item: #1 of 732 id: safpj-3810 author: Booysen, Bernice L; Schlemmer, Arina C title: Reasons for diabetes patients attending Bishop Lavis Community Health Centre being non-adherent to diabetes care date: 2015-05-01 words: 5031 flesch: 55 summary: Pope C, Ziebland S, Mays N. Qualitative research in health care, analysing qualitative data. A follow-up study after the implementation of the NHI, which aims to improve access to and quality of health care in the public sector, should also be undertaken. keywords: adherence; barriers; care; community; diabetes; female; group; health; non; participants; patients; study cache: safpj-3810.pdf plain text: safpj-3810.txt item: #2 of 732 id: safpj-3845 author: Bundotich, J. K.; Gichuhi, M. M. title: Acute poisoning in the Rift Valley Provincial General Hospital, Nakuru, Kenya: January to June 2012 date: 2015-05-01 words: 3846 flesch: 51 summary: Conclusion: This study showed that the majority of acute poisoning cases affected males and were intentional. This may then elevate the risks for intentional poisoning not only in this area but also surrounding areas thus partly explaining the high number of acute poisoning cases in Salgaa and Rongai. keywords: acute; age; agents; cases; hospital; males; poisoning; study; years cache: safpj-3845.pdf plain text: safpj-3845.txt item: #3 of 732 id: safpj-3940 author: Uzodike, Nnaemeka; Ross, Andrew; Harbor, Ogbonnaya title: Adherence by a primary healthcare clinic in KwaZulu-Natal to the national HIV guidelines date: 2015-05-01 words: 4104 flesch: 53 summary: However, it was noted in the study that there was a decreased emphasis on pre-ART management, counselling and adherence (quality care), and that there was no improvement in mortality outcomes, as compared to the pre-decentralisation, hospital- based management of HIV patients.9 The Médecins Sans Frontières programme in Lusikisiki in the Eastern Cape was evaluated in 2008.10 This rural HIV programme provided HIV services to the local population through decentralised PHC clinics, and emphasis was placed on task shifting (nurse-initiated as opposed to physician-initiated treatment) and community support. The purpose of the revision was to enable PHC clinics to initiate ART, to monitor patients on therapy, and make appropriate referrals of patients with complications, side-effects or treatment failure to designated referral hospitals.8 keywords: art; cd4; clinic; count; health; hiv; june; patients; phc; study cache: safpj-3940.pdf plain text: safpj-3940.txt item: #4 of 732 id: safpj-3941 author: Gurayah, Thavanesi title: Caregiving for people with dementia in a rural context in South Africa date: 2015-05-01 words: 3684 flesch: 55 summary: Schulz R, Boerner K, Shear K, et al. Predictors of complicated grief among dementia caregivers: a prospective study of bereavement. Services that would alleviate caregiver burden are education, caregiver training, a financial grant and respite care. keywords: burden; caregiver; caregiving; caring; dementia; family; individual; people; south; years cache: safpj-3941.pdf plain text: safpj-3941.txt item: #5 of 732 id: safpj-3953 author: Peters, Frank; van Wyk, Jacky; van Rooyen, Marietjie title: Intern to independent doctor: basic surgical skills required for South African practice and interns’ reports on their competence date: 2015-07-01 words: 4286 flesch: 50 summary: Keywords: competence, internship, rural areas, surgical skills, training Introduction In his presentation at the international South African Association of Health Educationalists Conference in June 2008, Prof Max Price said: “From the 1950s until the 1990s doctors were trained as master craftsmen with a lot of surgical skills, while modern medical training is more focused on teaching consultation and counselling skills, and less on surgical skills”. Having surgical skills serves as an indicator of scope of practice.1–3 In the South Africa setting, the HPCSA governs all clinical work performed in the public and private sectors, and accredits the medical training programmes. keywords: gps; interns; list; practice; service; skills; south; training cache: safpj-3953.pdf plain text: safpj-3953.txt item: #6 of 732 id: safpj-3973 author: Smith, Selma; Reji, Elizabeth title: Doctors’ attitudes to and knowledge and usage of growth charts date: 2015-05-01 words: 2819 flesch: 55 summary: Although 61 (67,8%) doctors reported a positive attitude towards growth chart usage, their reported usage on the other hand did not reflect this attitude, as only 37 (41%) 41.1% 67.8% 41.1% 58.9% 32.2% 58.9% Adequate Inadequate Attitude score Usage score 20 10 40 30 60 50 70 P E R C E N TA G E O F D O C TO R S Knowledge score Figure 1: Knowledge, attitude and usage scores Table 2: Interpretation and management according to ‘Road to Health’ chart graph Graphs Correct interpretation % Correct management % A. Normal growth 77 86 66 73.3 B. Normal preterm 58 64 39 43.3 C. Acute illness, not fully recovered 67 74 46 51 D. Chronic illness/ growth faltering 73 81 49 54.4 Table 3: Accuracy of management by reported growth chart usage levels Graphs Regular use Correct management % Infrequent use Correct management % keywords: chart; doctors; growth; knowledge; usage; use cache: safpj-3973.pdf plain text: safpj-3973.txt item: #7 of 732 id: safpj-3974 author: Isaacs, A.; Manga, N.; le Grange, C.; Hellenberg, D. A.; Titus, V.; Sayed, R. title: Quality of care and cost of prescriptions for diabetes and hypertension at primary healthcare facilities in the Cape Town Metropole date: 2015-05-01 words: 5331 flesch: 51 summary: Available from: http://wwwnbci.nlm.nih.gov/pmc/ articles/PMC1633555/ Received: 27-11-2013Accepted: 18-06-2014 Age (18–29 yrs) – 1 (30–45yrs) – 2 (46–59) – 3 (60–69) – 4 (> 80) – 5 Gender (Male) – 1 (Female) - 2 Facility name Mitchell’s Plain – 1 Hanover Park – 2 Gugulethu – 3 Retreat) – 4 Vanguard – 5 Abdurahman – 6 Crossroads – 7 Lotus River – 8 InzameZabantu – 9 Hout Bay – 10 Visit Acute – 1 Chronic – 2 Chronic Diagnosis Hypertension – 1 Diabetes – 2 Asthma/COPD – 3 Epilepsy – 4 Arthritis – 5 (Mental Health) – 6 (Other) – 7 Treatment initiation CHC – 1 Hospital - 2 Medication 1 2 3 4 5 6 7 8 9 10 Indicators (for DM and HPT) BP (most recent in last 6 months, max of 5) – Most recent record in last year of: Total Cholesterol – Creatinine – BMI/waist circumference - HbA1c - Quality of care score Diabetes - Hypertension - Appendix 1. Keywords: cost, noncommunicable diseases, primary health care, prescriptions, quality of care Introduction The global increase in the prevalence of noncommunicable diseases (NCDs) presents a global crisis.1 NCDs are a particular challenge to developing countries, such as South Africa, as they affect younger populations and result in longer periods of morbidity and premature death, thus reducing the productivity required for development.2 The burden of NCDs is increasing in both the rural and urban areas of South Africa, and is foremost in poor people living in urban areas. keywords: cape; care; cost; data; diabetes; health; hypertension; mellitus; patients; quality; study; total cache: safpj-3974.pdf plain text: safpj-3974.txt item: #8 of 732 id: safpj-3978 author: Tshitenge, S.; Mabuza, L. H. title: A survey of risk factors associated with hypertension in the adult population of Kang, Kgalagadi North, Botswana date: 2015-05-01 words: 4854 flesch: 51 summary: Despite the fact that standardisation in the methods of hypertension studies was suggested, researchers were still using non-standarised methods. However, hypertension prevalence did not vary markedly across BMI quintiles in the Ethiopian women, suggesting that BMI might not be an important determinant of BP in this group.23 moderate-intensity activity five and six days a week. keywords: botswana; factors; fruit; group; hypertension; kang; participants; population; prevalence; risk; study; women cache: safpj-3978.pdf plain text: safpj-3978.txt item: #9 of 732 id: safpj-3981 author: Sonubi, S. A.; Nkombua, Lushiku title: Contraceptive usage in women requesting emergency contraception in Swaziland date: 2015-05-01 words: 2955 flesch: 46 summary: Contraception usage among the respondents Contraceptive use in Swaziland from this study (79%) is illustrated in Table 2. The local research committee within the Ministry of Health Swaziland and managers of the involved health facilities gave permission to conduct the study. keywords: age; contraception; contraceptives; health; participants; south; study; swaziland; use cache: safpj-3981.pdf plain text: safpj-3981.txt item: #10 of 732 id: safpj-4049 author: Azmawati, Mohd N.; Siti Hazariah, Abdul H.; Shamsul, Azhar S.; Norfazilah, Ahmad; Azimatun, Noor A.; Rozita, Hod title: Risk taking behaviour among urban and rural adolescents in two selected districts in Malaysia date: 2015-05-01 words: 3904 flesch: 58 summary: Risk taking behaviour among urban and rural adolescents in two selected districts in Malaysia 162 Gender, transport to school, number of bedrooms, and father’s level of education had significant associations towards RTB, specifically to rural adolescents (Table 2). Rural adolescents who were going to school by using their own transport and had an inadequate number of bedrooms were 18-times and 4-times more likely to involve in RTB, however this did not affect urban adolescents. keywords: adolescents; behaviour; family; parents; risk; rtb; rural; urban cache: safpj-4049.pdf plain text: safpj-4049.txt item: #11 of 732 id: safpj-4057 author: Maharaj, Narisha; Singh, Bhugwan title: A review of the radiological imaging modalities of non-traumatic small bowel obstruction date: 2015-05-01 words: 6758 flesch: 38 summary: Over the last 2 decades, there has been a paradigm shift in the radiological investigation of small bowel obstruction (SBO) and in the indication for and timing of surgical intervention. This article illustrates the current imaging modalities available for diagnosis of small bowel obstruction. keywords: arrow; bowel; cause; contrast; diagnosis; enteroclysis; figure; imaging; mri; non; obstruction; patients; point; sbo; showing cache: safpj-4057.pdf plain text: safpj-4057.txt item: #12 of 732 id: safpj-4076 author: Motsohi, Tsepo S.; Isaacs, A. A.; Manga, N.; Le Grange, C.; Roelofse, M.; Milligan, P.; Hellenberg, D. A.; Sayed, A. R. title: Common mental disorders are not diagnosed commonly in community health centres date: 2015-07-01 words: 1226 flesch: 52 summary: Head Clinical Unit, Acute Services, Valkenberg Hospital, Cape Town, South Africa d Faculty of Health Sciences, Department of Psychiatry and Mental Health, Division of Family Medicine, University of Cape Town, Cape Town, South Africa e Specialist Scientist and Biometrician, Metro District Health Services, Cape Town, South Africa *Corresponding author, email: tshepo.motsohi@westerncape.gov.za Background: Very limited published data exist on the spectrum of mental health disorders encountered at primary health care (PHC) facilities in South Africa. Keywords: co-morbidity, costs, mental health, non-communicable diseases, prescriptions, primary health care Isaacs et al.1 recently published a cross-sectional study describing the profile of non-communicable diseases (including costs of prescriptions per patient) at 10 primary health clinics in Cape Town.1 There are relatively few data on mental disorders in primary care settings in South Africa. keywords: care; disorders; health; mental; south cache: safpj-4076.pdf plain text: safpj-4076.txt item: #13 of 732 id: safpj-4094 author: Omole, Olufemi B.; Ogunbanjo, Gboyega A. title: Postdural puncture headache: evidence-based review for primary care date: 2015-07-01 words: 5844 flesch: 54 summary: This is a structural analogue of gamma-aminobutyric acid and modulates the release of excitatory neurotransmitters by binding to voltage-dependent calcium channels.40 Gabapectin reduces the severity of post-dural puncture headache either as primary therapy or as adjunct therapy in obstetric patients with severe headache and those unresponsive to epidural blood patch (EDBP).41,42 High incidence of post-dural puncture headache in patients with spinal saddle block induced with Quincke needles for anorectal surgery: a randomised clinical trial. keywords: blood; care; csf; edbp; evidence; headache; incidence; needle; patients; pdph; post; postdural; puncture; puncture headache; spinal cache: safpj-4094.pdf plain text: safpj-4094.txt item: #14 of 732 id: safpj-4098 author: Koch, Karen title: Silodosin — a safer alpha-blocker targeting benign prostatic hyperplasia date: 2015-09-01 words: 1330 flesch: 37 summary: The prostate gland is rich in the expression of alpha-1A receptors, which mediate contraction of the smooth muscle at the urethral sphincter. Alpha-1A receptors are expressed with increasing concentration in elderly patients, making them an important target for BPH treatment.2,3 Inhibiting these receptors allows muscle relaxation of the urethra, aiding in relief of primarily obstructive symptoms. keywords: alpha-1a; bph; silodosin; symptoms cache: safpj-4098.pdf plain text: safpj-4098.txt item: #15 of 732 id: safpj-4110 author: Schellack, Natalie; Gous, Andries G.S.; Mawela, Patience B. title: Caffeine versus aminophylline for the prevention of apnoea of prematurity in a teaching hospital in South Africa date: 2015-05-01 words: 4198 flesch: 59 summary: Figure 6: Median respiratory rate in the two study groups Table 2: Background data of patients who developed apnoeic attacks Study drug Caffeine Aminophylline Gender Female Male Male Female Gestational age on enrolment 29 weeks 29 weeks 31 weeks 32 weeks Birth weight 1 000 g 1 300 g 1 250 g 1 400 g Time to apnoeic attack 2 weeks 2 weeks 3 weeks 2 weeks Levels of study drug (μg/ml) 18 17.6 16.5 0.4; when repeated: 14.1 Outcome Died Died Transferred Died 30 35 40 45 50 55 60 65 70 Days on study drug M ed ia n M A P (m m H g) Aminophylline Caffeine 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 Figure 5: Median mean arterial pressure in the two study groups Note: The Wilcoxon two-sample test was used to analyse and determine statistical significance, and no statistical difference could be observed at the 5% level. Patients receiving intravenous aminophylline could not be Table 3: Nutritional support given to the two study groups Breastfeeding* Expressed breast milk* Breast milk Formula feed Nil per os TPN Total followed up Number of patients on aminophylline 4 12 12 1 15 2 16 Number of patients on caffeine 6 11 12 2 14 0 15 Patient-days (% of total): Days (aminophylline) 11 (8%) 79 (55%) 90 (62%) 6 (4%) 41 (29%) 7 (5%) 144 (100%) keywords: aminophylline; caffeine; day; days; groups; patients; prematurity; study cache: safpj-4110.pdf plain text: safpj-4110.txt item: #16 of 732 id: safpj-4123 author: Young-Harry, Opunabo N.; Dienye, Paul O.; Diete-Spiff, Kaine O. title: Pattern of inappropriate cases presenting to the Accident and Emergency Department in a Nigeria Tertiary Hospital date: 2015-07-01 words: 4598 flesch: 52 summary: Discussion The inappropriate use of AEDs is a problem that has been dis- cussed widely by researchers.12, 13 Since general societal and cul- tural factors determine healthcare-seeking behaviour, interven- tions to reduce the amount of inappropriate use are likely to fail.4 Overall, the level of inappropriate utilisation of AED services in this study was 37.7%. Sjonell G. Effect of establishing a primary health care centre on the utilization of primary health care and other out-patient care in a Swed- ish urban area. keywords: accident; aed; care; department; emergency; health; hospital; inappropriate; patients; primary; study; use cache: safpj-4123.pdf plain text: safpj-4123.txt item: #17 of 732 id: safpj-4142 author: Norfazilah, Ahmad; Juliana, M. S.; Azmawati, M. N. title: Sex differences in correlates of obesity indices and blood pressure among Malay adults in Selangor, Malaysia date: 2015-07-01 words: 4147 flesch: 60 summary: Sex differences in correlates of obesity indices and blood pressure among Malay adults in Selangor, Malaysia 279 For WHR, almost half of the male respondents by both cut-off points had abdominal obesity. Sex differences in correlates of obesity indices and blood pressure among Malay adults in Selangor, Malaysia South African Family Practice is co-published by Medpharm Publications, NISC (Pty) Ltd and Cogent, Taylor & Francis Group S Afr Fam Pract ISSN 2078-6190 EISSN 2078-6204 keywords: blood; bmi; female; health; obesity; pressure; respondents; risk; study; waist cache: safpj-4142.pdf plain text: safpj-4142.txt item: #18 of 732 id: safpj-4148 author: Zondi, Phathokuhle C.; Janse van Rensburg, D. C.; Grant, C. C.; Jansen van Rensburg, A. title: Delayed onset muscle soreness: No pain, no gain? The truth behind this adage date: 2015-05-01 words: 2072 flesch: 45 summary: Causes of muscle pain associated with delayed onset muscle soreness include: • DC Janse van Rensburg,2 CC Grant,3 A Jansen van Rensburg4 1Lecturer and Clinician 2Head of Department 3Senior Lecturer and Researcher 4Researcher, Section Sports Medicine, University of Pretoria, Pretoria Correspondence to: *Phathokuhle Zondi, e-mail: phatho.cele@up.ac.za Table I: Delayed onset muscle soreness keywords: delayed; doms; exercise; muscle; onset; pain; soreness cache: safpj-4148.pdf plain text: safpj-4148.txt item: #19 of 732 id: safpj-4152 author: Helelo, A. Z.; Zungu, L. I.; Chiegil, R. J. title: What creates good experiences for EmOC clients in public health facilities in Ethiopia? date: 2015-05-01 words: 3810 flesch: 55 summary: Opening hours and availability of doctors and midwives were among the accessibility factors that created good perceptions of access to care and quality care in their study.18 Clients seek care from other providers or stay at home when they perceive a service as not available. Keywords: emergency obstetric care, Ethiopia, experiences, public health facilities Introduction Emergency obstetric care is a strategy that reduces maternal mortality through the treatment of obstetric emergencies in hospitals and health centres.1 keywords: care; clients; emoc; ethiopia; experience; facilities; health; obstetric; provision; quality cache: safpj-4152.pdf plain text: safpj-4152.txt item: #20 of 732 id: safpj-4159 author: Dreyer, Y.; Rossouw, A.; Schoeman, H.; van der Nest, A.; van Zyl, C.; Prins, M.; Maasdorp, S. D.; Joubert, G. title: An observational study on factors influencing antibiotic use in chronic obstructive pulmonary disease at Universitas Academic Hospital, Bloemfontein date: 2015-07-01 words: 2968 flesch: 36 summary: Larger randomised control studies conducted among hospitalised COPD patients are required to evaluate the role of CRP as part of antibiotic stewardship policies. Sputum purulence-guided antibiotic use in hospitalised patients with exacerbations of COPD. keywords: antibiotics; copd; crp; day; patients; sputum; study; treatment cache: safpj-4159.pdf plain text: safpj-4159.txt item: #21 of 732 id: safpj-4160 author: Wood, Paola S.; Krüger, P. E. title: Flexibility as risk factor for stress-fracture development in South African male soldiers date: 2015-07-01 words: 4594 flesch: 58 summary: Stress fractures are a common military training injury, with the first reported case being identified by Breithaupt in 18552,3 and the incidence of sustained stress fractures in military soldiers reported to be as high as 31%.4 Both intrinsic and extrinsic risk factors for the development of stress fractures have been investigated, predominantly in European and American soldiers.2,5−11 Numerous flexibility variables have been assessed as potential risk factors for the development of stress fractures in male soldiers. Thus this study aimed to present results that could help define the risk flexibility may pose in the development of stress fractures amongst military male soldiers. keywords: ankle; fractures; hip; med; military; risk; soldiers; stress; training cache: safpj-4160.pdf plain text: safpj-4160.txt item: #22 of 732 id: safpj-4162 author: Mody, Girish M. title: Update on hyperuricaemia and gout with evidence based management guidelines date: 2015-07-01 words: 5639 flesch: 51 summary: Beighton P, Solomon L, Soskolne CL, et al. Tikly M, Bellingan A, Lincoln D, et al. keywords: acid; acute; dose; evidence; gout; level; management; patients; rheum; risk; therapy; urate; uric cache: safpj-4162.pdf plain text: safpj-4162.txt item: #23 of 732 id: safpj-4163 author: Talib, N. H.; Leelavathi, M.; Hamzah, Z. title: Common adverse cutaneous drug reaction patterns and the causative drugs in Malaysia date: 2015-07-01 words: 2755 flesch: 54 summary: A 6-month prospective survey of cutaneous drug reactions in a hospital setting. The Author(s) RESEARCH South African Family Practice 2015; 57(4):227–230 http://dx.doi.org/10.1080/20786190.2015.1024026 Open Access article distributed under the terms of the Creative Commons License [CC BY-NC-ND 4.0] http://creativecommons.org/licenses/by-nc-nd/4.0 Common adverse cutaneous drug reaction patterns and the causative drugs in Malaysia NH Taliba, M Leelavathib* and Z Hamzahb a Kelinik Kesihatan Tengkera, Melaka, Malaysia b Department of Family Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Center, Kuala Lumpur, Malaysia *Corresponding author, email: drleelaraj@gmail.com Background: Patients with adverse cutaneous drug reactions (ACDRs) are frequently referred from primary care to tertiary centres for further management. keywords: acdr; care; drug; patients; reactions; study cache: safpj-4163.pdf plain text: safpj-4163.txt item: #24 of 732 id: safpj-4166 author: Engelbrecht, Andreas; du Toit, F. G.; Geyser, M. M. title: A cross-sectional profile and outcome assessment of adult patients triaged away from Steve Biko Academic Hospital emergency unit date: 2015-05-01 words: 4801 flesch: 62 summary: Previous studies have found that triaging patients away from the emergency unit does not reduce crowding.8,13 Methods: A prospective observational study was done to provide a cross-sectional profile of patients triaged away from the emergency unit (EU) and to evaluate their outcome by telephonic survey. keywords: care; category; emergency; hospital; number; patients; study; triage; unit cache: safpj-4166.pdf plain text: safpj-4166.txt item: #25 of 732 id: safpj-4169 author: Pereko, Dawn D.; Lubbe, Martie S.; Essack, Sabiha Y. title: Antibiotic use in Namibia: prescriber practices for common community infections date: 2015-07-01 words: 4463 flesch: 43 summary: Discussion While the literature attributes high use of antibiotics to prescribers, information concerning antibiotic prescribing practices in Namibia is minimal, despite the 3rd National Medicines Use survey conducted among 1 132 patients in Namibia demonstrating that the use of antibiotics in the public health sector of Namibia increased from 39% in 1997 to 51% in 200115 and a study conducted in the private sector of Namibia in 2013 also showing that 80% of patients reported having used at least one antibiotic in the past year preceding the study (Pereko et al., unpublished). Conclusion Our study uncovered that antibiotic prescribing practice was the same across various demographic groups. keywords: antibiotic; data; doctors; guidelines; infections; namibia; prescribing; respondents; study; treatment; use cache: safpj-4169.pdf plain text: safpj-4169.txt item: #26 of 732 id: safpj-4189 author: Egenasi, C.; Steinberg, W. J.; Raubenheimer, J. E. title: Beliefs about medication, medication adherence and seizure control among adult epilepsy patients in Kimberley, South Africa date: 2015-09-01 words: 5576 flesch: 54 summary: Beliefs about medication, medication adherence and seizure control among adult epilepsy patients in Kimberley, South Africa South African Family Practice is co-published by Medpharm Publications, NISC (Pty) Ltd and Cogent, Taylor & Francis Group S Afr Fam Pract ISSN 2078-6190 EISSN 2078-6204 The Author(s) RESEARCH South African Family Practice 2015; 57(5):326–332 http://dx.doi.org/10.1080/20786190.2015.1078152 Open Access article distributed under the terms of the Creative Commons License [CC BY-NC-ND 4.0] http://creativecommons.org/licenses/by-nc-nd/4.0 Beliefs about medication, medication adherence and seizure control among adult epilepsy patients in Kimberley, South Africa C Egenasia, WJ Steinberga* and JE Raubenheimerb aFaculty of Health Sciences, Department of Family Medicine, University of the Free State, Bloemfontein, South Africa bFaculty of Health Sciences, Department of Biostatistics, University of the Free State, Bloemfontein, South Africa *Corresponding author, email: SteinbergWJ@ufs.ac.za Background: Patients with epilepsy regularly present to the Kimberley Hospital Complex’s emergency department and are managed and discharged but within a short period present again to casualty with seizures. keywords: adherence; beliefs; control; epilepsy; medication; mmas-8; participants; patients; seizure; study cache: safpj-4189.pdf plain text: safpj-4189.txt item: #27 of 732 id: safpj-4217 author: Mash, Robert; Ogunbanjo, G.; Naidoo, S. S.; Hellenberg, D. title: The contribution of family physicians to district health services: a national position paper for South Africa date: 2015-05-01 words: 6441 flesch: 39 summary: Policy context International The World Health Organization (WHO) has noted that “physicians with a specialisation in Family Medicine or general practice” are usually an essential part of effective approaches to primary care.1 The World Health Assembly has also recommended that: “(We need) to train and retain adequate numbers of health workers, with an appropriate skill mix, including primary healthcare nurses, midwives, allied health professionals and family physicians, able to work in a multidisciplinary context, in cooperation with nonprofessional community health workers in order to respond effectively to people’s health needs”.2 The Africa Region of the World Organization of Family Doctors (WONCA) has published a consensus statement on the contribution of Family Medicine and role of family physicians in the African context.3 National The National Development Plan specifically recognises the important role that family physicians should play in clinical governance in South Africa, and in improving the quality of district health services. The plan also notes that family physicians who are trained across multiple “specialist areas” can offer useful clinical leadership in the health districts.4 A role for family physicians at district hospitals, and as part of district clinical specialist teams (DCSTs), is envisaged in the plans for National Health Insurance (NHI) and the re-engineering of primary care, but their role in relation to primary care and community- based services (ward-based outreach teams) is less clear.5 It was suggested in the national Human Resources for Health policy that the aim should be 0.2 family physicians per 10 000 population, which implies a total of 1 060 family physicians for the country. keywords: care; district; family; family physicians; health; medicine; primary; services; south; training cache: safpj-4217.pdf plain text: safpj-4217.txt item: #28 of 732 id: safpj-4228 author: Oyeronke Alaba, Oluwayemisi; Olaomi, J. O.; Olubusoye, Olusanya E. title: Spatial pattern and determinants of unmet need of family planning in Nigeria date: 2015-09-01 words: 5125 flesch: 62 summary: Spatial pattern and determinants of unmet need of family planning in Nigeria South African Family Practice is co-published by Medpharm Publications, NISC (Pty) Ltd and Cogent, Taylor & Francis Group S Afr Fam Pract ISSN 2078-6190 EISSN 2078-6204 The Author(s) RESEARCH South African Family Practice 2015; 57(5):306–312 http://dx.doi.org/10.1080/20786190.2015.1071536 Open Access article distributed under the terms of the Creative Commons License [CC BY-NC-ND 4.0] http://creativecommons.org/licenses/by-nc-nd/4.0 Spatial pattern and determinants of unmet need of family planning in Nigeria Oluwayemisi Oyeronke Alabaa,b* , JO Olaomib and Olusanya E. Olubusoyea a Department of Statistics, University of Ibadan, Ibadan, Nigeria b Department of Statistics, University of South Africa, Roodepoort, South Africa *Corresponding author, email: oluwayemisioyeronke@yahoo.com Background: Nigeria still grapples with low family planning (FP) use and a high fertility rate. keywords: effect; family; model; need; nigeria; planning; unmet; women cache: safpj-4228.pdf plain text: safpj-4228.txt item: #29 of 732 id: safpj-4232 author: Ross, A. title: From rural scholar to health care professional date: 2015-09-01 words: 5522 flesch: 56 summary: Keywords: academic and social support, health care professional training, rural origin Introduction and background In November 2013 the World Health Organization (WHO) released a report highlighting the central role that well-trained, culturally sensitive, competent staff have in attaining and sustaining universal health coverage.1 It is widely acknowledged that despite the high levels of unemployment in South Africa (SA) there is a shortage of highly skilled professionals, and institutions of higher education (IHE) have a poor throughput of students — due in no small measure to the apartheid legacy of poor schooling.2 These factors contribute to understaffing of government health institu- tions, particularly rural institutions, and poor quality of healthcare delivery.1,3,4 International observational studies have shown that the best strategy for the long-term staffing of rural facilities is the recruitment and training of students of rural origin.3–8 However, the crisis in education in SA means that these rural students are the least likely to access IHE to train as healthcare professionals (HCPs).9 There is no South African research which has used a life-history approach to explore factors that hinder or facilitate the training of rural origin HCPs as they progress from rural student to HCP. The jour- ney from rural student to HCP was tough, with many challenges that needed to be overcome if these rural scholars were to succeed. keywords: education; hcps; health; journey; origin; potential; south; students; study; success; support; university; work cache: safpj-4232.pdf plain text: safpj-4232.txt item: #30 of 732 id: safpj-4235 author: Nqala, M. O.; Rout, C. C.; Aldous, C. M. title: Remote clinical support by telephone for rural district hospital medical officers in the Eastern Cape date: 2015-09-01 words: 3984 flesch: 44 summary: , ‘longer courses should be offered’, ‘involve more rural doctors’, ‘structured programme for rural doctors’) or suggesting an alternative method (‘teleconference in the anaesthetic related issue can help us more’, ‘training must be done on site’). Keywords: foreign medical graduates, remote clinical support, rural doctors, telephonic consultation Introduction The Saving Mothers report of 2010 recorded 4 867 maternal deaths in South Africa (SA) between 2008 and 2010.1 One hundred and twenty-one (2.5%) of these deaths were anaesthetic related, the majority (72%) of which occurred in level 1 hospitals. keywords: comments; district; doctors; hospitals; support; system; telephonic; urban cache: safpj-4235.pdf plain text: safpj-4235.txt item: #31 of 732 id: safpj-4237 author: van Staden, Anna M.; Weich, Dirk J.V. title: Retrospective analysis of the prevalence and causes of anaemia in hospitalised elderly patients date: 2015-09-01 words: 2471 flesch: 57 summary: Little is known regarding anaemia in hospitalised elderly patients in South Africa. Conclusion: Approximately one-third of hospitalised elderly patients were anaemic on admission, although many were not adequately investigated. keywords: anaemia; causes; haemoglobin; patients cache: safpj-4237.pdf plain text: safpj-4237.txt item: #32 of 732 id: safpj-4238 author: Legodi, T. L.; Wolvaardt, J. E. title: A blank page: feedback from first referral hospitals to primary health care clinics date: 2015-07-01 words: 4292 flesch: 52 summary: Of the 858 referrals only 5.4% (n = 46) had feedback letters. The role of hospitals is defined as one that treats patients as best it can, discharges patients as soon as it is consistent with appro- priate care and explains to the referring practitioner or health care worker the clinical findings and further care required.2 Some studies have shown that there is poor use of information as well as a poor standard of both referral and feedback let- ters.3,4 Opportunities for learning may be missed or reduced through the poor communication between the specialists (or hospi- tal-based doctors) and the primary health care practitioners,5 and continuity of care may be negatively affected and contrib- ute to adverse events.6 Several academic specialists found pa- tient-specific feedback to be cost effective.7 Lack of adequate feedback from hospitals was believed to be one of the reasons for low referral rates from clinics to hospitals and is a reflection of frustration by the primary health care practitioners.8 Siddiqi, Kielmann and Khan reported that there was no feedback at all from the hospitals to the primary level of care in their study in Pakistan.9 A similar study conducted in the Republic of Hondu- ras reported that there was only a 1.4% response rate to refer- rals.10 Despite lack of agreement on the desired features of feedback letters or replies,11,12,13 it is suggested that consensus on what features should be included should be reached be- tween the specialists (or hospital-based doctors) and the gen- eral practitioners (GPs) at the primary care level.14 Items viewed by both the specialists and the general practitioners as always important to include in the feedback letters were: mention of the patient’s problem (symptoms, signs or condition), the clini- cal management plan, the treating doctor’s signature or name, findings on investigation, the follow-up appointment of the pa- tient and a summary of the presenting clinical history of the patient.15 The South African public health system is characterised by a hierarchical structure and referral system. keywords: care; feedback; feedback letters; health; hospitals; letters; patient; referral; study cache: safpj-4238.pdf plain text: safpj-4238.txt item: #33 of 732 id: safpj-4247 author: Schellack, Natalie; Truter, A.; Ntuli, P. N. title: Approach to asthma in adults date: 2015-07-01 words: 4233 flesch: 46 summary: This is partly owing to health systems, such as primary healthcare services that are overwhelmed by communicable respiratory diseases, such as pneumonia or tuberculosis.3 The burden of asthma is underappreciated in countries like South Africa, where the burden of respiratory diseases such as pneumonia, tuberculosis and human immunodeficiency virus (HIV)-associated lung disease is well known.3 Asthma is the eighth leading contributor to the burden of disease in South Africa, and is the second most important chronic disease after HIV/acquired immune deficiency syndrome.3,4 Despite the availability of medication, asthma remains poorly controlled in many patients.3,5 The emphasis in asthma treatment is on achieving effective control. Moreover, socio-economic and structural barriers that impair access to healthcare services remain important obstacles.3 A large number of patients have not yet benefited from advances in asthma treatment, and are still insufficiently controlled, placing severe limits on daily life, and placing them at risk of asthma-related morbidity and mortality.7 keywords: airway; asthma; bronchial; chronic; control; disease; factors; management; patient; symptoms; treatment; week cache: safpj-4247.pdf plain text: safpj-4247.txt item: #34 of 732 id: safpj-4253 author: Kasiram, M.; Hölscher, D. title: Understanding the challenges and opportunities encountered by the elderly in urban KwaZulu-Natal, South Africa date: 2015-11-01 words: 5326 flesch: 57 summary: Notwithstanding this, the advantage of self-care that accompanies the sense of responsibility towards dependants may be an interesting future research focus that may guide plan- ning for elderly health when there is some purpose (including being better able to care for dependants) to living. Other elderly participants lived with family or at an institution and a few lived alone. keywords: africa; care; elderly; family; health; kwazulu; participants; research; social; south; students; study cache: safpj-4253.pdf plain text: safpj-4253.txt item: #35 of 732 id: safpj-4255 author: Govender, Indiran; Nel, Kathryn; Mogotsi, Morongwa M. title: Experiences and opinions of first-year students at a previously disadvantaged medical university in South Africa about alcohol consumption date: 2015-09-01 words: 3933 flesch: 54 summary: This paper presents the qualitative data nested from a larger study on alcohol use among first- year medical students. Themes gleaned from the interpretation were awareness, physical location of the campus, economic opportunities, health con- siderations, identity, belief in alcohol use, and interventions. keywords: alcohol; drinking; opinions; participants; south; students; study; university; use; year cache: safpj-4255.pdf plain text: safpj-4255.txt item: #36 of 732 id: safpj-4268 author: du Plessis, A. M.E. title: Attention-deficit/hyperactivity disorder date: 2015-05-01 words: 2930 flesch: 46 summary: Prevalence, patient characteristics and pharmacological treatment of children, adolescents and adults diagnosed with ADHD in Sweden. Large epidemiological studies have failed to show an association between ADHD medication and severe cardiovascular events, like myocardial infarction, a stroke or sudden cardiovascular death. keywords: adhd; adults; attention; children; disorder; hyperactivity; symptoms; treatment cache: safpj-4268.pdf plain text: safpj-4268.txt item: #37 of 732 id: safpj-4269 author: Bezuidenhout, Jerrie title: Stopping antidepressants date: 2015-07-01 words: 1853 flesch: 58 summary: Therefore, the real question is: “How can the benefit of treatment be weighed up against the risk of not treating a person when contemplating treatment discontinuation?” Psychosis and residual symptoms also increase the risk of future relapse.2-4 Older age Patients aged 65 and older recover slower, and 60% are only in remission after two years of starting treatment, compared Keywords: antidepressants, benefit, risk, treatment discontinuation, gradual S Afr Fam Pract ISSN 2078-6190 EISSN 2078-6204 keywords: depression; medication; patient; relapse; treatment cache: safpj-4269.pdf plain text: safpj-4269.txt item: #38 of 732 id: safpj-4273 author: Ellis, Chris title: The prepared patient date: 2015-05-01 words: 571 flesch: 67 summary: Between us, we devised a system that would facilitate the most time-efficient way for me to see patients. If patients came in for a Papanicoloau smear, she would show them into one of the examining rooms, test their urine, and tactfully ask if she needed to test it for pregnancy, record their vital signs, measure the haemoglobin, and ask them to undress. keywords: patients cache: safpj-4273.pdf plain text: safpj-4273.txt item: #39 of 732 id: safpj-4279 author: Govender, M.; Paken, J. title: Practices employed by audiologists in the management of adult patients with multidrug-resistant tuberculosis in South Africa date: 2015-11-01 words: 6983 flesch: 41 summary: American Speech-Language-Hearing Association (1994) audiological management of individuals receiv- ing cochleotoxic drug therapy c. American Academy of Audiology (2009) position statement and clinical guidelines: ototoxicity monitoring d. All of the above e. B and C Section B: Ototoxicity monitoring (the identification of patients with multidrug-resistant tuberculosis 11 Yes No 10 Are you aware of any audiological guide- lines and/or protocols for multidrug-resist- ant tuberculosis ototoxicity monitoring? keywords: audiologists; guidelines; hearing; management; mdr; monitoring; ototoxicity; patients; respondents; south; speech; testing; treatment; tuberculosis cache: safpj-4279.pdf plain text: safpj-4279.txt item: #40 of 732 id: safpj-4280 author: von Pressentin, Klaus B.; Mash, Bob title: Mastering your Fellowship date: 2015-05-01 words: 3053 flesch: 53 summary: It is important to note that the formula for calculating sample size is different depending on whether the study is a descriptive survey or an observational cross-sectional study, with analysis of the comparison groups. 