Medical Technology SA - Volume 25, Issue 2, 2011
Volume 25, Issue 2, 2011
Source: Medical Technology SA 25 (2011)More Less
This edition of Medical Technology SA is the last one for 2011.
The year has come and gone rapidly however, the medical technology profession has experienced many highlights such as the approval of the new professional degree course by all the official bodies which resulted in the 1st year intake by CPUT in Jan 2011.
Lessons for South Africa from Asia on medical tourism's practice and potential : peer reviewed special articleAuthor A. NicolaidesSource: Medical Technology SA 25, pp 7 –16 (2011)More Less
This study focuses on the medical tourism market in Asia and particularly on India and Thailand, two countries South Africa should strive to emulate in their offerings for the local medical tourism industry. When tourists travel to another country for medical treatment as well as for sightseeing, the practice is called medical tourism. In the last few years this trend has increased. This emergent global trend of increased medical tourism is expected to gain momentum in the coming decades as travelers seek destinations abroad that are associated with wellness and affordable medical care. How countries are marketing medical tourism destinations and the choices of consumers in this regard are important aspects for the South African tourism market to consider. Additionally, the economic impact of medical tourism on countries such as especially India, where it is virtually a routine practice, and how tourism may be affected by the development of medical pharmaceuticals, medical equipment, and medical industry job creation, are aspects worthy of consideration as South Africa seeks to obtain an important part of the market. Medical tourists cannot make an informed choice about treatment when comparing different hospitals in different countries and at best make a partially informed choice. The strategy should be to get them to come to South Africa because we are a preferred option with a good reputation in healthcare. This article seeks to address these issues and make suggestions on how medical tourism offerings can be improved in South Africa so as to make medical tourism increase in volume.
Author Elizabeth Armstrong MooreSource: Medical Technology SA 25 (2011)More Less
A comparative Doppler-catheterization study of the left ventricular end diastolic pressure : peer reviewed original articleSource: Medical Technology SA 25, pp 17 –22 (2011)More Less
Objectives To assess the correlation between the non-invasively measured ratio of early transmitral filling velocity to early diastolic mitral annular velocity (E/E') and invasively measured left ventricular end diastolic pressure (LVEDP) in our context.
Methods This is a prospective study of 66 patients (40 males and 26 females) who underwent elective coronary angiogram done at Inkosi Albert Luthuli Central Hospital. Transthoracic spectral Doppler and tissue Doppler echocardiography was performed to measure early diastolic transmitral flow velocities (E) and early diastolic medial and lateral mitral annular velocity (E') respectively. LVEDP was directly measured during left ventriculography in a cardiac catheterization laboratory. Statistical analysis was done to compare E/E' lateral and E/E' medial to LVEDP in the study group and in different clinical subsets.
Results Among 21 patients with E/E' lateral and 27 patients with E/E' medial of >8, 17 (81%) lateral group and 18 (67%) medial group had a LVEDP of >15mmHg, p value of 0.001 and 0.008 respectively. Raised E/E' lateral ratio that is raised LVEDP was found in 90.9% of females, 52% in those with diabetes and 41.9% in those with hypertension which is statistically significant but not in smokers (30%) or those with dyslipidemia (31.3%) or a positive family history of premature coronary artery disease (20.5%).
Conclusion This study confirmed that non-invasively measured E/E' ratio correlates well with LVEDP in our study population.
Correlative analys is of Cintec P16 and detection of HPV DNA by PCR in cervical abnormalities : peer reviewed original articleSource: Medical Technology SA 25, pp 23 –29 (2011)More Less
Background The prognostic value of cervical aberrancies cannot be adequately determined by the Pap smear alone. Detection of HPV DNA by polymerase chain reaction (PCR) improves the diagnostic sensitivity however, it lacks sufficient specificity. Biomarkers that demonstrate the power to identify progressive cervical lesions may enhance the accuracy of Pap smear screening. The objective of this study is to investigate the relationship between P16 expression and HPV DNA in cervical smears, and the diagnostic accuracy of these assays.
Methods Following p16INK4A immunocytochemical analysis, we subjected 187 abnormally classified cervical smears to HPV detection by PCR. The correlation between HPV DNA and p16INK4A, stratified by cervical cytology, were examined.
Results Both assays produced a high sensitivity for the detection of HPV by p16INK4A 96.4% (95% CI, 86.2-99.4), and GP5+/6+ PCR 98.11% (95% CI, 88.6-99.9) in higher grade squamous intraepithelial lesions (HSILs), respectively. The specificity for P16 expression in conjunction with conventional cytology was significant in LSIL 85.7% (66.4-95.3) and ASC-US 50% (20.1-79.9) while the sensitivity peaked when conventional cytology was supplemented by p16INK4A in LSIL 90.12% (81-95.3) and ASC-US 71.4% (51.1-86) lesions.
