South African Gastroenterology Review - Volume 7, Issue 3, 2009
Volume 7, Issue 3, 2009
Author R. AllySource: South African Gastroenterology Review 7, pp 6 –11 (2009)More Less
Apart from complications directly relating to the liver dysfunction and increased hepatic venous pressure such as encephalopathy, prolonged INR, hormonal imbalances, oesophageal varices and ascites, extrahepatic complications relating to the systemic circulation, the heart, lungs, kidneys and brain can occur and aggravate the prognosis.
Non-tuberculosis intestinal obstruction - think endometriosis case study and a review of the literature : case reportSource: South African Gastroenterology Review 7, pp 12 –15 (2009)More Less
Mrs X presented to casualty with a week history of abdominal distension, nausea and vomiting post prandially. The patient was HIV positive and her CD4 was 416. Abdominal ultrasound done on admission showed dilated lops of bowel with no other significant abnormality. Plain abdominal X-Ray revealed dilated loops of small bowel. The chest X-Ray showed small bilateral effusions. The patient was admitted and a NGT was inserted and intra venous fluids started. The patient was kept nil per mouth. The patient at this time had a distended abdomen which was in keeping with gaseous distension.
Author J.F. BothaSource: South African Gastroenterology Review 7, pp 16 –18 (2009)More Less
This overview is based largely on the American Society for Gastrointestinal Endoscopy (ASGE) Guidelines published in Gastrointestinal Endoscopy. Despite the fact that a large number and variety of GI endoscopic procedures are performed, documented instances of infectious complications are estimated to occur in only 1 in 1.8 million procedures.
Source: South African Gastroenterology Review 7 (2009)More Less
With the development and recognition of the Hepatobiliary Unit at CH Baragwanath Hospital, more and more medical liver disease was being referred from a wide referral base extending all the way to Mafikeng. This presented an opportunity to re-establish a dedicated Liver clinic. Hence a combined surgical-medical liver clinic was started in June 2009 at Chris Hani Baragwanath Hospital. To date although unadvertised there are 30 patients being seen in the clinic. By definition these patients are suffering from liver disease which at some point would necessitate a liver transplant. Of the 30 patients 2 both under the age of 20 died from complications of liver failure (one a couple of weeks before she was to be assessed in Cape Town), and 1 has been listed and is awaiting transplantation in Cape Town; as the Wits Transplant Unit has yet to gain government support for public transplantation ( It is hoped that this situation may have changed by the time this goes to press). The remainder either does not require transplantation currently or do not have the "geosocioeconomic" potential to be considered for transplantation in Cape Town.
Author Kugan GovenderSource: South African Gastroenterology Review 7 (2009)More Less
During October 2009 I was one of a privileged few to be invited to Train the Trainers (TTT) in Santiago, Chile, South America. Having heard about TTT from numerous peers, I could not wait to finally experience what everyone described as 'the single best meeting you might ever attend'. I had high expectations and I was not to be disappointed.
Probiotics in children - what is the evidence of efficacy? Lecture SAGES Congress Cape Town 8th August 2009Author Hania SzajewskaSource: South African Gastroenterology Review 7 (2009)More Less
Professor Szajewska began her lecture by describing the use of meta-analysis of randomised controlled trials (RCTs), where the results of different studies are combined to obtain a qualitative estimate of the overall effect of a particular intervention or variable on a defined outcome. Two main reasons to perform a meta-analysis are to increase power and to increase precision of the results. The results of individual studied could be pooled together if the studies are considered sufficiently homogenous in terms of the question and methods. Documented results may be used to define treatment guidelines.
World Gastroenterology Organisation Global Guideline
Irritable bowel syndrome : a global perspective - April 20, 2009Source: South African Gastroenterology Review 7, pp 22 –30 (2009)More Less
Irritable bowel syndrome (IBS) is a functional bowel disorder in which abdominal pain or discomfort is associated with defecation or a change in bowel habit. Bloating, distension, and disordered defecation are commonly associated features. (In some languages, the words "bloating" and "distension" may be represented by the same term.) Irritable bowel syndrome is a relapsing functional bowel disorder defined by symptom-based diagnostic criteria, in the absence of detectable organic causes. The symptomatic array is not specific for IBS, as such symptoms may be experienced occasionally by almost every individual. To distinguish IBS from transient gut symptoms, experts have underscored the chronic and relapsing nature of IBS and have proposed diagnostic criteria based on the occurrence rate of symptoms.
Evaluating National Health Insurance (NHI) as a mechanism to increase access to healthcare through an ethics lens. : reportAuthor Elsabe KlinckSource: South African Gastroenterology Review 7, pp 31 –33 (2009)More Less
The inequities in South African society are well-known and acknowledged by most. These inequities have prompted many reforms. Till today these inequities underpin discussions on public transportation, education, housing and healthcare. Our Constitution recognises these rights and requires of government to take steps to address healthcare, education and housing in a progressive manner. The Constitution also recognises the financial implications of realising these rights, requiring the state to realise the rights "within its available resources". In a recent case, concerning access to water, and whether requiring of persons, after receiving a certain amount of water for free, the Constitutional Court recognised that the City of Johannesburg may not have the resources to immediately realise the right to its fullest extent, stating that such realisation must by its very nature, be progressive.
Author Stephen GroblerSource: South African Gastroenterology Review 7, pp 34 –35 (2009)More Less
Health care in South Africa is in a serious crisis and faces numerous, possibly insurmountable, challenges. These include the world-wide economic downturn, state health care suffering catastrophic implosion in many areas, health care worker shortages and strikes, rampant HIV, unemployment and threatened reformation with the voyeuristic potion of National Health Insurance (NHI).