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- Volume 11, Issue 2, 2013
South African Gastroenterology Review - Volume 11, Issue 2, 2013
Volume 11, Issue 2, 2013
Author Sandie ThomsonSource: South African Gastroenterology Review 11 (2013)More Less
Another issue hits the congress bags. This will be the first congress since Professor Solly Marks passed away. We are all reflecting on various aspects of this great man who initiated and influenced gastroenterology practice in this country and many career paths over the past 60 years. It is fitting that Professor Philip Bornman his lifelong colleague will be giving his eponymous lecture in the Drakensberg. I am certainly looking forward to it and the introspection it will engender.
Source: South African Gastroenterology Review 11 (2013)More Less
The organizing committee of SAGES 2013 welcomes you to the Champagne Sports Resort & Convention Centre. Nestled in the Drakensberg Mountains or "Umkhamhlamba - Barrier of Spears" you will be able to see these lofty peaks and if you are lucky - a black eagle circling in the sky. We believe that the program and speakers that we have assembled are befitting of this splendid backdrop. SAGES 2013 will update surgeons, physicians, general practitioners and nurses with the latest in diagnosis and treatment in Gastroenterology. You will be able to renew acquaintances, make new friends and strengthen the South African Gastroenterology Society, the Gastroenterology Foundation of South Africa and South African Gastrointestinal Nurses Society.
Author Gill WatermeyerSource: South African Gastroenterology Review 11, pp 7 –9 (2013)More Less
Crohn's disease (CD) and ulcerative colitis (UC) are the two commonest forms of inflammatory bowel disease (IBD). UC is limited to the colon and is characterised by continuous superficial inflammation. In contrast, CD may affect any part of the GIT in a discontinuous fashion from mouth to anus, most commonly involving the terminal ileum. CD is characterised histologically by non-necrotising granulomatous inflammation that is transmural in nature. CD is a life-long disorder which may manifest at any time from early childhood to late adulthood. Typically, however, CD is diagnosed in the late teens and early twenties, with over 80% before the age of 40 years.
Source: South African Gastroenterology Review 11, pp 11 –14 (2013)More Less
The rapid development of endoscopy with all its diagnostic and therapeutic possibilities gave a rise to the necessity of setting minimum requirements for the design and construction of endoscopy units. Publications with practical details are scarce. Designing the layout is extremely important, necessitating thoughtful planning to provide comfort to the endoscopy staff and patients, and efficient data archiving and transmission during endoscopic services.
Source: South African Gastroenterology Review 11, pp 16 –18 (2013)More Less
Paediatric gastroenterology has become an established subspecialty in the last two decades in developed and some developing countries. In South Africa however it has only recently been registered by the Health Professions Council and it is appropriate to review the development of the discipline in view of increasing local interest.
Source: South African Gastroenterology Review 11, pp 21 –22 (2013)More Less
A 51 year old male known with chronic alcoholic pancreatitis, presented to a local hospital with a history of melaena and exacerbation of chronic epigastric pain. He was stable, but pale with a tender palpable 4 cm diameter epigastric mass. Laboratory investigations confirmed anaemia with a haemoglobin level of 7,2 g/dL. Urea, creatinine and electrolyte levels were normal, while liver function tests showed normal bilirubin and aminotransferase levels, but mild elevations in alkaline phosphatase and gamma-glutamyl transpeptidase. Abdominal ultrasonography demonstrtated a 42mm aneurysm, located between the porta hepatis and the pancreas. No free fluid, biliary dilatation or cholelithiasis were present. Two units of packed red blood cells were transfused and the patient was referred for further assessment and management.
Source: South African Gastroenterology Review 11, pp 23 –25 (2013)More Less
Plummer-Vinson or Paterson Brown-Kelly syndrome presents as a classical triad of iron deficiency anaemia, dysphagia and oesophageal web or webs. It is a rare clinical entity in current medical practice with unclear aetiopathogenesis. These patients have a high risk of developing cancer of the hypo-pharynx and upper oesophagus. The response by these patients to iron supplementation and dilatation therapy is remarkable with an excellent prognosis. It is recommended that these patients are enrolled into a regular surveillance upper gastrointestinal endoscopy program for early detection of cancers in the hypo-pharynx and upper oesophagus. We report a case of this syndrome in a 44year old female with intermittent and long standing dysphagia. Investigation revealed iron deficiency anaemia with severe iron depleted state and oesophageal web on oesophagogram. She was treated successfully with iron supplementation and oesophageal dilatation. She is currently on a scheduled clinic follow up in our unit.
Source: South African Gastroenterology Review 11, pp 27 –29 (2013)More Less
A 29-year-old HIV negative woman was diagnosed with ulcerative colitis (UC) in her teens. At the age of 26 she developed jaundice with pruritus. Her biochemical profile was cholestatic. Given this, a clinical diagnosis of primary sclerosing cholangitis (PSC) was made in the absence confirmatory biliary imaging.
Private practice review : codes, tariffs, the Competition Commission and NHI : private practice reviewAuthor Stephen GroblerSource: South African Gastroenterology Review 11, pp 30 –31 (2013)More Less
There are major stumbling blocks in brokering remuneration and new coding and billing structures. The Competition Commission reigned in the abilities of service providers to negotiate fees. A surrogate replacement process to determine a cost-based Reference Price List (RPL) was an expensive failure. Legally there is no longer a RPL, nor a National Benchmark of tariffs (although the legal framework for it is still in existence and could be implemented without the requirement of an exemption from the Competition Act).
World Digestive Health Day, theme for the year : Liver cancer: Act today - save your life tomorrow : WDHDSource: South African Gastroenterology Review 11 (2013)More Less
World Digestive Health Day, an annual event of the World Gastroenterology Organisation, serves to highlight important digestive health issues. The South African Gastroenterology Society, an affiliate and special interest group of the South African Medical Association (SAMA), fully supports this initiative, particularly as this year the focus is on liver cancer, a significant yet potentially preventable disease in sub-Saharan Africa (SSA).The challenge for 2013 of 'acting today and saving a life tomorrow' with respect to hepatocellular carcinoma (HCC), is a formidable one. Globally, HCC is the 5th most common human cancer with approximately 800 000 new cases annually. It ranks 3rd in global cancer mortality and has the shortest survival time of any cancer.
Author Naayil RajaballySource: South African Gastroenterology Review 11, pp 33 –34 (2013)More Less
Here we are in July 2013! It has been eight months since we moved to Oxford and my fellowship at John Radcliffe Hospital is nearing its end. The fellows who were here before me have left and I am now regarded as a senior fellow, orienting the new recruits and advising the ones, who are about to leave their home, on accommodation and schooling in Oxford . So far, it has been an awesome eight months, made up of a mix of work, conference, hosting relatives and visiting various European destinations.
Source: South African Gastroenterology Review 11, pp 34 –35 (2013)More Less
The Discovery Foundation today announced an annual grant for top South African academic doctors to do clinical research and study at the Massachusetts General Hospital (MGH) in Boston, USA. The new award category is aimed at building global excellence in South African healthcare and supports the South African government's vision of boosting academic medicine in South Africa. The Discovery Foundation MGH Fellowship Award, which is valued at R2.1 million this year, forms part of the Discovery Foundation's investment in South African healthcare.