Conclusion The p16INK4A assay show potential to overcome the present restrictions often encountered during cervical cancer screening.
Serum total calcium, ionised calcium and corrected total calcium concentrations in Kwashiorkor and nephrotic syndrome patients : peer reviewed original articleAuthor M.J. DreyerSource: Medical Technology SA 25, pp 29 –32 (2011)More Less
Calcium in blood plasma circulates in two main states: The non-diffusible protein-bound calcium which constitutes approximately 45% of the total plasma calcium and the diffusible free calcium fraction which can be further subdivided into complexed calcium and ionised calcium. The ionised calcium fraction is the physiologically active form.
Albumin is the protein which binds approximately 80% of the protein-bound calcium fraction in plasma, therefore any changes in plasma albumin concentration will directly influence the plasma total calcium concentration.
To demonstrate this hypothesis, a study was done on patients with decreased plasma albumin concentrations to determine the effect on their total calcium, ionised calcium and corrected total calcium concentrations.
Our study clearly illustrates that ionised calcium and corrected total calcium concentrations are better indicators of calcium homeostasis in patients with hypoproteinaemia, than total calcium concentrations alone. Medical staff therefore, cannot only rely on total calcium concentrations in these patients.
Evaluation of the antimutagenic and mutagenic properties of Asparagus laricinus : peer reviewed original articleAuthor S. MasheleSource: Medical Technology SA 25, pp 33 –35 (2011)More Less
Several medicinal plants are traditionally used in the treatment of a variety of ailments including cancer in the rural areas of South Africa and our neighbouring countries where herbal medicine is one of the main components of the healthcare system. Many of these herbs, including Asparagus laricinus, have not been scientifically assessed for efficacy or safety. The study on which this article is based evaluated the antimutagenic and mutagenic water extract of Asparagus laricinus roots used in the treatment of cancer. The Ames test recommended for mutagenicity screening was employed. The mutagenic activity was evaluated in Salmonella typhimurium strains TA97, TA98, TA100 and TA102. The mutagenicity tests of aqueous extracts were negative throughout (1:10, 1:25, 1:50. 1:100, and 1:200). The highest antimutagenic effect in the order of 49% was observed using TA 98 (5μg daunomycin/plate), a strong mutagen. These results indicate the potential for use of this plant against cancer and oxidative stress-related diseases.
Source: Medical Technology SA 25, pp 36 –39 (2011)More Less
Thrombophilia is a disorder with a complex and little understood pathogenesis which can be either genetically inherited or acquired. Consequences can vary in severity from DVT to life threatening thromboembolism. The inherited thrombophilic mutations (Factor V Leiden, Methylenetetrahydrofolate reductase (MTHFR) and Prothrombin F2G20210A) are the most common ones found in Caucasian populations. Identification of these mutations and appropriate counselling can prepare affected individuals for the expected clinical course of their condition and influence decision-making on their future management. We report on the approximately 35 year period of thrombotic episodes which led to the final diagnosis in a 58 year old female patient. We describe the course of thrombotic events suffered over this period, her family history and that of her siblings and the testing of their descendants.
Source: Medical Technology SA 25, pp 39 –46 (2011)More Less
The presence of internal tandem duplication (ITD) mutations in FLT3 has prognostic value in AML patients with normal cytogenetic profiles. There are several methods that can be utilized to detect these mutations with the tendency these days towards using expensive capillary analyzers and real-time amplification instruments, which prohibit ITD detection in more basic molecular facilities. We evaluated the use of a modified agarose gel electrophoresis assay for the detection of FLT3ITD mutations, in comparison to capillary electrophoresis and high resolution melt (HRM) assays, to assess the clinical diagnostic potential of this simpler technique. Each technique was evaluated on detection sensitivity, accuracy, reagent costs and processing time. Overall, in spite of the lure of advanced technology to provide faster and more sensitive analysis, in the case of FLT3ITD detection, basic molecular methodology proved to be the most sensitive, the most cost-effective and was able to deliver a reportable result in a time comparable to capillary electrophoresis. Under our test conditions, the HRM assay was neither reliable nor clinically sensitive enough for the routine detection of these mutations. This study showed that basic agarose electrophoresis methodology can successfully be employed to generate clinically relevant data regarding the FLT3ITD status of AML patients, allowing smaller molecular laboratories to offer this important prognostic assay.
Source: Medical Technology SA 25, pp 46 –47 (2011)More Less
Following the transfer of a state-of-the-art R15 million diagnostic mobile laboratory from the Fraunhofer Institute for Biomedical Engineering in Saarland, Germany, to the Western Cape government at the end of last year, the laboratory has been operating as an extension of Caledon Hospital for the past four months. The mobile laboratory was officially handed over to the Western Cape at a ceremony in March this year.