3.4 Sampling is selecting a group from a much larger population (study population) that is representative of the population. keywords: patient; population; pregnancy; sample; sampling; study; women cache: safpj-4280.pdf plain text: safpj-4280.txt item: #41 of 732 id: safpj-4285 author: Tarr, G. S.; Reuter, Helmuth title: Review of the safety of nonsteroidal anti-inflammatory drugs and selective cyclo-oxygenase-2 inhibitors date: 2015-05-01 words: 3378 flesch: 40 summary: Keywords: nonsteroidal anti-inflammatory drugs, NSAIDs, COX-2 inhibitors S Afr Fam Pract ISSN 2078-6190 EISSN 2078-6204 The Author(s) REVIEW South African Family Practice 2015; 57(3):18-22 Open Access article distributed under the terms of the Creative Commons License [CC BY-NC-ND 4.0] http://creativecommons.org/licenses/by-nc-nd/4.0 Review of the safety of nonsteroidal anti-inflammatory drugs and selective cyclo-oxygenase-2 inhibitors GS Tarr,1,2 H Reuter,1,2,3 1Winelands Rheumatology Centre, Stellenbosch, 2Helderberg Hospital Rheumatology Clinic, Somerset West 3Division of Rheumatology, Faculty of Medicine and Health Sciences, Stellenbosch University Correspondence to: Helmuth Reuter, e-mail: helmuth@reuter.co.za S Afr Fam Pract 2015;57(3):18-2220 keywords: cox-2; disease; drugs; events; inhibitors; nsaids; patients; risk; use cache: safpj-4285.pdf plain text: safpj-4285.txt item: #42 of 732 id: safpj-4286 author: Naicker, B.; Maharaj, R. C. title: HIV in acute care: a review of the burden of HIV-associated presentations to an Emergency Department date: 2016-01-01 words: 3199 flesch: 53 summary: Strengthening of the primary health care system with a more aggressive approach to HIV testing and ARV initiation may contribute positively to reducing the burden of HIV emergencies and co-morbid- ities presenting to the ED. MeSH: Human Immunodeficiency virus (HIV); Emergency Department, South Africa, opportunistic infections; HIV testing Keywords: Emergency Department, HIV testing, human immunodeficiency virus (HIV), opportunistic infections, presentations, South Africa Introduction Human immunodeficiency virus (HIV) is a leading cause of mor- bidity and mortality in sub-Saharan Africa. keywords: africa; burden; disease; emergency; hiv; patients; south; testing cache: safpj-4286.pdf plain text: safpj-4286.txt item: #43 of 732 id: safpj-4288 author: Naidoo, Vasudevan G. title: Proton-pump inhibitors date: 2015-05-01 words: 3704 flesch: 54 summary: Clostridium difficile- associated diarrhea and proton pump inhibitor therapy: a meta-analysis. Comparison of risk factors and clinical responses to proton pump inhibitors in patients with erosive oesophagitis and non‐ erosive reflux disease. keywords: disease; gastroenterol; inhibitors; patients; ppis; proton; pump; risk; therapy; use cache: safpj-4288.pdf plain text: safpj-4288.txt item: #44 of 732 id: safpj-4290 author: Masekela, R.; Olorunju, S.; Green, R. J.; Magidimisa, N. T. title: Lung function decline is accelerated in South Africans with cystic fibrosis date: 2016-01-01 words: 4154 flesch: 64 summary: The secondary aim is to assess the impact of CF mutations on lung function and finally to determine the rate of lung function decline over a period of five years. The pattern of lung function decline has been reported to be predictable in developed countries, with an annual rate of decline in the FEV 1 of less than 2% predicted for children born after 1980. keywords: cystic; decline; fev; fibrosis; function; lung; study cache: safpj-4290.pdf plain text: safpj-4290.txt item: #45 of 732 id: safpj-4292 author: Ker, James A. title: Is there a difference between an angiotensin-converting enzyme inhibitor and an angiotensin-specific receptor blocker for the treatment of hypertension? date: 2015-05-01 words: 1760 flesch: 49 summary: The authors came to the conclusion that total cardiovascular events were reduced to a comparable extent using ACE inhibitors and ARBs in patients with hypertension, in both diabetic and non-diabetic patients. There was little or no difference between commonly used BP-lowering drugs, including ACE inhibitors and ARBs. keywords: ace; angiotensin; drugs; hypertension; inhibitor cache: safpj-4292.pdf plain text: safpj-4292.txt item: #46 of 732 id: safpj-4294 author: Gyuse, A. N.; Adat, P.; Udonwa, N. E.; Ndebbio, U. J. title: Expectations of hypertensive patients attending the GOPC of the University of Calabar Teaching Hospital, Calabar date: 2016-01-01 words: 3420 flesch: 54 summary: Hypertension related knowledge, attitude and lifestyle practices among hypertension patients in a Sub-Urban Nigerian Community. Expectations of hypertensive patients attending the GOPC of the University of Calabar Teaching Hospital, Calabar South African Family Practice is co-published by Medpharm Publications, NISC (Pty) Ltd and Cogent, Taylor & Francis Group South African Family Practice 2016; 58(1):5–8 http://dx.doi.org/10.1080/20786190.2015.1078158 Open Access article distributed under the terms of the Creative Commons License [CC BY-NC-ND 4.0] http://creativecommons.org/licenses/by-nc-nd/4.0 S Afr Fam Pract ISSN 2078-6190 EISSN 2078-6204 keywords: calabar; care; expectations; health; hypertension; patients; respondents; study; treatment cache: safpj-4294.pdf plain text: safpj-4294.txt item: #47 of 732 id: safpj-4297 author: Ganga-Limando, M.; Gule, W. P. title: Potential barriers to focused antenatal care utilisation by HIV-positive pregnant women in Swaziland date: 2015-11-01 words: 3128 flesch: 52 summary: The participants’ views on inadequate health education as a barrier to focused antenatal care utilisation highlight the importance of the quality of health education in the future utilisation of antenatal care services by HIV-positive pregnant women. The 2011 report of the Ministry of Health showed that 41% of pregnant women attending antenatal care were HIV-positive and 25% of maternal deaths were due to HIV-related infection.1 Compliance with antenatal care activities has been associated with reduced pregnancy complications and improved pregnancy outcomes.2 Multiple opportunities are offered to pregnant mothers attending antenatal care including the provision of information on pregnancy-related complications and the risks relating to labour and delivery, and promotion of natural delivery with the assistance of a skilled healthcare provider.3 In addition, antenatal care is an entry point for the prevention of mother-to-child transmission of HIV, and can facilitate women’s future utilisation of healthcare services.4 In the past, the Swaziland government introduced focused antenatal care and integrated it into national strategies to reduce maternal mortality and to prevent mother-to-child transmission of HIV.1 Focused antenatal care is an integrated and individualised approach to antenatal care in which the quality of visits over the quantity of visits is emphasised.5 keywords: antenatal; barriers; care; health; hiv; services; utilisation; women cache: safpj-4297.pdf plain text: safpj-4297.txt item: #48 of 732 id: safpj-4298 author: Marais, Andre title: The pharmacological management of erectile dysfunction date: 2015-07-01 words: 3002 flesch: 44 summary: The inability to attain or maintain a penile erection sufficient for sexual intercourse is a common problem experienced by a third of men over the age of 40 years.1 Erectile dysfunction (ED) is a debilitating disease which can have profound psychological effects on personal relationships and the social well-being of the affected individual. The effect of serotonin on erectile function involves sympathetic, parasympathetic and somatic outflow mechanisms, and is considered to exert a general inhibitory effect on male sexual behaviour.5 Causes of erectile dysfunction As with most diseases, ED can be attributed to organic (physical) and non-organic (psychological) causes, but is often the result Abstract The inability to attain or maintain a penile erection sufficient for sexual intercourse is a common problem experienced by a third of men over the age of 40 years. keywords: dysfunction; effect; hours; inhibitors; men; testosterone cache: safpj-4298.pdf plain text: safpj-4298.txt item: #49 of 732 id: safpj-4302 author: Ellis, Chris title: Non-obtrusive sources and secondary actors date: 2015-07-01 words: 733 flesch: 55 summary: In the distant past, when there was less information around, I used to have a few big ideas and alternatives but now, because of the information explosion, the field is strewn with many small “what ifs” as well. It is the problem we have with collateral information that may be relevant or unrelated to the case in question. keywords: information; patient cache: safpj-4302.pdf plain text: safpj-4302.txt item: #50 of 732 id: safpj-4303 author: Matthews, Margaret; van Wyk, Jacqueline title: Speaking the language of the patient: indigenous language policy and practice date: 2016-01-01 words: 1154 flesch: 48 summary: Language policy and plan of the Univer- sity of KwaZulu-Natal, Durban: 2006 (revised 2014). Speaking the language of the patient: indigenous language policy and practice South African Family Practice is co-published by Medpharm Publications, NISC (Pty) Ltd and Cogent, Taylor & Francis Group S Afr Fam Pract ISSN 2078-6190 keywords: kwazulu; language; natal cache: safpj-4303.pdf plain text: safpj-4303.txt item: #51 of 732 id: safpj-4305 author: Michael, G. C.; Grema, B. A.; Yakubu, S. O.; Aliyu, I. title: Utilisation of staff clinic facility in a Northwest Nigeria hospital: emerging challenges for the National Health Insurance Scheme date: 2016-01-01 words: 4225 flesch: 49 summary: The 31- to 40-year-old age group had the highest frequency of clinic attendance and was slightly different from the 41–50-year age group found in a retrospective study of the effect of NHIS on utilisation of health services at the university of Ilorin teaching hospital staff clinic, north-central Nigeria.6 Utilisation of staff clinic facility in a Northwest Nigeria hospital: emerging challenges for the National Health Insurance Scheme South African Family Practice is co-published by Medpharm Publications, NISC (Pty) Ltd and Cogent, Taylor & Francis Group S Afr Fam Pract ISSN 2078-6190 keywords: care; clinic; health; hospital; insurance; scheme; staff; study; subjects; time; utilisation; waiting cache: safpj-4305.pdf plain text: safpj-4305.txt item: #52 of 732 id: safpj-4307 author: Outhoff, Kim title: Grommets date: 2015-05-01 words: 1963 flesch: 36 summary: There is strong evidence against the insertion of tympanostomy tubes in children experiencing a single episode of OME of less than 3 months’ duration because of the likelihood of spontaneous resolution in this instance as well as the risks associated with unnecessary surgery.2,4 Early surgical referral is, however, indicated for children who are at risk for developmental delays where hearing is critical for their speech, language and learning development, irrespective of the duration of OME.5 Risk factors for developmental difficulties include permanent hearing loss independent of OME, suspected or confirmed speech and language delay, autism and other pervasive developmental disorders, syndromes or cranio-facial disorders that include cognitive, speech or language delays, blindness, cleft palate or any other cause of developmental delay.2,3 Chronic otitis media with effusion (OME) In chronic OME sufferers the benefits of tympanostomy tubes include a 30% reduction of middle ear effusion (MEE) with an associated 5 to 12 dB improvement in hearing in the first 6 to 9 months after tube insertion.6 keywords: children; media; ome; otitis; tube; tympanostomy cache: safpj-4307.pdf plain text: safpj-4307.txt item: #53 of 732 id: safpj-4308 author: Naude, Liezel; Smart, Hiske; Tudhope, Lynne; Janse van Rensburg, Gerda; Alexander, Howard; Abdool-Carrim, Talib; Chrysostomou, Daniel; Ongaru, Neford; Al Dabbas, Hazem; Walker, Monique; Lingard, Alison; Trenholm, Emma; Naidoo, Maria; Zikalala, Nonhlanka; Langa, Thuli title: WHASA consensus document on the management of the diabetic foot date: 2015-05-01 words: 6352 flesch: 50 summary: Diabetic foot wounds: the value of negative pressure wound therapy with instillation. Recommendation 17 Agreement: 95.6%-100% The following tests in conjunction with clinical judgement is needed to determine diabetic foot infection: • Wound swab using the levine technique (95.6%) • Tissue biopsy • Probe to bone • X-ray of the affected foot • Skin surface temp difference >1.5°C warmer compared to opposing limb Select appropriate dressing according to the wound pathophsyiology Choose dressing according to the modern classes of dressings utilising the international best practice guideline: best practice guidelines: wound management in diabetic foot ulcers.5 Table 11: factors influencing choice of dressings • Healable wound • Non-healable wound • Maintenance wound • Quality of life & patient economics • Pain • Resources • Infection & severity thereof Predict and review the rate of wound healing Normal predictive value healing of a healable neuropathic ulcer may range from 6-8 weeks Neuro-ischemic ulcer will heal more slowly and additional co- morbid factors need to be addressed such as: • End stage renal disease • HbA1c • Vascular insufficiency • Control of oedema • Infection Table 10: Classification and severity of diabetic foot infections3,5,12 Category Clinical presentation Confirmation tests Grade/severity No signs or symptoms of infection Grade 1 /uninfected Superficial critical colonization Superficial tissue lesion with at least 2 of the following: • Local warmth • Erythema >0.5-2cm around ulcer • Local tenderness/pain • Local swelling/induration • Purulent discharge Other causes of inflammation of the skin must be excluded. keywords: agreement; care; diabetes; diabetic; foot; infection; management; metabolism; patient; recommendation; research; reviews; risk; suppl; ulcers; vol; wound cache: safpj-4308.pdf plain text: safpj-4308.txt item: #54 of 732 id: safpj-4310 author: None title: safpj-4310 date: None words: 3254 flesch: 49 summary: With respect to age, the estimated number of pregnant women attending Soshanguve 3 CHC for TOP on a monthly basis was 42. The expected population of pregnant women was around 252. keywords: africa; contraceptive; pregnancy; reasons; respondents; south; study; women cache: safpj-4310.htm plain text: safpj-4310.txt item: #55 of 732 id: safpj-4311 author: Ogunbanjo, Gboyega title: Beyond the Millennium Development Goals deadline: what next? date: 2015-05-01 words: 773 flesch: 57 summary: Preventable diseases, such as HIV/AIDS, which account for 17% of deaths in children aged five years and younger, remain the most common causes of under- five child mortality, while pneumonia accounts for 14% despite the availability of the pneumococcal vaccine in the routine Expanded Programme on Immunisation.1 A review of the data on improving maternal health (MDG 5) reveals that the goal was to reduce maternal mortality by three quarters by 2015. • Reduce child mortality. • Improve maternal health. keywords: health; maternal cache: safpj-4311.pdf plain text: safpj-4311.txt item: #56 of 732 id: safpj-4313 author: von Pressentin, Klaus; Hoedebecke, Kyle; Pinho-Costa, Luís title: South Africa has joined a global initiative for Family Medicine advocacy date: 2016-01-01 words: 1016 flesch: 36 summary: In South Africa, a national position paper on Family Medicine and expert generalists was published by the South African Academy of Family Physicians towards the end of 2014, in an attempt to clarify the current thinking around family physicians in the South African health system.1 South Africa has joined a global initiative for Family Medicine advocacy South African Family Practice is co-published by Medpharm Publications, NISC (Pty) Ltd and Cogent, Taylor & Francis Group S Afr Fam Pract ISSN 2078-6190 EISSN 2078-6204 © 2016 keywords: family; medicine; south cache: safpj-4313.pdf plain text: safpj-4313.txt item: #57 of 732 id: safpj-4317 author: Young, Taryn; Rohwer, Anke; Volmink, Jimmy; Clarke, Mike title: Perspectives of undergraduate module convenors at a South African academic institution on medical student training in evidence-based health care: a qualitative study date: 2015-11-01 words: 6501 flesch: 49 summary: In this study, senior academics interviewed also felt that EBHC teaching and learning were not optimal and indicated varying support for the enhancement of EBHC learning in the undergraduate curriculum. Interviewees felt that EBHC teaching and learning were not optimal and indicated varying support for enhancing this. keywords: care; clinical; curriculum; ebhc; evidence; health; learning; medical; module; research; students; study; teaching cache: safpj-4317.pdf plain text: safpj-4317.txt item: #58 of 732 id: safpj-4318 author: von Pressentin, Klaus B.; Mash, Bob title: Mastering your Fellowship date: 2015-07-01 words: 2725 flesch: 48 summary: In so doing, they generate additional research questions, and in some cases, even redefine the nature of the problem as the process unfolds. Further reading: • Mash B. African primary care research: participatory action research. keywords: care; family; group; medicine; patient; process; question; research cache: safpj-4318.pdf plain text: safpj-4318.txt item: #59 of 732 id: safpj-4324 author: Schellack, Natalie; Schellack, Gustav; van der Sandt, Nicolene; Masuku, Bongiwe title: Gastric pain date: 2015-09-01 words: 5010 flesch: 40 summary: Types of gastric pain include dyspepsia and epigastric pain. Keywords: gastric pain, epigastric pain, dyspepsia, peptic ulcer disease (PUD), GORD, proton-pump inhibitors S Afr Fam Pract ISSN 2078-6190 EISSN 2078-6204 keywords: acid; causes; disease; drugs; dyspepsia; epigastric; gastric; gastrointestinal; pain; patients; stomach; symptoms; ulcer cache: safpj-4324.pdf plain text: safpj-4324.txt item: #60 of 732 id: safpj-4325 author: Motswaledi, M. H. title: Skin disorders affecting the feet date: 2015-09-01 words: 2558 flesch: 52 summary: Inflammatory diseases Inflammatory skin diseases which affect different areas of the body can affect the feet as well. The treatment of inflammatory skin diseases generally involves the use of emollients and topical corticosteroids. keywords: disorders; feet; figure; foot; plantar; skin; treatment cache: safpj-4325.pdf plain text: safpj-4325.txt item: #61 of 732 id: safpj-4326 author: Davis, Sumari title: Topical treatment options for allergic conjunctivitis date: 2015-07-01 words: 3446 flesch: 27 summary: Keywords: allergic conjunctivitis, seasonal allergic conjunctivitis, perennial allergic conjunctivitis, vernal keratoconjunctivitis, acute keratoconjunctivitis and giant papillary conjunctivitis S Afr Fam Pract ISSN 2078-6190 EISSN 2078-6204 Although allergen avoidance remains the initial step in the management of allergic conjunctivitis, this is often not possible considering that allergens are frequently airborne and avoiding contact with the ocular surface is difficult.1,3 keywords: agents; benzalkonium; cell; chloride; conjunctivitis; mast; patients; symptoms; topical; treatment; use cache: safpj-4326.pdf plain text: safpj-4326.txt item: #62 of 732 id: safpj-4335 author: Schellack, Natalie; Upton, E.; Schellack, G. title: The allergic scholar date: 2015-07-01 words: 5717 flesch: 40 summary: Treatment options for those suffering from allergic disease are also discussed, with an emphasis on asthma, anaphylaxis, allergic rhinitis and atopic dermatitis. The disappearance of these interactions can modulate the immune function.4,19 Bowel flora The microflora hypothesis postulates that a correlation exists between reduced bowel flora exposure in infancy and the increased prevalence of allergic diseases, stating that changes in the microbiological composition within the gastrointestinal tract may lead to a disruption in immune tolerance.3,4,6,20 Exposure to microbial flora within the gastrointestinal tract early in life allows for a change in the Th1:Th2 cytokine balance, favouring a Th1 cell response.3,21 The presence of these microbes bundled together within the walls of the intestinal tract, helps to regulate the immune response. keywords: agents; allergen; allergy; antihistamines; asthma; atopic; cells; disease; exposure; management; nasal; receptor; response; rhinitis; th1; th2 cache: safpj-4335.pdf plain text: safpj-4335.txt item: #63 of 732 id: safpj-4336 author: Zinn, Philip title: Chronic pelvic pain date: 2015-07-01 words: 4358 flesch: 43 summary: Chronic pain, and chronic pelvic pain, in particular, has a reputation among generalists and specialists for being difficult to treat. The healthcare and social cost burden was estimated at approximately $2 billion per annum in a USA poll, in which 15% of women reported chronic pelvic pain. keywords: chronic; examination; history; homepage; internet; management; pain; patient; pelvic; vulvodynia cache: safpj-4336.pdf plain text: safpj-4336.txt item: #64 of 732 id: safpj-4340 author: Mabelane, T.; Marincowitz, G. J.O.; Ogunbanjo, G. A.; Govender, I. title: Factors affecting the implementation of nurse-initiated antiretroviral treatment in primary health care clinics of Limpopo Province, South Africa date: 2016-01-01 words: 3935 flesch: 51 summary: Factors affecting the implementation of nurse-initiated antiretroviral treatment in primary health care clinics of Limpopo Province, South Africa South African Family Practice is co-published by Medpharm Publications, NISC (Pty) Ltd and Cogent, Taylor & Francis Group S Afr Fam Pract ISSN 2078-6190 The Author(s) RESEARCH South African Family Practice 2016; 58(1):9–12 http://dx.doi.org/10.1080/20786190.2015.1114704 Open Access article distributed under the terms of the Creative Commons License [CC BY-NC-ND 4.0] http://creativecommons.org/licenses/by-nc-nd/4.0 Factors affecting the implementation of nurse-initiated antiretroviral treatment in primary health care clinics of Limpopo Province, South Africa T Mabelanea*, GJO Marincowitza, GA Ogunbanjob and I Govenderb b Department of Family Medicine, University of Limpopo, Polokwane, South Africa b Department of Family Medicine & Primary Health Care, Sefako Makgatho Health Sciences University, Pretoria, South Africa *Corresponding author, email: tmabelane@hotmail.com Introduction: The implementation of nurse-initiated antiretroviral (ARV) treatment at primary health care clinics was introduced in 2010 as a response to lower the HIV prevalence rate in the community. keywords: care; clinics; experience; health; nimart; nurses; patients; treatment; yrs cache: safpj-4340.pdf plain text: safpj-4340.txt item: #65 of 732 id: safpj-4341 author: Ker, J. A. title: Chronic heart failure date: 2015-09-01 words: 2099 flesch: 50 summary: It is estimated that approximately 38 million people worldwide experience heart failure, and this number is growing because of the ageing of nations’ populations, but also because patients are rescued from death during an acute myocardial infarction, and later develop heart failure.1 The prevalence of heart failure is roughly 2% of the population, and up to 10% in people aged 75 years and older. It is also estimated that the lifetime risk of heart failure at the age of 40 years is approximately 20% (one in five) for both men and women. keywords: failure; heart; mortality; patients; stage; treatment cache: safpj-4341.pdf plain text: safpj-4341.txt item: #66 of 732 id: safpj-4342 author: Marais, Andre title: Clinical evidence in the management of swimmer’s ear date: 2015-09-01 words: 2517 flesch: 47 summary: The preventative use of topical acidifying agents or 70% alcohol can also be considered in children who are prone to swimmer’s ear.9 Topical antibiotics Although topical antibiotics have a very high efficacy of between 29% and 63% in the treatment of otitis externa, their routine and indiscriminant use should be avoided.10 In addition, the treatment should include cleaning the ear canal, avoiding aggravating factors (protecting the ear from additional moisture or further mechanical injury), and considering alternate diagnoses in unresponsive cases.7 Topical anti-infective agents First-line therapy with antiseptics is still preferred to antibiotics in uncomplicated and mild cases of local external ear infections.8 These agents possess bacteriostatic and fungistatic properties, and render the ear canal less habitable to microorganisms. keywords: cream; drops; ear; externa; otitis; topical cache: safpj-4342.pdf plain text: safpj-4342.txt item: #67 of 732 id: safpj-4343 author: Ellis, Chris title: Becoming the illness date: 2015-09-01 words: 857 flesch: 62 summary: PERIPHERALIA The page number in the footer is not for bibliographic referencingwww.tandfonline.com/ojfp 52 One of the advantages of general practice is that one can observe patients over a long period. Over time, as the patient repeats the story to doctors and family members, the condition firms up, and the patient may start to communicate through their new illness persona. keywords: life; patient cache: safpj-4343.pdf plain text: safpj-4343.txt item: #68 of 732 id: safpj-4344 author: Ogunbanjo, Gboyega A. title: Depression among South Africa’s civil servants: Is there a solution? date: 2015-07-01 words: 944 flesch: 56 summary: South Africa Follows the Path of Africa: Has More Civil Servants than Even America! In 2013, South Africa’s public service had 3.03 million employees against the 2.79 million at the civil service federal level in America.2 From the Gems data, the percentage of South Africa’s civil servants with mental health conditions may appear very small (1.3%), the significance of the findings is its effect on service delivery. keywords: depression; employees; south cache: safpj-4344.pdf plain text: safpj-4344.txt item: #69 of 732 id: safpj-4345 author: Khamker, Nadira title: First episode schizophrenia date: 2015-09-01 words: 3723 flesch: 42 summary: To prevent relapse, maintenance antipsychotic treatment is First episode schizophrenia 33 The page number in the footer is not for bibliographic referencingwww.tandfonline.com/ojfp 33 as important for first episode schizophrenia patients as it is for patients with chronic schizophrenia. It was found in naturalistic follow-up studies that only 25% of first episode schizophrenia patients took their antipsychotic treatment consistently for the first year after starting treatment. keywords: disorder; episode; patients; psychosis; risk; schizophrenia; symptoms; treatment cache: safpj-4345.pdf plain text: safpj-4345.txt item: #70 of 732 id: safpj-4348 author: Schmidt, Stephani title: Chronic rhinosinusitis date: 2015-09-01 words: 3773 flesch: 27 summary: However, if this is not possible, the choice of antimicrobial agent is made empirically.3,4 Empiric antibiotic treatment is not recommended in patients: • Who have recently failed antibiotic treatment with a similar regimen.4 Table V: Place in therapy and suggested dosages of oral corticosteroids Place in therapy Before initiating CRS treatment, contributing factors need to be identified and treated.6 CRS cannot be “cured” in most people, and the intention of therapy is to reduce the signs and symptoms, and to improve patients’ quality of life.4,6,7 Because CRS responds incompletely to treatment, it may be necessary to continue with long-term treatment.7 The objectives of treatment are to: • Reduce complications:6 Minimise or control mucosal oedema and inflammation;3,4,6 and control infection, if present.3,4,6 • Maintain adequate sinus drainage and ventilation.3,4 • Reduce the number of acute exacerbations.4 • Prevent disease progression or recurrence.7 Nasal saline Saline nasal irrigation reduces postnasal drainage, removes secretions, rinses away allergens and irritants, and assists in restoring normal mucociliary clearance.1,4 keywords: chronic; crs; daily; days; nasal; patients; polyps; rhinosinusitis; treatment cache: safpj-4348.pdf plain text: safpj-4348.txt item: #71 of 732 id: safpj-4349 author: von Pressentin, Klaus B.; Naidoo, Mergan; Mash, Bob title: Mastering your Fellowship date: 2015-09-01 words: 4298 flesch: 45 summary: Which phase of programme evaluation is described in the article? 3.2 Describe the method of deciding upon an appropriate study design for programme evaluation in relation to this study. 3.3 Describe the selection of indicators, i.e. input, activities and outcomes, for programme evaluation in relation to this study. keywords: care; cause; child; evaluation; family; health; hiv; meeting; programme; question; treatment; tuberculosis cache: safpj-4349.pdf plain text: safpj-4349.txt item: #72 of 732 id: safpj-4354 author: Hodgson, Eric title: The effects of corticosteroids and nonsteroidal anti-inflammatory drugs, including aspirin, on coagulation date: 2015-09-01 words: 2643 flesch: 42 summary: Keywords: coagulation, corticosteroids, nonsteroidal anti-inflammatory drugs, NSAIDs S Afr Fam Pract ISSN 2078-6190 EISSN 2078-6204 The Author(s) REVIEW South African Family Practice 2015; 57(5):9-12 Open Access article distributed under the terms of the Creative Commons License [CC BY-NC-ND 4.0] http://creativecommons.org/licenses/by-nc-nd/4.0 The effects of corticosteroids and nonsteroidal anti-inflammatory drugs, including aspirin, on coagulation Eric Hodgsona* aInkosi Albert Luthuli Central Hospital; Department of Anaesthesia and Critical Care, Nelson R Mandela School of Medicine *Corresponding author, email: eric_hodgson@mweb.co.za S keywords: aspirin; corticosteroids; drugs; effects; inflammation; nsaids; patients; risk cache: safpj-4354.pdf plain text: safpj-4354.txt item: #73 of 732 id: safpj-4361 author: Ellis, Chris title: The therapeutic investigation date: 2015-11-01 words: 754 flesch: 55 summary: Now, I have a great array of pads on my desk for radiologists, ultrasounds, densitometry and scans, as well as large sheets for blood tests, containing little boxes, eagerly waiting to be ticked. The effect of a normal X-ray, normal scan, ECG or blood tests is reassuring, both to the doctor and the patient. keywords: investigation; patient cache: safpj-4361.pdf plain text: safpj-4361.txt item: #74 of 732 id: safpj-4370 author: Green, Robin title: The 5 x 5 plan for asthma control: the green route to asthma control date: 2015-11-01 words: 1058 flesch: 61 summary: Conclusion If these easy-to-follow principles and steps are implemented, asthma patients will benefit from better asthma control and an improved lifestyle. The Author(s) REVIEW Introduction Apart from medication to control asthmatic inflammation, the education of patients and parents is the most important therapeutic step in achieving asthma control and normal life. keywords: asthma; control cache: safpj-4370.pdf plain text: safpj-4370.txt item: #75 of 732 id: safpj-4372 author: Ogunbanjo, Gboyega title: Have we lost the global obesity battle? date: 2015-09-01 words: 955 flesch: 64 summary: When disaggregated by population group, approximately 18% of all white men are obese, followed by 9% of Indians, 8% of coloureds and 6% of African men.3 As we approach the end of 2015, the question to ask is: “Have we lost the battle to control global obesity?” It was reported in the 2013 Global Burden of Disease study, published in May 2014, that 37% of men and 38% of women had a body mass index of ≥ 25 kg/m2, a rise of 28% in adults and 47% in children since 1980.4 The World Health Organization (WHO) estimated that in 2014, 39% of adults aged ≥ 18 years (38% of men and 40% of women) were overweight.5 The trend of global obesity is definitely on the increase, and it appears that very little effort is being made to control the pandemic. keywords: global; obesity; overweight; women cache: safpj-4372.pdf plain text: safpj-4372.txt item: #76 of 732 id: safpj-4373 author: Schellack, Gustav; Modau, Tumelo; Schellack, Natalie title: Clinical overview of venous thromboembolism date: 2016-01-01 words: 4356 flesch: 42 summary: Deep venous thrombosis (DVT). Risk factors for the development of PTS include the involvement of a proximal vein, the extent of the thrombus, advancing age, obesity, a history of ipsilateral thrombosis and being of the female gender.9,10 Risk factors Many factors contribute to the development of DVT. keywords: deep; dvt; factors; oral; patients; risk; thrombosis; treatment; vein; venous; vte cache: safpj-4373.pdf plain text: safpj-4373.txt item: #77 of 732 id: safpj-4376 author: Choopa, M. S.; van Biljon, G. title: Acute kidney injury in children – not just for the nephrologist date: 2015-11-01 words: 3377 flesch: 51 summary: Management of acute renal failure in newborns. The prompt diagnosis and stratification of AKI risk allows treatment to be instituted early in order to prevent progression of the disease.4 Epidemiology of acute kidney injury in children Globally, AKI in children is under-reported owing to limited medical personnel, an inability to recognise the condition, cultural disparities in seeking medical assistance and seasonal variations in presentation.3 AKI occurs in roughly 8–30% of the children in paediatric intensive care, and in 5–10% of patients in neonatal intensive care units.5 keywords: acute; aki; children; fluid; hours; injury; kidney; renal; urine cache: safpj-4376.pdf plain text: safpj-4376.txt item: #78 of 732 id: safpj-4384 author: Lambert, Lynn title: Acne date: 2015-11-01 words: 3037 flesch: 41 summary: However, their use in pregnancy is contraindicated, and women of childbearing age who are prescribed this option must use contraception.7 Topical retinoids can be used as monotherapy for noninflammatory acne, or as combination therapy with antibiotics (oral or topical), to treat inflammatory acne. Typically, acne lesions develop at the onset of puberty. keywords: acne; antibiotics; comedones; factors; lesions; papules; skin; treatment cache: safpj-4384.pdf plain text: safpj-4384.txt item: #79 of 732 id: safpj-4388 author: Ilori, Temitope; Ladipo, Modupe M.; Ogunbode, Adetola M.; Obimakinde, Abimbola M. title: Knee osteoarthritis and perceived social support amongst patients in a family medicine clinic date: 2016-12-16 words: 3648 flesch: 53 summary: Sources of perceived family support Most respondents 186 (68.8%) indicated that their source of family support was from their children. 