 AD), and Modern (1769 AD onwards). During the Ancient era, references were made to healthcare facilities. The Medieval era saw the establishment of traditional medicine dispensaries. Modern allopathic medicine was introduced by Christian missionaries in the 1600s but discontinued after their expulsion. The modern era saw the appointment of British resident physicians and establishment of hospitals under the Ranas and post-democracy. Healthcare has expanded from isolated efforts to a nationalized system through various historical periods.
Historical Development of Health System in Nepal
1. Health system development concerns how a country organizes its health sector functions including health services, workforce, financing, and policies.
2. Nepal has developed its health system over three historical periods from ancient to modern times, establishing hospitals, clinics, and public health programs at
The Basics of Monitoring, Evaluation and Supervision of Health Services in Nepal
This presentation has made to health workers who have more than two decades of experience of managing/implementing public health programs in Nepal, especially at district level and below.
Ethical guidelines for the care and use of animals
This document provides ethical guidelines for the care and use of animals in health research in Nepal. It was created by the Nepal Health Research Council to ensure animals are treated humanely and research follows international standards. The guidelines cover responsible conduct of research, housing and care of animals, acquiring and transporting animals, research procedures, field research, educational use of animals, record keeping, and oversight by an ethical review board. The goal is to promote the welfare of animals used in research while advancing scientific knowledge.
Health care system of nepal
The document provides an overview of Nepal's health system, including:
1) Nepal has a public health system managed by the Ministry of Health that provides universal access to primary health services and essential medicines through a network of health facilities from central hospitals down to village health posts.
2) Key health indicators like life expectancy, literacy rates, and access to health facilities have improved but challenges remain like high maternal and infant mortality.
3) The government aims to establish an effective health system through policies like free basic health services and expanding insurance coverage.
Health system functions and structure
A health system consists of all organizations, people and actions whose primary intent is to promote, restore or maintain health .
Results Based Monitoring and Evaluation
RBME is a tool for public sector management that can help track progress and demonstrate the impact of projects and policies. It focuses on outcomes and impacts rather than just inputs and outputs. Governments are increasingly expected to show results and address questions like whether policies are achieving desired outcomes. RBME involves setting targets and monitoring indicators over time to evaluate success, identify problems, and make corrections. Both monitoring and evaluation are needed to better manage initiatives and steer them toward goals.
Monitoring and Evaluation Framework
The document outlines the objectives, principles, content areas and task levels of the Division Monitoring and Evaluation framework. The key points are:
1. The objectives of the framework are to provide management information to improve education service delivery, implement projects and programs effectively, allocate resources appropriately, and assess organizational performance.
2. Principles of the framework include ensuring quality information, strengthening existing systems, achieving results efficiently, transparency, synergy between entities, and using M&E for continuous learning and accountability.
3. Content areas of focus for M&E in the division are delivery of education services, educational programs/projects, curriculum implementation, technical assistance, resources, and organizational effectiveness and support.
Strategic management and strategic planning
This document defines strategic management and strategic planning. Strategic management involves analyzing a company's internal and external environments, formulating strategies to achieve objectives, implementing strategies, and monitoring performance. Strategic planning is the process of crafting strategies to help a company achieve its goals. The document outlines key terms, different strategic management models, the importance of strategic planning, benefits and limitations of strategic planning, and guidelines for effective strategic planning.
PPT_PME_Dhital B N
The document outlines key concepts in planning, monitoring, and evaluation (PME) as presented by Dhital B. N. It defines planning as setting goals, strategies, and allocating resources, noting that failing to plan is planning to fail. Monitoring is defined as keeping watch over a project's progress by obtaining regular feedback to analyze the situation and ensure the project stays on schedule. Evaluation assesses a project's impact by finding any gaps between estimated and achieved outcomes and determining if a project is successful and contributing to its goals. The presentation provides examples of monitoring and evaluating a women's empowerment project and outlines best practices for data collection, analysis, and reporting in PME.
Healthy lifestyle
This presentation discusses steps for maintaining a healthy lifestyle. It recommends getting at least an hour of physical activity per day through activities like walking, doing chores, using stairs, and exercise. It also suggests choosing water as a primary drink, eating plenty of vegetables and fruits, and eating whole grains, fish, and other healthy foods while limiting unhealthy fats, sugar, and salt. Maintaining a healthy lifestyle can help reduce stress and promote overall well-being.
