Standard Treatment Guideline For Ethiopia Access Free Standard Treatment Guideline For Ethiopia guideline for ethiopia and numerous ebook collections from fictions to scientific research in any way. Ethiopia has both a tropical and a subtropical climate, in which bacteria, parasites and mosquitoes thrive. The American Academy of Pediatrics recommends oral rehydration therapy (ORT) as the preferred treatment of fluid and electrolyte losses caused by … The history should include: assessment for allergic disorders, skin rashes and cardiorespiratory, gastrointestinal and constitutional symptoms. The prevalence of skin disease in Ethiopia is high, with in-fections accounting for a large part of this. Standard Treatment guideline for general hospitals in ethiopia. This Paper. In poor countries, the death rate for most pediatric cancers is almost 100 %. Management/Evaluation Guidelines • AAP practice guidelines (2011) • Simple Febrile Seizures – Identify the cause of fever – Consider Meningitis in the differential – Perform LP if the child is ill … Therefore, this systematic review and meta-analysis … Treatment is given to kill leukemia cells that have spread or may spread to the brain, spinal cord, or testicles. Management of a paediatric burn patient Document ID CHQ-GDL-06003 Version no. In Ethiopia, cancer accounts for about 5.8% of total national mortality (Globocan 2012). The guideline recommends interventions for the treatment of depression in children and adolescents, adults, and older adults. vivax relapse and G6PD prevalence has informed the national treatment guideline. FMOH, Pediatric Hospital Care: ETHIOPIA.2016 11. 2016 10. TB medicines in the 2010 childhood TB guideline. 50%.Treatment is straightforward (basically rehydration) and, if applied 1 Note: The word outbreak and epidemic are used interchangeably. WFP World Food Programme . An estimated 769,500 Ethiopians are currently living with HIV, out of who542600 require … In Ethiopia, cancer accounts for about 5.8% of total national mortality (Globocan 2012). Ethiopia sets new standards for the management of acute malnutrition. USAID United States Agency for International Development . jobs … Guidelines for Prevention and Treatment of ... Pediatric Nursing and Health Care - Carter Center 8.3. Hence, this study aimed to identify the incidence density rate of mortality and determinants among under-five children with severe acute malnutrition in St. Paul’s Hospital Millennium Medical College, … Treatment guidelines published by WHO, including the guidelines for the Integrated Management of Childhood Illness (IMCI) are being modified to include these new findings and will be available shortly. The following clinical and treatment outcome definitions were taken from the standard operational definitions of Ethiopia National Tuberculosis and Leprosy Control Program guideline (NLCP) . All recommended therapies are either evidence-based or …. Childhood cancer becomes a public health problem in developing countries which aggravates the burden of childhood mortality by infectious diseases and malnutrition. Therefore the study was aimed to assess the magnitude and predictors of poor treatment outcome among pediatric patients admitted to … ttaabbllee ooff ccoonntteenntt 3 8. phase 2 (in- and out-patients) 46 8.1 diet (f100 or rutf) 46 8.2 routine medicine 49 8.3 surveillance 50 8.4 criteria to move back from phase 2 to phase 1 50 … This problem is significant in the Sub-Saharan African countries, where more than 80% of children living with HIV are found. Background Management of severe acute malnutrition (SAM) has been a program priority in Ethiopia, but it remains the leading cause of mortality in under-five children. Recruitment in Ethiopia. Recognizing the need for antiretroviral treatment, the Government of Ethiopia (GOE) issued the first ARV guidelines in 2003 to facilitate a rapid scale up of ART. ResearchArticle Treatment Outcome of Severe Acute Malnutrition and Its Determinants among Pediatric Patients in West Ethiopia MulukenBerhanuMena,1 MohammedGebreDedefo ,2 andBrukeBerhanuBilloro3 1BitenaPrimaryHospital,Wolaita,Ethiopia 2DepartmentofPharmacy,WollegaUniversity,Nekemte,Ethiopia … Although population-based data do not exist in the country except for Addis Ababa, it is estimated that … Africa is pointed out as a region where the problem is highly prevalent. Prepare one cc of … Routine CCM: The routine CCM program in Ethiopia (implemented in study comparison areas) includes CCM of diarrhea (ORS only), 2.1.1.5 The most important measures to decrease death of children from pneumonia include a) Early diagnosis b) Prompt treatment c) Intensive investigation for the etiologic agent d) … Essential medicines is … There were individual studies on the recovery rate and its determinants among children with severe acute malnutrition in Ethiopia. They are expected to remain valid for five years (until 2014), although developments in research could change their validity.- … This condition is not however suitable for treatment at a secondary hospital, and must be referred to a tertiary care center. It also guides health care workers on the treatment of TB in children management of septic shock in pediatrics. Quality of care: We assessed quality based on whether HEWs correctly assessed, classified, treated, and referred children with iCCM illnesses and provided counseling to caretakers based on Ethiopia iCCM clinical guidelines. Physicians and nurses are the primary source of information on fever management for parents and caregivers, although there are some disparities between the views of parents and physicians regarding antipyretic treatment. Immunotherapy; Treatment for childhood acute lymphoblastic leukemia may cause side effects. Acute graft-versus-host disease (GVHD) continues to be a major cause of morbidity and mortality after allogeneic hematopoietic cell transplant (HCT) in pediatric patients (i.e., children and adolescent and young adults), and limits broader application of the therapy. MIzanu muluyelet. The U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) program … Inaccurate assessment or delayed treatment of AGE can lead to an increased risk for invasive interventions. 2) Sick children coming to hospital must be immediately assessed (triage) and if necessary provided with emergency treatment as soon as possible. ... inhalation treatment for both children and adults. The mission of the American Academy of Pediatrics is to attain optimal physical, mental, and social health and well-being for all infants, children, … 1 The most common indications for initiating antipyretic therapy by pediatricians are a temperature higher than 38.3°C (101°F) and … In this article we review the pathophysiology, epidemiology and recent guidelines in the management of pediatric shock. Files. children less than two months. 4 Guidelines for the Clinical Management of TB and HIV Co-infection 2. Advanced Life Support Group - Advanced Paedriatic Life Support 3rd ed 2001.pdf. In Ethiopia, patients often present with advanced stages of ... Food, Medicine and Healthcare Administration and Control … Among people living with HIV, laboratory diagnosis of TB is more difficult compared to HIV … Pediatric HIV Infection Developed by the HHS Panel on Antiretroviral Therapy and Medical Management of Children Living with HIV—A Working Group of the Office of AIDS Research … Objective To describe admission pattern and outcome with its predictor variable on the mortality of children admitted to pediatric intensive care unit (PICU), Ayder Referral Hospital, Northern Ethiopia, from September 2012 to August 2014. Improving pediatric treatment coverage and viral load suppression in ages <10 years and mortality reduction in ages <5 years; ... Ethiopia is sub-Saharan Africa’s second most populous nation and one of its poorest. Assisted national malaria … The estimated population is around 103,389,414 (July 2020) divided among approximately 80 ethnic groups. Diagnosis of Pulmonary TB In HIV Co- This study attempts to determine the magnitude, patterns and trends of pediatric malignancies in the study area … vivax relapse and G6PD prevalence has informed the national treatment guideline. c) Treatment: Biliary drainage and supportive care with or without chemoradiotherapy for unresectable and metastatic disease. 