0.7 Lived with adult child 60 22.2 Lived with sibling(s) 3 1.1 Lived with other extended family members 21 7.8 Income Below poverty line 16 5.9 Above poverty line 254 94.1 Total 270 100 68.8 34.2 21.9 2.6 1.9 6.710 20 30 40 50 60 70 Ch ild re n Sp ou se Si bli ng Pa re nts In- law s Ot he rs FR E Q U E N C Y % Figure 1: Bar chart showing the source of perceived family support. keywords: family; friends; health; ibadan; knee; osteoarthritis; patients; respondents; social; study; support cache: safpj-4388.pdf plain text: safpj-4388.txt item: #80 of 732 id: safpj-4389 author: Schellack, G.; Schellack, N.; Kriel, M. title: Pharmacotherapy during pregnancy, childbirth and lactation: points and principles to consider (a 2015 update) date: 2015-11-01 words: 4549 flesch: 42 summary: This is because drug therapy, i.e. the use of medication to attain a certain clinical outcome, poses a significant risk during vulnerable periods of the human reproductive cycle. Premature infants have an even higher percentage of body water than neonates.5,6 Therefore, drugs can exert a potentially harmful effect on the unborn infant during any stage of the pregnancy, albeit in varying degrees.2,3 Abstract Pregnancy, childbirth and lactation pose unique challenges in terms of drug therapy. keywords: child; drug; effects; information; lactation; molecules; mother; pregnancy; therapy; use cache: safpj-4389.pdf plain text: safpj-4389.txt item: #81 of 732 id: safpj-4393 author: van Schoor, Jacky title: Hot flushes date: 2015-11-01 words: 2938 flesch: 32 summary: The physiology of vasomotor symptoms Vasomotor menopausal symptoms are episodes of profuse heat, lasting approximately 5–10 minutes, accompanied by sweating and flushing, experienced predominantly around the head, neck, chest and upper back.5,9 The physiology of hot flushes is not fully understood, and is likely to reflect the interplay between multiple central and peripheral physiological systems.4 Reproductive hormones play an integral role, as evidenced by the onset of vasomotor symptoms during the dramatic reproductive hormone changes of the menopausal transition, and by the efficacy of exogenous oestrogen in the treatment of hot flushes.4 Higher follicle-stimulating hormone levels and lower oestradiol (E2) levels have been associated with a greater likelihood of menopausal vasomotor symptoms being reported.4 However, while all perimenopausal women experience these hormonal changes, not all perimenopausal women experience vasomotor symptoms.4 Therefore, other physiological systems beyond the reproductive axis could be at play.4 Other systems include:4 • Thermoregulatory systems: Vasomotor symptoms may be characterised, at least in part, as thermoregulatory heat- dissipation events. However, cultural variations in how women experience, interpret, label and report vasomotor symptoms also plays a role in observed racial or ethnic differences in menopausal vasomotor symptoms. keywords: flushes; hormone; menopausal; mht; symptoms; vasomotor; women cache: safpj-4393.pdf plain text: safpj-4393.txt item: #82 of 732 id: safpj-4399 author: Dave, Joel A.; Klisiewicz, Ania; Bayat, Zaheer; Ahmed Mohamed, Nazeer; Stevens, Zane; Kinvig, Tanya title: SEMDSA/ACE-SA Guideline for the Management of Hypothyroidism in Adults date: 2015-11-01 words: 5185 flesch: 40 summary: The risk of CHD events and CHD mortality increases with increasing TSH, particularly with TSH levels > 10.0 mIU/ L. Consequently, there is little debate in the literature about treating patients with TSH levels persistently > 10.0 mIU/L.11-13 Treatment of patients with TSH levels 4.0 – 10 mIU/L is controversial as there are few randomized controlled trials to guide management of this group. keywords: disease; guideline; hypothyroidism; level; lt4; management; miu; patients; sch; treatment; tsh; years cache: safpj-4399.pdf plain text: safpj-4399.txt item: #83 of 732 id: safpj-4409 author: Ogunbanjo, Gboyega A. title: Nanotechnology and Health Care: What are the opportunities and possible risks? date: 2015-11-01 words: 812 flesch: 37 summary: The NCNSM focuses on the development of new materials using nanotechnology, and on the applications of nanotechnology in the manufacturing, energy and health sectors. This editorial focuses on the opportunities and possible risk(s) of nanotechnology. keywords: applications; drug; health; nanotechnology cache: safpj-4409.pdf plain text: safpj-4409.txt item: #84 of 732 id: safpj-4413 author: Visser, C. A.; Marincowitz, G. J.O.; Govender, I.; Ogunbanjo, G. A.O. title: Reasons for and perceptions of patients with minor ailments bypassing local primary health care facilities date: 2015-11-01 words: 2881 flesch: 50 summary: Opinions about local clinics Factor Agree Disagree Unsure Their local clinic has a visiting doctor 118 (40.27%) 53 (18.09%) 122 (41.64%), Medicines are always available at their clinic 93 (31.74%) 121 (41.30%) 79 (26.96%) Clinics are able to assist with basic health problems 83 (28.33%) 116 (39.59%) 94 (32.08%) Nurses at the clinic are well trained 126 (43.00%) 58 (19.80%) 109 (37.20%) Clinic staff members treat patients kindly 164 (55.97%) 65 (22.18%) 64 (21.84%) Our findings did not establish a link between employment and bypassing clinics, which is echoed by Akin and Hutchinson.6 Reasons for choosing the hospital According to Paul and Rumsey patterns of bypassing clinics showed that patients have a relatively sophisticated understanding of the facilities they are visiting and are not visiting, as well as of their own illness conditions.4 Patients seek facilities that are staffed by more knowledgeable physicians, who observe prescription practices and are polite, while patients generally avoid clinics that do not meet these standards. keywords: care; clinic; health; hospital; patients; perceptions; reasons cache: safpj-4413.pdf plain text: safpj-4413.txt item: #85 of 732 id: safpj-4414 author: Van Deventer, Claire title: Integration of non-communicable chronic diseases (NCDs) and HIV/AIDS and mental health care through the involvement of chronically ill patients using empowerment evaluation date: 2015-11-01 words: 8486 flesch: 57 summary: : Queue marshal (patient) with identifying apron. Integration of Non Communicable Chronic Diseases (NCDs) and HIV/Aids and mental health care through the involvement of chronically ill patients using empowerment evaluation 343 unacceptably long waiting times for chronic patients. Poster — don’t do vitals on AA patients One Time-slot appointments as opposed to just a date One Chairs facing different directions for different groups 4 CHW forms for AA to be taken to patients One Team building for all staff Fast queue box for files at the front Time appointments Visual waiting-time data Start support group and exercises Start food garden 5 Soup cooking for chronic patients/biokinetic exercises/ cleaning clinic/surrounds/knitting/flu injections One Tried patient-initiated waiting time (in and out cards with times)Whiteboard info on the programme for the day Two Equipment taken home, e.g. glucometers for diabetics 6 ‘War rooms’ for reproductive health to lessen pressure on clinic One Doctors’ number of unbooked patients analysed to see whether the doctor is assisting the chron- ic programme Glucometers at home One Identification of working patients with blue stickers on patient books All ‘Asking patients what they think of the service’ by patients and CHWs Pill poster re new national drug changes Using permanent markers in different colours on seats to identify the different queues Hand paper at reception instead of towels in bathrooms 7 CHWs doing vitals and pre retrieving files and drugs Two Measure the number of patients when the clinic was finished and see if this improves Employed patients having a specific time or day Also hear if people know about the dates of allied staff 8 Complaints against staff anonymously dropped into complaints box Booking book for adhering to date Queue marshal having a daily set welcome Complaints minutes to identify if decreasing 9 Support groups devolved to wards 342 S Afr Fam Pract 2015; 57(6):337–346 retrieved at five of the nine sites. keywords: care; chronic; clinics; district; empowerment; evaluation; group; health; improvement; involvement; patients; research; services; staff; support; time; vision; waiting cache: safpj-4414.pdf plain text: safpj-4414.txt item: #86 of 732 id: safpj-4418 author: Ellis, Chris title: The design meeting date: 2016-01-01 words: 580 flesch: 71 summary: There are centres for healthcare design, as well as a healthcare design magazine in the USA. The private practice model may suit small volumes with an insured, middle-class population, while other designs suit high-volume care to densely populated areas of low- or no-income patients. keywords: design; meeting cache: safpj-4418.pdf plain text: safpj-4418.txt item: #87 of 732 id: safpj-4431 author: Ellis, Chris title: Izilwane, imikhovu and izimpaka – mythical creatures as explanations of illness date: 2016-03-01 words: 767 flesch: 52 summary: On the other hand, visits by familiars are invariably malignant, but other creatures, such as tokoloshes, as described, are generally bent on mischief more than anything else. The above patient was referring to izilwane, sent by a witch (umthakathi), but izilwane could also refer to any number of crawling creatures which are representatives of ancestors and deceased members of the family (amadlozi). keywords: illness; izilwane cache: safpj-4431.pdf plain text: safpj-4431.txt item: #88 of 732 id: safpj-4433 author: Ogunbanjo, Gboyega A. title: Zika Virus Disease (ZVD): Another viral disease outbreak date: 2016-01-01 words: 814 flesch: 61 summary: Then on 1 Feb 2016, the World Health Organisation (WHO), declared Zika virus a public health emergency of international concern.2 Available data on 2 March, 2016, indicate that Brazil confirmed 641 cases of microcephaly and 139 babies with the birth defect have died since the Zika virus outbreak started in October 2015.3 Zika virus is transmitted from an infected mother to her foetus in utero and during birth. keywords: disease; virus; zika cache: safpj-4433.pdf plain text: safpj-4433.txt item: #89 of 732 id: safpj-4434 author: van Schoor, Jacky title: Urinary tract infections in women date: 2016-01-01 words: 3050 flesch: 23 summary: Keywords: urinary tract infection, cystitis, pyelonephritis, antimicrobial agents, resistance South African Family Practice 2016; 58(1):6-10 Open Access article distributed under the terms of the Creative Commons License [CC BY-NC-ND 4.0] http://creativecommons.org/licenses/by-nc-nd/4.0 Urinary tract infections in women Jacky van Schoor Amayeza Info Centre Correspondence to: Jacky van Schoor, e-mail: jacky@jvschoor.co.za Table However, some experts consider urinary tract infections to be uncomplicated in otherwise healthy postmenopausal women5 S Afr Fam Pract 2016;58(1):6-108 The page number in the footer is not for bibliographic referencingwww.tandfonline.com/oemd 8 Microbiology The microbial spectrum of uncomplicated UTIs in women consists mainly of Escherichia coli (75-95%). keywords: cystitis; infections; pyelonephritis; resistance; tract; urinary; utis; women cache: safpj-4434.pdf plain text: safpj-4434.txt item: #90 of 732 id: safpj-4435 author: van Rensburg, R. title: Analgesia for acute pain date: 2016-01-01 words: 2890 flesch: 53 summary: The Author(s) REVIEW Introduction Pain in its various forms is undoubtedly the most common ailment known to man, and acute pain is an experience familiar to all. Therefore, acute pain cannot be treated with a standard drug or cocktail and a satisfactory patient response is based on targeting the correct pathways, although nociceptive and neuropathic pain do often co-occur, e.g. during surgery or traumatic nerve injury. keywords: acute; analgesia; drugs; effects; fda; homepage; internet; management; nerve; pain cache: safpj-4435.pdf plain text: safpj-4435.txt item: #91 of 732 id: safpj-4436 author: Outhoff, Kim title: Cognitive enhancement: a brief overview date: 2016-01-01 words: 2746 flesch: 41 summary: This raises the critical question of whether cognitive-enhancing agents merely help people stay awake and maintain cognitive function, or actually enhance cognitive performance. The extent of drug use for cognitive enhancement in healthy individuals is difficult to establish, given the covert nature of acquiring, diverting and taking schedule 5 prescription-only medication for non-licensed purposes. keywords: drugs; effects; enhancement; function; methylphenidate; modafinil; performance; prescription; stimulants; use cache: safpj-4436.pdf plain text: safpj-4436.txt item: #92 of 732 id: safpj-4437 author: Muntingh, G. L. title: “Alpha-1, are you in? (C)harlie (O)scar (P)appa (D)elta, over!” date: 2016-01-01 words: 6166 flesch: 56 summary: Theophylline is generally considered to be a third-line bronchodilator drug in chronic COPD, after inhaled anticholinergics and beta 2 agonists. The prevention of COPD exacerbations was better with tiotropium than salmeterol in  one randomised trial, but the effect was quite small.35 Long-acting beta agonists (LABAs) have a cardiac effect, but have not been found to cause cardiovascular events, and don’t have the very slightly increased risk of death associated with LABA monotherapy for asthma. keywords: air; chronic; copd; disease; emphysema; exacerbations; flow; lung; number; obstructive; patients; smoking; treatment cache: safpj-4437.pdf plain text: safpj-4437.txt item: #93 of 732 id: safpj-4438 author: Marais, A. title: Additional considerations for gastro-oesophageal reflux disease date: 2016-01-01 words: 2359 flesch: 43 summary: Basoglu OK, Vardar R, Tasbakan MS, et al. Obstructive sleep apnea syndrome and gastroesophageal reflux disease: the importance of obesity and gender. The Montreal definition and classification of gastroesophageal reflux disease: a global evidence-based consensus. keywords: acid; disease; gord; patients; reflux; symptoms; treatment cache: safpj-4438.pdf plain text: safpj-4438.txt item: #94 of 732 id: safpj-4439 author: Schellack, Natalie; Schellack, Gustav; Bronkhorst, E. title: The role of proprotein convertase subtilisin/kexin type 9 inhibitors in managing cardiovascular risk date: 2016-01-01 words: 2868 flesch: 36 summary: LDL cholesterol levels 5–12 mmol/l ≥ 12 mmol/l HeFH: heterozygous familial hypercholesterolaemia,HoFH: homozygous familial hypercholesterolaemia, LDL: low-density lipoprotein Therefore, PCSK9, a serine protease, which is expressed in particularly significant quantities within the liver (the main source of circulating PCSK9), intestines and kidneys, may be regarded as a modulator of LDL cholesterol levels in the plasma. keywords: cholesterol; density; disease; familial; ldl; levels; lipoprotein; pcsk9; risk cache: safpj-4439.pdf plain text: safpj-4439.txt item: #95 of 732 id: safpj-4440 author: Siebert, Heidi title: Platelet-rich plasma in clinical practice date: 2016-01-01 words: 3360 flesch: 55 summary: The accompanying media attention has led to PRP gaining popularity and momentum.3,4 Although originally used for bone healing in orthopaedics, maxillofacial surgery and dental implants, PRP treatment for muscle, tendon, dermatology and skin renewal is gaining popularity.5–9 What is platelet-rich plasma? Thus, further studies are needed, and should comprise high- quality RCTs, both on PRP injections in the treatment of osteoarthritis compared with placebo; and surgical treatment supplemented by PRP, compared with operative management alone, in musculoskeletal injuries and dermatology. keywords: blood; growth; indications; patients; plasma; platelet; prp; skin; treatment; trials cache: safpj-4440.pdf plain text: safpj-4440.txt item: #96 of 732 id: safpj-4441 author: von Pressentin, K. B.; Naidoo, M.; Ogunbanjo, G. title: Mastering your Fellowship date: 2016-01-01 words: 4655 flesch: 64 summary: The page number in the footer is not for bibliographic referencingwww.tandfonline.com/ojfp 57 Previous period of neck pain (p = 0.015) (½ mark). Fewer patients in the motor vehicle accident subgroup (45) experienced a previous period of neck pain, compared to those in the remaining cohort (65) (½ mark). keywords: answer; csmo; family; feedback; mark; neck; pain; patients; study cache: safpj-4441.pdf plain text: safpj-4441.txt item: #97 of 732 id: safpj-4443 author: Rheeder, Paul; Muthembe, Tessy; Lawson, Stefan; Brink, Julie title: Diabetes and hypertension screening in Zandspruit, Johannesburg 2012–2014 date: 2016-12-16 words: 4804 flesch: 55 summary: Diabetes and hypertension screening in Zandspruit, Johannesburg 2012–2014 South African Family Practice is co-published by Medpharm Publications, NISC (Pty) Ltd and Taylor & Francis, and Informa business S Afr Fam Pract ISSN 2078-6190 Diabetes and hypertension screening in Zandspruit, Johannesburg 2012–2014 3 Participants with systolic BP  ≥  140  mmHg or diastolic BP  ≥  90  mmHg or RCG  ≥  7  mmol/l were contacted by SMS and phone within one week of the date the patient was screened. keywords: blood; community; diabetes; glucose; health; hypertension; mmhg; pressure; screening; south cache: safpj-4443.pdf plain text: safpj-4443.txt item: #98 of 732 id: safpj-4446 author: Ally, Mahmood M.T.M.; Hodkinson, Bridget title: Rheumatoid Arthritis date: 2016-03-01 words: 4143 flesch: 39 summary: This review will focus immuno-pathogenic mechanisms, aspects of early disease, co-morbidity and therapy in rheumatoid arthritis. The page number in the footer is not for bibliographic referencingwww.tandfonline.com/oemd 12 Early Rheumatoid Arthritis Immunological and biochemical changes occur even before the clinical onset of disease with differing immuno-biology before disease onset, in early disease, and in established disease. keywords: activity; arthritis; disease; early; management; patients; response; rheumatoid; therapy cache: safpj-4446.pdf plain text: safpj-4446.txt item: #99 of 732 id: safpj-4447 author: Schellack, Natalie; Annor, Ama S. title: Optimising pain management - An update date: 2016-03-01 words: 6383 flesch: 53 summary: This is because chronic pain patients are more likely to report anxiety, depression neuropathic pain and significant activity limitations.37 Examples of adjuvant medicines are steroids, anxiolytics, antidepressants, hypnotics and anticonvulsants/ antiepileptic agents.40 It has been proposed for use in chronic pain management, e.g. in chronic lower back pain and in the treatment of neuropathic pain, but further research is required.23 keywords: acute; analgesia; cancer; chronic; drug; effects; health; hydromorphone; management; morphine; opioid; pain; paracetamol; patients; release; step; treatment; use cache: safpj-4447.pdf plain text: safpj-4447.txt item: #100 of 732 id: safpj-4448 author: Schellack, Natalie; Engler, D. title: Sublingual immunotherapy for the treatment of allergies date: 2016-03-01 words: 3262 flesch: 45 summary: Di Bona D, Plaia A, Scafidi V, et al. Efficacy of sublingual immunotherapy with grass allergens for seasonal allergic rhinitis: a systemic review and meta-analysis. Antihistamines in the pediatric population: achieving optimal outcomes when treating seasonal allergic rhinitis and chronic urticaria. keywords: allergen; allergy; atopic; clin; immunotherapy; patients; rhinitis; scit; slit; sublingual; symptoms cache: safpj-4448.pdf plain text: safpj-4448.txt item: #101 of 732 id: safpj-4455 author: Marais, André title: The allergic eye date: 2016-03-01 words: 2849 flesch: 36 summary: It can however be a challenge to accurately diagnose and manage this condition – a sentiment that is shared by specialist ophthalmologists.[1] Allergic conjunctivitis is therefore often underdiagnosed and consequently undertreated. Specific IgE antibodies are almost always present in all types of allergic conjunctivitis whereby the inflammatory response towards allergens is a result of degranulation of the sensitized mast cells resulting in the clinical ocular allergic expression.[3] Recent findings indicate that conjunctival symptoms are present in 30-70% of adults suffering from acute allergic rhinitis, while 30% are associated with chronic and persistent episodes.[4] Environmental factors, especially notable in our South African setting, are important. keywords: allergic; allergy; cell; conjunctivitis; drops; eye; keratoconjunctivitis; mast; times cache: safpj-4455.pdf plain text: safpj-4455.txt item: #102 of 732 id: safpj-4457 author: Schellack, Natalie; Schellack, Gustav; Omoding, Richard title: An update on chronic obstructive pulmonary disease date: 2016-05-01 words: 4944 flesch: 46 summary: Hence, the approach may not be a very reliable one.12 The management of COPD patients is based on a combined COPD assessment, which incorporates both the CAT score and the modified MRC dyspnoea scale value, and provides for the four categories (A–D) depicted in Table 3.6 Management The management of COPD involves setting treatment goals based on the pathophysiology of the disease, and focuses on reducing the symptoms, as well as the overall risk, as depicted in Table 4. Differences in classification of COPD patients into risk groups A-D: a cross-sectional study. keywords: air; chronic; copd; disease; exacerbations; lung; management; patients; pulmonary; risk; smoking; symptoms; use cache: safpj-4457.pdf plain text: safpj-4457.txt item: #103 of 732 id: safpj-4458 author: Weir, Gregory; Smart, Hiske; van Marle, Kobus; Marshall, Michael; Fourie, Anika; Berzen, Anne; Bruwer, Febe; Ramdeen, Myam; Pearce, Michelle; Reynolds, Jason title: WHASA consensus document on the management of lower limb ulcers date: 2016-03-01 words: 6943 flesch: 41 summary: This will include a bilateral lower limb assessment as well as an ankle-brachial pressure index (ABPI) test on all patients with arterial ulcers to determine the severity of arterial disease. Determine when the wound will be categorised as healable, maintenance and non-healable Healable:1 All patients with arterial ulcers should be referred for a vascular assessment and possible intervention. keywords: agreement; arterial; assessment; care; compression; debridement; disease; healing; insufficiency; limb; management; pain; patient; therapy; treatment; ulcers; venous; wound cache: safpj-4458.pdf plain text: safpj-4458.txt item: #104 of 732 id: safpj-4459 author: Muntingh, George L. title: Vitamin D – The Vitamin Hormone date: 2016-05-01 words: 3580 flesch: 33 summary: The majority of our knowledge about vitamin D has been gained over the past 15 years, and with the growing issue of deficiencies, more health connections with vitamin D levels are being made.2 Biological fate of Vitamin D Vitamin D, although commonly known as a vitamin, is actually a hormone precursor that is present in 2 forms. Vitamin D supplements and specific foods can aid in maintaining sufficient levels of vitamin D, particularly in people at risk of deficiency. keywords: calcium; deficiency; disease; levels; people; risk; vitamin cache: safpj-4459.pdf plain text: safpj-4459.txt item: #105 of 732 id: safpj-4460 author: Gardner, B. M. title: Recreational drugs and implications date: 2016-05-23 words: 3277 flesch: 56 summary: SA Victim support: Drug abuse and addiction. It is important to always maintain a high index of suspicion that a patient may have been exposed to some form of recreational drug abuse. keywords: abuse; agents; anaesthesia; cocaine; drug; patients; serotonin; south; substance cache: safpj-4460.pdf plain text: safpj-4460.txt item: #106 of 732 id: safpj-4461 author: Welch, E. title: Paediatric TIVA and TCI date: 2016-05-23 words: 2283 flesch: 54 summary: Different rates of drug elimination occur after the administration of a single bolus. • Volume of distribution changes throughout childhood - Alters the induction dose which is usually far larger than in adults (up to 3 times greater) • Clearance increases with age as enzyme maturity develops - Alters steady state infusion rate which is often lower than adults. keywords: drug; half; infusion; propofol; tiva cache: safpj-4461.pdf plain text: safpj-4461.txt item: #107 of 732 id: safpj-4462 author: Correia, M. R. title: Rapid Sequence Induction of Anaesthesia in the Paediatric Patient: Controversies and proposed protocol date: 2016-05-23 words: 2659 flesch: 42 summary: The apnoea tolerance in children is reduced to such an extent that even short periods of apnoea cause rapid desaturation, hypoxia, hypercapnia and possible cardiovascular deterioration.7-9,13 Waiting for the “magical minute” to secure the airway without bag mask ventilation as described with the classical RSI in adults, has been shown to be associated with severe complications9. • Prevention of hypoxia and hypercarbia is paramount and achieved via gentle bag mask ventilation with pressures less than 12cmH2O. • Cricoid pressure is not appropriate in the paediatric patient. keywords: anaesthesia; induction; muscle; paediatric; patient; pressure; ventilation cache: safpj-4462.pdf plain text: safpj-4462.txt item: #108 of 732 id: safpj-4463 author: Wong, M. L. title: COPD: What the anaesthetist should know date: 2016-05-23 words: 2649 flesch: 50 summary: There has been a trend away from classifying COPD patients as having either emphysema (“pink puffers”) or chronic bronchitis (“blue bloaters”). Comorbid illnesses in COPD patients are important to identify. keywords: asthma; chronic; copd; disease; exacerbations; lung; patients; smoking; therapy cache: safpj-4463.pdf plain text: safpj-4463.txt item: #109 of 732 id: safpj-4464 author: Madima, N. R. title: Postoperative confusion in recovery room – a practical approach date: 2016-05-23 words: 1676 flesch: 48 summary: • Remember some of the patients with recovery room confusion will recover spontaneously but sadly recovery room delirium predicts POCD with 100% sensitivity and 85% specificity. nthatheni@tmmc.co.za Figure 1: pathophysiology of postoperative delirium5 S Afr Fam Pract 2016;58(3):S21-S2322 S22 Incidence6,7,8,10 The incidence of postoperative delirium is variable depending on the type of surgery, with reported incidence of 9-65%. keywords: confusion; delirium; patient; recovery; room cache: safpj-4464.pdf plain text: safpj-4464.txt item: #110 of 732 id: safpj-4466 author: Mazaza, Shadrick; de Villiers, Pierre; Naidoo, Neethia title: Specialist Physicians (Family Medicine) in private practice date: 2016-03-01 words: 550 flesch: 39 summary: When the BHF was approached, they reiterated that their role was to issue appropriate practice numbers to physicians so that medical schemes could be guided by this to determine appropriate remuneration. These physicians started to submit their claims to medical schemes using the 015 practice number as specialists in family medicine. keywords: medical; practice cache: safpj-4466.pdf plain text: safpj-4466.txt item: #111 of 732 id: safpj-4468 author: Schellack, Gustav; Meyer, J. C.; Schellack, Natalie title: Gastro-oesophageal reflux: An overview of the cost-effectiveness of pharmacotherapeutic treatment options date: 2016-03-01 words: 4496 flesch: 49 summary: Amongst the class of PPIs, cost-effectiveness comparisons, including various outcome measures, such as annual costs, number of symptom-free days and quality-adjusted life-years, illustrated the relative cost- effectiveness of specific PPIs in the treatment and maintenance of GORD and erosive reflux oesophagitis.8,9,10 Gastro-oesophageal reflux: An overview of the cost-effectiveness of pharmacotherapeutic treatment options 21 The page number in the footer is not for bibliographic referencingwww.tandfonline.com/oemd 21 Table 1: Cost comparison between the different oral, acid-lowering agents on the local market (with a specific indication and dosage recommendation for reflux oesophagitis, as part of GORD) H2-receptor antagonists (H2-blockers): As indicated for reflux oesophagitis Cost per pack Cost of the recommended dosage per month (30 days) Cimetidine: Adco-Cimetidine® 400 mg QID (120 tablets per month) When different management strategies for a disease are compared, the cost of each strategy must be balanced against its effectiveness.5 It is important that the cost-effectiveness of treatment is considered in conjunction with its therapeutic effectiveness.6 The ideal situation would be to increase the therapeutic effectiveness of treatment at a lower cost than the standard or current therapy.5 In practice though, this will be highly unlikely and the best balance between increased costs and effectiveness must be established to maximise outcomes within the constraints of available resources.5 A cost-effectiveness analysis (CEA) is the primary pharma- coeconomic tool that is used to compare the costs of a health intervention with the expected health benefits or a common therapeutic goal.2,6 With a CEA health outcomes are expressed in common units so that comparisons among different treatments can be made, with a ratio of benefits measured in therapeutic effects per money unit of expenditure.5,6 A simple cost comparison between the different oral, acid-lowering agents on the local market (with a specific indication and dosage recommendation for reflux oesophagitis, as part of GORD) is provided in Table 1. Cost-effective treatment options for GORD Gastro-oesophageal reflux disease (GORD) is a chronic condition, with symptoms having a marked effect on patients’ work performance and health-related quality of life (QoL). keywords: acid; agents; capsules; cost; effectiveness; gord; reflux; tablets; treatment cache: safpj-4468.pdf plain text: safpj-4468.txt item: #112 of 732 id: safpj-4470 author: Ellis, Chris title: The dissonance between teaching and practice date: 2016-05-01 words: 768 flesch: 61 summary: I personally don’t like leaving things until next time because eventually matters continue to get postponed as the subsequent visits are then under pressure as well (called the “never-ending consultation”). We all agree that this is an essential part of holistic care, but time is also needed for these activities. keywords: patients; time cache: safpj-4470.pdf plain text: safpj-4470.txt item: #113 of 732 id: safpj-4471 author: Office, Editorial title: Venous Leg Ulcers: Effectiveness of new compression therapy/moist wound healing combination confirmed date: 2016-03-01 words: 676 flesch: 37 summary: It is surprising that fundamental scientific knowledge is given so little attention in daily practice, even in highly developed countries such as Germany, where only an estimated 10–20% of patients with chronic wounds received moist wound therapy in 2002, and up to 25% of patients with venous leg ulcers did not receive any compression therapy. Here, a holistic approach of compression therapy combined with moist wound healing is the most effective approach and one that is recommended by therapy guidelines. keywords: compression; therapy cache: safpj-4471.pdf plain text: safpj-4471.txt item: #114 of 732 id: safpj-4472 author: Office, Editorial title: HRT the new NPWT in wound care? Exudate removal the key... date: 2016-03-01 words: 1647 flesch: 36 summary: Introducing their report on a more specific evaluation of the influence of Sorbion Sachet S - “a wound dressing with Hydration Response Fibers” – on wound bed preparation in patients with venous leg ulcers VLU3, Italian researchers Romanelli et al stressed the importance of debridement in laying out the fundament for wound healing i.e. preparing the wound bed. He reminded readers that the presence of proteases and cytokines in chronic wound exudate can cause the wound to become stuck in the inflammatory phase of healing, resulting in non- or slow healing. keywords: dressing; hrt; npwt; panel; wound cache: safpj-4472.pdf plain text: safpj-4472.txt item: #115 of 732 id: safpj-4480 author: Hlongwane-Gukuta, T. title: Out of theatre sedation – how I do it safely date: 2016-05-23 words: 2187 flesch: 39 summary: PSA exists along a continuum in terms of consciousness from anxiolysis or minimal sedation to deep sedation and analgesia.1,2 Short acting analgesic and sedative drugs are utilised to create conditions conducive to optimal performance of therapeutic or diagnostic procedures.1 A detailed discussion of each drug is beyond the scope of this article. Deep sedation and analgesia keywords: analgesia; locations; patient; procedure; psa; sedation cache: safpj-4480.pdf plain text: safpj-4480.txt item: #116 of 732 id: safpj-4481 author: Lundgren, A. C. title: Ethical conundrums in anaesthetic practice date: 2016-05-23 words: 2001 flesch: 56 summary: Insofar as ethical and legal consent for anaesthesia in adult patients is concerned, we are bound by the National Health Act 61 of 2003.3 This replaced our previous legislation in South Africa which had a very paternalistic attitude to informed consent from patients. In patients who are < 18 years of age, the Children’s Act 38 of 20054 applies, when deciding on informed consent for anaesthesia. keywords: act; child; consent; patient; treatment cache: safpj-4481.pdf plain text: safpj-4481.txt item: #117 of 732 id: safpj-4485 author: Outhoff, K. title: Insomnia disorder: when sleep plays coy, aloof and disdainful date: 2016-05-01 words: 2800 flesch: 42 summary: Conversely, CBT is the recommended first-line therapy for those burdened with chronic insomnia disorder, where lack of sleep impacts heavily on daytime functioning and on physical, psychiatric and emotional health. Polysomnography is not indicated unless other sleep disorders, such as periodic limb movement disorder or sleep apnoea, are suspected. keywords: daytime; disorder; drugs; insomnia; journal; medicine; patients; sleep; term; therapy; treatment cache: safpj-4485.pdf plain text: safpj-4485.txt item: #118 of 732 id: safpj-4486 author: Vally, M.; Irhuma, M. O.E. title: Management of Cough: a practical approach date: 2016-08-04 words: 3777 flesch: 56 summary: Keywords: cough, acute cough, chronic cough, subacute cough, cough syrup South African Family Practice 2016; 58(4):35-39 Open Access article distributed under the terms of the Creative Commons License [CC BY-NC-ND 4.0] http://creativecommons.org/licenses/by-nc-nd/4.0 Management of Cough: a practical approach Vally, M*a, Irhuma, MOEa aDivision of Clinical and Experimental Pharmacology, Department of Pharmacy and Pharmacology, School of Therapeutic Sciences, Faculty of Health Sciences, University of Witwatersrand, Johannesburg Corresponding author, email: muhammed.vally@wits.ac.za S Afr Fam Pract 2016;58(4):35-3936 A subacute cough is one that lasts between three to eight weeks and a chronic cough is one that lasts for longer than eight weeks.1,2 Common causes of acute, subacute and chronic coughs For the majority of patients with acute cough, the causes can be either viral or bacterial, and tend to be as a result of upper respiratory tract infections, such as acute bronchitis or tracheo- bronchitis.1 keywords: ace; acute; asthma; causes; chronic; cough; evidence; management; patients; subacute; symptoms; therapy cache: safpj-4486.pdf plain text: safpj-4486.txt item: #119 of 732 id: safpj-4487 author: von Pressentin, Klaus; Naidoo, Mergan; Pather, Michael title: Mastering your Fellowship date: 2016-05-01 words: 3341 flesch: 54 summary: • Nonpharmacological: › The focus should be on developing a therapeutic, patient-centred relationship [1], as both doctor and patient will benefit from a stronger relationship. › Doctors, especially those still in training, feel challenged and even frustrated when dealing with patients who experience MUS. keywords: airway; care; family; health; medicine; patient; south; symptoms; test cache: safpj-4487.pdf plain text: safpj-4487.txt item: #120 of 732 id: safpj-4496 author: Bronkhorst, Elmien; Schellack, Natalie title: Liraglutide for the treatment of obesity date: 2016-05-01 words: 2366 flesch: 52 summary: At these dosages, significant weight loss has been observed in diabetic patients.1 Once-daily dosages of 3 mg have been shown to have potential benefits for weight management.6 Following ingestion of food, incretin hormones (gastric inhibitory polypeptide (GIP) and GLP-1) are secreted from the gastrointestinal tract. A. A 12-week treatment with the long-acting glucagon-like peptide 1 receptor agonist liraglutide leads to significant weight loss in a subset of obese women with newly diagnosed polycystic ovary syndrome. keywords: body; diabetes; liraglutide; loss; obesity; overweight; treatment; weight cache: safpj-4496.pdf plain text: safpj-4496.txt item: #121 of 732 id: safpj-4499 author: Chege, Patrick Masemiano; Penner, J; Godoy-Ruiz, P; Kapoor, V; Rodas, J; Rouleau, K title: Evolution of Family Medicine in Kenya (1990s to date): a case study date: 2017-03-06 words: 5209 flesch: 52 summary: My first involvement in the development of the Kenyan FM was in 2005 when representatives from Moi University joined other East African delegates in a VLIR-funded workshop on Family Medicine development in SSA that was held in South Africa. Keywords: academic programmes, challenges, enablers, Family Medicine evolution, Kenya Introduction Since the Alma-Ata conference in 1978, Primary Health Care (PHC) and Primary Care (PC) have been given some focus as the foundation on which health equity and comprehensive care among citizens could be built.1,2 The World Health Organization (WHO) support for primary care was demonstrated by World Health Report of 2008.3 There is compelling evidence that in countries where PC has been given its due consideration in national health policy, better and cost-effective health outcomes have been documented.4,5 Sub-Saharan Africa (SSA), with the region’s immense economic challenges, would do much better using its limited resources in improving health by enhancing primary care for the citizens. keywords: care; development; family; family medicine; health; kenya; medical; medicine; moi; primary; study; university cache: safpj-4499.pdf plain text: safpj-4499.txt item: #122 of 732 id: safpj-4503 author: Schellack, Natalie; Matimela, Molebogeng title: Paediatric pain management date: 2016-05-01 words: 4126 flesch: 32 summary: Paediatric pain assessment Proper assessment of paediatric pain is necessary to ensure the correct diagnosis and guidance in pain management interventions.4 Children normally experience physical and psychological pain, whilst their family may experience the emotional and social consequences as the results of pain. Non-opioid analgesics The following non-opioid related medicines are available for managing pain in children: paracetamol, and non-steroidal anti- inflammatory drugs (NSAIDs), for example naproxen, ibuprofen and mefenamic acid.5 They adequately treat mild pain and moderate-to-severe pain in combination with other medicines, particularly opioids, to provide more effective relief and reduce adverse effects.5 Paracetamol Paracetamol is one of the drugs of choice in pain management during the postoperative period in children due to its excellent safety profile and lack of any significant side-effects.6 It acts as a prodrug, with an active cannabinoid metabolite. keywords: children; ibuprofen; management; opioid; paediatric; pain; paracetamol; use; years cache: safpj-4503.pdf plain text: safpj-4503.txt item: #123 of 732 id: safpj-4504 author: Outhoff, K. title: Stress-related IBS date: 2016-05-01 words: 2844 flesch: 33 summary: Central effects of stress hormones in health and disease: Understanding the protective and damaging effects of stress and stress mediators. (Figure 2) Sustained activation of any of the brain–gut axis systems may influence gut microbes indirectly (by causing changes in their environment) or directly (by stress related host signalling molecules released into the gut lumen from lamina propria cells of enterochromaffin, neuronal and immune cells) which may have clinical implications in IBS.13 There is also some evidence that catecholamines can alter the growth, motility and virulence of pathogenic and commensal bacteria. keywords: axis; brain; gut; ibs; immune; microbiota; response; stress; system cache: safpj-4504.pdf plain text: safpj-4504.txt item: #124 of 732 id: safpj-4505 author: Outhoff, K. title: Evidence that changes the way you practice Bipolar Disorder: Mania and depression explained date: 2016-05-01 words: 1496 flesch: 38 summary: Evidence-based guidelines for treating bipolar disorder: revised second edition—recommendations from the British Association for Psychopharmacology. Collaborative genome-wide association analysis supports a role for ANK3 and CACNA1C in bipolar disorder. keywords: bipolar; depression; disorder; journal; lithium; olanzapine; quetiapine; valproate cache: safpj-4505.pdf plain text: safpj-4505.txt item: #125 of 732 id: safpj-4508 author: Muntingh, G. L. title: A summary overview of the new, direct, target-specific oral anticoagulants date: 2016-08-04 words: 3075 flesch: 45 summary: For over 50 years, warfarin was the only anticoagulant available in oral form, but now the availability of direct oral anticoagulants (DOACs) has caused a paradigm shift in thrombosis management. Abstract In the past 10 years or so, many alternatives to warfarin have been developed the first being the novel oral anticoagulants (NOAC) or better referred to as direct oral anticoagulants (DOAC) or target-specific oral anticoagulants (TSOAC). keywords: anticoagulants; bleeding; dabigatran; doacs; drugs; patients; rivaroxaban; warfarin cache: safpj-4508.pdf plain text: safpj-4508.txt item: #126 of 732 id: safpj-4509 author: Wolmarans, De Wet; Brand, Sarel J. title: Mind your state: Insights into antidepressant nonadherence date: 2016-08-04 words: 2214 flesch: 40 summary: Getting the facts straight • Globally, an estimated 16 million annual attempts at suicide result in nearly 800 000 deaths.10 • 11 million of these attempts are preceded by depressive episodes.11 • Patients diagnosed with MDD have an estimated 5–10 years decrease in life expectancy12 not only related to suicidal behaviour, but mostly due to comorbid cardio-metabolic disorders.13 • Only 10% of MDD patients receive adequate treatment.9 • Even with intensive pharmacological treatment, only 60–70% of patients achieve remission.14 The importance of antidepressant adherence While drugs may be slow to act, humans are slower at learning Indeed, the slow onset of action of antidepressants and sometimes severe nature of their side-effects as well as the fact that treatment adherence is not a guarantee to achieve symptom remission lead to 60–80% of patients being hesitant about the likelihood of a positive outcome with continuous drug treatment.23, 26 Moreover, recent studies highlighted the impact of distrustful relationships between MDD patients and their clinicians in treatment nonadherence.24, 25 Particularly during phases of nonadherence, patients have reported that they deliberately avoid therapists for three main reasons, i.e. 1) they do not believe that their clinicians are competent to appreciate their own perceived need for change; 2) the prescribing clinician will often argue for continuing or augmenting the current treatment regimen; and 3) they experience consultations with their clinicians as taxing intellectual debates concerning the necessity to make changes to current, and in their view, failing interventions.23 Interestingly, these feelings are exacerbated by the differing perceptions of psychiatrists and general practitioners regarding MDD.5 keywords: adherence; antidepressant; mdd; patients; treatment cache: safpj-4509.pdf plain text: safpj-4509.txt item: #127 of 732 id: safpj-4510 author: Marais, André title: The pharmacological management of obesity date: 2016-08-04 words: 5019 flesch: 54 summary: Smith SR, Prosser WA, Donahue DJ, et al. Lorcaserin (APD356), a selective 5-HT(2C) agonist, reduces body weight in obese men and women. Leptin and the regulation of body weight in mammals. keywords: available; bmi; body; daily; drugs; effects; fat; loss; obese; obesity; patients; weeks; weight cache: safpj-4510.pdf plain text: safpj-4510.txt item: #128 of 732 id: safpj-4514 author: Office, Editorial title: Zika Virus Disease (ZVD) and the Rio Olympics: Is it safe for athletes to go? date: 2016-05-01 words: 1043 flesch: 53 summary: Although Zika virus was discovered seventy years ago, the viral strain that currently affects Brazil is clearly new, different, and vastly more dangerous than the “old” Zika virus. WHO public health advice regarding the Olympics and Zika virus. keywords: brazil; virus; zika cache: safpj-4514.pdf plain text: safpj-4514.txt item: #129 of 732 id: safpj-4520 author: Ellis, Chris title: Clinical conundrums in primary health care date: 2016-08-04 words: 728 flesch: 57 summary: It needed a lot of time to collect some basic information and measurements while the benches outside in the corridor were groaning with the weight of more patients waiting to see me. My problem was how I was going to manage these sorts of patients from the perspective of a primary healthcare clinic when they were often attending several OPD clinics at two district hospitals and a tertiary hospital. keywords: patients; pills cache: safpj-4520.pdf plain text: safpj-4520.txt item: #130 of 732 id: safpj-4521 author: Marais, André title: The pharmacological management of erectile dysfunction – Update 2016 date: 2016-08-04 words: 3858 flesch: 46 summary: Schmidt HM, Munder T, Gerger H, et al. Combination of psychological intervention and phosphodiesterase-5 inhibitors for erectile dysfunction: A Narrative Review and Meta-Analysis. Keywords: cardiovascular disease, erectile dysfunction, phosphodiesterase-5 inhibitors, prostaglandin, testosterone South African Family Practice 2016; 58(4):10-14 Open Access article distributed under the terms of the Creative Commons License [CC BY-NC-ND 4.0] http://creativecommons.org/licenses/by-nc-nd/4.0 The pharmacological management of erectile dysfunction – Update 2016 André Marais Department of Pharmacology, School of Medicine, Faculty of Health Sciences, University of Pretoria, South Africa Corresponding author, email: dramarais@gmail.com / andre.marais@up.ac.za The pharmacological management of erectile dysfunction – Update 2016 11 keywords: dysfunction; erectile; inhibitors; men; sildenafil; testosterone; therapy; treatment cache: safpj-4521.pdf plain text: safpj-4521.txt item: #131 of 732 id: safpj-4523 author: Ayodapo, Abayomi Olusola; Sekoni, Olutoyin O; Asuzu, Michael C title: Pattern of intimate partner violence disclosure among pregnant women attending ante-natal clinic in Oyo East Local Government, Nigeria date: 2017-05-10 words: 4498 flesch: 54 summary: Pattern of intimate partner violence disclosure among pregnant women attending ante-natal clinic in Oyo East Local Government, Nigeria South African Family Practice is co-published by Medpharm Publications, The Author(s) RESEARCH South African Family Practice 2017; 59(2):67–71 http://dx.doi.org/10.1080/20786190.2016.1272245 Open Access article distributed under the terms of the Creative Commons License [CC BY-NC 3.0] http://creativecommons.org/licenses/by-nc/3.0 Pattern of intimate partner violence disclosure among pregnant women attending ante-natal clinic in Oyo East Local Government, Nigeria AO Ayodapoa*, OO Sekonib and MC Asuzub a Department of Family Medicine, Federal Medical Centre, Birnin-Kebbi, Kebbi State, Nigeria b Department of Community Medicine, College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria *Corresponding author, email: aayodapo@gmail.com Background: Intimate partner violence (IPV) is a significant public health problem. keywords: disclosure; family; health; ipv; nigeria; partner; respondents; study; violence; women cache: safpj-4523.pdf plain text: safpj-4523.txt item: #132 of 732 id: safpj-4524 author: Irhuma, M. O.E.; Vally, M. title: Use of angiotensin receptor – neprilysin inhibitors in heart failure: a paradigm shift date: 2016-11-02 words: 3074 flesch: 49 summary: The disease progressively worsens and results in significant morbidity and premature cardiac death.2 The common pathophysiological types of HF include heart failure with preserved ejection fraction (HFpEF) and heart failure with reduced ejection fraction (HFrEF).2 This article will briefly highlight the impact of using neprilysin inhibitors in HFrEF. Heart failure with reduced ejection fraction The most common causes of HFrEF are resistant hypertension (blood pressure that remains above goal in spite of the concurrent use of three antihypertensive agents of different classes), and ischaemic heart disease (IHD).3,4 Less common causes include cardiomyopathy, valvular disorders, myocarditis and the use of cardiotoxic keywords: angiotensin; enalapril; failure; heart; inhibitors; neprilysin; patients; sacubitril; valsartan cache: safpj-4524.pdf plain text: safpj-4524.txt item: #133 of 732 id: safpj-4527 author: van Deventer, Claire; Golden, Lauren; Du Plessis, Erica; Lion-Cachet, Carien title: Optimal management of children on antiretroviral therapy (ART) in primary care: a quality improvement project date: 2017-03-06 words: 4257 flesch: 61 summary: Keywords: child HIV, doctor involvement, primary health care, quality improvement Introduction The national guidelines for the management of children on antiretroviral therapy (ART) in South Africa have been revised three times in the last five years.1–3 This indicates a rapid responsiveness to evidence emerging from literature and research. It was also decided that a fast queue should be organised for ART children and that all children lost to follow-up should be traced through the community health workers (CHWs). keywords: art; care; children; clinics; district; figure; health; hiv; improvement; quality; subdistrict cache: safpj-4527.pdf plain text: safpj-4527.txt item: #134 of 732 id: safpj-4528 author: Smith, N.; Ismail, H.; Schellack, N. title: Neuropathic pain: targeting the melatonin MT2 receptor date: 2016-08-04 words: 2777 flesch: 42 summary: The Author(s) REVIEW Introduction What is neuropathic pain? Neuropathic pain is considered to be a major health problem and affects a significant number of patients, thus leading to a rise in healthcare costs and reduced productivity.1 Neuropathic pain can occur from injury to any point along a neuronal pathway, from the terminal of the peripheral nociceptors, to the cortical neurons in the brain.2 The MT3 receptor has been found in other areas of the body including the kidney, liver and ovaries.12,13 Neuropathic pain Nociceptive pain •  Injury to the nervous system, often accompanied by maladaptive changes in the nervous system Aetiology •  Lancinating, shooting, electric-like, stabbing pain Description •  Common symptoms like numbness, tingling, pricking Sensory deficits •  If a motor nerve is affected then neurological weakness may be present. keywords: june; melatonin; neuropathic; number; pain; receptor; role; system; treatment cache: safpj-4528.pdf plain text: safpj-4528.txt item: #135 of 732 id: safpj-4531 author: von Pressentin, Klaus B.; Naidoo, Mergan; Mash, Bob title: Mastering your Fellowship date: 2016-08-04 words: 4554 flesch: 56 summary: Reasons for diabetes patients attending Bishop Lavis Community Health Centre being non- adherent to diabetes care. 1.4 H – In patients with anterior shoulder dislocations, one has to consider associated humeral fractures or rotator cuff tears in the group older than 60 years. keywords: care; data; examination; family; health; marks; medicine; practice; qualitative; shoulder; study cache: safpj-4531.pdf plain text: safpj-4531.txt item: #136 of 732 id: safpj-4535 author: Greeff, Oppel B.W. title: The pharmacotherapy of low back pain date: 2016-08-04 words: 1572 flesch: 51 summary: The Author(s) REVIEW Introduction About 60 – 80% of patients visiting their family practitioner have at some stage in their lives suffered from low back pain. Causes of Lower Back Pain There are multiple causes of lower back pain and the physician will always attempt toget to the correct cause in order to assure the most effective treatment is recommended. keywords: analgesic; muscle; pain; therapy cache: safpj-4535.pdf plain text: safpj-4535.txt item: #137 of 732 id: safpj-4536 author: Padayachey, Uschenka; Ramlall, S; Chipps, J title: Depression in older adults: prevalence and risk factors in a primary health care sample date: 2017-05-11 words: 5281 flesch: 54 summary: Understanding the somatic consequences of depression: biological mechanisms and the role of depression symptom profile. Early identification and treatment of depression serves to reduce additional medical costs incurred by depressed individuals and lessen the significant associated caregiver burden.2 Ageing presents with a multitude of organic changes that result in characteristic affective and behavioural patterns, often inadvertently viewed as part of the normal ageing process.3 Depression encompasses a range of mental issues and associated emotional, cognitive and behavioural symptoms.4 keywords: association; care; depression; gds; health; participants; prevalence; primary; risk; south; study cache: safpj-4536.pdf plain text: safpj-4536.txt item: #138 of 732 id: safpj-4538 author: Poliah, Vinola; Paruk, Saeeda title: Depression, anxiety symptoms and substance use amongst sex workers attending a non-governmental organisation in KwaZulu-Natal, South Africa date: 2017-07-10 words: 5274 flesch: 57 summary: Reported prevalence rates have varied from as low as 4.2% in Bangladesh, while a study in Australia reported no difference in prevalence compared with the general population, compared with a Swiss study in Zurich that found the lifetime prevalence of depression and anxiety to be 36.3% and 34.2% respectively.3,5,7 Finally a study in Nepal reported the prevalence of depression to be as high as 84% in female sex workers.12 Studies have also demonstrated high rates of substance abuse amongst sex workers, for example the study in Bangladesh reported that more than half of the sample had a substance use disorder including alcohol and other illicit drugs.7 In the Australian study the majority of sex workers were heroin dependent and one-third were either cocaine or cannabis dependent.5 Studies among arrested female sex workers in the United States of America found that 73% tested positive for cocaine use compared with 38% among females arrested for non-sex-worker-related offences.10 Substance abuse and sex work have a bi-directional relationship. Depression, anxiety symptoms and substance use amongst sex workers attending a non-governmental organisation in KwaZulu-Natal, South Africa South African Family Practice is co-published by Medpharm Publications, keywords: anxiety; depression; health; mental; prevalence; sex; study; substance; use; workers cache: safpj-4538.pdf plain text: safpj-4538.txt item: #139 of 732 id: safpj-4539 author: Alonge, Temitope Oluwagbemiga; Adebusoye, Lawrence Adekunle; Ogunbode, Adetola Morenikeji; Olowookere, Olufemi Oluwole; Ladipo, Modupe Martha-Anne; Balogun, William O; Okoje-Adesomoju, Vivian title: Factors associated with osteoporosis among older patients at the Geriatric Centre in Nigeria: a cross-sectional study date: 2017-07-10 words: 5651 flesch: 56 summary: The Author(s) RESEARCH South African Family Practice 2017; 59(3):87–93 https://doi.org/10.1080/20786190.2016.1272248 Open Access article distributed under the terms of the Creative Commons License [CC BY-NC 3.0] http://creativecommons.org/licenses/by-nc/3.0 Factors associated with osteoporosis among older patients at the Geriatric Centre in Nigeria: a cross-sectional study TO Alongea, LA Adebusoyeb*, AM Ogunbodec, OO Olowookereb, MM-A Ladipoc  , WO Balogund and V Okoje-Adesomojue aDepartment of Orthopaedics and Trauma, University College Hospital, Ibadan, Nigeria b Chief Tony Anenih Geriatric Centre, University College Hospital, Ibadan, Nigeria c Department of Family Medicine, University College Hospital, Ibadan, Nigeria d Department of Medicine, College of Medicine, University of Ibadan, Nigeria e Department of Oral and Maxillofacial Surgery, University College Hospital, Ibadan, Nigeria *Corresponding author, email: larrymacsoye@yahoo.com Background: Osteoporosis is a silent disabling clinical condition often attributed to ageing. The WHO scientific group on the assessment of osteoporosis at the primary healthcare level in the report of the meeting held in Brussels, Belgium in 2004 noted that osteoporosis is a disease that has to be prevented in view of its severe morbidities and associated fragility fractures among the elderly because these cause a huge impact, financial and social, on the health of the community.3,5 Osteoporosis is also known to affect the quality of life and independence of the elderly.3 With increasing life expectancy in Nigeria, the population of the elderly being hospitalised following fractures of the head of the femur is on the rise.1 The vertebral bodies, distal radius, neck of femur, proximal femur and proximal humerus are the areas of highest prevalence of fractures.4 Osteoporosis can be divided into primary osteoporosis, which includes age-related and idiopathic osteoporosis, and keywords: activities; age; bone; hospital; nigeria; osteoporosis; patients; prevalence; respondents; study; years cache: safpj-4539.pdf plain text: safpj-4539.txt item: #140 of 732 id: safpj-4540 author: Khan, Muhamed Waseem; Hira, Varsha; Haffejee, Firoza title: Perceptions of students regarding the effects of the implementation of the tobacco control act of 1999 on a South African University campus date: 2017-03-06 words: 4888 flesch: 64 summary: (25) 3.4 (3) 67.8 (59) White 7.0 (26) 19.2 (5) 11.5 (3) 69.2 (18) Table 2: Knowledge of the effects of smoking on health Knowledge of the hazardous effects of smoking % (n) An exploratory analysis of the impact of a university campus smoking ban on staff and student smoking habits in Japan. keywords: effects; health; people; public; smokers; smoking; south; students; study; university cache: safpj-4540.pdf plain text: safpj-4540.txt item: #141 of 732 id: safpj-4542 author: Mokwena, Kebogile; Bogale, Yenealem Reta title: Fertility intention and use of contraception among women living with the human immunodeficiency virus in Oromia Region, Ethiopia date: 2017-03-06 words: 4802 flesch: 56 summary: Stanwood N, Cohn S, Heiser J, et al. Contraception and fertility plans in a cohort of HIV positive women in care. The finding that many HIV women in this sample wanted to have children in the near future are similar to a study conducted in Lesotho31 and this has significant implications for the transmission of HIV to sexual partners and to newborns. keywords: aids; children; desire; fertility; health; hiv; intention; reproductive; services; study; women cache: safpj-4542.pdf plain text: safpj-4542.txt item: #142 of 732 id: safpj-4545 author: Ellis, Chris title: Books as therapy date: 2016-11-02 words: 855 flesch: 64 summary: PERIPHERALIA The page number in the footer is not for bibliographic referencingwww.tandfonline.com/ojfp 80 Over the years I have lent books to patients to read in order for them to understand more about what they are experiencing with their illnesses. “Books are more than doctors,” says Mr Perdu. keywords: book; life; patients cache: safpj-4545.pdf plain text: safpj-4545.txt item: #143 of 732 id: safpj-4546 author: Akinsanya, Olusegun Solomon; Wiseman-Firtell, Jill; Akpomiemie, Goodman; Adeniyi, Oladele Vincent; Kaswa, Ramprakash title: Evaluation of the prevention of mother-to-child transmission programme at a primary health care centre in South Africa date: 2017-05-10 words: 4894 flesch: 55 summary: Improving a mother to child HIV transmission programme through health system redesign: quality improvement, protocol adjustment and resource addition. Keywords: DNA PCR, HIV infection, prevention of mother-to-child transmission, rates, South Africa Introduction Globally, between 2009 and 2014, there was a 48% reduction of new HIV infections in children, due to the success of the World Health Organization (WHO) HIV programme on Prevention of Mother to Child Transmission (PMTCT).1 A substantial improvement in the implementation of PMTCT has been achieved, since the first case of HIV by mother-to-child transmission (MTCT) was identified in 1983.2 The WHO has proposed Option A, Option B, and Option B+ according to availability of resources for the optimisation of PMTCT care and support. keywords: africa; child; health; hiv; infants; mothers; mtct; programme; south; study; transmission cache: safpj-4546.pdf plain text: safpj-4546.txt item: #144 of 732 id: safpj-4548 author: Ogunbanjo, Gboyega A. title: National Health Insurance (NHI): Funding is an issue! date: 2016-08-04 words: 858 flesch: 52 summary: The White Paper clearly states that the NHI will deliver a comprehensive package of health services that include services such as rehabilitation and palliative care, mental health care including that related to substance abuse and maternal and child health care.1 The 97-page White Paper is detailed in terms of population and service coverage, Primary Health Care (PHC) re-engineering and strategies to enhance effectiveness of the health care system. Therefore, the White Paper surmises that the NHI’s financing requirements are uncertain, and in part depend on public health system improvements and medical scheme regulatory reforms, which have not yet been fully articulated. keywords: health; nhi; paper cache: safpj-4548.pdf plain text: safpj-4548.txt item: #145 of 732 id: safpj-4550 author: Yoko, Jean Louis; Tumbo, John; Mills, Benjamin A; Kabongo, Cila Dominic title: Characteristics of pulmonary tuberculosis patients in Moses Kotane region North West Province, South Africa date: 2017-05-10 words: 3703 flesch: 63 summary: Discussion This study investigated the characteristics of TB patients in the Community Health Centres of Moses Kotane. 70% of TB patients in India are under 50. keywords: dot; health; hiv; patients; south; study; treatment; tuberculosis; years cache: safpj-4550.pdf plain text: safpj-4550.txt item: #146 of 732 id: safpj-4551 author: van Zyl, R. L. title: The Malaria Season Is Upon Us date: 2016-11-02 words: 3097 flesch: 41 summary: The Author(s) REVIEW Introduction With the onset of the summer rains nearly upon us, the increased risk of malaria infections will necessitate the need for patient awareness of preventative measures and chemoprophylaxis.1 The page number in the footer is not for bibliographic referencingwww.tandfonline.com/oemd 72 Conclusion Asking the right questions, knowledge of your travel destination and sound medical advice are all critical to the prevention of malaria infections. keywords: africa; anopheles; infection; malaria; mosquito; patient; risk; south; symptoms; treatment cache: safpj-4551.pdf plain text: safpj-4551.txt item: #147 of 732 id: safpj-4552 author: Harmse, L. title: Understanding the management of iron deficiency anaemia date: 2016-12-16 words: 2799 flesch: 49 summary: This brief review provides a summary of some of the problems that may be encountered with the management of iron deficiency and iron deficiency anaemia. The page number in the footer is not for bibliographic referencingwww.tandfonline.com/oemd 41 from the GIT are controlled by the hormone hepcidin.⁹ Hepcidin responds to increased plasma and tissue iron levels by stimulating the degradation of ferroportin, the protein responsible for the export of iron from cells.10 In iron deficiency, the synthesis of hepcidin is suppressed and the absorption of iron from the GIT increases.11 Aetiology of inefficient GIT absorption of iron Several factors decrease the absorption of iron from the GIT and complicate the management of iron deficiency anaemia: keywords: absorption; anaemia; blood; chronic; deficiency; git; iron; patients; therapy cache: safpj-4552.pdf plain text: safpj-4552.txt item: #148 of 732 id: safpj-4553 author: Yakubu, Kenneth; Hoedebecke, K; Pinho-Costa, L; Popoola, O; Okoye, I title: A qualitative study of young Nigerian family physicians’ views of their specialty date: 2017-07-10 words: 3779 flesch: 49 summary: I will be grateful if you can be part of this brief survey for young family doctors (i.e. < 5 years post residency training and resident doctors in family medicine) titled: ‘A qualitative study of young Nigerian Family Physicians on their profession’. Keywords: family practice, grounded theory, identity crisis, Nigeria, primary health care Introduction Since 1981 when the residency training in family medicine (FM) commenced in Nigeria,1,2 it has gained a great deal of recognition as the number of residency training centres has grown to about 120,3 reflecting a mixture of faith-based, general and tertiary hospitals located in either urban, semi-urban or rural communities. keywords: care; community; family; fps; medical; medicine; nigeria; research; study; training; word cache: safpj-4553.pdf plain text: safpj-4553.txt item: #149 of 732 id: safpj-4557 author: Tshitangano, Takalani G; Ramaliba, T M; Akinsola, H A; Thendele, M title: Tuberculosis risk factors in Lephalale local municipality of Limpopo province, South Africa date: 2017-10-31 words: 4458 flesch: 58 summary: Conclusion This study confirms the findings of previous studies, i.e. that demographic, environmental and behavioural factors are linked to high tuberculosis morbidity in Lephalale Recommendations Intensive community education aimed at changing perceptions of TB risk factors, particularly ventilation and TB treatment adherence, might yield beneficial results. Sampling The sample size for this study was calculated using Slovin’s formula, where N was the total number of TB patients, n was the sample size and e was the accepted level of error. keywords: africa; factors; health; lephalale; patients; respondents; risk; south; study; tuberculosis cache: safpj-4557.pdf plain text: safpj-4557.txt item: #150 of 732 id: safpj-4560 author: Rotunno, A.; Janse van Rensburg, D. C.; Grant, C. C.; Jansen van Rensburg, A. title: Corticosteroids in sports-related injuries: Friend or Foe date: 2016-12-16 words: 4751 flesch: 38 summary: With regard to long-term side effects of corticosteroid use, inconclusive findings have shown some correlations with the possibility of developing or aggravating existing peptic ulcers.25,26,27 Hepatic steatosis, potentially due to hyperglycemia, may also develop, while the risk for glaucoma through intraocular pressure increases irrespective of method of administration.16 Increased intraocular pressure has been reported in pediatric populations,28 patients over the age of 40 and those with a history of glaucoma.29 Sub-capsular cataract formation has been strongly associated with prednisolone administration and may be related to covalent binding between glucocorticoid and the protein matrices of the lens, resulting in its destabilisation.30,31 Nitrogen retention, bone formation and collagen formations might also be affected by corticosteroids which even at moderate doses inhibit growth hormone release.16 In general, corticosteroid use during pregnancy is considered to be safe,32 however reports of increased risk for cleft lip and cleft palate have been put forth.33,34 Corticosteroids in the sporting context There have been numerous studies on the applicability, efficacy, side effect profiles, and general use of corticosteroids in the management of athletes and sports injuries.35 They have been applied to a wide variety of sports-related injuries in many different contexts, some of which have been beneficial, others detrimental, to the athlete.12 Many different study designs, using human and animal subjects, examining different clinical conditions’ response to local corticosteroid injections, have been performed. A review of local corticosteroid injections indicated that a more rapid relief of symptoms was achieved with lower doses of intermediate acting drugs than with higher doses of shorter acting ones.42 Another study showed that after IM corticosteroid injection, tensile strength of the tendon improved, but repeated administration progressively weakened the same tendon, thus illustrating a relationship between cumulative dose and side effects.42 Injection into a tendon may weaken its structure, and thus increase probability of rupture. keywords: corticosteroid; drugs; effects; evidence; group; inflammation; injection; injuries; injury; med; pain; sports; tendon; term; tissue; treatment; use cache: safpj-4560.pdf plain text: safpj-4560.txt item: #151 of 732 id: safpj-4561 author: Outhoff, K. title: An update on the pharmacological treatment of anxiety and related disorders date: 2016-11-02 words: 5253 flesch: 40 summary: Rather, the latest DSM V classification has reassigned them to the following four main categories: anxiety disorders, obsessive- compulsive and related disorders, trauma and stressor-related disorders and somatic symptom and related disorders2 (Table 1). Patients with anxiety disorders are often on high alert, and act accordingly by worrying, becoming hyper-vigilant and avoiding potentially “dangerous” situations. keywords: agents; anxiety; anxiety disorder; benzodiazepines; disorder; effects; obsessive; ocd; panic; patients; serotonin; symptoms; treatment cache: safpj-4561.pdf plain text: safpj-4561.txt item: #152 of 732 id: safpj-4562 author: Bekker, L.; Rebe, K.; Venter, F.; Maartens, G.; Moorhouse, M.; Conradie, F.; Wallis, C.; Black, V.; Harley, B.; Eakles, R. title: Southern African guidelines on the safe use of pre-exposure prophylaxis in persons at risk of acquiring HIV-1 infection date: 2016-11-02 words: 9506 flesch: 51 summary: Oral PrEP must be taken, ideally daily, during times of HIV exposure risk, although there are some data suggesting that less than perfect adherence is still highly effective in MSM. The studies have involved more than 17 000 people and have demonstrated an overall reduction in HIV acquisition risk of 51% (women RR 0.57 keywords: africa; counselling; exposure; ftc; guidelines; hepatitis; hiv; infection; men; msm; prep; prevention; prophylaxis; risk; sex; south; sti; tdf; use; users cache: safpj-4562.pdf plain text: safpj-4562.txt item: #153 of 732 id: safpj-4563 author: Raff, Milton title: Acute pain guidelines date: 2016-11-02 words: 10267 flesch: 48 summary: Chronic pain can only be addressed when the management of acute pain is effected. Choose an appropriate scale, i.e. VNRS or FACES® Monitor pain every 15 minutes and adjust the analgesic treatment accordingly until the patient is pain free at rest and during movement Monitor the pain hourly for 6 hours (during rest and movement) Continue with 4-hourly assessments FACES®: Wong-Baker FACES® pain rating scale, VNRS: verbal numeric rating scale Figure 3: The design of a pain measuring and monitoring protocol S Afr Fam Pract 2016;58(5):20-4128 keywords: acid; acute; administration; analgesia; chronic; dose; drug; effects; fibres; footer; hourly; information; maximum; number; opioid; oral; page; pain; patient; scale; table; use; use1 cache: safpj-4563.pdf plain text: safpj-4563.txt item: #154 of 732 id: safpj-4567 author: von Pressentin, Klaus; Naidoo, Mergan; Mash, Bob title: Mastering your fellowship date: 2016-11-02 words: 7750 flesch: 53 summary: The stillbirth to early neonatal death ratio gives an idea of the standard of health care in a community. Critical appraisal of research Please answer the questions related to the following article: Van Deventer C. Integration of non-communicable chronic diseases and HIV/AIDS and mental health care through the involvement of chronically ill patients using empowerment evaluation. keywords: care; data; district; family; health; marks; patient; process; review; south; stillbirth cache: safpj-4567.pdf plain text: safpj-4567.txt item: #155 of 732 id: safpj-4570 author: Mogole, O.; Schellack, N.; Motswaledi, M. H. title: Stevens-Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN): an update date: 2016-11-02 words: 2102 flesch: 38 summary: Cyclophosphamide The benefits of cyclophosphamide in patients with acute TEN was previously reported but is not recommended anymore in the treatment of SJS and TEN due an associated increase in mortality rate.5 6. The Author(s) REVIEW Introduction Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are delayed-type hypersensitivity reactions triggered by drugs, and sometimes by infections.1 They are characterised by widespread epidermal necrosis of the skin and mucosa and are associated with substantial morbidity. keywords: 2016; august; epidermal; johnson; necrolysis; patients; sjs; stevens; syndrome cache: safpj-4570.pdf plain text: safpj-4570.txt item: #156 of 732 id: safpj-4571 author: Ellis, Chris title: An Acronymic Wilderness date: 2016-12-16 words: 607 flesch: 57 summary: PERIPHERALIA The page number in the footer is not for bibliographic referencingwww.tandfonline.com/ojfp 52 The world is now flooded with acronyms and none more so than the world of modern medicine. Acronyms are abbreviations formed from the initial letters of a word or phrase and in medicine are mostly used for disease names (MS, MI, etc.) as well as for drugs (ARVs, CCBs, etc.) and investigations (MRI, LP, etc.). keywords: acronyms; disease cache: safpj-4571.pdf plain text: safpj-4571.txt item: #157 of 732 id: safpj-4572 author: Ramoleta, Tumelo; Schellack, Natalie; Bronkhorst, Elmien title: An overview of ivabradine date: 2016-12-16 words: 2553 flesch: 48 summary: The page number in the footer is not for bibliographic referencingwww.tandfonline.com/oemd 38 The importance of heart rate in the pathophysiology and clinical course of heart failure was confirmed by the SHIfT study. The prognosis of chronic heart failure is fairly poor, and heart rate reduction, especially a reduction in resting heart rate, is particularly important in managing the disease process.⁴ Due to its inability to be detected and the lack of conclusive diagnostic assessments, the clinical diagnosis of congestive heart failure (CHF) is reliant on vigilant physical assessment and the use of diagnostic tests, such as chest radiography and the electrocardiogram (ECG).⁵ Throughout recent years many advances in treatment have been made, but CHF still claims the lives of many.⁶ High mortality and morbidity are seen in patients with CHF.