South African Family Practice - Volume 56, Issue 5, 2014
Volume 56, Issue 5, 2014
Author Gboyega OgunbanjoSource: South African Family Practice 56 (2014)More Less
From time to time, the South African National Blood Service disseminates messages that the country's blood stock levels are running very low. The average blood stock level varies from 4.6 days for group B to 10.7 days for group AB blood in non-emergency situations. However, with the December festive period approaching, these blood stock levels usually drop significantly as the demand for blood transfusion increases because of fatalities from motor vehicle accidents, traumatic injuries and obstetric haemorrhage. The solution to blood shortage is not simple in South Africa as potential blood donors dwindle, safety fears increase with regard to contracting bloodborne infections and healthcare workers constantly deal with the ethical dilemma of Jehovah's Witnesses whose doctrine forbids them from accepting blood transfusions. Globally, the safety of blood transfusion has improved substantially since the 1980s, when human immunodeficiency virus (HIV) was discovered to be blood transmissible. However, one of the biggest challenges to blood safety in sub-Saharan Africa is being able to access safe and adequate quantities of blood and blood products.
Author K. OuthoffSource: South African Family Practice 56, pp 5 –8 (2014)More Less
Since their introduction in 1987, statins have become the largest-selling prescription drugs worldwide, and have kept both the scientific and lay press captivated. There were reports this year alone that statins may prevent hysterectomies in women with fibroids, are linked to better health outcomes after brain haemorrhage, may protect against the microvascular complications of diabetes, as well as against cerebral reperfusion injuries, may lower the risk of Barrett's oesophagus, alter the inflammatory response to the common cold, slow the progression of advanced multiple sclerosis, and offer added benefit to men with erectile dysfunction. Amid this hype and against a backdrop of more the a billion people potentially taking statins, the obvious question is whether or not current evidence on the safety and efficacy of statins still overwhelmingly favours these agents for their licensed indication of lowering cholesterol and preventing cardiovascular disease morbidity and mortality.
Source: South African Family Practice 56, pp 9 –15 (2014)More Less
Hypertension affects more than 1 billion people worldwide, and is a major risk factor for coronary artery disease, myocardial infarction, cardiac failure, stroke, cerebrovascular events including dementia, atherosclerosis and the development of renal failure. It is also associated with dyslipidaemia, diabetes and obesity. The incidence of hypertension, and in particular systolic hypertension, increases with age. It is estimated that 60% of the world's adult population are hypertensive as defined by "The World Hypertension Society/International Society of Hypertension" (WHO/ISH).
Part 1 : Medico-legal documentation
South African Police Services forms, Department of Justice forms and patient information : reviewSource: South African Family Practice 56, pp 16 –22 (2014)More Less
Medical practitioners share the responsibility of action against crime by supporting the justice system. The best way for a medical practitioner to achieve this is by proper examination of victims and/or perpetrators, and completing the legal documents meticulously. This can be a frightening experience without proper formal training.
Paper 1 addresses the role and responsibility of the medical practitioner and issues around consent, general information on the completion of the J88, as well as the perceived gold standard of medical information relayed to the courts.
Medico-legal documentation is more than the compilation of a medico-legal report. The clinical notes are part and parcel of the documentation to protect practitioners against negligence and malpractice investigations. Valid medico-legal consent differs from medical consent.
Knowledge of legislation pertaining to child pornography and the practical and ethical aspects of photography is also necessary.
Inappropriate completion of medico-legal documentation may necessitate the practitioner having to explain the documentation to make it understandable to the court.
Source: South African Family Practice 56, pp 24 –28 (2014)More Less
Emergence from anaesthesia is by definition the process of return to baseline physiological function of all organ systems after cessation of administration of general anaesthesia and is the stage from general anaesthetic that includes a return to spontaneous breathing, voluntary swallowing and normal consciousness. It is a time of great physiological stress for many patients and should ideally happen smoothly in a controlled environment but, unfortunately, can happen on the way to the recovery room.
Source: South African Family Practice 56, pp 29 –32 (2014)More Less
Sleep-disordered breathing (SDB) disorders include: central sleep apnoea (Cheyne-Stokes respiration), obstructive sleep apnoea and mixed or complex sleep apnoea. Obstructive sleep apnoea (OSA) is the most common of these three disorders and is defined as airway obstruction during sleep, accompanied by at least five episodes of apnoea or hypopnoea per hour. Each episode is often associated with a decrease in arterial oxygen saturation of > 4%.
Source: South African Family Practice 56, pp 33 –37 (2014)More Less
Surgical site infections (SSIs) are a worldwide problem that has far reaching implications on patient morbidity and mortality as well as significant financial implications. Worldwide it has an incidence of between 2-5%, with an incidence as high as 20% in colorectal surgery. It is the third most common nosocomial infection, and the most common nosocomial infection amongst surgical patients with up to 38% of nosocomial infections being due to surgical site infections. On average, it increases length of hospital stay by 7-10 days and in America in 2002, it was estimated to cost between $3 000 - $30 000 per incident of a surgical site infection. This cost estimate excluded cost to the patient after discharge from hospital. Patients whose surgery was complicated by a SSI had a 2-11% higher risk of death. In those patients who died, 75% was directly attributable to the SSI.
Source: South African Family Practice 56 (2014)More Less
An international research consortium led by the Institute of Tropical Medicine in Antwerp (ITM) will assess whether treatment with antibodies in the blood of Ebola survivors could help infected patients to fight off the disease. If proven effective, this straightforward intervention could be scaled up in the short term and provide an urgently needed treatment option for patients in West Africa.
Source: South African Family Practice 56, pp 38 –42 (2014)More Less
Self-prescription practices by Nigerian medical doctors
An evaluation of stress in medical students at a South African university
The nutrient intake of children aged 12-36 months living in two communities in the Breede Valley, Western Cape province, South Africa
Effectiveness of a Buddy intervention support programme for suicidal behaviour in a primary care setting
Factors which predict interpersonal violence in South Africa
Acute poisoning in the provincial general hospital, Nakuru, Kenya: January to June 2012
An exploration of anaemia in low-birthweight infants exposed to perinatal zidovudine at the neonatal unit at a regional hospital in Durban
Self-efficacy, medication beliefs and adherence to antiretroviral therapy by patients attending a health facility in Pretoria
The prevalence of multiple losses experienced by children from birth to 18 years of age in the National District Hospital in Bloemfontein
The management of latent tuberculosis infection in healthcare workers at hospitals in the Vhembe district
Author Chris EllisSource: South African Family Practice 56 (2014)More Less
The doctor and the patient often start a consultation with different rhythms and conversational patterns, and then after a few minutes, they start to achieve a shared rhythm and common ground. The speech rates tend to equalise, and sometimes the hands and body movements may synchronise. It is part of the way in which we are hardwired to unconsciously mirror (called motor mimicry) the behaviour of other human beings.