Recurrent venous thrombosis - an unusual first presentation of autoimmune polyendocrinopathy syndrome type 3B
S Afr Med J. 2023 Dec 31;114(1):17-21. doi: 10.7196/SAMJ.2024.v114i1.1477.ABSTRACTA 45-year-old female presented with unprovoked recurrent venous thromboembolism (VTE), in unusual sites, and pancytopenia, posing a complex diagnostic challenge. Work-up for inherited thrombophilia, antiphospholipid syndrome (APLS) and paroxysmal nocturnal haemoglobinuria were unremarkable. Investigations revealed autoimmune thyroid disease, and a mixed iron/vitamin B12 deficiency due to pernicious anaemia and resultant atrophic gastritis. Hyperhomocysteinaemia due to vitamin B12 deficiency was identified as a potential contributor to her rec...
Source: South African Medical Journal - March 25, 2024 Category: African Health Authors: N Letete D Vaz P H Malishi J J Pogieter P Rheeder Source Type: research
POPIA does indeed apply to health research: A response to Bronstein and Nyachowe
This article critically analyses the authors' interpretation of section 3(2)(b) of POPIA and challenges two of its aspects.PMID:38525625 | DOI:10.7196/SAMJ.2023.v113i11.1345 (Source: South African Medical Journal)
Source: South African Medical Journal - March 25, 2024 Category: African Health Authors: D W Thaldar Source Type: research
Implementing E-MOTIVE for detection and treatment of postpartum haemorrhage in South Africa
S Afr Med J. 2023 Dec 4;113(12):24. doi: 10.7196/SAMJ.2023.v113i12.1164.ABSTRACTPostpartum haemorrhage is the leading cause of preventable maternal mortality in South Africa. In a significant breakthrough in the management of PPH, the E-MOTIVE trial found that a multifaceted health service intervention reduced severe PPH after vaginal delivery by 60% in 78 hospitals in Nigeria, Kenya, Tanzania and SA. The E-MOTIVE approach comprises objective blood loss measurement monitored every 15 minutes during the first hour after delivery to detect PPH early and trigger a bundle of first-line treatments, including massaging the uteru...
Source: South African Medical Journal - March 25, 2024 Category: African Health Authors: M Singata-Madliki S Fawcus N Moran E Arends E Muller S Mandondo G J Hofmeyr Source Type: research
Knowledge, attitudes and practices of oral HIV pre-exposure prophylaxis (PrEP) among healthcare workers in the Ekurhuleni District, South Africa
CONCLUSION: Among the healthcare workers tasked with generating demand and identifying clients eligible for HIV PrEP services, low knowledge of HIV PrEP and negative attitudes towards HIV PrEP may be barriers to the uptake of HIV PrEP. Training healthcare workers on HIV PrEP is recommended.PMID:38525627 | DOI:10.7196/SAMJ.2023.v113i12.1171 (Source: South African Medical Journal)
Source: South African Medical Journal - March 25, 2024 Category: African Health Authors: E Mahlare E Ramutshila A Musekiwa L Kuonza T Mabuto Source Type: research
The use of emergency medical services for palliative situations in Western Cape Province, South Africa: A retrospective, descriptive analysis of patient records
CONCLUSION: EMS in SA frequently encounter palliative situations for symptoms that may be managed within their scope of practice. Consequently, it appears that EMS have an important role to fulfil in the care of patients with palliative needs. Integrating EMS and palliative care may result in improved palliative care provision and, therefore, EMS and palliative care integration would be beneficial in SA.PMID:38525628 | DOI:10.7196/SAMJ.2023.v113i11.1136 (Source: South African Medical Journal)
Source: South African Medical Journal - March 25, 2024 Category: African Health Authors: C Gage B Spies K Crombie L Gwyther W Stassen Source Type: research
Pancreatic cancer mortality in South Africa: A case-control study
CONCLUSION: Smoking and certain occupations increased the risk of pancreatic cancer mortality. Further research is needed to evaluate the associations between other extrinsic and intrinsic factors and pancreatic cancer mortality.PMID:38525629 | DOI:10.7196/SAMJ.2024.v114i1.1132 (Source: South African Medical Journal)
Source: South African Medical Journal - March 25, 2024 Category: African Health Authors: M L Nhleko I Edoka E Musenge Source Type: research
Informal gold miners with mercury toxicity: Novel asymmetrical neurological presentations
S Afr Med J. 2023 Dec 4;113(12):20. doi: 10.7196/SAMJ.2023.v113i12.1127.ABSTRACTMercury is a highly toxic heavy metal that may cause neurological, respiratory, gastrointestinal and dermatological illnesses. Previously described neurological manifestations of mercury toxicity are symmetrical, and include a pancerebellar syndrome, generalised seizures and encephalopathy. Mercury is used in the gold mining process, and in artisanal or illicit gold mining, often without necessary protection. Here we describe the cases of two artisanal gold miners from western Johannesburg, South Africa, who presented with atypical neurological...