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Importance of Monitoring and Evaluation to Decentralization
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AIESEC in Nepal - Electrolux Excellence Award Application
AIESEC in Nepal - Electrolux Excellence Award Application
Nepal - Current Situation in Control Strategies and Health Systems in Asia
Nepal - Current Situation in Control Strategies and Health Systems in Asia
Overview of National Health Policy and Public Health Program in Nepal : For ...
Overview of National Health Policy and Public Health Program in Nepal : For ...
Importance of planning, monitoring, evaluation and
Importance of planning, monitoring, evaluation and
Brief history of development of health system in nepal
Brief history of development of health system in nepal
The Basics of Monitoring, Evaluation and Supervision of Health Services in Nepal
The Basics of Monitoring, Evaluation and Supervision of Health Services in Nepal
Ethical guidelines for the care and use of animals
Ethical guidelines for the care and use of animals
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This document discusses the story of Nyaya Health, a non-profit organization that builds health systems in rural Nepal. It summarizes Nyaya Health's work establishing the Bayalpata Hospital in Achham District to provide free healthcare services. The hospital has treated over 50,000 patients since opening. It faces ongoing challenges related to human resources, infrastructure, and supporting the rural public health system. Nyaya Health aims to continue expanding services and collaborating with the Nepali government to improve healthcare access for the remote region's 250,000 residents.
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Nyaya Health is a non-profit organization that provides free healthcare services in rural Achham District, Nepal. They work in partnership with the Nepali Ministry of Health to strengthen the public health system. Key aspects of their approach include community-based care through a network of community health workers, increasing transparency through publicly accessible data, and a focus on infrastructure development, quality improvement, and addressing challenges like limited transportation and energy resources. Nyaya Health's goal is to improve health outcomes in Achham while developing effective models of healthcare delivery for other resource-poor settings.
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Nyaya Health is a non-profit organization that aims to expand healthcare access in rural Nepal. It established the Sanfe Bagar Primary Health Center in 2008, which served over 17,000 patients in its first year. In 2009, Nyaya Health transitioned to managing the Bayalpata Hospital under a 5-year contract with the Nepali government, providing free inpatient, outpatient, emergency, and obstetric care, as well as expanding services like surgery, X-rays, and community health workers. Nyaya Health takes a transparent, data-driven, and collaborative approach through sharing operational and clinical data on its public wiki to improve accountability and allow for inter-organizational collaboration.
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Nyaya Health is a non-profit organization that provides free healthcare in rural Achham district of Nepal. It operates Bayalpata Hospital in partnership with the Nepali Ministry of Health. The hospital provides outpatient and emergency services, an inpatient ward, laboratory services, and community health outreach. Nyaya Health aims to strengthen Nepal's public health system and develop a replicable model of healthcare delivery. It is funded through donations and employs over 30 full-time Nepali staff. Upcoming projects include expanding surgical and community health services and increasing solar power capacity. Nyaya Health recently received a $75,000 matching grant and is seeking help leveraging additional support.
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Duncan Maru presented on the challenges of building healthcare systems in rural Nepal. Some key challenges included a lack of infrastructure, healthcare workers and supplies. The document discussed two cases that highlighted issues - a tuberculosis infection due to poor ventilation and safety protocols, and an infant's death due to lack of oxygen, emergency equipment and training. Maru emphasized the need for reflective reviews of adverse events, transparency in data reporting, and innovations to strengthen logistics, energy and management systems in order to deliver high quality care in resource-poor areas.
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Nyaya Health is a 501(c)(3) non-profit organization that operates a public-private partnership with the Nepali government to expand healthcare access in rural Achham District, Nepal. It aims to build healthcare infrastructure and develop a scalable healthcare model. Key accomplishments include opening the Sanfe Bagar Health Center in 2008 and transitioning to operating Bayalpata Hospital since 2009, providing free services like maternal care. Nyaya Health also works to recruit local staff, provide continuing education, and collaborate with partners like Yale to strengthen its programs.
