In a dietary study on a representative sample of 983 adult African men and women aged 154 years, resident in the Cape Peninsula, South Africa, trained professional nurses administered a 24 hour recall interview. This formed part of a cross-sectional study on the prevalence of coronary risk factors (BRISK) in this population. The macronutrient profile reflected a diet meeting the Prudent Dietary Guidelines, but low in fibre. Mean intakes of vitamins and minerals indicated a nutritionally depleted diet. Comparisons with rural African populations have revealed that the dietary intake of this urbanising study population represents a transitional phase towards a progressively atherogenic Western diet.
A medical audit was performed in Umzingwane District, Zimbabwe, to assess the quality of antenatal care in 1991 regarding detection and management of syphilis. Two thousand one hundred and sixty one women booked for antenatal care, 1433 (66 pc) received a RPR test result. 197 (14 pc) tests were positive. In 32 (16 pc) of the 197 RPR positive women the outcome of the pregnancy could not be established. Of 165 women 111 (67 pc) received adequate treatment for syphilis. A perinatal mortality rate (PNMR) of 173/1 000 was associated with inadequately or not treated RPR positive mothers and a PNMR of 21/1 000 with RPR negative and untested mothers (odd's ratio=9,9; 95 pc confidence interval 3,8-24,9, p < 0,001). It is estimated that only 42 pc of all pregnant women and 24 pc of the couples with syphilis in 1991 were treated adequately. Recommendations are made to improve the quality of surveillance of syphilis in pregnancy in a rural district.
To determine the aetiology, pattern and prognosis of fractures of the spine in Dar es Salaam, Tanzania we studied a total of 54 patients who had sustained fractures of the spine and were managed by the Orthopaedic/Trauma Department of Muhimbili Medical Centre from January to December 1992. Of these patients 50 were males and four females. Their ages ranged between 12 and 69 years with a mean of 35,5 years. The 21-30 year age group formed the majority of the patients (48,2 pc). Common causes for fractures of the spine observed were motor traffic accidents (MTA) accounting for 38,9 pc of the fractures, falls from heights (46,3 pc) and injuries from falling objects (11,1 pc). The vertebra in the C3-C5 and T11 - L3 regions were most frequently fractured. Neurological deficits were observed in 33 patients (61,1 pc) with paraplegia and quadriplegia dominating the neurological pathology. Full recovery of the neurological deficit was observed in five patients (15,2 pc) and partial recovery in 10 (30,3 pc). The overall case fatality rate was 29,6 pc all of whom had neurological deficit. Cervical spine fractures had the worst prognosis accounting for 43,8 pc of the mortality. All patients except two were treated conservatively. There is a need to disseminate knowledge on the initial care for spinal injury patients so as to improve the prognosis of such patients.
We investigated fatty acid composition in 20 uncontrolled insulin dependent diabetic patients for a period of 12 weeks. Hyperglycaemic control indices were also carried out during the study. The plasma levels of 18:3 w 6; 20:3 w 6; 18:1 w 9 polyunsaturated and saturated fatty acids had changed to near normal levels.This study suggests that Î? 6 Î? 9 desaturates activity is influenced by insulin. The study also highlights a possible explanation for the accumulation of oleic acid in diabetes. This might have implications in dietary supplementation in diabetic patients.
Rhodococcus equi is a facultatively-aerobic, grampositive and intracellular bacteria that causes pulmonary and disseminated infections in immuno-compromised patients. It is a common agent that causes pneumonia in farm animals and only rarely is transmitted to man. I report a case of pneumonia caused by this agent in a patient with AIDS who had been misdiagnosed as tuberculosis and treated as such for five months before the correct diagnosis was made. The diagnosis should be suspected on clinical and radiologic grounds as treatment is considerably different from other opportunistic pathogens in AIDS.
A case of epileptic seizures associated with multiple fllariasis is presented. The possibility of an aetiological association between epileptic seizures and filariasis is explored in the light of available published literature.