SA Pharmaceutical Journal - Volume 73, Issue 1, 2006
Volume 73, Issue 1, 2006
Source: SA Pharmaceutical Journal 73, pp 8 –12 (2006)More Less
ART should not be started too early in the course of the disease. <BR>Pre-treatment evaluation and counselling is necessary. <BR>Initiation of therapy is based on the clinical status and CD<SUB>4</SUB> count. <BR>Psychosocial factors should also be taken into account. <BR>Three classes of antiretrovirals are available in SA. Use of three antiretrovirals in combination is necessary. <BR>The goal of ART is to suppress viraemia and improve quality of life.
Author Gerald JacobsSource: SA Pharmaceutical Journal 73, pp 13 –15 (2006)More Less
Source: SA Pharmaceutical Journal 73, pp 16 –21 (2006)More Less
STIs are highly prevalent in South Africa. <BR>STIs may cause morbidity and mortality through their impact on reproductive and child health. <BR>STIs, particularly those that cause genital ulcers, facilitate the transmission of HIV. <BR>STIs have been inadequately managed in both the public and private health sector of South Africa. <BR>The WHO recommends that STIs be managed using the syndromic approach including education, counselling and partner notification. <BR>An STI syndrome is identified by a combination of symptoms and signs a patient complains of and it is treated with combination therapy for all the common causes of the syndrome. <BR>There are both advantages and disadvantages to managing STIs syndromically but within the South African context, the advantages outweigh the disadvantages.
Source: SA Pharmaceutical Journal 73, pp 24 –28 (2006)More Less
Thorough history of illness and travel movements is essential. <BR>Ask about existing medical conditions. <BR>Focus initially on diagnosing infections that are dangerous for patient and community. <BR>Skin lesions are important clues to many travel-related infections. <BR>Malaria must always be considered in a traveller with fever and flu-like symptoms. <BR>Tick bite fever is common in travellers in Africa, and the typical rash may be absent. <BR>Fever, rash and arthritis is suggestive of arboviral infections. <BR>Fever and eosinophilia is commonly due to acute schistosomiasis (Katayama fever). <BR>Full blood count, blood smear examination, and liver function tests are obligatory initial investigations. <BR>Getting a diagnosis before treatment is ideal, but must be balanced against the need to treat severe illness.
Author David P. Van VeldenSource: SA Pharmaceutical Journal 73, pp 30 –39 (2006)More Less
Comprehensive lifestyle changes along with the usual medical management can reverse what were previously held to be irreversible processes. <BR>Doctors now realise the importance of the more holistic bio-psychosocial approach to health and disease for whole-person wellness. <BR>Lifestyle modifications to increase the healing potentials of the body include a healthy diet, avoiding environmental toxins, smoking cessation, exercise, stress reduction, music and, for some, spiritual enlightenment. <BR>In order to develop and understand effective management protocols for disease treatment, the holistic, interactive nature of a person needs to be understood. <BR>We do have control of the phenotypic expression of disease tendencies even if we cannot alter our basic genetic blueprint. <BR>Caring effectively for the physical body by eating the right foods, getting sufficient rest and relaxation, regular exercise, smoking cessation, alcohol in moderation and the prevention of substance abuse remains one of the most important components of optimal health.