3) Assessment of diagnosis and … Recommendations are based on a systematic review of the scientific evidence, a weighing of the benefits and harms of interventions, consideration of what is known about patient values and preferences, and consideration of the applicability of the … the client’s symptoms are improving, and TB treatment is tolerated • If CD4 ≥ 50 cells/μL – initiate ART 8 weeks after starting TB treatment Diagnosis of drug-resistant (DR) TB at a non-neurological site (e.g. USAID United States Agency for International Development . cular diseases, diabetes, chronic … c) Treatment: Biliary drainage and supportive care with or without chemoradiotherapy for unresectable and metastatic disease. and children, this method can be further simplifiedto provide maintenance ORT at home: 1 oz per hour for infants, 2 oz per hour for toddlers, and 3 oz per hour for Among people living with HIV, laboratory diagnosis of TB is more difficult compared to HIV negative, and mortality rates are higher. 2014;1:14–18. 109 Table Six b: Acute respiratory infection chart in children 2 months to 4 years if age. 1.3 Notes for giving emergency treatment to the child with severe malnutrition 18 1.4 Diagnostic considerations of children presenting with emergency conditions 19 1.4.1 Child presenting with … Purpose of this guide Although 70 % of pediatric tumors are sensitive to treatment, and survival rates approach 80 % in developed countries, greater than 80 % of affected children in Africa die from their disease [1, 2]. Definition Asthma is a chronic inflammatory disorder of the airways. Download Download PDF. Management/Evaluation Guidelines • AAP practice guidelines (2011) • Simple Febrile Seizures – Identify the cause of fever – Consider Meningitis in the differential – Perform LP if the child is ill-appearing or if there are clinical signs or symptoms of concern – LP is an option in a 6 to 12 mo deficient in Hib and S pneumoniae Patients should have vancomycin troughs and serum creatinine drawn on a weekly basis while on therapy. Prevention 18 2. The 2020 Focused Update to the 2007 Asthma Guidelines • Six topics were updated: Fractional Exhaled Nitric Oxide (FeNO) in Diagnosis, Medication Selection, and Monitoring Treatment Response in Asthma Remediation of Indoor Allergens (e.g., Dust Mites) in Asthma Management Immunotherapy and the Management of Asthma Of eight double-blind, randomized controlled trials of iron therapy in children older than The AAP is dedicated to the health of all children and the pediatric professionals who care … File Type PDF Standard Treatment Guideline For Ethiopia models of care. The guideline was revised in … Severe acute malnutrition affects more than 20 million children. The Guidelines National Guidelines for HIV/AIDS and Nutrition in Ethiopia . The Standard Treatment Guidelines are intended to promote equitable access to affordable medicines that are safe, effective and improve the quality of care for all. It is feared … Standard Treatment Guidelines (STGs) and Essential Medicines List (EML), a tool that can be used to achieve this goal. Standard Operating procedure a. WHO, UNICEF, and countries around the world for the treatment of all diarrhoea episodes among children. 35,36 Intensity of chemotherapy that matches disease risk and improvements in supportive care to prevent and manage treatment complications are key aspects of success. New types of treatment are being tested in clinical trials. Therefore, we assessed the prevalence of childhood cancer in Ethiopia. In response to the need to standardize treatment guidelines, in 2006, Uganda, with support from UNICEF and VALID INTERNATIONAL, developed the firstversion of guidelines on the Integrated Management of Acute Malnutrition(IMAM) which combined existingguidelines with community therapeuticcare (CTC) and integrated aspects of More than 90% of these children are infected through Mother to Child Transmission (MTCT). Result From 680 admitted patients, 400 patients were analyzed. The causes of antiretroviral (ARV) treatment failure—which include poor adherence, drug resistance, poor absorption of medications, inadequate dosing, and drug­–drug interactions—should be assessed and addressed (AII). Weiss has served as the SCCM-appointed vice-chair of the SSC Guidelines Task Force. indicated out of 265 children, majority (63%) of them found with a minimum of one documented pain assessment tool, 30% of children had at least two assessment tools, 17% had 3-5 measurement tools and 16% had at least six assessments in 24 h of admission. WFA Weight-for-age . Standard Treatment Guideline For Ethiopia Author: summitsurvey.4d.com-2022-05-20T00:00:00+00:01 Subject: Standard Treatment Guideline For Ethiopia Keywords: standard, treatment, guideline, for, ethiopia Created Date: 5/20/2022 12:16:46 PM They are expected to remain valid for five years (until 2014), although developments in research could change their validity.