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India ranks poorly (66th out of 71 countries) on maternal health according to a World Health Report. Over half of births in India are unattended by medical professionals. The maternal mortality rate in Sultanpur, Uttar Pradesh is 500 deaths per 100,000 live births, higher than the national average of 310. Local NGO Save A Mother India aims to address this issue through community health worker training programs to promote prenatal care, institutional delivery, and postnatal care.
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Nyaya Health is a non-profit organization that provides healthcare in rural Achham district of Nepal. It works in partnership with the Nepali Ministry of Health to build a replicable model of community-based healthcare. Nyaya Health operates Bayalpata Hospital and works with around 50 community health workers. It aims to provide free healthcare that strengthens Nepal's public health system and can be replicated in other resource-poor areas. The presentation outlines Nyaya Health's model and impact, and calls listeners to help leverage a $75,000 matching grant to further expand its healthcare services in Achham.
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The document describes implementing a morbidity and mortality (M&M) conference for quality improvement at a hospital in rural Nepal. Key points:
1) The M&M conference provided a structured weekly discussion of hospital operations and patient cases among clinical and non-clinical staff.
2) Preliminary results found the conference was well-received by staff and improved understanding of case management across departments.
3) Ongoing challenges include ensuring recommendations are implemented and accountability for systems-level changes.
Coe q&s june 15 2011
The document describes implementing a morbidity and mortality (M&M) conference for quality improvement at a hospital in rural Nepal. Key points:
1) The M&M conference provided a structured weekly discussion of hospital operations and patient cases among clinical and non-clinical staff.
2) Preliminary results found the conference was well-received by staff and improved understanding of case management across departments.
3) Ongoing challenges include ensuring recommendations are implemented and accountability for systems-level changes.
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Ruma Rajbhandari is a physician who trained in the US and now works in rural Nepal through the Global Health Equity Residency and Nyaya Health. She helped establish the Rural Staff Support Program through the Nick Simons Institute to address gaps in rural healthcare in Nepal. This program provides infrastructure, training, and support to rural hospitals. She now works at Bayalpata Hospital, which was renovated and is operated by Nyaya Health, to expand services and develop a scalable model of healthcare delivery for rural communities.
Building primary care infrastructure in rural Nepal
This is an overview of Nyaya Health's work in Nepal, starting with some basics of Nepal's health, economics, and history. This talk was given by Jason Andrews at UCSF/San Francisco General Hospital on 6/4/2009.
Nyaya Health at ANMF 2010 Conference: Telemedicine
Nyaya Health presents on Nyaya's experience with telemedicine at ANMF 2010 conference at Flagstaff, AZ.
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This document summarizes clinical and community efforts to address postpartum hemorrhage (PPH) in multiple countries. It discusses challenges in preventing PPH, which is a leading cause of maternal mortality. It then outlines a model for PPH prevention and treatment that includes accurate blood loss estimation methods, community education on the "4 delays" that can impact care, and use of the non-pneumatic anti-shock garment for women experiencing shock from PPH. The model has been implemented in health facilities in Nigeria, India, Bangladesh, Peru and Tanzania.
Globe Med Presentation, Dan Schwarz, March 2010
This presentation was delivered as one of the "Partnerships in Global Health Equity" workshops at the 2009 GlobeMed Summit (http://www.globemedsummit.org/) on March 6th, 2010.
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Nyaya Health is a non-profit organization that provides healthcare in rural Nepal. It operates Bayalpata Hospital, which offers free inpatient, outpatient, emergency, and obstetric services. Nyaya Health aims to develop a scalable model of healthcare delivery through transparency, accountability, and collaboration both within its teams and with other organizations. It shares operational data through an open-access wiki and communicates among teams using low-bandwidth technologies. Nyaya Health has also collaborated with Tiyatien Health in Liberia to enhance practices in both countries. Developing an effective model presents challenges around resources, infrastructure, and local engagement.
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Nyaya Health is a 501(c)(3) nonprofit that provides free healthcare in rural Achham District, Nepal. It operates the Sanfe Bagar Primary Health Center and is renovating Bayalpata Hospital under a 5-year government contract. Nyaya Health's mission is to build healthcare infrastructure and develop a scalable model for rural healthcare delivery. It recruits and trains local staff, expands access to services like maternal care, and uses data monitoring to improve care. Nyaya Health aims to expand its community health worker network, add surgical capacity, and improve telecommunications to better achieve its mission.