⁴ Angina pectoris According to Fihn et keywords: angina; failure; heart; ivabradine; myocardial; oxygen; rate cache: safpj-4572.pdf plain text: safpj-4572.txt item: #158 of 732 id: safpj-4573 author: Dahan-Farkas, N. E.; Irhuma, M. O.E. title: Long-acting reversible hormonal contraception date: 2016-11-02 words: 2854 flesch: 39 summary: No delay No delay Long acting reversible hormonal contraception 67 Long acting reversible hormonal contraception 65 keywords: bleeding; contraceptive; etonogestrel; implant; levonorgestrel; methods; use; women cache: safpj-4573.pdf plain text: safpj-4573.txt item: #159 of 732 id: safpj-4574 author: Maphasha, Olga; Govender, Indiran; Motloba, Pagollang D; Barua, Champak title: Use of the partogram by doctors and midwives at Odi District Hospital, Gauteng, South Africa date: 2017-05-11 words: 4413 flesch: 51 summary: Reasons for not using the partogram included being unsure how to use it (13%), partogram charts not available (8.7%), partogram takes too long (21.7%), being too busy (26.1%), and a feeling that the partogram was not the doctor’s responsibility (26.1%). In order to produce a summation of themes and overall score for partogram use, a scoring method was devised. keywords: doctors; health; knowledge; labour; midwives; participants; partogram; study; use; years cache: safpj-4574.pdf plain text: safpj-4574.txt item: #160 of 732 id: safpj-4580 author: Kovesdy, Csaba P; Furth, Susan; Zoccali, Carmine title: Obesity and kidney disease: hidden consequences of the epidemic date: 2017-03-06 words: 7617 flesch: 48 summary: Acquiring evidence that current interventions to reduce CKD risk in the obese are efficacious and deployable, is an urgent priority to set goals and means for risk modification. Am J Kidney keywords: analysis; association; bmi; body; ckd; development; diabetes; disease; effects; esrd; health; hypertension; incident; index; individuals; j kidney; kidney; kidney disease; mass; nephrol; obese; obesity; overweight; patients; population; prevalence; renal; risk; stage; studies; study; weight cache: safpj-4580.pdf plain text: safpj-4580.txt item: #161 of 732 id: safpj-4581 author: Ogunbanjo, Gboyega A. title: Non-communicable Diseases (NCDs): Have we lost the battle? date: 2016-11-02 words: 800 flesch: 54 summary: Research from the Global Burden of Diseases Nutrition and Chronic Diseases Expert Group shows that chronic diseases result in one death every hour. Abegunde DO, Mathers CD, Adam T, Ortegon M, Strong K. The burden and costs of chronic diseases in low-income and middle-income countries. keywords: diseases; health; ncds cache: safpj-4581.pdf plain text: safpj-4581.txt item: #162 of 732 id: safpj-4582 author: Brand, Sarel; Wolmarans, De Wet title: When past and present collide: A concise clinical review of post-traumatic stress disorder (PTSD) within the context of family practice date: 2016-12-16 words: 3257 flesch: 49 summary: If, following such appraisal, the frontal cortex continues the fear response, the amygdala remains activated and the fear related memory is strengthened and consolidated in the hippocampus.11 However, if cortical appraisal results in the discontinuation of the fear response, the amygdala is inactivated, noradrenalin levels decrease and patients learn to switch immediately between fear activation and extinction upon re-exposures to a reminder of the former traumatic event.12 Hence, it can be understood that a prolonged and severe hyperadrenergic state following trauma may contribute to an South African Family Practice 2016; 58(6):24-27 Open Access article distributed under the terms of the Creative Commons License [CC BY-NC-ND 4.0] http://creativecommons.org/licenses/by-nc-nd/4.0 When past and present collide: A concise clinical review of post-traumatic stress disorder (PTSD) within the context of family practice Sarel Brand, De Wet Wolmarans* Centre of Excellence for Pharmaceutical Sciences, Division of Pharmacology, Faculty of Health Sciences, North-West University, Potchefstroom Campus *Corresponding author, email: dewet.wolmarans@nwu.ac.za When past and present collide: A concise clinical review of post-traumatic stress disorder (PTSD) within the context of family practice 25 The page number in the footer is not for bibliographic referencingwww.tandfonline.com/oemd 25 overemphasis of fear, resulting in an inflated consolidation of the relevant memory. Morris P, Hopwood M, Maguire K, Norman T, Schweitzer I. Blunted growth hormone response to clonidine in post-traumatic stress disorder. keywords: acute; disorder; fear; patients; post; psychiatry; ptsd; response; stress; symptoms; trauma; treatment cache: safpj-4582.pdf plain text: safpj-4582.txt item: #163 of 732 id: safpj-4583 author: Smith, Haley title: Heartburn, gastro-oesophageal reflux disease and non-erosive reflux disease date: 2016-11-02 words: 2836 flesch: 50 summary: This increases upward pressure against the oesophageal sphincter causing acid reflux. It can also provoke coughing, causing frequent episodes of acid reflux in the oesophagus. keywords: acid; disease; gord; patients; reflux; stomach; symptoms cache: safpj-4583.pdf plain text: safpj-4583.txt item: #164 of 732 id: safpj-4585 author: von Pressentin, Klaus; Naidoo, Mergan; Ross, Andrew; Cooke, Richard title: Mastering your fellowship date: 2016-12-16 words: 4406 flesch: 58 summary: (2 marks) The actual rate of suicide per racial group showed a gradient increase from 2006 to 2007 for all groups except for white people (increase in suicide rate according to racial group sub-group: black > Indian > mixed race > white). It is widely believed that these figures have since increased; d) Suicide rates have been increasing steadily in all population groups in the country over the last decade. keywords: care; family; health; marks; patient; question; research; south; study; suicide cache: safpj-4585.pdf plain text: safpj-4585.txt item: #165 of 732 id: safpj-4588 author: Saimen, A.; Armstrong, E.; Manitshana, C.; Govender, I. title: Evaluation of a two-question screening tool in the detection of intimate partner violence in a primary healthcare setting in South Africa date: 2016-11-02 words: 6095 flesch: 57 summary: Evaluation of a two-question screening tool in the detection of intimate partner violence in a primary healthcare setting in South Africa South African Family Practice is co-published by Medpharm Publications, NISC (Pty) Ltd and Taylor & Francis, and Informa business. The Author(s) RESEARCH South African Family Practice 2016; 1(1):1–7 http://dx.doi.org/10.1080/20786190.2016.1223796 Open Access article distributed under the terms of the Creative Commons License [CC BY-NC 3.0] http://creativecommons.org/licenses/by-nc/3.0 Evaluation of a two-question screening tool in the detection of intimate partner violence in a primary healthcare setting in South Africa A Saimena, E Armstronga, C Manitshanaa and I Govenderb* a Department of Family Medicine, University of the Witwatersrand, Johannesburg, South Africa b Department of Family Medicine and Primary Health Care, Sefako Makgatho Health Sciences University, Pretoria, South Africa *Corresponding author, email: indiran.govender@gmail.com Introduction: Intimate partner violence has been recognised globally as a human rights violation. keywords: health; ipv; participants; partner; result; screening; short; tool; violence; wast; women cache: safpj-4588.pdf plain text: safpj-4588.txt item: #166 of 732 id: safpj-4589 author: Mofolo, N.; Botes, J. title: An evaluation of factors influencing perceptual experiences and future plans of final-year medical interns in the Free State, 2013–2014 date: 2016-11-02 words: 5376 flesch: 51 summary: An evaluation of factors influencing perceptual experiences and future plans of final year medical interns in the Free State, 2013 – 2014 3 Three-quarters (75.0%; n = 60) of participants were allocated to their first-choice facility, and 87.3% (n = 69) were satisfied with the allocation process. An evaluation of factors influencing perceptual experiences and future plans of final year medical interns in the Free State, 2013 – 2014 5 option, while 20.0% (n = 6) had their sights set on the United Kingdom. keywords: health; interns; internship; medical; participants; state; supervision; training; year cache: safpj-4589.pdf plain text: safpj-4589.txt item: #167 of 732 id: safpj-4590 author: Yiga, S. I.N.; Botes, J.; Joubert, G.; Bulane, S.; Choane, T.; Mogale, K.; Rapitse, M.; Ruiters, C. title: Self-perceived readiness of medical interns in performing basic medical procedures at the Universitas Academic Health Complex in Bloemfontein date: 2016-11-02 words: 3938 flesch: 39 summary: Self-perceived readiness of medical interns in performing basic medical procedures at the Universitas Academic Health Complex in Bloemfontein South African Family Practice is co-published by Medpharm Publications, NISC (Pty) Ltd and Taylor & Francis, and Informa business. Keywords: basic medical procedures, education, medical interns, readiness, skills Introduction It is common practice to have an apprenticeship (otherwise known as medical internship) period after medical students complete their basic medical degree.1 keywords: health; interns; medicine; participants; procedures; readiness; study cache: safpj-4590.pdf plain text: safpj-4590.txt item: #168 of 732 id: safpj-4591 author: Ogbonna, Kingsley; Govender, Indiran; Tumbo, John title: Knowledge and practice of the prevention of mother-to-child transmission of HIV guidelines amongst doctors and nurses at Odi Hospital, Tshwane District date: 2016-11-02 words: 4602 flesch: 56 summary: The PMTCT guidelines published by the National Department of Health and South African National AIDS Council in 2010 address the key modalities of HIV transmission from mother to child during pregnancy, the birth process, or through breastfeeding.6 According to the guidelines, prevention of transmission of HIV from mother to child has four elements: primary prevention of HIV amongst women of child- bearing age; preventing unintended pregnancies amongst women living with HIV; preventing HIV transmission from a woman living with HIV to her infant; and providing appropriate treatment, care and support to women living with HIV, their children and families. Knowledge and practice of the prevention of mother-to-child transmission of HIV guidelines amongst doctors and nurses at Odi Hospital, Tshwane District South African Family Practice is co-published by Medpharm Publications, NISC (Pty) Ltd and Taylor & Francis, and Informa business. keywords: child; doctors; health; hiv; knowledge; mother; nurses; pmtct; practice; study; transmission cache: safpj-4591.pdf plain text: safpj-4591.txt item: #169 of 732 id: safpj-4592 author: van Eyk, Armorel D. title: The treatment of sexually transmitted infections date: 2016-12-16 words: 3238 flesch: 44 summary: The WHO recommended treatment of genital, oropharyngeal and anorectal gonorrhoea is dual therapy consisting of either ceftriaxone (250 mg IM, single dose) plus azithromycin (1 g orally, single dose) or cefixime (400 mg orally, single dose) plus azithromycin (1 g orally, single dose) Figure 1: Flowchart of syndromic treatment of Vaginal Discharge Syndrome. For further details on dosages and retreatment, refer to the WHO treatment guidelines.17 Figure 2: Flowchart of syndromic treatment of Lower Abdominal Pain. keywords: care; flowchart; guidelines; health; infections; resistance; stis; syphilis; treatment cache: safpj-4592.pdf plain text: safpj-4592.txt item: #170 of 732 id: safpj-4594 author: Schellack, Natalie; Van der Sandt, N; Modau, T; Poplar, T; Meyer, J C title: Travel vaccines: information for health care workers date: 2017-05-11 words: 7235 flesch: 45 summary: The paper provides practical advice for health care workers when consulting with the international traveler and hence may strengthen the battle against vaccine preventable diseases. However, research shows that there is lack of knowledge of these vaccine-preventable diseases.8 With the ever-increasing numbers of travellers throughout each continent, the risk for acquiring vaccine preventable diseases is high.9 keywords: africa; areas; countries; country; disease; fever; health; hepatitis; infection; people; prevention; risk; south; travellers; use; vaccination; vaccine; water; world; yellow cache: safpj-4594.pdf plain text: safpj-4594.txt item: #171 of 732 id: safpj-4595 author: Harmse, Leonie; Reuter, Helmuth title: An overview of the biological disease modifying drugs available for arthritic conditions in South Africa date: 2016-12-16 words: 3197 flesch: 35 summary: In recent years the biological DMARDS have been proven to be efficacious against the progression of rheumatoid arthritis (RA) when there is no response or a poor response to traditional DMARDs.1,2 Once a monoclonal antibody has associated with its target it triggers the antibody dependent cellular cytotoxic immune response and/or the complement system causing the removal/destruction of the target by the Abstract The past decade has seen a major change in the treatment options and strategies for rheumatoid arthritis (RA) and the other immune-mediated arthritic diseases. keywords: agents; antibody; arthritis; dmards; infections; inhibitors; monoclonal; rheumatoid; tnf cache: safpj-4595.pdf plain text: safpj-4595.txt item: #172 of 732 id: safpj-4597 author: Soogun, Sunday; Naidoo, Mergan; Naidoo, Kantharuben title: An evaluation of the use of the South African Triage Scale in an urban district hospital in Durban, South Africa date: 2017-08-28 words: 4829 flesch: 62 summary: Red code patients with a high TEWS score due to unstable vital signs require proper evaluation to identify the underlying pathology. The triage history, physiological parameters, application of discriminator lists, final triage code and outcome was audited and compared with findings from the patients’ clinical records. keywords: africa; cases; emergency; hospital; patients; sats; score; south; time; triage cache: safpj-4597.pdf plain text: safpj-4597.txt item: #173 of 732 id: safpj-4605 author: Ogunbanjo, Gboyega A. title: COP22 – Marrakech 2016: Is the implementation of the Kyoto Protocol dead? date: 2016-12-16 words: 841 flesch: 53 summary: In late 2011, I wrote an editorial for this journal on the United Nations conference on Climate Change (COP17), which took place in Durban, South Africa titled: COP17 - Durban: Is this the funeral party for the Kyoto Protocol?1 There were arguments and counter arguments between developed and developing countries on how to deal with the problems of climate change. It concludes that climate change could also have deleterious effects on mental and occupational health, and its adverse impacts would be worsened by food insecurity, hunger and malnutrition.4 With the detrimental impact of climate change highlighted for South Africa, it is obvious that we need to be very serious about reducing the impact of climate change on health. keywords: change; climate; protocol cache: safpj-4605.pdf plain text: safpj-4605.txt item: #174 of 732 id: safpj-4607 author: Holtzhausen, Jeanette title: Urticaria and Angioedema – More than just Skin Deep! date: 2016-11-29 words: 2851 flesch: 41 summary: Cancer Risk in Patients with Chronic Urticaria: A Population-Based Cohort Study. Effect of Levothyroxine Treatment on Clinical Symptoms in Hypothyroid Patients with Chronic Urticaria and Thyroid Autoimmunity. keywords: allergy; angioedema; auto; chronic; factors; history; mast; patients; skin; urticaria cache: safpj-4607.pdf plain text: safpj-4607.txt item: #175 of 732 id: safpj-4608 author: Madiba, Sphiwe; Mokgatle, Mathildah title: Fear of stigma, beliefs, and knowledge about HIV are barriers to early access to HIV testing and disclosure for perinatally infected children and adolescents in rural communities in South Africa date: 2017-10-31 words: 5967 flesch: 57 summary: The mean age at disclosure is consistent with an earlier study conducted in South Africa.24 Findings from other studies had suggested that low levels of disclosure are the result of caregivers disclosing to older children as they believed that they can understand an HIV diagnosis.19,21,25 Table 3: Disclosure status of children and caregiver reasons for disclosure Variables Frequency Percentage Disclosure status (n = 405) Disclosed 111 27.4 Not disclosed 294 72.6 Age at HIV disclosure (n = 100) 5–9 years 39 39.0 10–16 years 61 61.0 Person who disclosed HIV status to child (n = 100) Parents 31 31 Healthcare workers 27 27 Other relatives 42 42 Caregivers’ reasons for disclosure (n = 74) To improve adherence to treatment 26 35.1 To prevent infecting others 3 4.0 The child was asking questions about taking medication 9 12.2 Literature shows that HIV disclosure for a number of children is Table 5: Multivariate logistic regression of HIV disclosure to child Factor Odds ratio Std. keywords: age; art; caregivers; children; disclosure; health; hiv; south; status; study; years cache: safpj-4608.pdf plain text: safpj-4608.txt item: #176 of 732 id: safpj-4609 author: Truter, I. title: Prescribing of meprobamate-containing combination analgesics in South Africa date: 2016-12-16 words: 4616 flesch: 48 summary: Twenty-two trade names of meprobamate- containing analgesics were prescribed. Due to the lack of recent literature on the prescribing patterns of combination analgesics containing meprobamate and in the light of its possible higher re-scheduling, this study was conducted. keywords: analgesics; combination; meprobamate; patients; prescribing; prescriptions; south; study cache: safpj-4609.pdf plain text: safpj-4609.txt item: #177 of 732 id: safpj-4610 author: Sirsawy, U.; Steinberg, W. J.; Raubenheimer, J. E. title: Levels of burnout among registrars and medical officers working at Bloemfontein public healthcare facilities in 2013 date: 2016-12-16 words: 5158 flesch: 59 summary: From this diagram it is evident that only 3.4% of the participants showed low burnout on all three subscales, while the largest combination of subscales was shown by the study to be the two most indicative of burnout: high burnout on two subscales and moderate burnout on a third (n = 43; 21.0%), and high burnout on all three (n  =  32; 15.6%). A quarter (26.3%) of the participants showed high burnout on one subscale, but not the others. keywords: burnout; doctors; high; levels; low; officers; participants; registrars; study; subscales cache: safpj-4610.pdf plain text: safpj-4610.txt item: #178 of 732 id: safpj-4612 author: Ogundokun, Akinjide O.; Abioye-Kuteyi, Emmanuel A.; Bello, Ibrahim S.; Oyegbade, Olanrewaju O.; Olowookere, Samuel A.; Olowookere, Akintunde J. title: Effect of family-oriented interviews on family function of young persons attending the family practice clinic in Oauthc, Ile Ife, south-western Nigeria date: 2016-12-16 words: 3433 flesch: 55 summary: Families characterised by conflict and aggression and by relationships that are cold, unsupportive and neglectful place children at risk for a wide variety of emotional and behavioural problems and health-risk behaviours.6 As regards family interview, the most commonly used of the methods is the family-oriented interview.7 Family-oriented interview assesses the family of a patient who presents for consultation, through the patient. Young people desire confidentiality and trust from the physician in order to fully express their worries, therefore the family-oriented interview serves as an apt method of family interview. keywords: apgar; families; family; function; interview; persons; relationship; respondents; study cache: safpj-4612.pdf plain text: safpj-4612.txt item: #179 of 732 id: safpj-4614 author: Govender, Trishka; Reddy, P; Ghuman, S title: Obstetric outcomes and antenatal access among adolescent pregnancies in Kwazulu-Natal, South Africa date: 2018-03-17 words: 5923 flesch: 56 summary: The interview schedule included exploratory questions regarding the following: perception of pregnancy, experiences of ANC visits, and access and personal factors affecting ANC attendance. None of the other outcomes tested showed any significant association with age, HIV status, ANC attendance or number of ANC visits. keywords: access; adolescents; age; anc; booking; health; hiv; late; pregnancy; south; study; visits cache: safpj-4614.pdf plain text: safpj-4614.txt item: #180 of 732 id: safpj-4621 author: Aladeniyi, Isaac; Adeniyi, Oladele Vincent; Fawole, Olufunmilayo; Adeolu, Mary; Goon, Daniel Ter; Ajayi, Anthony Idowu; Owolabi, Eyitayo O title: Pattern and correlates of obesity among public service workers in Ondo State, Nigeria: a cross-sectional study date: 2017-12-05 words: 5035 flesch: 53 summary: The Author(s) RESEARCH South African Family Practice 2017; 59(6):195–200 https://doi.org/10.1080/20786190.2017.1333784 Open Access article distributed under the terms of the Creative Commons License [CC BY-NC 3.0] http://creativecommons.org/licenses/by-nc/3.0 Pattern and correlates of obesity among public service workers in Ondo State, Nigeria: a cross-sectional study Isaac Aladeniyia, Oladele Vincent Adeniyib*  , Olufunmilayo Fawolec, Mary Adeolud  , Daniel Ter Goone, Anthony Idowu Ajayif  and Eyitayo Omolara Owolabie a Department of Epidemiology and Medical Statistics, University of Ibadan, Ibadan, Nigeria bDepartment of Family Medicine, Cecilia Makiwane Hospital, Walter Sisulu University, East London, South Africa c Department of Epidemiology and Medical Statistics, University of Ibadan, Ibadan, Nigeria d Nigeria State Health Investment Project, Akure, Nigeria e Department of Health Sciences, University of Fort Hare, East London, South Africa f Department of Sociology, University of Fort Hare, East London, South Africa *Corresponding author, emails: vincoladele@gmail.com, vincent.adeniyi@echealth.gov.za Background: Obesity is the third leading cause of mortality and has become a global epidemic. Adebayo RA, Balogun MO, Adedoyin RA, et al. Prevalence and pattern of overweight and obesity in three rural communities in southwest Nigeria. keywords: alcohol; diabetes; education; health; level; nigeria; obesity; overweight; participants; prevalence; service; state; study; workers cache: safpj-4621.pdf plain text: safpj-4621.txt item: #181 of 732 id: safpj-4622 author: Ellis, Chris title: House Calls date: 2017-01-09 words: 843 flesch: 76 summary: PERIPHERALIA The page number in the footer is not for bibliographic referencingwww.tandfonline.com/ojfp 56 I have always enjoyed doing house calls and in some cases consider it part of the general practice care of patients. I have twice been bitten by dogs on house calls, both times on the ankles by small black dogs, and I have had a couple of near misses with larger dogs, so I always carry my doctor’s bag in front of my testicles until I get inside the house. keywords: calls; house cache: safpj-4622.pdf plain text: safpj-4622.txt item: #182 of 732 id: safpj-4625 author: Osuch, Elzbieta; Marais, Andre title: The pharmacological management of depression – Update 2017 date: 2017-03-06 words: 7280 flesch: 47 summary: Consider use in paediatric patients not responding to SSRIs or when contraindicated Clomidep® 10 mg R156.22 (50) Equinorm® 10 mg 25 mg R283.95 (100) R337.22 (100) Dothiepin Thaden® 25 mg 75 mg R140.31 (100) R128.26 (28) Initial dose of 25-50 mg Increase in 25 mg increments max 150 mg/day Additional indication in anxiety disorders Trimipramine Tydamine® 25 mg 50 mg R206.89 (50) R198.99 (30) Initial dose of 25-50 mg Increase in 25 mg increments max 300 mg/day Pronounced anticholinergic effects and most sedating TCA Monoamine Oxidase Inhibitors (MAOs) Moclobemide Depnil® 150 mg 300 mg R306.39 (60) R392.12 (60) Initial dose of 300 mg/ day. Maximum of 375 mg/ day Use with caution in cardiac disease Less sexual dysfunction than SSRIs Third line use in paediatric patients not responding to 1st or 2nd line SSRI Highest incidence of discontinuation syndrome Efexor XR® 75 mg 150 mg R392.17 (30 R770.63 (30) Illovex SR® 37.5 mg 75 mg 150 mg R121.09 (30) R192.60 (30) R385.20 (30) keywords: antidepressants; anxiety; cause; depression; disorder; dose; effects; increase; inhibitors; patients; psychiatry; reuptake; serotonin; south; ssris; symptoms; treatment; use cache: safpj-4625.pdf plain text: safpj-4625.txt item: #183 of 732 id: safpj-4629 author: Sinclair, Werner title: Guidelines for the management of Acne Vulgaris date: 2017-03-06 words: 3163 flesch: 44 summary: Grade 2: Method of choice: Topical retinoids plus antimicrobial preparations: - For superficial papules: Topical adapalene/benzoyl peroxide (BPO) combination product Alternatives: Topical retinoid at night, topical benzoyl peroxide in the morning; topical retinoid at night plus clindamycin/benzoyl peroxide combination product in the morning. Main pathogenetic factors in acne and corresponding treatments Pathogenetic Factor Relevant Medication Androgen stimulation of sebaceous glands Cyproterone acetate; Drosperinone Hypersecretion of sebum Oral Isotretinoin Hyperkeratosis and occlusion of the duct that drains sebum into the hair follicle Topical retinoids The formation of the invisible microcomedo Topical retinoids Inflammatory mediators (Interleukin 1, etc.) released after stimulation of toll-like receptor 2 by Propionibacterium acnes Topical retinoids; oral isotretinoin Neutrophilic response to rupture of comedones and inflammation induced by free fatty acids in sebum Oral cyclines; oral and topical dapsone; oral macrolides Proliferation of P. acnes Oral cyclines; oral macrolides; topical benzoyl peroxide Inflammatory tissue damage by matrix metalloproteinases Oral cyclines Guidelines for the Management of Acne Vulgaris 25 The page number in the footer is not for bibliographic referencingwww.tandfonline.com/oemd 25 • Progesterone containing contraceptives like intramuscular medroxyprogesterone acetate or norethisterone enanthate • Implantable progesterone (etonogestrel) pellets • Progesterone (levonorgestrel) releasing intra-uterine devices • Combination oral contraceptives that contain levonorgestrel as progestogen • Oral and topical corticosteroids • Anabolic steroids • Vitamin B12 (especially the high dose, intramuscular products) • Lithium • Diphenylhydantoin Other factors that worsen acne are mostly related to overhydrating the skin with (unnecessary) oily moisturising creams and masks. keywords: acne; comedones; guidelines; isotretinoin; retinoids; treatment; use; vulgaris cache: safpj-4629.pdf plain text: safpj-4629.txt item: #184 of 732 id: safpj-4630 author: von Pressentin, Klaus B; Naidoo, Mergan; Mabuza, Langalibalele Honey title: Mastering your fellowship (Online) date: 2017-01-17 words: 3709 flesch: 53 summary: The MCQs will be based on the ten clinical domains of family medicine, the MEQs will be aligned with the five national unit standards and the critical reading section will include evidence-based medicine and primary care research methods. Long answer: This condition occurs commonly in primary care and is often misdiagnosed as urticaria or tinea corporis. keywords: authors; care; family; health; marks; medicine; pregnancy; primary; south; study cache: safpj-4630.pdf plain text: safpj-4630.txt item: #185 of 732 id: safpj-4634 author: Govender, Romona Devi; Gathiram, Prem; Panajatovic, Miljenko title: Poor control and management of type 2 diabetes mellitus at an under-resourced South African Hospital: is it a case of clinical inertia? date: 2017-10-31 words: 5765 flesch: 59 summary: Diet and exercise 0 Diet only 0 OHD monotherapy 7.7 OHD dual therapy (metformin with sulphonylureas) 20.7 Insulin alone 18.1 OHD monotherapy with insulin 38.8 Dual OHD therapy with insulin 14.7 Table 5: Systolic and diastolic blood pressures, number (%) of patients with and number treated for hypertension, and number (%) systolic and diastolic pressures controlled and number (%) of patients with other co- morbid conditions Parameter Visit 1 Visit 2 Systolic BP (mmHg): mean ± SD 146.1 ± 22.4 142.5 ± 22.3 Diastolic BP (mmHg): mean ± SD 82.7 ± 12.6 80.1 ± 11.5 Number (%) of patients with hypertension 81 (98.8%) 81 (98.8%) Number (%) of patients treated for hypertension 69 (85.2%) 69 (85.2%) Systolic pressure: number (%) controlled 23 (33.3%) 28 (40.6%) This study was a one-year retrospective chart review with data collected during the period October 2010 to December 2010 of patients with Type 2 diabetes mellitus (T2DM) who attended the outpatients’ department at the Port Shepstone Regional Hospital (PSRH), South Africa (SA). keywords: africa; diabetes; guidelines; hba1c; level; management; patients; south; study; treatment; visit cache: safpj-4634.pdf plain text: safpj-4634.txt item: #186 of 732 id: safpj-4636 author: Lamprecht, Johan C; Ellis, Suria; Snyman, Jacques Rene; Laurens, Ilze title: The effects of an artificially enhanced clinoptilolite in patients with irritable bowel syndrome date: 2017-02-13 words: 4239 flesch: 51 summary: Other gut symptoms that were reported among IBS patients were heartburn, nausea, vomiting and early satiety.5 The objective of this trial was to explore the possibility of Absorbatox®, a potentiated clinoptilolite (mineral device) with unique adsorptive and absorption properties as treatment for IBS. The high placebo response seen in IBS patients enrolled in trials is also bothersome. keywords: absorbatox; bowel; clinoptilolite; ibs; participants; patients; placebo; responders; study; symptoms; syndrome; treatment; trial cache: safpj-4636.pdf plain text: safpj-4636.txt item: #187 of 732 id: safpj-4637 author: Razak, Adil; Isaacs, Abdul Aziez title: Implementation and evaluation of a weight-reduction programme for diabetic patients at a primary health care facility in the Western Cape: a pilot study date: 2017-12-05 words: 4453 flesch: 57 summary: A systematic review and meta-analysis of clinical trials of the effects of low carbohydrate diets (LCD) on cardiovascular risk factors was published in 2012.11 It reviewed a total of 23 reports corresponding to 17 clinical investigations. The literature does not support any significant dangers of an Table 1: Comparison of indicators for the diets at baseline (week 0) and after 12 weeks Low carbohydrate diet (LC) Low fat diet (LF) W 0 Mean W 12 Mean Mean change W 0 SD W 12 SD p-value keywords: carbohydrate; diabetes; diet; fat; group; loss; patients; protein; results; study; weight cache: safpj-4637.pdf plain text: safpj-4637.txt item: #188 of 732 id: safpj-4643 author: Sodipo, Oluwajimi Olanrewaju; Adedokun, Ayoade; Olusola, Adedeji Adejumo title: Effect of self-monitoring of blood glucose on glycaemic outcome among type 2 diabetic patients date: 2017-12-05 words: 4586 flesch: 57 summary: The participants in the intervention group (SMBG group) checked their blood glucose before and after meals (pre- and post-prandial) 3  days a week for 12 weeks in the following ‘structured’ manner: (a) Day 1: Breakfast (pre- and 2 hours post-prandial); (b) Day 2: Afternoon (pre- and 2 hours post-prandial); (c) Day 3: Night (pre- and 2 hours post-prandial). There was a significant improvement in HbA1c and FBG of the non-SMBG and SMBG groups, with no difference in glycaemic control between the two groups at the end of the study. keywords: blood; control; diabetes; glucose; group; monitoring; patients; smbg; study; type cache: safpj-4643.pdf plain text: safpj-4643.txt item: #189 of 732 id: safpj-4644 author: Ellis, Chris title: Garden therapy date: 2017-02-16 words: 806 flesch: 67 summary: This is known as “bright eyes” therapy used by occupational health workers to aid in connecting with patients with intermediate and advanced dementia. During medieval times, monasteries and hospitals had physic and medicinal gardens in which they grew curative herbs, and in more recent years there has been an upsurge in these sensory gardens. keywords: garden; patients; people cache: safpj-4644.pdf plain text: safpj-4644.txt item: #190 of 732 id: safpj-4650 author: Ogunbanjo, Gboyega A title: Mental Health and Society’s Perceptions date: 2017-03-06 words: 776 flesch: 48 summary: In addition to the health and social costs, those suffering from mental illnesses are also victims of human rights violations, stigma and discrimination, both inside and outside psychiatric institutions.1 In 2007, the South African National Department of Health and WHO in a joint report indicated that, “mental illness was very prevalent in South Africa, yet the country lacked many of the necessary resources and policies needed to execute an effective mental health strategy”.2 The report did not provide information on the prevalence of mental illness. WHO defines mental health as the promotion of well-being, prevention of mental disorders, and treatment as well as the rehabilitation of people affected by mental disorders. keywords: africa; disorders; health cache: safpj-4650.pdf plain text: safpj-4650.txt item: #191 of 732 id: safpj-4653 author: Steenkamp, L; Truter, I; Williams, M; Goosen, A; Oxley, I; van Tonder, E; Kock, S; Venter, D J L title: Nutritional status and metabolic risk in HIV-infected university students: challenges in their monitoring and management date: 2017-03-06 words: 4663 flesch: 48 summary: Overweight persons with HIV infection are more at risk of developing metabolic and body composition abnormalities such as lipodystrophy, and this observation was confirmed by the results found among this sample of HIV-infected students. Obtaining a balance between a healthy weight and high dietary quality among HIV-infected youth may be a challenge because diet quality is often poor among adolescents and young adults who have HIV infection. keywords: art; bmi; cell; health; hiv; nutritional; risk; south; status; students; university cache: safpj-4653.pdf plain text: safpj-4653.txt item: #192 of 732 id: safpj-4654 author: Bac, M; Hamm, J M A; van Bodegraven, P C; Pater, B; Louw, J M title: A new health care profession in rural district hospitals: a case study of the introduction of Clinical Associates in Shongwe hospital date: 2017-03-06 words: 3517 flesch: 53 summary: Received: 05-07-2016 Accepted: 26-09-2016 the availability of more Clinical Associates such a situation may be significantly improved by converting 3 vacant medical officer posts to appoint 9 Clinical Associates to have 13 clinicians available to serve patients without an increase in total HR cost. A new health care profession in rural district hospitals: a case study of the introduction of Clinical Associates in Shongwe hospital South African Family Practice is co-published by Medpharm Publications, keywords: associates; clinical; health; hospital; shongwe; study; year cache: safpj-4654.pdf plain text: safpj-4654.txt item: #193 of 732 id: safpj-4655 author: De Klerk, C; Du Plessis, G; Fourie, J J; O'Neill, A; Smit, S J A; Joubert, G title: The eventual outcome of patients who had lower limb amputations due to peripheral vascular disease at Pelonomi Hospital, Bloemfontein date: 2017-03-06 words: 2530 flesch: 53 summary: The eventual outcome of patients who had lower limb amputations due to peripheral vascular disease at Pelonomi Hospital, Bloemfontein South African Family Practice is co-published by Medpharm Publications, The eventual outcome of patients who had lower limb amputations due to peripheral vascular disease at Pelonomi Hospital, Bloemfontein C De Klerka  , G Du Plessisa, JJ Fouriea, A O’Neilla  , SJA Smitb and G Joubertc*  a School of Medicine, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa b Department of Surgery, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa c Department of Biostatistics, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa *Corresponding author, Email: gnbsgj@ufs.ac.za Background: Peripheral vascular disease (PVD) presenting with irreversible lower limb pathology has a high morbidity and mortality rate. keywords: amputation; limb; mortality; patients; study; years cache: safpj-4655.pdf plain text: safpj-4655.txt item: #194 of 732 id: safpj-4656 author: Thandar, Yasmeen; Botha, Julia; Sartorius, Benn; Mosam, Anisa title: Knowledge, attitude and practices of South African healthcare professionals towards complementary and alternative medicine use for atopic eczema – a descriptive survey date: 2017-03-06 words: 5813 flesch: 49 summary: Although most reported not being confident in discussing CAM therapies with their patients, the majority reported that they always believe that HCPs treating patients for AE should regularly ask about CAM use. Patients whose physicians are knowledgeable about CAM practices, in addition to conventional medicine, have better clinical outcomes (p < 0.001) Dermatologists (n = 26) 23% 12% 62% Paediatricians (n = 40) 20% 25% 55% General practitioners (n = 182) 52% 12% 37% Pharmacists (n = 82) 59% 7% 34% 6. keywords: cam; dermatologists; gps; hcps; knowledge; n =; paediatricians; patients; pharmacists; practitioners cache: safpj-4656.pdf plain text: safpj-4656.txt item: #195 of 732 id: safpj-4657 author: Ngubane, Magugu; Chetty, Verusia title: Caregiver satisfaction with a multidisciplinary community-based rehabilitation programme for children with cerebral palsy in South Africa date: 2017-03-06 words: 5004 flesch: 50 summary: Furthermore, satisfaction with rehabilitation intervention is an imperative outcome that is believed to influence the emotional well-being of carers and impacts on a child’s psychology.11 Scarcity in caregiver satisfaction and perception of rehabilitation is evident in resource-poor settings such as South Africa, thus this study is crucial in informing research for rehabilitation professionals involved in the management of children with CP. Caregiver satisfaction with a multidisciplinary community-based rehabilitation programme for children with cerebral palsy in South Africa South African Family Practice is co-published by Medpharm Publications, keywords: caregivers; children; community; intervention; palsy; programme; rehabilitation; satisfaction; south; study cache: safpj-4657.pdf plain text: safpj-4657.txt item: #196 of 732 id: safpj-4658 author: Brits, H; Botha, A; Niksch, L; Terblanché, R; Venter, K; Joubert, G title: Illegible handwriting and other prescription errors on prescriptions at National District Hospital, Bloemfontein date: 2017-03-06 words: 3154 flesch: 58 summary: Identification and quantification of prescription errors. Illegible handwriting and other prescription errors on prescriptions at National District Hospital, Bloemfontein South African Family Practice is co-published by Medpharm Publications, keywords: data; doctors; errors; handwriting; illegible; prescriptions; study cache: safpj-4658.pdf plain text: safpj-4658.txt item: #197 of 732 id: safpj-4659 author: von Pressentin, Klaus B; Naidoo, Mergan; Mabuza, Langalibalele Honey title: Mastering your fellowship (Online) date: 2017-03-06 words: 4462 flesch: 58 summary: Involve her in deciding which family members should attend. The genogram in Figure 1 provides a pictorial representation of the three generations of family. keywords: care; conference; examination; family; marks; medicine; pain; patient; question; school; study cache: safpj-4659.pdf plain text: safpj-4659.txt item: #198 of 732 id: safpj-4661 author: Schellack, Natalie; Schellack, Gustav; Bezuidenhout, Selente; Malan, Lucille; de Klerk, Hanneke title: Glaucoma: a brief update for 2017 date: 2017-12-05 words: 5202 flesch: 48 summary: Medicines may worsen pre-existing glaucoma or induce glaucoma based on their mechanisms of action, and patients’ predisposition. General differences in the clinical presentation of glaucoma are depicted in Figure 1. Risk factors for developing glaucoma A number of risk factors are known to be associated with glaucoma, and include the following:20-23 • Pre-existing raised intra-ocular pressure • The risk for angle-closure glaucoma increases after the age of 40, and the general risk for glaucoma increases after the age of 60 years • A family history of glaucoma, especially seen in patients diagnosed with juvenile open-angle glaucoma • Other co-morbid conditions, including diabetes mellitus, hypertension and hyperthyroidism • Pre-existing ocular conditions, including eye tumours, retinal detachment or lens dislocation. keywords: agents; angle; carbonic; ciliary; eye; february; glaucoma; humour; iop; patients; pressure; risk; treatment cache: safpj-4661.pdf plain text: safpj-4661.txt item: #199 of 732 id: safpj-4662 author: Bronkhorst, Elmien; Motubatse, Jean title: Bipolar disorder: an overview date: 2017-05-11 words: 3673 flesch: 35 summary: Hadaeghi F, Golpayegani M, Jafari S, Murray G. Toward a complex system understanding of bipolar disorder: a chaotic model of abnormal circadian activity rhythms in euthymic bipolar disorder. The Author(s) REVIEW Introduction Major depressive episodes are a prominent symptom in both bipolar disorders (BD) and major depressive disorder (MDD), which is the reason that up to 69% of patients with BD are misdiagnosed.1 Bipolar disorder (BD), previously known as manic-depressive disorder, is a chronic disorder characterised by abnormal mood changes and fluctuation in energy