Source: South African Medical Journal - March 25, 2024 Category: African Health Authors: J George E Sadiq I Moola S Maharaj A Mochan Source Type: research
The characteristics of dermatology inpatients seen at the quaternary Inkosi Albert Luthuli Central Hospital in Durban, South Africa, over a 5-year period - 2015 - 2020
CONCLUSION: A broad range of diagnoses is managed through the dermatology inpatient service, particularly as consultations. These services remain essential in the holistic management of patients.PMID:38525631 | DOI:10.7196/SAMJ.2024.v114i1.1098 (Source: South African Medical Journal)
Source: South African Medical Journal - March 25, 2024 Category: African Health Authors: L Mthembu J T Masuka K Duze A Mosam Source Type: research
Dyslipidaemia in patients with chronic kidney disease - a neglected cardiovascular risk factor
CONCLUSION: This cohort comprised a large proportion of patients classified as high or very high risk for ASCVD. Despite this, the use of LLT was inadequate, and <20% of patients were at target LDL-C levels. These data suggest a greater need for awareness of initiating LLT to achieve recommended target LDL-C levels in patients with CKD.PMID:38525632 | DOI:10.7196/SAMJ.2023.v113i11.1089 (Source: South African Medical Journal)
Source: South African Medical Journal - March 25, 2024 Category: African Health Authors: M R Essop F Seedat F J Raal Source Type: research
Antivirals for the treatment of mild and moderate COVID-19 in South Africa
S Afr Med J. 2023 Dec 4;113(12):33. doi: 10.7196/SAMJ.2023.v113i12.1066.ABSTRACTWhile the majority of COVID-19 cases in South Africa (SA) are mild, patients with severe COVID-19 requiring hospitalisation present with significant morbidity and mortality and place a substantial burden on healthcare services. Given the low vaccine uptake in SA and other low- and middle-income countries in sub-Saharan Africa, the high prevalence of comorbidities and limited healthcare system capacity, evidence-based interventions that reduce the risk of severe disease and death should be considered for implementation. Several antiviral classes...
Source: South African Medical Journal - March 25, 2024 Category: African Health Authors: R Perumal V Naidoo S Govender T N Gengiah Source Type: research
Wrong-route drug administration errors: A review of the literature
S Afr Med J. 2023 Dec 4;113(12):29. doi: 10.7196/SAMJ.2023.v113i12.1043.ABSTRACTOral drug formulations and enteral feeds may inadvertently be administered intravenously. Intravenous medications may be inadvertently administered intra-arterially. These examples of wrong-route drug administration errors have the potential to cause significant organ dysfunction and even death. This narrative review aims to explore the pathophysiological mechanisms underlying such errors and investigate preventive strategies and potential therapeutic options.PMID:38525634 | DOI:10.7196/SAMJ.2023.v113i12.1043 (Source: South African Medical Journal)
Source: South African Medical Journal - March 25, 2024 Category: African Health Authors: J Taylor M Blockman Source Type: research
Prescribed Minimum Benefits complaints: a five-year retrospective review
CONCLUSION: Chronic conditions are the main diseases that medical scheme members complained about. Member education and clear definition of PMBs should be prioritised by medical schemes and the Council for Medical Schemes.PMID:38525635 (Source: South African Medical Journal)
Source: South African Medical Journal - March 25, 2024 Category: African Health Authors: Lindelwa Mitchele Ngobeni Lucky Moropeng Evelyn Thsehla Source Type: research
An outbreak within an outbreak: The impact of Infection Prevention and Control strategies on hospital-acquired infections and the occurrence of multi-drug resistant organisms during the COVID-19 pandemic
CONCLUSION: We observed a very significant rise in HAIs in the COVID-19 ICU during the third wave compared with the first, with almost three times as many patients developing HAIs. Unsurprisingly, it was associated with a longer mean stay in ICU and a higher mortality. The outbreak of both CRE and A. baumannii, and the fact that many patients cultured the same CRE organism and A. baumannii, strongly suggests that a critical breakdown in IPC measures had occurred.PMID:38525636 | DOI:10.7196/SAMJ.2023.v113i12.971 (Source: South African Medical Journal)
Source: South African Medical Journal - March 25, 2024 Category: African Health Authors: B Mashigo A Parker U Lalla B W Allwood M S Moolla T Lovelock C F N Koegelenberg Source Type: research
Progress towards 90-90-90 and 95-95-95 strategy implementations and HIV positivity trends in the City of Johannesburg
CONCLUSION: This study has established positive progress made by the CoJ towards HIV testing, ART initiation, viral load suppression and HIV positivity rate. On the other hand, gaps in linkage to care after testing positive have been highlighted. It is therefore critical in the 95-95-95 strategy implementation era to focus on finding those missed during the 90-90-90 phase through revised and renewed innovative approaches.PMID:38525637 | DOI:10.7196/SAMJ.2024.v114i1.862 (Source: South African Medical Journal)
Source: South African Medical Journal - March 25, 2024 Category: African Health Authors: J C Y Nyasulu I Maposa Source Type: research
Trisomy 21 screening with αlpha software and the Fetal Medicine Foundation algorithm
CONCLUSION: Screening with FMF software has a similar screen positive rate and better detection rate than screening with αlpha software. The low prenatal detection rate of trisomy 21 is mainly due to a low prevalence of screening. More research is needed in the SA setting to explore why screening and confirmatory testing after high-risk results are not performed in many pregnancies.PMID:38525638 | DOI:10.7196/SAMJ.2023.v113i11.885 (Source: South African Medical Journal)
Source: South African Medical Journal - March 25, 2024 Category: African Health Authors: L Pistorius C A Cluver I Bhorat L Geerts Source Type: research