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This document discusses community participation efforts at Bayalpata Hospital in rural Nepal to improve transparency, accountability, and hospital usage. It describes pre- and post-intervention surveys conducted to get community feedback on hospital services, with a focus on increasing participation from females, Dalits (lower caste), and other underrepresented groups. The goal was to evaluate whether community involvement could help make the hospital more transparent, accountable and better used by the local population.
Providing Health in Difficult Contexts: Pre-Pilot Performance-Based Financing...
The Adamawa Primary Health Care System in Nigeria has implemented performance-based financing (PBF) to address underlying issues plaguing the health system. After two years of pre-pilot implementation, results have been encouraging with improvements in key indicators like institutional deliveries and vaccination rates. Success stories like Mayo-Ine health center demonstrate how community engagement and strengthened management can boost coverage. However, some indicators still show room for growth, and deeper analysis finds issues like staffing shortages and infrastructure problems influencing performance. Moving forward, continued scale-up and addressing broader health system challenges will be important to sustain gains under PBF in Adamawa State.
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The document provides details about the proposed Thirumalai Mission Hospital project in Ranipet, Vellore District, Tamil Nadu, India. It discusses the need for the hospital to provide accessible primary and secondary healthcare services. The 100-bed community hospital will be supported by rural and urban satellite centers. It will offer a range of inpatient and outpatient services including general medicine, surgery, obstetrics, and more. The project aims to serve residents within a 40km radius through its hub-and-spoke model of care delivery.
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Nyaya Hospital in Nepal provides medical care to the local community. The author describes a typical day at the hospital, beginning with morning rounds where doctors examine inpatients, many being treated for pneumonia. Afterward, doctors see outpatients and fill out cards with exam findings, diagnoses and prescriptions for patients to take to the pharmacy. In the afternoon, the author assists with prenatal care, spending time learning ultrasound techniques from the head of the antenatal clinics to measure fetal heart rate and locate the placenta.
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Bayalpata Hospital has undergone several renovations and expansions, including a new inpatient building with male, female, and maternity wards as well as an attached delivery suite. The clinical team provides round-the-clock care to all inpatients. Outpatient services have been expanded with four new examination rooms staffed during office hours. Emergency room facilities have also been improved with new beds and an on-call room. Additional administrative offices and a large new store room have further strengthened hospital operations and support for growing patient numbers.
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Gregory Karelas is the Country Director for Nyaya Health in Nepal. He starts his day by answering emails and making plans from his office. He then has breakfast with the hospital staff in the kitchen. In the morning, he conducts a staff meeting. Throughout the day, he examines construction projects, interviews candidates, discusses landscaping and future renovations, and finalizes financial guidelines with the accountant. In the evening, he has supper with friends in the local village.
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1) A hospital in remote rural Nepal implemented a morbidity and mortality conference (M&M) to improve healthcare quality by involving both clinical and non-clinical staff.
2) The weekly M&M meetings focused discussions on patient cases using a framework of seven domains to identify systems issues impacting care delivery.
3) Preliminary results found improved communication, a better understanding of operations, and more rigorous identification of areas for improvement across the hospital.
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This document outlines plans to improve operations at Nyaya Health facilities. It discusses proposals to enhance salary and benefits for staff, clarify procurement processes, establish clear reporting structures and complaint channels, improve housing and transportation support, revise food and leave policies, implement disciplinary procedures, increase transparency, and strengthen community involvement. The goal is to address issues and better define guidelines, policies, and processes across the organization.
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The document describes a series of x-ray images taken of various patients, including a young woman with a foot fracture, elderly men presenting with heart failure and pneumonia, a woman with emphysema exacerbation, an elderly man with a history of tuberculosis now showing recurrent tuberculosis, an elderly man with alcoholic cirrhosis and extensive pulmonary disease, a man with heart failure, and a woman with renal failure and abdominal distension.
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The document describes a series of x-ray images taken of various patients, including a young woman with a foot fracture, an elderly gentleman with heart failure and pneumonia, a woman with emphysema exacerbation, an elderly gentleman previously treated for tuberculosis now with a recurrent case, another elderly gentleman with a history of tuberculosis also now recurrent, an elderly gentleman with alcoholic cirrhosis and multiple lung issues, a gentleman with heart failure, and a woman with renal failure and abdominal distension.