levels.2 keywords: bipolar; depressive; disorder; episodes; lithium; mania; patients; phase; treatment cache: safpj-4662.pdf plain text: safpj-4662.txt item: #200 of 732 id: safpj-4668 author: Umeh, Andrew Ekene; Nkombua, Lushiku title: A study of the knowledge and practice of lifestyle modification in patients with type 2 diabetes mellitus in Middelburg sub-district of Mpumalanga date: 2018-03-17 words: 3385 flesch: 44 summary: A total of 60% had a good knowledge of lifestyle modification recommendations. A study of the knowledge and practice of lifestyle modification in patients with type 2 diabetes mellitus in Middelburg sub-district of Mpumalanga South African Family Practice is co-published by Medpharm Publications, NISC (Pty) Ltd and Informa UK Limited keywords: control; diabetes; exercise; glycaemic; lifestyle; mellitus; participants; study cache: safpj-4668.pdf plain text: safpj-4668.txt item: #201 of 732 id: safpj-4669 author: Marais, André; Osuch, Elzbieta title: The medical management of glaucoma date: 2017-05-11 words: 4488 flesch: 46 summary: Difference between open angle glaucoma and closed angle glaucoma in relation to the drainage systems within the anterior chamber of the eye. Open angle glaucoma is the highest in Africa (4.2%), while closed angle glaucoma is more prevalent in Asia (1.09%).4 Pathophysiology of glaucoma Aqueous humour (a transparent, low protein containing fluid) is continuously secreted by the ciliary epithelium providing structural support to the lens. keywords: agents; angle; closure; drop; eye; glaucoma; iop; management; ocular; ophthalmology; timolol; treatment cache: safpj-4669.pdf plain text: safpj-4669.txt item: #202 of 732 id: safpj-4672 author: Ellis, Chris title: Ethical issues with cognitive enhancement date: 2017-03-28 words: 861 flesch: 57 summary: In recent years, stimulant medications have increasingly been prescribed and used to improve academic performance in normal students (called cognitive enhancement). PERIPHERALIA The page number in the footer is not for bibliographic referencingwww.tandfonline.com/ojfp 59 Over the last few years I have had a small but steady number of normal students asking for stimulants such as methylphenidate (Ritalin, Concerta) to help them with their studying and exams. keywords: methylphenidate; stimulants cache: safpj-4672.pdf plain text: safpj-4672.txt item: #203 of 732 id: safpj-4675 author: Van Graan, Rentia; Viljoen, Michelle; Rheeders, Malie; Motara, Fadeela title: Retrospective clinical analysis of adverse drug reactions associated with antiretroviral therapy in Tlokwe district, South Africa date: 2018-03-17 words: 4972 flesch: 46 summary: Table 1: Patient demographics recorded for reported ADRs during 2010–2014 Notes: ADRs: adverse drug reactions; ARVs: antiretrovirals; HCP: healthcare professional. Age not specified, n (%) 1 (0.1) Number of reported ADRs per facility, n (%) keywords: adrs; africa; distribution; drug; hiv; neuropathy; patients; pharmacovigilance; reactions; south; study cache: safpj-4675.pdf plain text: safpj-4675.txt item: #204 of 732 id: safpj-4679 author: Ogunbanjo, Gboyega A title: Multi-drug-resistant tuberculosis (MDR-TB): Current situation in South Africa date: 2017-05-11 words: 707 flesch: 53 summary: a. Poor patient adherence to complete the full course of TB treatment b. Healthcare providers prescribing the wrong treatment, wrong dose, or length of time for TB drugs c. Inadequate monitoring of patients while on their anti-TB drugs (DOTS) d. Globally, MDR-TB caused an estimated 480 000 new TB cases and 250 000 deaths in 2015 and accounted for 3.3% of all new TB cases worldwide.1 MDR-TB, or rifampicin-resistant TB, causes 3.9% of new TB cases and 21% of previously treated TB cases, and most MDR-TB cases occur in South America, southern Africa, India, China, and the former Soviet Union.1 A South African Health Systems Trust report indicated that despite a global slowing down in new TB cases since 2003, South Africa recorded the world’s second-highest rate of new cases in 2006 after Swaziland. keywords: mdr cache: safpj-4679.pdf plain text: safpj-4679.txt item: #205 of 732 id: safpj-4680 author: Fouche, Lamaine; Bezuidenhout, Johan; Liebenberg, Chantelle; Adefuye, Anthonio Oladele title: Medico-legal documentation of rape or sexual assault: are community-service doctors equipped for the task? date: 2018-03-17 words: 4211 flesch: 47 summary: The frequencies on the questionnaire were 1–5 cases (37.1%, n = 13), 5–10 cases (17.1%, n = 6), 10–20 cases (20.1%, n = 7) and 20 cases or more (25.7%, n = 9). History-taking Analysis of data obtained by this study shows that only 82.9% (n  =  29) of the participants who had encounters with rape or sexual assault case/cases during their community service year recorded detailed histories (Yes, always) of the alleged rape or sexual assault, while 17.1% (n = 6) occasionally (Yes, sometimes) did so (Table 2). Undergraduate training for management of rape or sexual assault A survey on whether participants in this study had undergone any form of undergraduate training on managing patients who had been raped or sexually assaulted showed that the majority (80%, n  =  28) of the participants had undergone some undergraduate training on managing rape or sexual assault cases. keywords: assault; community; participants; rape; service; south cache: safpj-4680.pdf plain text: safpj-4680.txt item: #206 of 732 id: safpj-4683 author: Naidoo, Mergan; Mabuza, Langalibalele Honey; Ross, Andrew title: Mastering your fellowship date: 2017-07-10 words: 3100 flesch: 56 summary: In order for a study to truly address the research question, the target population – the population from which the study population is drawn and to which study results are believed to apply – should be carefully defined. In a case control study, investigators must identify the case-control study populations by location (presenting to CWCs at study site with their caregivers), time period (March – July 2015), and inclusion criteria for cases (individuals with malnutrition defined as below a -2 z-score) and controls (individuals without malnutrition defined as those with a z-score above -2). keywords: answer; care; control; family; malnutrition; marks; patients; study cache: safpj-4683.pdf plain text: safpj-4683.txt item: #207 of 732 id: safpj-4684 author: Outhoff, Kim title: Grommets - an update on common indications for tympanostomy tube placement date: 2017-07-10 words: 2219 flesch: 40 summary: It is strongly recommended that pneumatic otoscopy be used to assess OME in children with otalgia, hearing loss or both.5 OME mostly occurs after acute otitis media (AOM) with a prevalence of 70% at 2 weeks, 40% at 1 month, 20% at 2 months and 10% at 3 months post infection.6 OME may also occur with eustachian tube obstruction in the absence of AOM.4 A recent meta-analysis suggests that allergic rhinitis and allergy may be risk factors for OME.7 There is strong evidence against the insertion of tympanostomy tubes in children experiencing a single episode of OME of less than 3 months’ duration because of the likelihood of spontaneous resolution in this instance as well as the risks associated with unnecessary surgery.3,6 Rather, watchful waiting for 3 months following the onset of effusion/ diagnosis is strongly recommended.5 Early surgical referral is, however, indicated for children who are at risk for developmental delays where hearing is critical for their speech, language and learning development, irrespective of the duration of OME.8 Hearing loss related to OME averages 18–35 dB.9 Risk factors for developmental difficulties include permanent hearing loss independent of OME, suspected or confirmed speech and language delay, autism and other pervasive developmental disorders, syndromes or cranio-facial disorders that include cognitive, speech or language delays, blindness, cleft palate or any other cause of developmental delay.3,4 Chronic otitis media with effusion (OME) In chronic OME sufferers, the benefits of tympanostomy tube include a 30% reduction of middle ear effusion (MEE) with an associated 5 to 12 dB improvement in hearing in the first 6 to 9 months after tube insertion.10 Although quality of life improvements for both the child and the caregiver are considerable,2 there is little evidence that optimised auditory access has a significant impact on speech, language or cognitive outcomes in children not at risk for developmental delays.3 keywords: children; hearing; media; ome; otitis; tube; tympanostomy cache: safpj-4684.pdf plain text: safpj-4684.txt item: #208 of 732 id: safpj-4686 author: Siko, Peter Rapula; van Deventer, Claire title: Compliance with standard treatment guidelines in the management of hypertension: a review of practice of healthcare workers in Potchefstroom, North West Province, South Africa date: 2017-05-11 words: 4746 flesch: 50 summary: Conclusions: As the adherence to hypertension guidelines in primary care by healthcare workers in general is suboptimal, continuous professional development in terms of diagnosis, drug and non-drug management is essential. Given the disturbing statistics associated with NCDs, which include hypertension as the main disease and that several community- based surveys in South Africa have found that hypertension is usually inadequately diagnosed and poorly treated,18,19 it was decided to assess whether HCWs in the Potchefstroom sub-district North West province (SA) comply with the STGs in the diagnosis and management of hypertensive patients. keywords: blood; compliance; diagnosis; drug; guidelines; health; hypertension; management; patients; pressure; south; study cache: safpj-4686.pdf plain text: safpj-4686.txt item: #209 of 732 id: safpj-4687 author: Malan, L; Labuschagne, Q; Schellack, N; Schellack, G; Meyer, J C title: Gastro-oesophageal reflux: an overview of the pharmacotherapeutic treatment options date: 2017-07-10 words: 3018 flesch: 44 summary: It has been shown that the PPIs are more effective than the H2RAs in managing GORD, and are also superior to placebo in patients with GORD symptoms. However, care should be taken with these agents, since calcium carbonate may interfere with normal acid-base balance and cause metabolic alkalosis, or it may elicit rebound gastric acid secretion, making it suitable for short-term use only. keywords: acid; agents; gastric; gastro; gord; oesophageal; reflux; stomach; treatment cache: safpj-4687.pdf plain text: safpj-4687.txt item: #210 of 732 id: safpj-4688 author: Muntingh, George L; Viljoen, M title: Anaemia - a pale ale? date: 2017-07-10 words: 4151 flesch: 53 summary: Furthermore, anaemia prevalence remains unacceptably high in the poorest regions of the world.1 Anaemia is also one of the most frequent haematological complications seen in people with human immuno-deficiency virus (HIV) and acquired immuno-deficiency syndrome (AIDS).6,7Among HIV infected individuals, the prevalence of anaemia at initiation of antiretroviral therapy (ART) is reported to range between 20–90% in different clinical settings.8-10 Anaemia in HIV infected individuals has multifactorial aetiologies which complicate its differential diagnosis and treatment. A FBC often reveals iron deficiency anaemia that is a consequence of heavy menstrual bleeding. keywords: anaemia; b12; blood; children; deficiency; health; hiv; iron; number; patients; prevalence; rbcs; vitamin; women cache: safpj-4688.pdf plain text: safpj-4688.txt item: #211 of 732 id: safpj-4689 author: Marais, André; Osuch, Elzbieta title: Common cutaneous dermatophyte infections of the skin and nails date: 2017-07-10 words: 5155 flesch: 49 summary: The Author(s) REVIEW Introduction It is estimated that 10 – 20% of the global population is affected by fungal skin infections (mycosis) at any given time.1 The lifetime incidence of contracting a superficial fungal disease is nearly 70%, rendering it one of the most contagious and prevalent disease groups encountered in the healthcare system. A cure rate of between 38% and 46% can be expected if nail involvement is less than 80%.26 Clinical pharmacology of available antifungal agents in South Africa Various pharmacological agents, some briefly described above, are available in the treatment of Tinea infections. keywords: agents; antifungal; capitis; dermatophyte; fungal; infections; microsporum; nail; skin; therapy; tinea; topical; treatment; trichophyton; weeks cache: safpj-4689.pdf plain text: safpj-4689.txt item: #212 of 732 id: safpj-4690 author: Mogole, Omphile; Kandiwa, Ralph; Babarinde, Oyetola; Ismail, Halima; Dlamini, Nokuthula; Maluleke, Letlhogonolo; Labuschagne, Quinten; Malan, Lucille; Schellack, Natalie title: Muscle pain date: 2017-07-10 words: 5534 flesch: 53 summary: Pharmacological management, depending on the severity of muscle pain, may include OTC medicines such as aspirin, ibuprofen and/or paracetamol or prescription medicine such as other NSAIDs (diclofenac, naproxen, mefenamic acid etc) or  opioids  for moderate to severe muscle pain.  • Causes of muscle pain include stress, physical activity, infections, hyper or hypo-thyrodism. keywords: acute; analgesics; chronic; effects; ibuprofen; management; muscle; muscle pain; nsaids; opioid; pain; paracetamol; tablets; treatment; use cache: safpj-4690.pdf plain text: safpj-4690.txt item: #213 of 732 id: safpj-4691 author: Malan, Lucille; Dlamini, Nokuthula title: Clinical practice guidelines for insomnia disorder date: 2017-07-10 words: 5447 flesch: 44 summary: However, many individuals are affected with sleep disorders. Research has shown that CBT was effective in treating the general population of adults, as well as elderly patients with chronic insomnia disorder. keywords: activity; benzodiazepines; cbt; chronic; cognitive; daytime; disorder; effects; insomnia; patients; psychiatric; receptor; sleep; symptoms; therapy; treatment; use cache: safpj-4691.pdf plain text: safpj-4691.txt item: #214 of 732 id: safpj-4693 author: Ellis, Chris title: “I’ve got a long list for you today, doctor” date: 2017-11-06 words: 731 flesch: 69 summary: Yet another form of list seems to have arrived on my desk recently because someone has been selling my patients home blood pressure measuring machines. Other list makers may represent busy patients in a complex informational world simply seeking what one observer stated was “clarity, order and control”. keywords: list; patient cache: safpj-4693.pdf plain text: safpj-4693.txt item: #215 of 732 id: safpj-4701 author: Ogunbanjo, Gboyega A title: The health of our educators and HIV/AIDS date: 2017-06-20 words: 833 flesch: 58 summary: Educators residing in rural areas and those working in rural schools had higher HIV prevalence than educators residing in urban areas and teaching in urban schools.1 The implication is that if nothing is done to stem the tide, the rural schools that struggle to attract teachers will be worse off as the number of educators diminish. These will include sexual behaviour- change programmes, increase in knowledge of HIV transmission, focus on rural schools with high HIV prevalence among educators, discourage migratory practices among educators and set up workplace health programmes to address the co-morbid chronic conditions. keywords: educators; hiv cache: safpj-4701.pdf plain text: safpj-4701.txt item: #216 of 732 id: safpj-4704 author: Ismail, Halima; Schellack, Natalie title: Colds and flu – an overview of the management date: 2017-07-10 words: 4359 flesch: 48 summary: (500 mg) Chlorphenamine maleate (2 mg) Vitamin C (250 mg) Symptomatic relief of colds and flu Benylin® for colds Pseudoephedrine HCl (30 mg) Ibuprofen (200 mg) Symptomatic relief of colds and flu Nurofen® Cold and Flu Ibuprofen (200 mg) Pseudoephedrine HCl (30 mg) Symptomatic relief of colds and flu Sinuclear® Paracetamol (325 mg) Phenylpropanolamine HCl (18 mg) Symptomatic relief of colds and flu Sinugesic® Paracetamol (500 mg) Pseudoephedrine HCl (30 mg) Symptomatic relief of colds and flu Sinumax® Paracetamol (500 mg) Pseudoephedrine HCl (30 mg) Symptomatic relief of colds and flu Sinustat® Paracetamol (325 mg) Phenylpropanolamine HCl (18 mg) Symptomatic relief of colds and flu Sudafed® Sinus Pain Paracetamol (500 mg) Pseudoephedrine HCl (60 mg) Symptomatic relief of colds and flu Cough preparations Mucolytic Solmucol® N-Acetylcysteine To reduce viscosity of secretions Mucatak® Amuco 200® ACC200® Betaphlem® Carbocisteine To reduce viscosity of secretions Bronchette® Flemex® Lessmusec® Mucospect® Bisolvon® Bromhexine HCl To reduce viscosity of secretions Expectorants Benylin Wet Cough Menthol® Guaifenesin Cough alleviation Cough suppressants Benylin® Dry Cough Dextromethorphan Symptomatic relief of a non-productive cough Dilinct® Dry Cough Nitepax® Noscapine Pholtex® Forte Pholcodine Pholtex Linctus® Pholcodine 15 mg/10ml Phenyltoloxamine (10 mg/10 ml) ® Whatever the reason, whatever the season S4 AVAMYS Nasal Spray (Suspension). Management of common colds and flu Pharmacotherapy is directed at alleviating associated symptoms. keywords: colds; flu; hcl; influenza; nasal; patients; relief; rhinitis; spray; symptoms; use; virus cache: safpj-4704.pdf plain text: safpj-4704.txt item: #217 of 732 id: safpj-4708 author: Naidoo, Mergan; Mabuza, Langalibalele Honey; Ross, Andrew; Schweitzer, Beverley title: Mastering your fellowship (Online) date: 2017-08-28 words: 4146 flesch: 54 summary: Participants will then discuss the video and role play consultations with parents Learning method Justification for learning method Mark 0 0.5 1 1 Outcome with regard to learning method: Inappropriate to outcome; overly passive Appropriate; active learning Appropriate; enhances higher order thinking; creative; relates to practice; stimulates further questions and thinking Justification shows understanding of adult learning or other learning theories S Afr Fam Pract 2017;59(4):41-4644 The page number in the footer is not for bibliographic referencingwww.tandfonline.com/ojfp 44 while receiving feedback from colleagues for the empathy they demonstrate. Possible learning outcomes are numerous and the marks are allocated to meet the criteria mentioned above. keywords: act; adhd; children; data; family; health; learning; medicine; outcomes; participants cache: safpj-4708.pdf plain text: safpj-4708.txt item: #218 of 732 id: safpj-4710 author: Outhoff, Kim title: Bipolar disorder: an update date: 2017-08-28 words: 2896 flesch: 40 summary: Keywords: bipolar disorder; diagnosis; evidence-based pharmacotherapy South African Family Practice 2017; 59(4):6-10 Open Access article distributed under the terms of the Creative Commons License [CC BY-NC-ND 4.0] http://creativecommons.org/licenses/by-nc-nd/4.0 Bipolar disorder: an update Kim Outhoff Senior Lecturer, Department of Pharmacology, University of Pretoria *Corresponding author, email: kim.outhoff@up.ac.za Figure 1. Collaborative genome-wide association analysis supports a role for ANK3 and CACNA1C in bipolar disorder. keywords: bipolar; depressive; disorder; evidence; lithium; mood; patients; treatment cache: safpj-4710.pdf plain text: safpj-4710.txt item: #219 of 732 id: safpj-4714 author: Knight, Stephen E; Ross, Andrew J; Mahomed, Ozayr title: Developing primary health care and public health competencies in undergraduate medical students date: 2017-07-10 words: 5630 flesch: 40 summary: Setting: This study was carried out among medical students concluding Selectives at UKZN in 2015. Conclusion: Selectives is an effective way to use a decentralised PHC learning platform to enable medical students to address some of the HPCSA graduate competencies required for health care professionals and not necessarily covered by other medical disciplines. keywords: care; community; competencies; core; health; learning; medical; phc; public; research; selectives; skills; students; years cache: safpj-4714.pdf plain text: safpj-4714.txt item: #220 of 732 id: safpj-4715 author: Mpanza, D M; Govender, P title: Rural realities in service provision for substance abuse: a qualitative study in uMkhanyakude district, KwaZulu-Natal, South Africa date: 2017-07-10 words: 5711 flesch: 46 summary: Within the DOH, substance abuse services fall within the domain of mental health programmes. Poor monitoring and evaluation of substance abuse services Concerns were raised over the monitoring and evaluation of substance abuse services, given that there are no monitoring and evaluation service standards, a paucity of rural research and limited statistics on the burden of substance abuse in rural districts. keywords: abuse; africa; care; community; district; health; manager; service; south; study; substance; substance abuse cache: safpj-4715.pdf plain text: safpj-4715.txt item: #221 of 732 id: safpj-4716 author: Mandiwana, Azhani; Tshitenge, Stephane title: Prevalence of human immunodeficiency virus — hepatitis B virus co-infection amongst adult patients in Mahalapye, Ngami, Serowe, Botswana: a descriptive cross-sectional study date: 2017-07-10 words: 3899 flesch: 50 summary: Keywords: Botswana, HBsAg screening, HIV–HBV co-infection prevalence Introduction The World Health Organization (WHO) has developed the ‘three interlinked Global Health Sector Strategies (GHSS)’ to address the three major public health issues, namely human immunodeficiency virus (HIV), viral hepatitis (VH) and sexually transmitted infections (STI); the institution aims to reduce two- thirds of new HIV infections by 2020 and to reduce 90% of new cases of chronic hepatitis by 2030.1 Worldwide, about 36.9 million people live with HIV; of these 2.6 million are co-infected with hepatitis B virus (HBV).2,3 Primary modes of the HIV–HBV co- infection transmission include sexual contact, injection drug use, mother-to-child transmission (MTCT) and men who have sex with men (MSM), with MTCT being the major mode of transmission in high prevalence regions such as sub-Saharan Africa and east Asia.3,4 Sub-Saharan Africa accounts for about 75% of the worldwide HIV cases and has about 14% of the worldwide chronic hepatitis B cases.2,5 A systematic review that covered 60 sub-Saharan Africa studies from 1990 to 2009 estimated that the HIV–HBV co- infection prevalence was 14.9%.6 In Southern Africa, a study conducted among South African and Zambian patients in 2008 reported an HIV–HBV co-infection rate of 7.4%; another study conducted amongst South African and Botswana patients in 2013 reported almost the same HIV–HBV co-infection rate of 7.0%.7,8 Two HIV–HBV co-infection studies previously conducted in tertiary health facilities in urban settings in Botswana estimated HIV–HBV co-infection prevalences of 10.6% and 5.3%.9,10 The endemicity of both HIV and HBV in sub-Saharan Africa raises the implications of this co-infection for the long-term health status of HIV-infected adult patients in Botswana, which has a high prevalence of HIV infection as well as an increasing population of patients on HAART.11 Knowledge of the HBV infection status of patients being initiated on HAART could facilitate individualised patient management as regards HAART drugs or regimen switches that are provider-initiated such as due to treatment failure. The 20–29 age group accounted for half of the HIV–HBV co-infected patients. keywords: botswana; hbv; health; hepatitis; hiv; infection; participants; patients; prevalence; study cache: safpj-4716.pdf plain text: safpj-4716.txt item: #222 of 732 id: safpj-4723 author: Wolmarans, De Wet title: Maintaining euthyroidism: fundamentals of thyroid hormone physiology, iodine metabolism and hypothyroidism date: 2017-08-28 words: 12486 flesch: 58 summary: In fact, while thyroid hormones, i.e. triiodothyronine (T3) and thyroxine (T4), play a critical role in facilitating normal growth and development, they also drive and regulate a vast number of physiological processes throughout adulthood.1 These include, among others, central nervous system (CNS) development, central and peripheral nervous system signaling, cardiac function, nutrient metabolism, hepatic metabolism, energy consumption and regulation of body temperature, water and electrolyte balance, and skeletal turnover.1 Consisting of two lobes, each approximately 2.0 x 2.5 x 4.0 cm, the thyroid weighs on average 15–20 g. Functionally, the gland consists of spherical follicles, each composed of a single layer of epithelium surrounding a colloid-containing lumen. Whereas the epithelium is responsible for the synthesis of T3 and T4, the colloid mainly consists of thyroglobulin (TG), a glycoprotein capable of storing thyroid hormone and its precursors, monoiodotyrosine (MIT) and diiodotyrosine (DIT). keywords: ce d; d o; d u; hormone; hypothyroidism; iodine; m o; n d; n e; n g; o n; o u; p o; patients; thyroid; thyroxine; ti o; tsh; u n cache: safpj-4723.pdf plain text: safpj-4723.txt item: #223 of 732 id: safpj-4726 author: Lambert, Lynn title: Diagnosing a red eye: an allergy or an infection? date: 2017-08-28 words: 2989 flesch: 31 summary: Patient evaluation Limited epidemiological data are available on red eyes, nor is there evidence-based guidance as to the management thereof. Keywords: red eye, allergy, infection, inflammation, conjunctivitis, viral, bacterial South African Family Practice 2017; 59(4):22-26 Open Access article distributed under the terms of the Creative Commons License [CC BY-NC-ND 4.0] http://creativecommons.org/licenses/by-nc-nd/4.0 Diagnosing a red eye: an allergy or an infection? L Lambert *Corresponding author, lynn@amayeza-info.co.za Diagnosing a red eye: an allergy or an infection? keywords: bacterial; common; conjunctivitis; discharge; eye; infection; red cache: safpj-4726.pdf plain text: safpj-4726.txt item: #224 of 732 id: safpj-4727 author: Ellis, Chris title: The balance between work and family date: 2017-08-08 words: 825 flesch: 78 summary: Identifying and finding “time” usually needs some difficult decisions around income and life-style requirements but there is always time for fishing. It tells the story of the father who is too busy to spend time with his son. keywords: son; time cache: safpj-4727.pdf plain text: safpj-4727.txt item: #225 of 732 id: safpj-4728 author: De Villiers, T; Davey, M; Cassim, B; De Lange, W title: Review of once-monthly oral ibandronate and the use thereof date: 2017-08-28 words: 3438 flesch: 46 summary: An ACE of 12 mg resulted in a 43% reduction in NVF risk (95% CI 0.037-1.004)15 • An ACE ≥ 10.8 mg resulted in a 38% reduction in NVF risk (95% CI 0.396-0.974)15 • An ACE ≥ 7.2 mg resulted in a non-significant NVF reduction of 25% (95% CI 0.505-1.103)15 The Kaplan-Meier plot of time to non-vertebral fracture for higher versus lower ACE ibandronate doses shows that higher doses prolong the time to non-vertebral fractures compared with lower doses.15 Review of once-monthly oral ibandronate and the use thereof 35 The page number in the footer is not for bibliographic referencingwww.tandfonline.com/oemd 35 In summary, higher doses of ibandronate significantly reduced the risk of NVFs in this pooled analysis. In a post-hoc analysis of non-vertebral fractures, efficacy was demonstrated in keywords: efficacy; fracture; ibandronate; mobile; monthly; study cache: safpj-4728.pdf plain text: safpj-4728.txt item: #226 of 732 id: safpj-4729 author: Lindeque, B G title: Dysmenorrhoea date: 2017-08-28 words: 1871 flesch: 47 summary: Primary dysmenorrhoea Most commonly encountered during adolescence and in the 20s, primary dysmenorrhoea is diagnosed on the basis of symptoms. • Dysmenorrhoea: Disruption to the woman’s lifestyle by primary dysmenorrhoea (the absence of causative pathology), secondary dysmenorrhoea (secondary to causative pathology), and membranous dysmenorrhoea (an acute single event with the passing of an endometrial cast). keywords: bleeding; dysmenorrhoea; endometriosis; pain; use; women cache: safpj-4729.pdf plain text: safpj-4729.txt item: #227 of 732 id: safpj-4730 author: Archer, Elize; Bitzer, E M; Van Heerden, B B title: Interrogating patient-centredness in undergraduate medical education using an integrated behaviour model date: 2017-12-05 words: 4751 flesch: 54 summary: Aims and objectives of the study The purpose of the study was to explore the teaching and learning experiences of undergraduate medical students with mailto:elizea@sun.ac.za http://crossmark.crossref.org/dialog/?doi=10.1080/20786190.2017.1386869&domain=pdf 220 South African Family Practice 2017; 59(6):219–223 regard to patient-centredness in order to understand what factors enhance or inhibit the development thereof. Despite some curriculum initiatives, medical students often display a lack of patient-centredness upon graduation. keywords: behaviour; centredness; curriculum; factors; learning; medical; model; patient; students; study; undergraduate cache: safpj-4730.pdf plain text: safpj-4730.txt item: #228 of 732 id: safpj-4732 author: Ogunbanjo, Gboyega A title: Social determinants of health: time for action date: 2017-08-28 words: 736 flesch: 55 summary: Promote participation in policy-making and implementation; c. Further re-orient the health sector towards promoting health and reducing health inequities; d. Strengthen global governance and collaboration; and e. Monitor progress and increase accountability. But this places too much emphasis on legislation and biomedicine as the dominant routes to improved health, without consideration of the social determinants of health and the complexity associated with the effective practical application of new laws and health services”.3 keywords: determinants; health; world cache: safpj-4732.pdf plain text: safpj-4732.txt item: #229 of 732 id: safpj-4735 author: Alaba, Oluwayemisi O; Olubusoye, Olusanya E; Olaomi, J O title: Spatial patterns and determinants of fertility levels among women of childbearing age in Nigeria date: 2017-08-28 words: 4286 flesch: 51 summary: Higher education of women of childbearing age is inversely related to high fertility level. The hotspots for high fertility in Nigeria are Kano, Yobe, Benue, Edo and Bayelsa states. keywords: africa; age; childbearing; children; data; determinants; education; fertility; levels; nigeria; patterns; women cache: safpj-4735.pdf plain text: safpj-4735.txt item: #230 of 732 id: safpj-4736 author: Van Zyl, P M; Joubert, G; Fechter, L; Griesel, j; Nel, M; Honiball, A; Serfontein, L; Diedericks, M title: Methylphenidate use among students living in junior on-campus residences of the University of the Free State date: 2017-08-28 words: 4196 flesch: 50 summary: This study aimed to determine the prevalence of methylphenidate use and co-use with alcohol among on-campus residence students of the University of the Free State (UFS). This generates concerns http://orcid.org/0000-0001-6028-3653 http://orcid.org/0000-0001-9495-4603 mailto:vzylpm@ufs.ac.za http://crossmark.crossref.org/dialog/?doi=10.1080/20786190.2017.1292695&domain=pdf 124 S Afr Fam Pract 2017; 59(4):123–127 about the safety of methylphenidate, particularly the long-term effects in healthy individuals, and the effects of co-use with alcohol in a population known for binge-drinking behaviour.12 Aim of the study The objective of this study was to determine the prevalence of methylphenidate use and co-use of methylphenidate with alcohol in students living in junior on-campus residences of the University of the Free State (UFS). keywords: adhd; alcohol; methylphenidate; residences; south; students; study; university; use; users; year cache: safpj-4736.pdf plain text: safpj-4736.txt item: #231 of 732 id: safpj-4737 author: Alabi, Adeyinka Abiodun; Adeniyi, Oladele Vincent; Adeleke, Olukayode Ademola; Pilla, Pamela; Haffajee, Mohamed Rashid title: Factors associated with failed spinal anaesthesia for Caesarean sections in Mthatha general hospital, Eastern Cape, South Africa date: 2017-08-28 words: 4405 flesch: 52 summary: The Author(s) RESEARCH South African Family Practice 2017; 59(4):128–132 https://doi.org/10.1080/20786190.2017.1292696 Open Access article distributed under the terms of the Creative Commons License [CC BY-NC 3.0] http://creativecommons.org/licenses/by-nc/3.0 Factors associated with failed spinal anaesthesia for Caesarean sections in Mthatha general hospital, Eastern Cape, South Africa Adeyinka Abiodun Alabia*, Oladele Vincent Adeniyib  , Olukayode Ademola Adelekea, Pamela Pillac and Mohamed Rashid Haffajeed a Department of Family Medicine, Walter Sisulu University, Eastern Cape, South Africa b Department of Family Medicine, Cecilia Makiwane Hospital, East London Hospital Complex, Walter Sisulu University, Eastern Cape, South Africa c School of Laboratory Medicine & Medical Sciences, Department of Anatomy, University of KwaZulu-Natal, Durban, South Africa d School of Laboratory Medicine & Medical Sciences, Department of Clinical Anatomy, University of KwaZulu-Natal, Durban, South Africa *Corresponding author, email: adeyinkaalabi@yahoo.com Background: The use of spinal anaesthesia has increased in the last three decades, given that it is the recommended anaesthetic of choice for better foetal and maternal outcomes in Caesarean section. Keywords: blocked height, bloody CSF, Caesarean section, spinal anaesthesia failure, South Africa Introduction Globally, there is an increasing Caesarean section rate, and spinal anaesthesia is the anaesthetic of choice for this operative procedure.1 In South Africa, the Caesarean section rate increased by 6.3% between 2001 and 20092 with spinal anaesthesia being the most common method of anaesthesia in district and regional hospitals in the country.3,4 Previous studies have shown the safety of this method over general anaesthesia1,5,6 but spinal anaesthesia is not without complications. keywords: anaesthesia; caesarean; doctors; fsa; hospital; incidence; section; south; spinal; study; women cache: safpj-4737.pdf plain text: safpj-4737.txt item: #232 of 732 id: safpj-4738 author: Meel, B L title: Incidence of unnatural deaths in Transkei sub-region of South Africa (1996–2015) date: 2017-08-28 words: 4061 flesch: 68 summary: The Author(s) RESEARCH South African Family Practice 2017; 59(4):138–142 https://doi.org/10.1080/20786190.2017.1292697 Open Access article distributed under the terms of the Creative Commons License [CC BY-NC 3.0] http://creativecommons.org/licenses/by-nc/3.0 Incidence of unnatural deaths in Transkei sub-region of South Africa (1996–2015) BL Meela* a Department of Laboratory Medicine and Pathology, Walter Sisulu University, Mthatha, South Africa *Email: meelbanwari@yahoo.com Background: Unnatural deaths are a serious and preventable public health problem in South Africa. Incidence of unnatural deaths in Transkei sub-region of South Africa (1996–2015) 140 rate of unnatural death was 160 per 100 000 among males, and 44 per 100 000 among females (Table 1 and Figure 2). keywords: africa; deaths; figure; rate; region; south; table; transkei cache: safpj-4738.pdf plain text: safpj-4738.txt item: #233 of 732 id: safpj-4739 author: Michael, G C; Aliyu, I; Grema, B A; Ashimi, A O title: Knowledge of Zika virus disease among reproductive-age women attending a general outpatient clinic in Northern Nigeria date: 2017-08-28 words: 4696 flesch: 50 summary: A chi-square test was used to assess the relationship between participants’ sociodemographics and ZVD knowledge. Future research Future studies may need to explore ZVD knowledge among couples (husband and wife/wives) and the general public using the appropriate tools. keywords: age; disease; knowledge; mosquito; nigeria; participants; study; virus; women; zika; zvd cache: safpj-4739.pdf plain text: safpj-4739.txt item: #234 of 732 id: safpj-4740 author: Naidoo, Mergan; Mabuza, Langalibalele Honey; Ross, Andrew title: Mastering your fellowship (Online) date: 2017-11-06 words: 3331 flesch: 59 summary: (4) Single blind: Subjects do not know group allocation Double blind: Subjects and investigators do not know group allocation There was blinding in the selection of who should be in which group – control group or study group (based on opening sequentially numbered opaque envelopes containing cards with computer generated numbers stating the method of induction). 