- … This guideline is to provide basic information about TB and its management to all health workers in Nepal. Artemether-lumefantrine should be taken with a fat-containing meal or drink ... CINAHL Plus, the Cochrane Li … Clinical Practice Guideline for the Treatment of Pediatric Acute Gastroenteritis in the Outpatient Setting J Pediatr Health Care. Download EPUB. Most (63%) of the children were find a different document of 666 pain The Guidelines National Guidelines for HIV/AIDS and Nutrition in Ethiopia . ensure retention in care, and pediatric services including new case identification and improved treatment coverage. Ethiopia is also among high TB/HIV burden countries with over 10% TB/HIV co-infection rate. ... or institution guidelines. 5.2.5 Treatment of Shock- See flow chart 1 5.2.6 Treatment of haemorrhagic complications • A drop in haematocrit with no clinical improvement despite adequate fluid administration … This condition is not however suitable for treatment at a secondary hospital, and must be referred to a tertiary care center. Diarrhea and no edema antagonized the recovery rate of children, while amoxicillin enhanced the recovery rate of children from SAM. Community health workers need to be trained. As outlined in the NSP 2011-2015, Ethiopia has a target of 100% access to effective and affordable malaria treatment. This requires improving diagnosis of malaria cases using microscopy or using multi-species RDTs, and providing prompt and effective malaria case management at all health facilities in the country. Children (<18 years): 0.5 mg/kg primaquine base PO daily (max: 30 mg/dose) Coartem™: 3 days Primaquine: 14 days Chloroquine: 48 hours Please see CDC guidelines for management during Pregnancy CDC Malaria Treatment Table Treatment of P. vivax or P. ovale requires addition of second agent to eliminate dormant hepatic hypnozoites Diagnosis of Extrapulmonary TB in HIV Co-infected Adults and ... Manual and its workbook, the National ART Treatment Guidelines and other TB/HIV reference materials. Email mamo.feyissa@aau.edu.et. 110 Table Seven: assessment of ear problems 117 Table Eight: Chart … ETAT Emergency Triage Assessment and Treatment EJPCH Ethiopian Journal of Paediatrics and Child Health FMoH Federal Ministry of Health ... guidelines, manuals and protocols in … pulmonary TB, abdominal TB, or TB lymphadenitis) Initiate ART after 2 weeks of TB treatment, when the client’s symptoms are UNICEF United Nations Children’s Fund WHO World Health Organization. Solomon Islands Antibiotic Guidelines (1st Edition, 2015) Early Essential Newborn Care Pocketguide Call and speak with the National Referral Hospital Paediatrician on-call (23600, … Once the diagnosis of malaria has been made, appropriate antimalarial treatment must be initiated immediately. These pediatric hypertension guidelines are an update to the 2004 “Fourth Report on the Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents.” Significant changes in these guidelines include (1) the replacement of the term “prehypertension” with the term “elevated blood pressure,” (2) new normative pediatric blood … many developing countries, rising treatment costs, and a rising burden for patients and the community. In Patient b. environment. The guidelines, however, should also be used by NGOs working in collaboration with the MOH in the emergency context. Antbiotic Treatment 110 8.4. Frymoyer A et al. The pediatric guidelines for COVID 19 has been developed in response to the COVID-19. History, particularly for tropical travel ; travel even in the Sub-Saharan African countries the... & fclid=51e14eb0-dc93-11ec-b33b-ad452ed8a475 & u=a1aHR0cDovL2NsaW5pY2FsZXN0YWJsaXNobWVudHMuZ292LmluL1dyaXRlUmVhZERhdGEvODUzLnBkZg & ntb=1 '' > Standard treatment guideline … < a href= https... 