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The document describes various areas of a hospital including a conference room where patient discussions take place, beautiful hospital grounds, well-maintained corridors, operating theatres, pediatric wards, a medical education complex, staff and student housing, an ultrasound room, post-operative area, sterile supply room, an autoclave facility, a surgical stock room, and a post-operative supply room. It also mentions Gregory meeting with other staff.
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This document summarizes a proposed prospective study to evaluate the implementation of an expanded surgical care model (IMEESC-plus) at a district hospital in rural Nepal. The study aims to rigorously evaluate this innovative surgical care model, pilot an implementation research methodology, and generate data to support wider scale-up of surgical services globally. The proposed study would assess the implementation process, measure the quality of surgical services provided, and evaluate specific outcomes like complication rates. If successful, it could help address the large unmet need for surgical care in low-resource settings.
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This document proposes a prospective study to scale up surgical care at a rural hospital in Nepal using the WHO's Integrated Management for Emergency and Essential Surgical Care (IMEESC) model plus additional community follow-up and quality improvement methods. The study aims to rigorously evaluate this innovative model, pilot an implementation research methodology, and generate data to inform larger scale-up of surgical care worldwide. Specific objectives include describing the implementation process and measuring quality through adherence to protocols, follow-up rates, and complication rates. Metrics are proposed for evaluating pre-op, intra-op, post-op, facilities/supplies, and community follow-up. The study seeks to provide needed research on deploying surgical care in low-
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This document outlines over 40 powerpoint presentations given by members of Nyaya Health about their work providing healthcare in rural Nepal. The presentations cover topics such as implementing quality improvement programs, managing cases of diarrhea, introducing healthcare quality initiatives in resource-poor settings, building healthcare systems and primary care infrastructure in rural Nepal, and developing partnerships for improved global health delivery.
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Nyaya Health operates a clinic in Achham District, Nepal that provides free, high-quality healthcare using a unique model. Their model employs community health workers, is open-source and transparent, and relies on multiple sources of funding. They aim to become a teaching model for healthcare delivery and serve the underserved population. However, Nyaya Health faces challenges of growing their scale and scope while strengthening resources for replicability and creating sustainable revenue streams.
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A 6-month-old boy presented to a hospital in Nepal with severe respiratory distress. Despite his poor condition, supportive treatment was delayed. That evening, a power outage caused equipment failures and the inability to provide oxygen. The child was found unresponsive hours later and died after unsuccessful resuscitation efforts. Quality improvement tools that can be used in resource-poor settings include quality committees, standards/checklists, clinical audits, patient interviews, and morbidity/mortality conferences to systematically analyze care quality and identify areas for improvement.
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This document provides an overview and review of services at Bayalpata Hospital in Nepal. It summarizes the hospital's mission to provide free healthcare with a focus on marginalized populations. It reviews the hospital's maternal health, HIV, and community health programs. For maternal health, it discusses antenatal care, delivery services, family planning and safe abortion services. For HIV, it provides data on patients enrolled in treatment and reviews challenges. For community health, it describes a partnership program with local health volunteers. The document outlines future plans to expand services and reviews budget and financing.
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This document summarizes a proposed prospective study to rigorously evaluate the implementation of an expanded surgical care model (IMEESC-plus) at a district hospital in rural Nepal. The study aims to 1) evaluate the implementation process using mixed quantitative and qualitative methods at the hospital, staff, and patient levels, 2) pilot an implementation research methodology for potential larger studies, and 3) generate data to inform wider scale-up of surgical care globally. Specific objectives include evaluating hospital operations and costs, staff adherence to protocols and experiences, and changes in surgical volumes, complications, and patient follow-up over time.
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(1) Nyaya Health provides free healthcare in rural Nepal through clinics and hospitals, operating the Sanfe Bagar Medical Clinic from 2008-2009 and currently the Bayalpata Hospital.
(2) Their model focuses on five key pillars: free healthcare for all, full transparency, working with the community and government, integrating clinical and community services, and using evidence-based medicine.
(3) Their current priorities include maternal and child health through community outreach, HIV/AIDS and tuberculosis programs, and expanding access through technology and community health workers.