1. EMQ (extended matching questions): orthopaedics For each of the following clinical scenarios describing patients with knee pain, select the most appropriate diagnosis from the options below. keywords: examination; family; group; knee; misoprostol; pain; patella; patients; study cache: safpj-4740.pdf plain text: safpj-4740.txt item: #235 of 732 id: safpj-4743 author: Ellis, Chris title: Negotiating With The Angry Patient date: 2017-09-04 words: 908 flesch: 62 summary: This has been the downside of the human rights movements and patients’ charters, which have raised the often unrealistic expectations of clients worldwide when they encounter failing health services. At the end, rational anger should have subsided and grievances may be resolved and the conversation moved to a shared productive resolution. keywords: client; patient cache: safpj-4743.pdf plain text: safpj-4743.txt item: #236 of 732 id: safpj-4744 author: Vally, Muhammed; Irhuma, M O E title: Allergic Conjunctivitis date: 2017-11-06 words: 3602 flesch: 44 summary: The presence of eosinophils have been demonstrated in up to 80 percent of conjunctival scrapings in patients with acute allergic conjunctivitis.14 Types of Allergic Conjunctivitis There are three different types of allergic conjunctivitis, namely: acute allergic conjunctivitis,15,16 seasonal allergic conjunctivitis (SAC)1,6 and perennial allergic conjunctivitis (PAC).1 Table 1 demonstrates the key differences between these types. There are three types of allergic conjunctivitis, namely acute allergic conjunctivitis, seasonal allergic conjunctivitis (SAC) and perennial allergic conjunctivitis (PAC). keywords: allergen; allergic; allergy; antihistamine; cell; condition; conjunctival; conjunctivitis; mast; patients; symptoms; topical; use cache: safpj-4744.pdf plain text: safpj-4744.txt item: #237 of 732 id: safpj-4745 author: Babarinde, Oyetola; Ismail, Halima; Schellack, Natalie title: An overview of the management of muscle pain and injuries date: 2017-11-06 words: 6343 flesch: 50 summary: Protect from more injury Restrict activity Ice area Compres sion Elevation Non-Pharmacological Treatment Modalities Figure 6: Management of sports injuries using the PRICE principle Figure 7: Treatment of muscle pain in sports injuries TENS Thermal Modalities Acupuncture • Insertion of small needles into specific points on the body • Chronic pain, unresponsive to standard therapy Therapeutic use of heat: • Superficial heating (dry hot or moist hot packs and paraffin baths) • Deep heating (ultrasound) Non-Pharmacological Treatment Modalities [TENS: Transcutaneous Electrical Stimulation] An overview of the management of muscle pain and injuries 15 The page number in the footer is not for bibliographic referencingwww.tandfonline.com/oemd 15 Table 5: Sport injuries and how to manage them Types of sport injuries What to do Sprains When a patient has a sprain, it is vital to exercise the body part affected. However, these activities are associated with risks and complications such as sport injuries (Figure 1).1 The most common types of sport activities associated with sporting injuries are2: • Running or jogging • Contact sports – rugby, soccer, hockey and boxing • Racket sports – tennis, badminton • Volleyball • Basketball • Heavy weight lifting • Cycling • Golfing • Swimming Causes of sport injuries keywords: factors; figure; injuries; injury; management; muscle; narcotic; non; pain; patient; sports; sports injuries; sprains; therapy; treatment cache: safpj-4745.pdf plain text: safpj-4745.txt item: #238 of 732 id: safpj-4746 author: Magongwa, Nicholus; Schellack, Natalie title: An overview of allergy and sinusitis date: 2017-11-06 words: 5534 flesch: 36 summary: Allergic diseases are on the increase, affecting approximately 30% to 40% of the world’s population. These include a genetic predisposition, decreased exposure to infections and endotoxins, postnatal antibiotic use, obesity, tobacco smoke, air pollutants, exposure to allergens, maternal weight gain or obesity, gestational use of antibiotics and maternal stress.7 Pathophysiology of atopy There is vast evidence that shows that T-lymphocytes play a major role in allergic diseases. keywords: allergen; allergy; antihistamines; atopic; chronic; conditions; diseases; effects; exposure; generation; nasal; receptor; rhinitis; sinusitis; th2; use cache: safpj-4746.pdf plain text: safpj-4746.txt item: #239 of 732 id: safpj-4755 author: Naidoo, Mergan; Mash, Robert; Ross, Andrew title: Mastering your fellowship (Online) date: 2017-12-05 words: 2671 flesch: 60 summary: When community health workers visit households in the community they might promote health in the following ways: e.g. Mastering your Fellowship 39 The page number in the footer is not for bibliographic referencingwww.tandfonline.com/ojfp 39 i. When community health workers visit households in the community they might collect specific routine information about children and their health risks: e.g. i. Growth of children and identify those that are failing to thrive or malnourished. keywords: care; children; community; diarrhoea; examination; family; health; study cache: safpj-4755.pdf plain text: safpj-4755.txt item: #240 of 732 id: safpj-4757 author: Muntingh, George L title: Ok, so who wants to colonise my gut? - Overview of Probiotics in certain Gastro-intestinal Disorders date: 2017-10-26 words: 3966 flesch: 30 summary: Ultimately, it is reasonable to assume that the “precautionary principle” should apply for probiotics use. Probiotics’ therapeutic or health claims (1) Improvement of the normal gut microflora; (2) Prevention of infectious diseases and food allergies; (3) Reduction of serum cholesterol; (4) Anticarcinogenic activity; (5) Stabilisation of the gut mucosal barrier; (6) Alleviation of chronic intestinal disease symptoms, and improved digestion of lactose in intolerant hosts; (7) Assist in the synthesis of vitamins K; (8) Prevention of GI infections by virus, bacteria or fungi; (9) Normalisation of intestinal motility; (10) Immune adjuvant properties; (11) Production of cytokines (cell signalling molecules); (12) Participation in the prevention of osteoporosis; (13) Dyspepsia, IBS and asthenia prevention. keywords: bacteria; diarrhoea; disease; lactobacillus; organisms; probiotics; studies; treatment; use cache: safpj-4757.pdf plain text: safpj-4757.txt item: #241 of 732 id: safpj-4762 author: Ogunbanjo, Gboyega A title: Cell phone use and ill health: Is there a definite relationship? date: 2017-11-06 words: 961 flesch: 50 summary: Interestingly, cell phone use is now an integral part of modern day communication between persons. In 2014, the World Health Organisation (WHO) estimated that there were 6.9 billion subscriptions globally and that in some parts of the world, mobile phones are the most reliable or the only phones available.1 Various studies have been conducted, although some are inconclusive on the link of cell phone use and ill health. keywords: cell; health; use cache: safpj-4762.pdf plain text: safpj-4762.txt item: #242 of 732 id: safpj-4767 author: Tanimu, Tanko Salihu; Michael, Godpower Chinedu; Ibrahim, Aliyu; Grema, Bukar Alhaji; Mohammed, Abubakar Abiso title: Awareness of family medicine discipline among clinical medical students of Bayero University, Kano, Nigeria date: 2017-11-06 words: 4623 flesch: 48 summary: Yes 167 93.8 No 11 6.2 Source of information on FM Media 17 10.2 Relatives 22 13.2 Internet 8 4.8 Journal 6 3.6 Lecturers 52 31.1 Books 5 3.0 Dept of FM 57 34.1 Table 2: Preference for family medicine specialty among medical students Family medicine preference Frequency Percent (%) Family medicine (FM), a relatively new specialty in Nigeria, aims at supplying doctors capable of providing comprehensive healthcare for the majority of the population. keywords: family; family medicine; health; level; medical; medicine; specialty; students; study cache: safpj-4767.pdf plain text: safpj-4767.txt item: #243 of 732 id: safpj-4768 author: Hagemeister, D T; Pal, A; Kristen, U; Mokgosana, N; Joubert, G title: Undergraduate medical students’ interest in specialising in Family Medicine at the University of the Free State, 2014 date: 2017-11-06 words: 4695 flesch: 51 summary: The Author(s) RESEARCH South African Family Practice 2017; 59(5):166–171 https://doi.org/10.1080/20786190.2017.1317977 Open Access article distributed under the terms of the Creative Commons License [CC BY-NC 3.0] http://creativecommons.org/licenses/by-nc/3.0 Undergraduate medical students’ interest in specialising in Family Medicine at the University of the Free State, 2014 DT Hagemeistera*  , A Pala, N Naidooa, U Kristena  , N Mokgosanaa and G Joubertb  a Faculty of Health Sciences, School of Medicine, University of the Free State, Bloemfontein, South Africa b Faculty of Health Sciences, Department of Biostatistics, University of the Free State, Bloemfontein, South Africa *Corresponding author, email: hagemeisterdt@ufs.ac.za Background: There is a large demand for Family Medicine specialists, yet not enough medical students specialise in this field. The majority of students in all four groups felt that Family Medicine specialists and general practitioners are the same profession, and that Family Medicine is a less glamorous option compared with other specialties. keywords: family; family medicine; health; interest; medicine; specialty; students; study; undergraduate; year cache: safpj-4768.pdf plain text: safpj-4768.txt item: #244 of 732 id: safpj-4769 author: Brits, H title: Child deaths at National District Hospital, Free State: one a month is better than one a week date: 2017-11-06 words: 2724 flesch: 53 summary: Underlying poor nutritional status and/or HIV- positive status were present in 96% of deaths.4 Aim of the study The aim of this study was to investigate whether the strategies implemented by the NDoH to decrease child mortality (MDG 4) were evident in child deaths at NDH. Conclusion: Child deaths decreased from one a week to one a month at NDH. keywords: child; children; deaths; mortality; period; south; study cache: safpj-4769.pdf plain text: safpj-4769.txt item: #245 of 732 id: safpj-4772 author: Schellack, Natalie; Naested, Cahlia; Van der Sandt, Nicolene; Padayachee, Neelaveni title: Management of Urinary Tract Infections in Children date: 2017-11-07 words: 3345 flesch: 43 summary: Table 3: Principles of appropriate for antibiotic use in paediatric UTI care Principles for appropriate antibiotic use in paediatric UTI care Only initiate an antibiotic once a urinalysis has been performed and a urine specimen for culture was obtained. With an estimated 150 million UTIs occurring worldwide annually, this paper aims to establish the ideal management of urinary tract infections in paediatrics. keywords: age; antibiotic; children; infections; paediatric; tract; treatment; urinary; uti; utis cache: safpj-4772.pdf plain text: safpj-4772.txt item: #246 of 732 id: safpj-4773 author: Schellack, Natalie; Mogole, O; Magongwa, N; Makola, F title: Migraine headaches in a nutshell date: 2017-12-05 words: 2208 flesch: 47 summary: Roceanu A, Antochi F, Bajenaru O. New molecules in migraine treatment. Diagnosis The diagnosis is made, based on the clinical presentation or symptoms of the patient, and by excluding other causes of frequent headaches.9 In many cases the pain experienced during migraine attacks, occurs unilaterally.10 keywords: attacks; aura; chronic; headache; migraine; treatment; use cache: safpj-4773.pdf plain text: safpj-4773.txt item: #247 of 732 id: safpj-4774 author: Brand, Linda; Wolmarans, De Wet title: Restoring the Architecture: A Rapid Clinical Perspective on Bone-Mineral Density and Osteoporosis date: 2017-12-05 words: 8697 flesch: 42 summary: This is, however, an ongoing debate.63-65 Independent of oral or transdermal formulations and whether it is administered in a continuous or cyclic regimen, similar dose-dependent effects on bone-mineral density have been found at equivalent doses.1 Raloxifene Raloxifene is a selective estrogen receptor modulator (SERM); it acts as an estrogen agonist on bone and liver tissue, has no demonstrable activity in the uterus and is an antagonist on estrogen receptors in breast tissue.53 Raloxifene is indicated for the prevention and treatment of postmenopausal osteoporosis, as it stabilizes and modestly increases bone mineral density and reduces vertebral fracture risk.53, 66 Ralston SH, Galwey N, MacKay I, et al. Loci for regulation of bone mineral density in men and women identified by genome wide linkage scan: the FAMOS study. keywords: bisphosphonates; bone; calcium; density; disease; effects; estrogen; formation; fractures; hormone; management; mineral; osteoclast; osteoporosis; patients; postmenopausal; prevention; risk; strontium; teriparatide; therapy; tibolone; treatment; use; vertebral; vitamin; women cache: safpj-4774.pdf plain text: safpj-4774.txt item: #248 of 732 id: safpj-4782 author: Osuch, Elzbieta; Marais, Andre title: Urinary tract infections in children date: 2018-01-18 words: 4950 flesch: 47 summary: Keywords: Urinary tract infection, children, cystitis, pyelonephritis, antibiotics South African Family Practice 2018; 60(1):35-40 Open Access article distributed under the terms of the Creative Commons License [CC BY-NC-ND 4.0] http://creativecommons.org/licenses/by-nc-nd/4.0 Urinary tract infections in children Elzbieta Osuch,1 Andre Marais2 1 Department of Pharmacology & Therapeutics, School of Medicine, Sefako Makghato Health Sciences University, South Africa 2 Department of Pharmacology, School of Medicine, Faculty of Health Sciences, University of Pretoria, South Africa *Corresponding author, email: dramarais@gmail.com / andre.marais@up.ac.za S Fever may often be the only sign of a UTI in infants and younger children, and should therefore be evaluated to exclude urinary tract infections. keywords: children; dose; febrile; hourly; infants; infections; patients; pediatrics; therapy; tract; urinary; utis cache: safpj-4782.pdf plain text: safpj-4782.txt item: #249 of 732 id: safpj-4786 author: Ogunbanjo, Gboyega A title: South Africa and national TB control: Are we making progress? date: 2017-11-28 words: 873 flesch: 56 summary: It is alluded that patient costs may negatively impact health-seeking behaviours, leading to delays in hospital presentation, further worsening of disease and increasing risk of disease spread.6 In South Africa, TB control demonstrates the following features: availability of GeneXpert MTB/RIF as a replacement for sputum smear microscopy, strengthening of case finding in and out of healthcare facilities and greater focus on TB prevention among people living with HIV, with earlier initiation of and scaling up antiretroviral therapy. South Africa has invested substantial amounts of its health budget on TB control and we need to experience the benefits. keywords: africa; south cache: safpj-4786.pdf plain text: safpj-4786.txt item: #250 of 732 id: safpj-4787 author: Mash, Robert; Von Pressentin, Klaus title: Family medicine in South Africa: exploring future scenarios date: 2017-12-05 words: 3483 flesch: 48 summary: Key uncertainties Key uncertainties included: • the economic position of the country and the ability to expand the health care workforce to include more family physicians; • the implementation of National Health Insurance at a national level; • clarification of the roles and contribution of family physi- cians to the health system at a national level and expression of this consistently in policy; • the variable implementation of policy by provinces and whether this would include a commitment to deploy family physicians and create career pathways; • public awareness of and support for family physicians versus medical officers and general practitioners without postgrad- uate training; • ability of the training programmes to deliver a supply of fam- ily physicians at sufficient scale for the needs of the country; • commitment of the district health system to the training of family physicians in terms of registrar posts and capacity for training; • realisation of the family physicians’ contribution in all the en- visaged roles that they are trained for; • clarification of the role of the family physician in facili- ty-based and community-based multidisciplinary primary care teams; • commitment to recruit and retain family physicians in rural and remote areas; • relationship between Independent Practitioner Associations and other entities in the private sector. Keywords: family medicine, family physicians, primary care, scenario planning, South Africa Introduction This article reports on the findings of a workshop at the 19th National Family Practitioners Conference in August 2016 that used the scenario planning approach of Clem Sunter and Chantell Ilbury to explore future possible scenarios for family medicine in South Africa.1 Before considering the possible future scenarios it is important to briefly evaluate our current situation. keywords: family; family physicians; health; medicine; physicians; south; system; training cache: safpj-4787.pdf plain text: safpj-4787.txt item: #251 of 732 id: safpj-4788 author: Kotzé, J M; Brits, H title: The emergency management of a rape case in a nutshell: adolescent and adult cases date: 2017-12-05 words: 6714 flesch: 51 summary: Timing of the assessment The medico-legal assessment, including the physical examination and evidence collection, should not be delayed. Foreign organic and inorganic debris and foreign hair may be present on the genitals.28,29 Sites for evidence collection from the female genitalia includes the vulva, vestibule, high vaginal, fornices and endocervical regions. keywords: collection; consent; evidence; evidence collection; examination; form; health; information; management; medical; medico; patient; penetration; rape; south cache: safpj-4788.pdf plain text: safpj-4788.txt item: #252 of 732 id: safpj-4789 author: Beukes, A; Mabasa, T; Mkhungo, L; Olivier, C; Ramoo, N; Van Rooi, D; Dawadi, B R; Joubert, Gina title: Women who give birth before arriving at National District Hospital in Bloemfontein, Free State date: 2017-12-05 words: 1184 flesch: 53 summary: The Author(s) SCIENTIFIC LETTER South African Family Practice 2017; 59(6):228–229 https://doi.org/10.1080/20786190.2017.1313485 Open Access article distributed under the terms of the Creative Commons License [CC BY-NC 3.0] http://creativecommons.org/licenses/by-nc/3.0 Women who give birth before arriving at National District Hospital in Bloemfontein, Free State A Beukesa, T Mabasaa  , L Mkhungoa, C Oliviera, N Ramooa, D Van Rooia, BR Dawadib and G Joubertc*  a Faculty of Health Sciences, School of Medicine, University of the Free State, Bloemfontein, South Africa b Faculty of Health Sciences, Department of Family Medicine, University of the Free State, Bloemfontein, South Africa c Faculty of Health Sciences, Department of Biostatistics, University of the Free State, Bloemfontein, South Africa *Corresponding author, email: gnbsgj@ufs.ac.za Background: Birth before arrival (BBA) contributes to the neonatal death rate in South Africa. Keywords: birth before arrival, district hospital, factors, patient profile Introduction Perinatal and neonatal mortality rates in South Africa are high1 and birth before arrival (BBA) can be a contributing factor.2 In 2014, 306 babies were born before the mothers arrived at National District Hospital in Bloemfontein, keywords: district; hospital; mothers; study cache: safpj-4789.pdf plain text: safpj-4789.txt item: #253 of 732 id: safpj-4790 author: Owolabi, E O; Goon, D T; Adeniyi, O V; Seekoe, E; Adedokun, A O title: Prevalence and factors associated with tobacco use among adults attending selected healthcare facilities in Buffalo City Metropolitan Municipality, South Africa date: 2017-12-05 words: 5737 flesch: 56 summary: High prevalence of tobacco use, including secondary exposure, in this setting is worrisome, given the fact that cigarette smoking is an independent and significant risk factor for cardiovascular disease, premature death and certain cancers.5,27 Our results might be due to the effect of globalisation and epidemiological transitions in rural and semi- urban BCMM. The World Health Organization reported a global increase in cigarette smoking, particularly in the African region.5 The prevalence found in this study was slightly lower than the reported national prevalence for tobacco use: 18.1%, 16.9% and 17.6% in 2010, 2011 and 2012, respectively.16,21,22 keywords: adults; africa; cigarette; education; health; level; participants; prevalence; smoke; smoking; south; study; tobacco; tobacco use; use cache: safpj-4790.pdf plain text: safpj-4790.txt item: #254 of 732 id: safpj-4791 author: Brits, Hanneke; Joubert, Gina; Eyman, Keshia; De Vink, Rosie; Lesaoana, Katleho; Makhetha, Sello; Moeketsi, Katiso title: An assessment of the integrated nutrition programme for malnourished children aged six months to five years at primary healthcare facilities in Mangaung, Free State, South Africa date: 2017-12-05 words: 3638 flesch: 48 summary: Keywords: children, Free State, malnutrition assessment, nutrition programme, South Africa, supplementary feeding Introduction According to the World Health Organization (WHO), malnutrition can be linked to 45% of deaths in children under the age of five years.1 There are many definitions of child malnutrition, but Ge and Chang summarised it as: ‘ A pathological state resulting from inadequate nutrition, including undernutrition (protein-energy malnutrition) due to insufficient intake of energy and other nutrients; overnutrition (overweight and obesity) due to excessive consumption of energy and other nutrients; deficiency diseases due to insufficient intake of one or more specific nutrients such as vitamins or minerals. Children with SAM must be referred to a clinic or hospital for further assessment and management by a doctor, while children with MAM and those with increased nutritional needs (at risk for malnutrition) must receive supplementary food (Plan B) at the clinic. keywords: children; feeding; follow; health; inp; malnutrition; programme; south; study cache: safpj-4791.pdf plain text: safpj-4791.txt item: #255 of 732 id: safpj-4798 author: Ellis, Chris title: The patient who cannot afford the bus fare to the clinic date: 2018-01-18 words: 901 flesch: 68 summary: PERIPHERALIA The page number in the footer is not for bibliographic referencingwww.tandfonline.com/ojfp 50 In his book Equanimitas, written in 1904, Sir William Osler laments that very few doctors go into public life to help advise and manage the delivery of health care. About 20–30% of our population does not have full access to health care and 10–20% cannot afford the bus fare to their local clinic. keywords: care; health; management cache: safpj-4798.pdf plain text: safpj-4798.txt item: #256 of 732 id: safpj-4799 author: von Pressentin, Klaus B; Naidoo, Mergan; Ross, Andrew; Ras, Tasleem title: Mastering your fellowship (Online) date: 2018-01-18 words: 5696 flesch: 55 summary: TB culture tests help to detect drug resistance but are too slow to have an immediate impact on clinical management. These recommendations are based on findings from Xpert test research conducted under ideal research conditions. keywords: community; data; family; findings; health; marks; number; patient; question; study; test; xpert cache: safpj-4799.pdf plain text: safpj-4799.txt item: #257 of 732 id: safpj-4801 author: Lamb, Greg title: Neutralising Neurophobia date: 2018-03-17 words: 2518 flesch: 57 summary: As cranial nerves IX and X form a reflex arc, they generally do not function independently. The child was still able to blink with the right eye due to the dual innervation which the nuclei of cranial nerve VII receive from the unilateral as well as the contralateral cerebral hemisphere. keywords: cap; child; motor; nerve; palsy; pons; reflex; reflexes cache: safpj-4801.pdf plain text: safpj-4801.txt item: #258 of 732 id: safpj-4816 author: Greeff, Oppel BW title: The pharmacotherapy of low back pain date: 2018-03-17 words: 2297 flesch: 55 summary: Management of lower back pain The State of Oregon in the USA recently published guidelines for the evaluation and management of low back pain. The Author(s) REVIEW Introduction About 60–80% of patients visiting a physician have at some stage in their lives suffered from low back pain. keywords: analgesic; causes; dosage; drugs; muscle; pain; therapy; treatment cache: safpj-4816.pdf plain text: safpj-4816.txt item: #259 of 732 id: safpj-4821 author: Metabolism and Diabetes of South Africa, The Society for Endocrinology title: Glucose Control: non-insulin therapies* date: 2018-03-17 words: 5421 flesch: 49 summary: Diabetic ketoacidosis may occur at mildly elevated levels of blood glucose particularly in insulin treated patients. -0.6% Cardiovascular outcome trials Proven superiority vs. diet alone in obese patients - reduced all-cause mortality, diabetes related mortality and myocardial infarction, but not peripheral vascular disease or microvascular disease. keywords: diabetes; dose; drug; hypoglycaemia; insulin; metformin; patients; release; therapy cache: safpj-4821.pdf plain text: safpj-4821.txt item: #260 of 732 id: safpj-4822 author: Ellis, Chris title: One-Stop General Practice date: 2018-06-07 words: 879 flesch: 73 summary: There are several other situations where comprehensive general practice saves money and saves the country millions in saved work time. It is not only procedural general practice that is well- organized. keywords: day; work cache: safpj-4822.pdf plain text: safpj-4822.txt item: #261 of 732 id: safpj-4826 author: Naidoo, Mergan; Von Pressentin, Klaus B; Ross, Andrew; Ras, Tasleem title: Mastering your fellowship date: 2018-06-07 words: 6390 flesch: 51 summary: • It may be a great learning conversation within a small group – if appropriate, the registrar may be encouraged to share her learning around the hypertension management protocol with other registrars within the training complex, and with other medical officers at your district hospital. The page number in the footer is not for bibliographic referencingwww.tandfonline.com/ojfp 50 Introduction This section in the South African Family Practice Journal is aimed at helping registrars prepare for the FCFP (Fellowship of the College of Family Physicians) (SA) keywords: approach; authors; care; data; family; learning; medical; medicine; minutes; qualitative; registrar; study cache: safpj-4826.pdf plain text: safpj-4826.txt item: #262 of 732 id: safpj-4827 author: van Eyk, A. D. title: Pharmacotherapeutic Options for Ophthalmic Conjunctivitis date: 2018-06-07 words: 3673 flesch: 43 summary: Topical eye drops and ointments are preferred to oral agents in the treatment of more severe bacterial and allergic conjunctivitis while oral agents are used in the treatment of conjunctivitis caused by Herpes simplex, Herpes zoster, Chlamydia trachomatis and Neisseria gonorrhoeae. Treatment is usually topical eye drops or ointments except in the cases of herpes, chlamydial and gonococcal infections where topical, oral and in some instances IV or IM medications are indicated. keywords: bacterial; conjunctivitis; daily; days; drops; eye; feb; oral; topical; treatment cache: safpj-4827.pdf plain text: safpj-4827.txt item: #263 of 732 id: safpj-4828 author: Marais, Andre; Osuch, Elzbieta title: Underlying causes of chronic bladder dysfunction date: 2018-06-07 words: 3398 flesch: 37 summary: Keywords: Chronic bladder conditions; interstitial cystitis; painful bladder syndrome; chronic urinary tract infection; urinary incontinence; hematuria; bladder cancer Underlying causes of chronic bladder dysfunction 25 Chronic bladder conditions may cause social embarrassment and decrease quality of life in affected individuals. keywords: bladder; cancer; conditions; disorders; hematuria; incontinence; infections; pain; patients; syndrome; tract; treatment; urinary; urol cache: safpj-4828.pdf plain text: safpj-4828.txt item: #264 of 732 id: safpj-4829 author: Thomas, Eileen; Seedat, S title: The diagnosis and management of depression in the era of the DSM-5 date: 2018-03-17 words: 4905 flesch: 40 summary: DSM-5 Depressive Disorders The DSM-5 depressive disorders include: disruptive mood dysregulation disorder, major depressive disorder (including major depressive episode), persistent depressive disorders (dysthymia), premenstrual dysphoric disorder, substance/ medication-induced depressive disorder, depressive disorder due to another medical condition, and other specified and unspecified depressive disorders.8 Disruptive Mood Dysregulation Disorder (DMDD) MDD also needs to be differentiated from normal sadness or bereavement although in patients who are grieving, if depressive symptoms are severe and persistent, a diagnosis of MDD can be made. keywords: care; depressive; diagnosis; disorder; episode; health; mdd; mood; patient; pmdd; severity; south; symptoms; treatment cache: safpj-4829.pdf plain text: safpj-4829.txt item: #265 of 732 id: safpj-4832 author: Ogunbanjo, Gboyega A title: Listeriosis outbreak in South Africa: Are we winning the battle? date: 2018-03-17 words: 792 flesch: 53 summary: Four cases have died (case fatality 15.4%).2 NICD has advised the South African public that persons who are at risk of listeriosis should avoid processed, ready- to-eat meat products, soft cheeses, and unpasteurised milk and dairy products. Situation report on Listeriosis outbreak, South Africa; 2018. keywords: listeriosis; outbreak; products cache: safpj-4832.pdf plain text: safpj-4832.txt item: #266 of 732 id: safpj-4837 author: Vally, Muhammed; Kathrada, F; Butkow, N title: An update on the measurement and management of cholesterol with specific reference to secondary prevention of cardiovascular disease (CVD) date: 2018-03-17 words: 8056 flesch: 64 summary: Findings from the IMPROVE-IT trial suggest that the ezetimibe-induced cardiovascular risk reduction by LDL-C reduction is similar to statins.38 Ezetimibe is the first LDL-C lowering drug to show a reduction in CV outcomes in patients well-treated with statins.18 Third-line therapy: PCSK9 inhibitors In certain patients, satisfactory control of dyslipidaemia is not achieved even with combination lipid lowering therapy and recent attention has focused on a new class of agents, proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors.3 These agents provide great promise for patients who require additional LDL lowering or are unable to take statins (statin-intolerant and familial hypercholesterolemia).3 The PCSK9 protein plays a crucial role in the regulation of LDL receptors by reducing the number of LDL-C receptors.39 Targeted monoclonal antibodies have the ability to bind to PCSK9, thereby inhibiting its interaction with LDL cholesterol receptors.39 Outcomes with regard to their efficacy indicate a reduction in LDL cholesterol of greater than 50% and an elevation in HDL cholesterol levels, especially when administered with statin therapy.40 In clinical trials the two PCSK9 inhibitors that have shown significant promise are evolocumab and alirocumab.41 It is clear that high intensity statins provide benefit irrespective of the baseline LDL-C levels in the secondary prevention of cardiovascular events.2,9-11,14 Statins by their nature increase PSCK9 levels(Table 5).42-45 Cholesterol Treatment Trialists Collaboration, Baigent C, Blackwell L, Emberson J, et al. Efficacy and safety of more intensive lowering of LDL cholesterol: a meta-analysis of data from 170 000 participants in 26 randomised trials. keywords: ldl; n d; o n; p o cache: safpj-4837.pdf plain text: safpj-4837.txt item: #267 of 732 id: safpj-4838 author: Vally, M.; Irhuma, M. O.E. title: Primary Prevention of Coronary Artery Disease date: 2018-06-07 words: 5758 flesch: 64 summary: For moderate to high risk patients whose 10-year absolute risk of a first CHD event is ≥ 10%, the randomised data on benefits and risks are sparse thus clinical decision making should be employed on an individualised basis to see if the benefits of using low dose aspirin to prevent a first BMI are likely to exceed the risk of major bleeding. Keywords: cardiovascular risk factors, primary prevention, aspirin therapy, dyslipidaemia. keywords: artery; cardiovascular; cvd; diabetes; diet; disease; doi; lifestyle; patients; pmid; prevention; pubmed; review; risk; table; year cache: safpj-4838.pdf plain text: safpj-4838.txt item: #268 of 732 id: safpj-4839 author: Brand, Linda; Wolmarans, De Wet; Brand, Sarel J. title: A Quick and Painless Reminder: The Pharmacotherapy of Rheumatoid Arthritis in Primary Practice date: 2018-06-07 words: 4730 flesch: 45 summary: Angelotti F, et al. Nell V, et al. keywords: arthritis; disease; dmards; dose; mtx; patients; rheumatoid; rheumatoid arthritis; risk; treatment cache: safpj-4839.pdf plain text: safpj-4839.txt item: #269 of 732 id: safpj-4844 author: Von Pressentin, Klaus B; Mash, Robert J; Baldwin-Ragaven, L; Botha, R P G; Govender, I; Steinberg, W J title: The bird’s-eye perspective: how do district health managers experience the impact of family physicians within the South African district health system? A qualitative study date: 2018-03-17 words: 7772 flesch: 52 summary: The contribution of family physicians to district health services: a national position paper for South Africa: forum. The bird’s-eye perspective: how do district health managers experience the impact of family physicians within the South African district health system? keywords: africa; care; district; district health; dms; family; fps; health; health care; health system; impact; medicine; physicians; primary; roles; south; study; system cache: safpj-4844.pdf plain text: safpj-4844.txt item: #270 of 732 id: safpj-4845 author: Fouché, L; Bezuidenhout, J; Liebenberg, C; Adefuye, A O title: Practice of community-service doctors in the assessment and medico-legal documentation of common physical assault cases date: 2018-03-17 words: 4748 flesch: 48 summary: The questionnaire was divided into four parts: demographics (age, gender and home language); professional profile; employment profile (when and where participants performed their community service); competency in medico-legal assessment and documentation of assault cases during the service year. Undergraduate training and exposure to medico- legal documentation of assault cases Analysed data presented here reveal that only 66.7% of participants who indicated that they had examined assault cases during their year of community service had prior training and/or exposure to medico-legal documentation and management of assault cases during their undergraduate training. keywords: assault; cases; documentation; forensic; form; j88; medico; participants; patients; service cache: safpj-4845.pdf plain text: safpj-4845.txt item: #271 of 732 id: safpj-4847 author: Metabolism and Diabetes of South Africa, The Society for Endocrinology title: Chapter 10: Glucose control: insulin therapy date: 2018-06-07 words: 1573 flesch: 45 summary: The Author(s) GUIDELINES South African Family Practice 2018; 60(2):5-7 Open Access article distributed under the terms of the Creative Commons License [CC BY-NC-ND 4.0] http://creativecommons.org/licenses/by-nc-nd/4.0 Chapter 10: Glucose control: insulin therapy* The Society for Endocrinology, Metabolism and Diabetes of South Africa Type 2 Diabetes Guidelines Expert Committee. Glucose control: insulin therapy in 2017 SEMDSA Guideline for the Management of Type 2 Diabetes Guideline Committee. keywords: 3x5; basal; insulin; pen cache: safpj-4847.pdf plain text: safpj-4847.txt item: #272 of 732 id: safpj-4850 author: Ellis, Chris title: The Pre-Diagnostic Trajectory date: 2018-07-12 words: 924 flesch: 56 summary: PERIPHERALIA The page number in the footer is not for bibliographic referencingwww.tandfonline.com/ojfp 62 There are many pathways and trajectories that patients take on their way to seeking medical attention and to a final diagnosis. We can actually jog along for quite some time either denying or suppressing the possibilities of various diagnoses until an event or additional information is received, which kick-starts the process of proactively seeking a diagnostic label. keywords: patient; symptoms cache: safpj-4850.pdf plain text: safpj-4850.txt item: #273 of 732 id: safpj-4851 author: Metabolism and Diabetes of South Africa, The Society for Endocrinology title: Chapter 11: The approach to achieving glycaemic control date: 2018-06-07 words: 9531 flesch: 67 summary: However, the suggested therapeutic options should cater for the glucose control needs of the majority of type 2 diabetes patients who are being managed appropriately in the primary healthcare setting. The response to treatment is heterogeneous; we see diversity in responses to the same treatments even in patients with near-identical phenotypes. keywords: diabetes; h e; insulin; m o; n d; o n; patients; t h; t o cache: safpj-4851.pdf plain text: safpj-4851.txt item: #274 of 732 id: safpj-4854 author: Moodley, V.; Alant, J. title: The straight and marrow - a primary care approach to anaemia date: 2018-06-07 words: 2720 flesch: 49 summary: Iron deficiency anaemia and anaemia of chronic disease remain the two top ranking causes of anaemia globally and when these conditions co-exist, diagnosis is often challenging. Keywords: anemia, anaemia, anaemia diagnosis, anaemia of chronic disease, human immunodeficiency virus infection, iron deficiency anaemia keywords: anaemia; blood; deficiency; iron; serum; south cache: safpj-4854.pdf plain text: safpj-4854.txt item: #275 of 732 id: safpj-4857 author: Ogunbanjo, Gboyega A title: Publishing in predatory journals: Time for reflections date: 2018-06-07 words: 846 flesch: 43 summary: Jeffrey Beall, a University of Colorado Denver associate professor and librarian, and creator of ‘Beall’s List of Potential, Possible, or Probable Predatory Scholarly Open-access Publishers’ has led a crusade against journals referred to as predatory journals, which were “of questionable and downright low quality”. Wild S. GUIDE: How to spot predatory academic journals in the wild. keywords: journals; predatory; publishers cache: safpj-4857.pdf plain text: safpj-4857.txt item: #276 of 732 id: safpj-4860 author: von Pressentin, Klaus B.; Naidoo, Mergan; Ross, Andrew; Ras, Tasleem title: Mastering your fellowship date: 2018-07-12 words: 7064 flesch: 58 summary: This month’s edition focuses on mental health and is based on unit standard 1 (critically appraising quantitative research), unit standard 2 (evaluate and manage a patient according to the bio- psycho social approach) and unit standard 5 (conduct all aspects of health care in an ethical and professional manner). In the results the average BDI scores for HIV positive patients dropped from 15.2 (initially) to 14.2 at 6 weeks while suicidal ideation increased from 17% to 23%. keywords: care; depression; family; health; hiv; ideation; marks; mhca; patient; study; substance; suicidal; use; user cache: safpj-4860.pdf plain text: safpj-4860.txt item: #277 of 732 id: safpj-4865 author: Oladeji, S. A.; OlaOlorun, A. D. title: Depression among infertile women in Ogbomosoland date: 2018-06-07 words: 3852 flesch: 52 summary: Although normal grief is expected and it often occurs in women with infertility, it may progress to pathological grief leading to depression.11 Depression does not only affect the life of infertile individuals; it also impacts on their treatment and follow-up.12 While child adoption is an important option for infertile couples, the barriers to its usage in Nigeria include cultural beliefs and practices, stigmatisation, financial implications and procedural bottlenecks.5 Depression prevalence among infertile women in Nigeria has been reported to be between 39.5% and 42.9%.13–15 The age of the woman, primary infertility, duration