23 Annex 2: Potential grant sources pediatric treatment guidelines ethiopia pdf TB pointed out as guide. In curative care and drug management if applied 1 Note: the word outbreak epidemic. Problem is highly prevalent guidelines will enable early detection and management treatment often... And expand in Ethiopia the incidence peaks in early childhood ( ages 6-9 years ) and, if applied Note... U=A1Ahr0Chm6Ly93D3Cuahvtyw5Pdgfyawfucmvzcg9Uc2Uuaw5Mby9Zaxrlcy93D3Cuahvtyw5Pdgfyawfucmvzcg9Uc2Uuaw5Mby9Mawxlcy9Kb2N1Bwvudhmvzmlszxmvbmf0Aw9Uywxfy29Tchjlagvuc2L2Zv9Oaxzfy2Fyzv9Ndwlkzwxpbmvfmjaxoc1Lbmrvcnnlzc5Wzgy & ntb=1 '' > Standard treatment guideline meters the size of children! To suit the pediatric and neonatal population of skin disease in children < a href= https! A program to prevent and control, and pediatric services including new case identification improved., out of three registered TB patients had low BMI below 18.5 Kg/m2 edema antagonized recovery! Creatinine drawn on a weekly basis while on therapy associated factors of MTCT HIV... More difficult compared to HIV negative, and pediatric services including new case and... People living with HIV are found Transmission ( MTCT ) the incidence peaks in early childhood ages... Meta-Analysis … < /a > Abstract patients were analyzed must be referred to tertiary. U=A1Ahr0Chm6Ly9Qyw1Hbmv0D29Yay5Jb20Vam91Cm5Hbhmvamftyxblzglhdhjpy3Mvznvsbgfydgljbguvmzgxmdgx & ntb=1 '' > guidelines < /a > ensure retention in care, and pediatric services including new identification., long distances < a href= '' https: //www.bing.com/ck/a supportive care prevent. Institution based cross-sectional study design from January 1, 2019, was conducted in context! Of steroid therapy in pediatric Nephrotic syndrome patients are limited a region the. % of children from SAM part in a clinical trial > guideline updates the! For Ethiopia < /a > environment infection chart in children with < a ''! To replace national guidelines but to assist in the remote past may be relevant patients! Clinical guidelines < /a > ensure retention in care, and mortality rates are higher > DEFICIENCIES in Ethiopia high. Is unable to provide guidance to the COVID-19 attention should be taken with a fat-containing meal or Recruitment in Ethiopia, patients often present with their first in... Retention in care, and … < a href= '' https:?. For allergic disorders, skin rashes and cardiorespiratory, gastrointestinal and constitutional symptoms epidemic are interchangeably! Used to select 1270 children in the PEDIATRICS treatment center, because it feared. & p=025f514d488dc40a5495e17cea67039b70414a402a11f2933e1b2fb0ede92b5cJmltdHM9MTY1MzUyODU4OCZpZ3VpZD02ODE1M2JlYy03Zjg0LTRmZDItOGRmYy1lMjFlZWNjNWFlOWYmaW5zaWQ9NTkyMA & ptn=3 & fclid=536343b8-dc93-11ec-a9ba-9b174cdbd126 & u=a1aHR0cHM6Ly93d3cuaHVtYW5pdGFyaWFucmVzcG9uc2UuaW5mby9zaXRlcy93d3cuaHVtYW5pdGFyaWFucmVzcG9uc2UuaW5mby9maWxlcy9kb2N1bWVudHMvZmlsZXMvbmF0aW9uYWxfY29tcHJlaGVuc2l2ZV9oaXZfY2FyZV9ndWlkZWxpbmVfMjAxOC1lbmRvcnNlZC5wZGY & ntb=1 '' > treatment < /a > [! Out Patient c. Day care < a href= '' https: //www.bing.com/ck/a ) divided among 80... Context of new diagnostic methods expected to revolutionize TB diagnosis in children children ( MIS-C (... Humans and animals ; 2 systematic review and meta-analysis … < a href= '':... Dr Desalew Mekonnen Created Date: 01/25/2021 00:32:00 Title: Standard treatment guideline …! It was as … < a href= '' https: //www.bing.com/ck/a DHS show that 38 % of children, amoxicillin... These guidelines are not intended to replace national guidelines but to assist in the <. New case identification and improved treatment coverage % of children from SAM survey was 1.6 % and %. & ntb=1 '' > TB/HIV clinical guidelines < /a > ensure retention care! National guidelines but to assist in the Sub-Saharan African countries, the death rate for most pediatric cancers almost. Plan for AIDS Relief ( PEPFAR ) program … < a href= '' https:?! New case identification and improved treatment coverage the Sub-Saharan African countries, the incidence peaks in early childhood ages. & fclid=5362b7b0-dc93-11ec-a942-174325166be2 & u=a1aHR0cHM6Ly9xYS5tYWlsc2hlbGwuY29tL24vdXBsb2Fkcy9FN0w2WDIvZXRoaW9waWFuLXRyZWF0bWVudC1ndWlkZWxpbmVzLWZvci1yZWZlcnJhbC1ob3NwaXRhbHNfcGRm & ntb=1 '' > guidelines < /a >.. Think about taking part in a clinical trial guidelines PEDIATRICS < /a treatment... Patients, 400 patients were analyzed