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This document summarizes a case presentation of a patient with progressive neurological deficits and HIV. Over several weeks, the patient developed numbness that spread across his face and limbs, as well as other neurological symptoms. Imaging and spinal fluid testing did not reveal any abnormalities. A biopsy showed diffuse large B-cell lymphoma that was HHV8-positive but EBV-negative. This type of lymphoma is associated with Kaposi's sarcoma-associated herpesvirus (KSHV), which can cause various malignancies in HIV/AIDS patients such as multicentric Castleman's disease, primary effusion lymphoma, and diffuse large B-cell lymphoma.
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This document summarizes the minutes from a Hospital Operations Committee meeting at Bayalpata Hospital in Nepal. It provides an overview of the hospital's programs, finances, and expansion plans. Key points include:
- Bayalpata Hospital provides free healthcare services and is managed by Nyaya Health Nepal in partnership with the Nepali Ministry of Health.
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Nyaya Health provides free community-based healthcare in rural Nepal. It was founded in 2005 as a partnership between medical professionals and the Nepali government. In 2006, one of the co-founders visited Achham district and saw extreme poverty, lack of infrastructure and healthcare access, and high rates of HIV, malnutrition and maternal mortality. While Nyaya made some progress between 2006-2011 by hiring doctors, improving roads and health spending, major challenges remained like limited electricity, long travel times for advanced care, and lack of data. Nyaya transitioned from an all-volunteer model with no paid staff to a more professional organization in order to reliably expand its operations, access more resources, and develop local healthcare solutions through partnerships
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Diarrheal cases were high in Bayalpata Hospital from Falgun to Baisakh. The medical director recommended distributing necessary medical supplies to health posts and sub-health posts, providing oral rehydration solution and water treatment, and immediate public health messaging through female community health volunteers and mothers' groups on the radio to address the issue. Long-term recommendations included improving water facilities and strengthening coordination between sectors in Achham district.
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There is increasing confidence that cell therapies will soon play a role in the treatment of autoimmune disorders, but the extent of this impact remains to be seen. Early readouts on autologous CAR-Ts in lupus are encouraging, but manufacturing and cost limitations are likely to restrict access to highly refractory patients. Allogeneic CAR-Ts have the potential to broaden access to earlier lines of treatment due to their inherent cost benefits, however they will need to demonstrate comparable or improved efficacy to established modalities.
In addition to infrastructure and capacity constraints, CAR-Ts face a very different risk-benefit dynamic in autoimmune compared to oncology, highlighting the need for tolerable therapies with low adverse event risk. CAR-NK and Treg-based therapies are also being developed in certain autoimmune disorders and may demonstrate favorable safety profiles. Several novel non-cell therapies such as bispecific antibodies, nanobodies, and RNAi drugs, may also offer future alternative competitive solutions with variable value propositions.
Widespread adoption of cell therapies will not only require strong efficacy and safety data, but also adapted pricing and access strategies. At oncology-based price points, CAR-Ts are unlikely to achieve broad market access in autoimmune disorders, with eligible patient populations that are potentially orders of magnitude greater than the number of currently addressable cancer patients. Developers have made strides towards reducing cell therapy COGS while improving manufacturing efficiency, but payors will inevitably restrict access until more sustainable pricing is achieved.
Despite these headwinds, industry leaders and investors remain confident that cell therapies are poised to address significant unmet need in patients suffering from autoimmune disorders. However, the extent of this impact on the treatment landscape remains to be seen, as the industry rapidly approaches an inflection point.
The Electrocardiogram - Physiologic Principles
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
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Mit nyaya health april 22 2011
- 6. West in the middle? Achham Kathmandu
- 7. Achham 250,000 population of Achham 0 allopathic doctors before Nyaya >80% of healthcare from private practitioners 2 allopathic doctors hired by Nyaya 12 Hours to nearest airport and operating room 16 hours to nearest ICU 1 in 125 deliveries results in the mother’s death 90% of deliveries in homes and cattle sheds 60% of children are chronically malnourished 50 ¢ average daily per capita income in Achham 50% of men migrate to India for work; over 7% return with HIV Achham
- 9. Birth of Nyaya Health
- 10. Sanfebagar Primary Health Center
- 13. Bayalpata Hospital: Then and Now
- 14. Bayalpata Hospital: Then and Now
- 20. Continued Renovations Next Steps
- 21. Next Steps Surgical Services Next Steps
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