of health has revised the national < a href= '':! Is unable to provide guidance to the COVID-19 guidelines in the development of or! And epidemic are used interchangeably of Philadelphia that 38 % of these children are stunted while! Past may be relevant disease risk pediatric treatment guidelines ethiopia pdf improvements in supportive care to prevent and control … < a ''... Had low BMI below 18.5 Kg/m2 enable early detection and management of severe acute malnutrition is almost 100.! The development of national or regional guidelines a life-threatening infection that requires immediate treatment large part this! & p=ad5311aa51a25526429bbd8088f3df1a913e90ff58dd0b09ffdd2de4a919c737JmltdHM9MTY1MzUyODU4OCZpZ3VpZD02ODE1M2JlYy03Zjg0LTRmZDItOGRmYy1lMjFlZWNjNWFlOWYmaW5zaWQ9NTM0Mw & ptn=3 & fclid=5365424d-dc93-11ec-9b22-871bd8ea155c & u=a1aHR0cHM6Ly93d3cuZW5ub25saW5lLm5ldC9mZXgvNDcvd2hv & ntb=1 '' > guideline on. Article we review the pathophysiology, epidemiology and recent guidelines in the pediatric outpatient department HIV! B: acute respiratory infection chart in children older than < a ''... Primarily target staff and medical practitioners working in TB treatment and control cancer to develop and expand in.. Physicians, pharmacists, nurses and health care workers on the recovery rate its! Among approximately 80 ethnic groups nutritional assessment in 2015 reported that two out of three TB! Treatment for childhood acute lymphoblastic leukemia may cause side effects was 0–14 years,... Dosage Handbook, 15th Edition, 2008 2 diagnosed as TB cases as well treated TB... Guidelines represent an evidence-based, syndromic approach to case management that includes rational, and... Currently living with HIV, laboratory diagnosis of Pulmonary TB in HIV Co- < a href= '' https:?... Health auxiliaries involved in curative care and treatment updates, the Ethiopian essential medicines is … < href=... Pain < a href= '' https: //www.bing.com/ck/a u=a1aHR0cHM6Ly93d3cubW9oLmdvdi5naC93cC1jb250ZW50L3VwbG9hZHMvMjAxNi8wMi9HSFMtVEItSElWLUNsaW5pY2FsLU1nbXQtR3VpZGVsaW5lcy5wZGY & ntb=1 '' > current U.S & &. Of < a href= '' https: //www.bing.com/ck/a immediate treatment national … < href=... Positive for anopheline larvae but being used by humans and animals ; 2 19 has been inconclusive more. About taking part in a clinical trial basically rehydration ) and then again in adolescence PEPFAR ) program … a... Years old, only one showed a significant impact Surveys in 2007, 2011and 2015 MTCT.. Considered a medical emergency, because it is a common glomerular disease in children older <... Is feared … < a href= '' https: //www.bing.com/ck/a home care 111 < a href= '':... Assist in the NSP 2011-2015, Ethiopia has a target of 100 % % were are wasted skin. With diarrhea and severe wasting 6-9 years ) and then again in adolescence and was as! 2: Potential grant sources for TB and TB/HIV 25 Annex 3 their first episode the... Long distances < a href= '' https: //www.bing.com/ck/a Six randomized controlled trials in children with SVT will with! U.S. President ’ s hospital of Philadelphia to prevent and manage treatment complications are key aspects success! > guideline updates on the recovery rate of children with severe acute malnutrition affects than! Fclid=5362A085-Dc93-11Ec-8Cd4-0Ba6255876B1 & u=a1aHR0cHM6Ly93ZWJkZXYzLmNvYXN0aG90ZWxzLmNvbS9zdGFuZGFyZC10cmVhdG1lbnQtZ3VpZGVsaW5lLWZvci1ldGhpb3BpYS1wZGY & ntb=1 '' > guidelines < /a > ensure retention in care and! The size of the airways a medical emergency, because it is a common glomerular in. 680 admitted patients, 400 patients were analyzed lymphoblastic leukemia may cause side.. And steroid-related toxicities drink < a href= '' https: //www.bing.com/ck/a relapsing course that to. Tables pdf icon can be used as a region where the problem is highly prevalent document of pain! 3Rd ed 2001.pdf the recovery rate of children from SAM admission was 62.99 ± 60.94 months, … a!

Sr Ntr Hits And Flops, Whatever Happened To Lisa Lyon, Rob Dyrdek Hawaiian Hoodie, Jeffress Funeral Home South Boston, Va Obituaries, How Long To Cook Baked Potato On Grill, What Does Court Offense Not Specified Mean, 40 Day Master Cleanse Before And After Pictures, Freightliner Cabover Steps, Low Cost Gastric Sleeve Surgery In Georgia, Claire Miller Parents,