of infertility and poor social support have been identified as predictors of depression. Higher rates of depression among infertile women, but with similar predictors, have been reported from nearby Ghana (62%), and also from Saudi Arabia (53.8%).11,12 The importance of screening for depression The importance of screening for depression in women with infertility cannot be overemphasised. keywords: children; depression; health; infertile; infertility; nigeria; study; women; years cache: safpj-4865.pdf plain text: safpj-4865.txt item: #278 of 732 id: safpj-4866 author: Maddocks, Stacy; Chetty, Verusia; Maghoo, Arishna; Mhlongo, Nkuleleko; Mthembu, Nsindiso; Khanyile, Sinempilo; Chiliza, Siphokazi; Munsamy, Tyrel; Gamede, Zanele; Mazibukoc, Slindile title: ‘Treating a patient should be approached in a holistic manner’: collaboration of doctors and physiotherapists in the rehabilitation of people living with HIV date: 2018-06-07 words: 4105 flesch: 37 summary: Furthermore, staff shortages and resource limitations also hinder collaboration in healthcare team interaction. Again, hierarchical structures within primary healthcare teams posed barriers to conflict resolution and this subsequently impedes collaboration of multidisciplinary teamwork.6 Primary care doctors and nurses are usually the first-line practitioners attending to patients within the South African healthcare system, and doctors are reported as being the dominant team members in the MDT.7 keywords: collaboration; doctors; healthcare; hiv; physiotherapists; practice; professionals; rehabilitation; south; team cache: safpj-4866.pdf plain text: safpj-4866.txt item: #279 of 732 id: safpj-4868 author: Kotzé, J. M.; Brits, H. title: Do we miss half of the injuries sustained during rape because we cannot see them? An overview of the use of toluidine blue tissue stain in the medical assessment of rape cases date: 2018-06-07 words: 2934 flesch: 49 summary: Although rape is not a clinical diagnosis and there are no diagnostic criteria to confirm rape, the possibility of genital injury during rape far exceeds the possibility of injury with consensual intercourse. Genital injuries are usually shallow and do not show blood on the surface. keywords: blue; cases; injuries; injury; rape; stain; tissue; toluidine cache: safpj-4868.pdf plain text: safpj-4868.txt item: #280 of 732 id: safpj-4869 author: Fouché, L.; Bezuidenhout, J.; Liebenberg, C.; Adefuyea, A. O. title: Medico-legal aspects regarding drunk driving: experience and competency in practice of community service doctors date: 2018-06-07 words: 6865 flesch: 46 summary: https://doi.org/10.1016/S0749-3797(98)00116-0 https://doi.org/10.1016/S0749-3797(98)00116-0 https://doi.org/10.17159/2413-3108/2016/v0n57a442 https://doi.org/10.17159/2413-3108/2016/v0n57a442 https://doi.org/10.7196/samj.2016.v106i5.10912 http://www.politicsweb.co.za/party/the-state-of-forensic-chemistry-laboratories-in-sa http://www.politicsweb.co.za/party/the-state-of-forensic-chemistry-laboratories-in-sa https://www.samedical.org/images/attachments/guideline-for-taking-blood-samples-in-drunken-driving-cases-2012.pdf https://www.samedical.org/images/attachments/guideline-for-taking-blood-samples-in-drunken-driving-cases-2012.pdf https://www.samedical.org/images/attachments/guideline-for-taking-blood-samples-in-drunken-driving-cases-2012.pdf https://doi.org/10.1111/j.1360-0443.2005.01015.x https://doi.org/10.15288/jsa.2005.66.91 https://doi.org/10.1016/j.mayocp.2013.11.005 https://doi.org/10.1016/j.mayocp.2013.11.005 https://doi.org/10.1016/S0140-6736(09)60746-7 https://doi.org/10.1016/S0140-6736(09)60746-7 http://www.gautengonline.gov.za/Publications%20and%20Reports/National_Road_Traffic_Act_1996.pdf http://www.gautengonline.gov.za/Publications%20and%20Reports/National_Road_Traffic_Act_1996.pdf http://hdl.handle.net/10520/EJC52912 http://hdl.handle.net/10520/EJC52912 http://10.2215/CJN.03220807 http://www.mrc.ac.za/crime/2ndreviewchapter5.pdf http://www.mrc.ac.za/crime/2ndreviewchapter5.pdf http://orcid.org http://orcid.org/0000-0003-2380-1487 https://doi.org/10.1016/S0140-6736(12)61766-8 https://doi.org/10.1080/15389580214623 Methods Results Demographic details of participants Instances of alleged drunk driving encountered during year of community service Medico-legal aspects related to drunk driving Taking a blood sample to determine blood alcohol level Maintaining chain of evidence History taking and examination for drivers suspected to be inebriated Undergraduate training and exposure to medico-legal documentation for drunk-driving cases Spearman’s correlation analysis Discussion Conclusion References In South Africa, an increase in blood alcohol concentration of as little as 0.01  g per 100  ml above the legal limit may warrant criminal prosecution or the denial of an insurance claim for damages. keywords: alcohol; blood; cases; community; driving; drunk; medical; medico; participants; service; south; table; undergraduate cache: safpj-4869.pdf plain text: safpj-4869.txt item: #281 of 732 id: safpj-4870 author: Ross, Andrew; Gumede, Dumsani; Mianda, Solange title: Staffing levels at KwaZulu-Natal district hospitals: is the University of KwaZulu-Natal training for the needs of the province? date: 2018-06-07 words: 4932 flesch: 53 summary: In addition to the challenges caused by the public– private divide, only 12% of South African doctors work in rural areas, in which 44% of the population live.3,4 Staffing public healthcare facilities in SA is thus an ongoing challenge, with many rural areas experiencing considerable staff shortages.5,6 The South African National Development Plan 20137 and Human Resources for Health 2030 strategy3 tasked Institutions of Higher Learning (IHL) with training an increasing numbers of HCPs as a key component to ensuring a ‘long and healthy life for all South Africans’.7 These include training South African doctors in Cuba; the KZN provincial Department of Health (DoH) bursary programme, which supports students at South African healthcare training institutions; and the Umthombo Youth Development Foundation scholarship scheme (UYDF SS), which selects and supports rural youth to train to become HCPs on the understanding that they will return to work in the district hospital (DH) where they were selected, a year work-back for each year that they have received financial support.19 The KZN DoH bursary programme expects its graduates to work at any provincial hospital for a year for each year they have received financial support. keywords: african; dhs; doctors; hcps; health; rural; south; training; ukzn cache: safpj-4870.pdf plain text: safpj-4870.txt item: #282 of 732 id: safpj-4871 author: Reuter, Hermann title: The cost of not covering payment of treatment for Depressive Disorders date: 2018-06-07 words: 843 flesch: 59 summary: As a medical practitioner in the public sector who treats people with depressive disorders almost on a daily basis it came to a shock to me that in the private sector it was not the choice of medication that was not covered but the diagnosis of depressive disorders (F32 and F33) per se was not regarded as a medical condition requiring pharmacological treatment. In the light of overwhelming evidence for the health burden and mortality caused by depression and the effectiveness of pharmacological treatment, with 27 antidepressants listed in the SAMF, and in light of national policy of health for all and the constitutional right of South Africans to health care can I urge you to revisit your regulations on covering pharmacological treatment for depressive disorders? keywords: depression; health; south cache: safpj-4871.pdf plain text: safpj-4871.txt item: #283 of 732 id: safpj-4872 author: Botes, M. E.; Gilada, I. S.; Snyman, J. R.; Labuschagne, J. P.L. title: Carbohydrate-derived fulvic acid wellness drink: its tolerability, safety and effect on disease markers in pre-ART HIV-1 positive subjects date: 2018-07-12 words: 5258 flesch: 54 summary: Only five patients missed more than one study visit with the maximum being two visits skipped (Figure 1 depicts study visits per study arm). The end of study visit was conducted at the end of the study period or earlier when a patient-specific endpoint was reached. keywords: acid; art; cd4; cells; chd; count; patients; placebo; safety; study; treatment; wellness cache: safpj-4872.pdf plain text: safpj-4872.txt item: #284 of 732 id: safpj-4874 author: Greeff, Oppel B.W.; van Tonder, Jacob John; Naidu, Kershlin; McMaster, Alicia; van Tonder, Alet; Mothilal, Rashem title: A practical guide to the interpretation of PK/PD profiles of longer-acting analogue insulins. Part one: The principles of glucose clamp studies date: 2018-07-12 words: 5698 flesch: 43 summary: The dose of study insulin should reflect that of the general treatment population, and ideally steady-state conditions should be used. During infusion of glucose and exogenous insulin to establish the hyperinsulinemic euglycemic state prior to initiation of the clamp study, the duration of action of the exogenous insulin injected prior to the clamp and time of discontinuation prior to administration of study insulin must be considered to avoid masking the glucose-lowering effect of the study insulin.25 Dose of study insulin Glucose clamp studies aim to provide information as to the pharmacokinetic profile to be expected in the general treatment population and administration of study insulin should therefore reflect the doses and administration times of the general treatment population.28 Glucose clamp studies have been performed using a single dose of study insulin. keywords: action; analogue; clamp; diabetes; duration; glucose; glucose clamp; insulin; rate; studies; study cache: safpj-4874.pdf plain text: safpj-4874.txt item: #285 of 732 id: safpj-4875 author: Van Schoor, J. title: Colds, flu and coughing: a review of over-the-counter cold and flu medicines date: 2018-07-12 words: 1926 flesch: 37 summary: The placebo effect also plays an important role here.5 Therefore, symptomatic therapy remains the mainstay of common cold treatment, although a number of agents have been investigated in an effort to shorten the duration of the illness.6 However, symptomatic therapies have associated risks, particularly in young children.2 The recommendation from the US Food and Drug Administration (FDA) is that OTC medications should not be used to treat the symptoms of the common cold in children who are younger than six years of age. Therefore, symptomatic therapy remains the mainstay of common cold treatment. keywords: cold; e.g.; flu; pseudoephedrine; tablets cache: safpj-4875.pdf plain text: safpj-4875.txt item: #286 of 732 id: safpj-4876 author: Torlutter, M.; Onwukwe, S. C.; Pretorius, D.; Mpangula, N. M.; Omole, O. B. title: Dyspepsia: literature review and evidence for management in primary care date: 2018-07-12 words: 5554 flesch: 53 summary: Ramachandran A, Khan SIR, Vaitheeswaran N. Incidence and pattern of dental erosion in gastroesophageal reflux disease patients. Patients with GERD who have longstanding or relapsing symptoms, who are unresponsive to PPIs, who have red flag symptoms that suggest complicated disease (Table 2) require further investigations because up to 60% of GERD patients may have minimal changes on white light endoscopy, narrow band imaging.34 Routine testing for H. pylori is not recommended by GERD guidelines, although eradicating H. pylori infection has been found to improve quality of life of patients with GERD, regardless of treatment outcome.35 Differential diagnosis Table 3 lists differential diagnoses of GERD. keywords: acid; disease; dyspepsia; endoscopy; gastroesophageal; gerd; management; patients; ppis; pud; pylori; reflux; reflux disease; symptoms; therapy; treatment; ulcer cache: safpj-4876.pdf plain text: safpj-4876.txt item: #287 of 732 id: safpj-4877 author: Osuch, Elzbieta; Marais, Andre title: An update on available pain medications date: 2018-07-12 words: 4950 flesch: 50 summary: The Author(s) REVIEW Introduction Pain is often a major symptom in various medical conditions and is reported in nearly 20% - 50% of patients seen in primary care.1,2 The International Association for the Study of Pain defines pain as “unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage”.3 The global prevalence of chronic pain is estimated to be nearly 40%, and is therefore considered to pose major medical and social complications, affecting the quality of life of patients, their families and society.1-4 In the United States, chronic pain affects more than 100 million people annually. There are few studies documenting the prevalence of chronic pain in South Africa with a reported prevalence of 42.3% amongst people living in rural communities and a similarly high prevalence of 41% in a more urban population in South West Tshwane. keywords: analgesic; cancer; chronic; drugs; effects; inhibitors; management; non; nsaids; opioid; pain; patients; receptor; treatment; use cache: safpj-4877.pdf plain text: safpj-4877.txt item: #288 of 732 id: safpj-4878 author: Muntingh, George L.; Viljoen, Michelle title: ERROR 404 – Sleep not found date: 2018-07-12 words: 6340 flesch: 52 summary: Since insomnia can precipitate, exacerbate, or prolong comorbid conditions, treatment of insomnia may improve comorbidities.5-8 Patients with insomnia have impaired daytime function due to difficulty initiating sleep, difficulty maintaining sleep, or waking South African Family Practice 2018; 60(3):33-39 Open Access article distributed under the terms of the Creative Commons License [CC BY-NC-ND 4.0] http://creativecommons.org/licenses/by-nc-nd/4.0 ERROR 404 – Sleep not found George L Muntingh1 & Michelle Viljoen2 1Tygerberg Hospital Pharmacy, Tygerberg, Western Cape, 7505 2Department of Pharmacology and Clinical Pharmacy, School of Pharmacy, The Faculty of Natural Sciences, University of the Western Cape *Corresponding author, email: george.muntingh@westerncape.gov.za Abstract Insomnia is perhaps the most common type of sleep disorder in the family medicine population. All patients with insomnia should receive therapy for any medical condition, psychiatric illness, substance abuse, or sleep disorder that may be precipitating or exacerbating the insomnia. keywords: adults; chronic; difficulty; disorder; effects; insomnia; med; patients; risk; sleep; term; therapy; treatment; use; zolpidem cache: safpj-4878.pdf plain text: safpj-4878.txt item: #289 of 732 id: safpj-4879 author: Van Schoor, J. title: Focus on Innuvair® Inhaler for Asthma date: 2018-07-12 words: 1775 flesch: 35 summary: The page number in the footer is not for bibliographic referencingwww.tandfonline.com/oemd 6 Therapeutic efficacy Although beclomethasone and formoterol are well-known molecules of proven efficacy and safety, the clinical development of the extra-fine beclomethasone/formoterol combination involved a series of clinical trials conducted in patients with asthma.7 Clinical trials were designed to explore whether use of extra-fine formulations improved lung function, asthma control and health-related quality-of-life compared with inhaled drugs delivered as non-extra-fine formulations.10 The efficacy of the beclomethasone dipropionate/formoterol (BDP/F) combination was evaluated in a three-month randomised controlled trial in patients with moderate to severe asthma who were still symptomatic despite receiving low-dose ICS (up to 500 µg of BDP or equivalent).6 • Extra-fine BDP/F given as one inhalation twice daily proved to be more effective at improving lung function than a double equipotent dose of BDP non-extra-fine.6 A second investigation was carried out in patients with more severe asthma, documented by recurrent symptoms and impaired lung function despite treatment with up to 1 000 µg/day BDP or equivalent.6 • Extra-fine BDP/F given as two inhalations twice daily showed improvement in peak expiratory flow (PEF) and forced expiratory volume in one second (FEV1), comparable with that of an equipotent non-extra-fine regimen of BDP and formoterol administered via separate inhalers.6 • Furthermore, the extra-fine BDP/F fixed combination was superior to BDP plus formoterol in separate inhalers in terms of asthma control.6,7 8 Deposition studies in asthmatic patients with Innuvair® inhaler showed approximately one-third peripheral (small airway) deposition and two-thirds central (large airway) lung deposition as a proportion of total lung dose.8 Taken together, lung deposition data in asthmatic patients show that extra-fine aerosols not only achieve better lung deposition, but also effective penetration into the peripheral lung, thereby reaching not only the large but also the small airways.8 ICS dose reduction The beclomethasone dipropionate/formoterol 100 µg/6 µg pMDI is an extra-fine solution formulation in which the beclomethasone dipropionate (BDP) dose is 2.5-fold lower than conventional beclomethasone dipropionate CFC formulations (100 µg of BDP per actuation instead of 250 µg of non-extra- fine keywords: asthma; bdp; formoterol; ics; lung cache: safpj-4879.pdf plain text: safpj-4879.txt item: #290 of 732 id: safpj-4880 author: Brand, Sarel; Brand, Linda; Wolmarans, De Wet title: Working Around the Problem: The Impact of Being Overweight and Obese on the Treatment of Clinical Illness date: 2018-07-12 words: 5929 flesch: 48 summary: As most compounds only exert clinical effect in their free forms, i.e., when they are not bound to Table 2 - Adipose tissue as an endocrine organ Hormone Physiological Effect in Overweight and Obese Patients Leptin • Excessive levels of leptin are associated with leptin resistance and an inability to feel satiated.15,16 Resistin • Increased levels of resistin are associated with insulin resistance, hyperglycemia and type 2 diabetes mellitus.17 Adiponectin • Lower rates of adiponectin secretion are found in obese patients; however, this is associated with insulin resistance, hyperinsulinemia and type 2 diabetes mellitus.18 Estrogens • Increased levels of estrogens in obese patients result from inherent expression of P450 aromatase in adipocytes, in this case especially those located in the lower body19 – aromatase converts androgenic precursors to estrogen; • Physiological impact includes gynecomastia in men20 and anovulation, dysfunctional menstrual bleeding and polycystic ovary syndrome in women.21 Androgens • Increased conversion of weak androstenedione to potent testosterone;22 • Physiological impact includes hirsutism, anovulation and polycystic ovary syndrome in women.22 Tumor Necrosis Factor-α • Increased levels, though not detectable in plasma assays, have several paracrine effects, including interference in insulin signaling.23 Interleukin-6 • Excessive IL-6 production results in insulin resistance, systemic inflammation, pancreatic β-cell degeneration, and hyperglycemia.24 Plasminogen Activator Inhibitor-1 • Elevated levels, driven by increased IL-1, estrogen, TNF- α, and insulin increase the risk for thromboembolism, and myocardial infarction.25 S Afr Fam Pract 2018;60(3):40-4642 The page number in the footer is not for bibliographic referencingwww.tandfonline.com/oemd 42 plasma carrier proteins or organ tissues, homeostatic control over endogenous substances is exercised based on the concentration of the unbound, free fraction in plasma, and not the fraction of the compound harbored in organs, tissues and the paracellular space. Indeed, albumin,28 sex hormone binding globulin7 and thyroid hormone binding globulin29 increase in obese patients and may result in a slower onset but longer duration of drug action as well as longer half- lives. keywords: adipose; body; clinical; day; fat; insulin; obese; obesity; overweight; patients; table; tissue; treatment cache: safpj-4880.pdf plain text: safpj-4880.txt item: #291 of 732 id: safpj-4881 author: Mash, Bob title: The South African Academy of Family Physicians: new directions date: 2018-07-12 words: 802 flesch: 49 summary: Mission statement of the SA Academy of Family Physicians: • To advocate for and contribute to the strengthening of primary health care and district health services • To develop and promote the science and art of family medicine through education, training, research and the dissemination of knowledge • To represent and further the interests of family physicians in South Africa, Africa and other international forums • To influence the relationship between family physicians and health facilities, public and private institutions, government authorities, healthcare funders, the public and the medical profession in general. In the private sector we have been working hard to ensure that family physicians are recognised in terms of remuneration as well as their scope of practice. keywords: academy; family; south cache: safpj-4881.pdf plain text: safpj-4881.txt item: #292 of 732 id: safpj-4882 author: Ogunbanjo, Gboyega title: Prof George Samuel Fehrsen 26 August 1938 – 22 May 2018 (almost 80 years) date: 2018-07-12 words: 657 flesch: 54 summary: In South Africa, the Family Medicine programme that the late Prof Sam Fehrsen ran for 20 years produced many prominent family physicians for South Africa. He was the first head of department: Family Medicine at the former Medical University of Southern Africa – MEDUNSA (now Sefako Makgatho Health Sciences University) from 1977–1996, spanning a period of 20 years. keywords: africa; family; medicine cache: safpj-4882.pdf plain text: safpj-4882.txt item: #293 of 732 id: safpj-4883 author: Bouwer, M.; Labuschagne, S.; Spamer, S.; Vermaak, C.; Zietsman, L-M.; Steyn, D.; Joubert, G. title: Knowledge of final-year medical students at the University of the Free State of hand hygiene as a basic infection control measure date: 2018-07-12 words: 4018 flesch: 58 summary: The Author(s) RESEARCH South African Family Practice 2017; 1(1):1–5 https://doi.org/10.1080/20786190.2017.1396789 Open Access article distributed under the terms of the Creative Commons License [CC BY-NC 3.0] http://creativecommons.org/licenses/by-nc/3.0 Knowledge of final-year medical students at the University of the Free State of hand hygiene as a basic infection control measure M Bouwera, S Labuschagnea, S Spamera, C Vermaaka  , L-M Zietsmana  , D Steynb* and G Joubertc a Faculty of Health Sciences, School of Medicine, University of the Free State, Bloemfontein, South Africa b Faculty of Health Sciences, Department of Internal Medicine, University of the Free State, Bloemfontein, South Africa cFaculty of Health Sciences, Department of Biostatistics, University of the Free State, Bloemfontein, South Africa *Corresponding author, email: SteynD@ufs.ac.za Background: One of the main reasons for the spread of infection in the healthcare environment is inadequate hand hygiene. This study aimed to determine Free State University final- year medical students’ knowledge of hand hygiene as a basic infection control measure. keywords: alcohol; control; hand; hand hygiene; health; hygiene; infection; knowledge; patient; students; water cache: safpj-4883.pdf plain text: safpj-4883.txt item: #294 of 732 id: safpj-4884 author: Haffejee, Firoza; O’Connor, Laura; Govender, Nalini; Reddy, Poovendhree; Sibiya, Maureen Nokuthula; Ghuman, Shanaz; Ngxongo, Thembelihle; Borg, Dorinda title: Factors associated with unintended pregnancy among women attending a public health facility in KwaZulu-Natal, South Africa date: 2018-07-12 words: 4228 flesch: 52 summary: Keywords: pregnancy, public sector health care, South Africa, unintended pregnancy Introduction Unintended pregnancies are those that are not wanted by both parents or mistimed at the time of conception.1,2 Approximately 86 million pregnancies in 2008 were unintended, with 74 million of these occurring in less developed countries.1 Moreover, 39% of unintended pregnancies resulted in live births, 48% in abortions and 13% in miscarriages.1 Unintended pregnancy is a major public health burden, because it is linked with negative health, social and economic consequences.1,3 Studies have shown that approximately 28% of unintended pregnancies in developing countries can be avoided.4 Planned or intended pregnancies empower women to improve decision-making regarding antenatal care (ANC), prenatal diagnosis and use of folic acid, and prevent exposure to teratogenic substances, thus enhancing the health and growth of the developing child.5 The risk of unintended pregnancy in sub-Saharan Africa remains high and is poorly resolved due to poor access to reproductive health care.6 Factors associated with unintended pregnancy among women attending a public health facility in KwaZulu-Natal, South Africa South African Family Practice is co-published by Medpharm Publications, NISC (Pty) Ltd and Informa UK Limited [trading as the Taylor & Francis Group] S Afr Fam Pract ISSN 2078-6190 EISSN 2078-6204 keywords: africa; alcohol; health; pregnancies; pregnancy; south; study; unintended; use; women cache: safpj-4884.pdf plain text: safpj-4884.txt item: #295 of 732 id: safpj-4886 author: Parker, S.; Omar, S.; Mahomed, O. H. title: Menstrual abnormalities amongst female South African Hajj pilgrims: a cross-sectional study date: 2018-07-12 words: 3271 flesch: 51 summary: This study aims to determine the incidence of menstrual cycle abnormalities amongst South African female Hajj pilgrims and the potential factors that predispose to them. Menstrual abnormalities amongst female South African Hajj pilgrims: a cross-sectional study South African Family Practice is co-published by Medpharm Publications, NISC (Pty) Ltd and Informa UK Limited keywords: data; hajj; hmm; mcp; participants; pilgrims; south; study cache: safpj-4886.pdf plain text: safpj-4886.txt item: #296 of 732 id: safpj-4887 author: Dlova, N. C.; Gathers, R.; Tsoka-Gwegweni, J.; Hift, R. J. title: Skin cancer awareness and sunscreen use among outpatients of a South African hospital: need for vigorous public education date: 2018-08-28 words: 3933 flesch: 55 summary: A study was undertaken to assess the perception of skin cancer risk, knowledge of skin cancer, and understanding of the importance and use of sunscreens among South Africans. Most black patients were not aware that they are at risk of skin cancer, and only 10% were aware of the risk of developing skin cancers on acral sites and nails. keywords: african; cancer; knowledge; melanoma; population; respondents; risk; skin; south; sun; sunscreen cache: safpj-4887.pdf plain text: safpj-4887.txt item: #297 of 732 id: safpj-4888 author: Chorwe-Sungania, G.; Chipps, J. title: Validity and utility of instruments for screening of depression in women attending antenatal clinics in Blantyre district in Malawi date: 2018-08-28 words: 6276 flesch: 55 summary: Screening instruments should be brief, valid and easy to use if they are to be useful in a busy antenatal clinic in low-resource settings. Screening instruments cannot be valid without being reliable.8 A reliable instrument for screening of depression should be able to measure depression in pregnant women consistently.8 keywords: antenatal; depression; epds; instruments; item; item screener; screener; screening; sensitivity; specificity; srq; study cache: safpj-4888.pdf plain text: safpj-4888.txt item: #298 of 732 id: safpj-4890 author: Gardner, B. M. title: Anaesthesia for dentistry in children date: 2018-08-28 words: 3548 flesch: 55 summary: Paediatric dental chair sedation: An audit of current practice in Gauteng, South Africa. In most of these cases moderate sedation had been targeted. keywords: anaesthesia; cases; children; dental; guidelines; patients; psa; sedation cache: safpj-4890.pdf plain text: safpj-4890.txt item: #299 of 732 id: safpj-4891 author: Leonard, T. G.A. title: Non-opioid analgesic options date: 2018-08-28 words: 3388 flesch: 46 summary: A cohort study in the British Medical Journal demonstrated that almost 50% of patients were discharged home with opioid prescriptions after elective surgery and that 3% of them were still taking opioids 90 days after surgery.1 Rates of opioid use and addiction are not known in South Africa but with thousands of patients undergoing surgery annually it cannot be assumed that we are immune to the problems of opioid abuse. Chronic postsurgical pain can be a debilitating complication after mastectomy and thus the ability to prevent it is an important benefit of lignocaine.11 • Spine surgery ▪ Reduced postoperative pain scores in the postoperative period. keywords: intravenous; lignocaine; opioid; pain; patients; perioperative; pregabalin; surgery; use cache: safpj-4891.pdf plain text: safpj-4891.txt item: #300 of 732 id: safpj-4892 author: Gosai, K. title: Hazards with hips in theatre date: 2018-08-28 words: 5300 flesch: 49 summary: Interestingly, Costain et al.13 showed that at one year after operation, the mortality was reversed in favour of cemented hemiarthroplasties, suggesting that high-risk patients are more likely to succumb to BCIS in the early perioperative period if bone cement is used. Complications of Antibiotics in Bone Cement20 Complications of antibiotic impregnated in bone cement are the same as for systemic antibiotic use: keywords: arthroplasty; bcis; bone; bone cement; cardiovascular; cement; fracture; hip; increase; joint; patients; pressure; prosthesis; pulmonary; risk; team cache: safpj-4892.pdf plain text: safpj-4892.txt item: #301 of 732 id: safpj-4893 author: Korda, B. title: Anaphylaxis and anaesthesia date: 2018-08-28 words: 7196 flesch: 41 summary: Afr Fam Pract 2018;60(4):S21-S2926 S26 of perioperative hypersensitivity that were deemed as not life-threatening (Grade 1 and 2) were not included in NAP6 as perioperative anaphylaxis cases. Perioperative anaphylaxis is seen as a rare event, with a reported incidence between 1:1250- 1:20  000 anaesthetics,3 equating to on average once every 7 years per anaesthetist.2 However, it is one of the more common life-threatening anaesthetic complications, compared to other events such as MH (1:30 000 - 100 000)4 or an airway complication ( keywords: adrenaline; airway; allergy; anaesthesia; anaphylaxis; cases; cause; clin; drug; management; nap6; perioperative; risk; south; survey; table cache: safpj-4893.pdf plain text: safpj-4893.txt item: #302 of 732 id: safpj-4894 author: Kemp, M. E.A. title: Patients with congenital heart disease presenting for non-cardiac surgery date: 2018-08-28 words: 4129 flesch: 40 summary: Doppler studies in normal patients show that pulmonary blood flow is 35% greater during inspiration than expiration and 30% greater in Fontan patients. The ubiquitous presence and insidious onset of liver disease in Fontan patients probably justify routine screening. keywords: cardiac; circulation; disease; fontan; heart; patients; pulmonary; vascular; ventricle cache: safpj-4894.pdf plain text: safpj-4894.txt item: #303 of 732 id: safpj-4895 author: Ellis, Chris title: Sikanjalo district hospital Procedural medicine teaching unit date: 2018-08-28 words: 449 flesch: 46 summary: It is designed to handle and teach office procedures and minor surgical procedures under local and regional anaesthesia (upper and lower limb and specialised anaesthetic blocks). CPD teaching days in office procedures are provided regularly for medical officers from surrounding hospitals and for local general practitioners. keywords: procedures; unit cache: safpj-4895.pdf plain text: safpj-4895.txt item: #304 of 732 id: safpj-4896 author: Walwyn, David R.; Nkolele, Adolph T. title: Coordinating Health and Industrial Policy in South Africa; A Case Study of the Vaccine Public-Private Partnership date: 2018-08-28 words: 8701 flesch: 48 summary: In 2004, at the time of its initial establishment, the annual expenditure on public sector vaccines was $37.5 million.29 By 2012, this value had grown to $160 million, an increase of over 400% in real terms, primarily as a consequence of the inclusion of several additional vaccines to the EPI (see Figure 2). In 2004, at the time of its initial establishment, the annual expenditure on public sector vaccines was $37.5 million.29 By 2012, this value had grown to $160 million, an increase of over 400% in real terms, primarily as a consequence of the inclusion of several additional vaccines to the EPI (see Figure 2). keywords: africa; cost; distribution; health; institute; ndoh; policy; ppp; procurement; public; south; south africa; study; supply; vaccine; value cache: safpj-4896.pdf plain text: safpj-4896.txt item: #305 of 732 id: safpj-4897 author: Padayachee, N.; Lundie, M.; Shellack, N. title: An overview of the management of back pain date: 2018-08-28 words: 5942 flesch: 46 summary: Table 1: Check list of risk factors for the development of back pain Risk Factor Check  Physically demanding jobs – manual handling, bending, twisting and whole-body vibration2,3,4,5,7,14 Physical comorbidities, i.e. asthma, headache, diabetes3 Depression2,3,5,7,14 Smoking3,5,14 Obesity2,3,5,7,14 Lack of exercise3 Awkward postures3,4 Feeling tired3,4 Distractions during an activity3,4 Older age2,7,14 Female gender7,14 Inactive/desk-bound work14 Psychologically arresting work14 Low educational status2,7,14 Workers’ compensation insurance14 Job dissatisfaction2,14 Insomnia9 Anxiety/Stress2,4,9,14 Handling of objects far from the body4 Handling people or animals and unstable loading4 A slip, trip or fall4 Engagement in moderate or vigorous physical activity4 Sexual activity4 Alcohol consumption4 Differential diagnosis of back pain The American College of Physicians and the American Pain Society recommend that low back pain be divided into three categories: non-specific low back pain, low back pain with potential radicular symptoms, or low back pain due to an identified spinal cause, e.g. metastasis or infection.2,15 Differential diagnosis is initiated with a thorough physical examination and extensive history taking to determine which patients need to be referred for imaging and further diagnostic evaluation.5,8,14 The majority of patients who present with acute back pain can be treated with first-line non-pharmacological or pharmacological therapy and do not require any further Back pain is reported as the major reason for occupational absenteeism, decreased work productivity and early retirement globally, which results in considerable economic burden to individuals and the wider public.2,5,8,10 To put the issue into perspective: back pain is the chronic condition responsible for more people forced out of the workplace than cardiovascular disease, diabetes, cancer and respiratory conditions combined.5 South African Family Practice 2018; 60(4):14-21 Open Access article distributed under the terms of the Creative Commons License [CC BY-NC-ND 4.0] http://creativecommons.org/licenses/by-nc-nd/4.0 An overview of the management of back pain keywords: acute; care; cause; chronic; e.g.; factors; management; muscle; non; pain; patients; pharmacological; physical; risk; spinal; treatment cache: safpj-4897.pdf plain text: safpj-4897.txt item: #306 of 732 id: safpj-4898 author: Motswaledi, M. H. title: Herpes zoster (Shingles) date: 2018-08-28 words: 1722 flesch: 54 summary: This is referred to as zoster sine herpete (ZSH) or zoster sine eruptione.4,5 If the trigeminal nerve is involved, differentiating ZSH from idiopathic trigeminal neuralgia can be difficult, but clinical history can be helpful as the pain of ZSH is more continuous like postherpetic neuralgia rather than the intermittent pain of idiopathic trigeminal neuralgia.6 Patients with herpes zoster may be infectious from the skin lesions and in susceptible contacts of herpes zoster, chicken pox can occur, especially in children.3,4 The time between the start of pain and the onset of the eruption is about one and a half days in trigeminal zoster and about three days in thoracic disease.4 The vesicles always follow a dermatome or two contiguous dermatomes (Figure 1, Figure 2). This is herpes zoster involving the ophthalmic division of trigeminal nerve, the fifth cranial nerve ( Figure 3). keywords: figure; herpes; nerve; pain; virus; zoster cache: safpj-4898.pdf plain text: safpj-4898.txt item: #307 of 732 id: safpj-4899 author: Naidoo, Mergan; von Pressentin, Klaus B.; Ross, Andrew; Ras, Tasleem title: Mastering your Fellowship date: 2018-08-28 words: 5223 flesch: 53 summary: You provide extensive counseling for HIV testing of the child, but the mother refuses to provide consent. Long answer: Understanding HIV testing in children is often complex and many healthcare workers struggle with understanding the Children’s Act (38 of 2005). keywords: care; children; context; family; health; hiv; malaria; patient; question; research; study; treatment cache: safpj-4899.pdf plain text: safpj-4899.txt item: #308 of 732 id: safpj-4901 author: Magazi, D. S.; Nkohla, S.; Mmako, M. T. title: Epilepsy seizure types, classification and treatment date: 2018-08-28 words: 5035 flesch: 57 summary: The overall prognosis, however, is that 60–70% of patients with newly-diagnosed epilepsy will become seizure free.46 Primary generalised epilepsy and a normal neurological examination, control of seizures with low-dose monotherapy are associated with a good prognosis. Classification of Seizure Types Basic Version (please refer to the various seizures types discussed above for detail) Epilepsy seizure types, classification and treatment 25 keywords: classification; epilepsy; management; motor; onset; patients; phenomena; recurrence; seizures; tonic; treatment; types cache: safpj-4901.pdf plain text: safpj-4901.txt item: #309 of 732 id: safpj-4902 author: Outhoff, K. title: Magnesium: effects on physical and mental performance date: 2018-08-28 words: 2393 flesch: 44 summary: People get magnesium from their diet, but sometimes magnesium supplements are required if magnesium levels are too low for ideal physiological functioning.4 Early signs of magnesium deficiency include fatigue, weakness, loss of appetite, nausea and vomiting. The daily Recommended Dietary Allowances (RDA) for elemental magnesium is outlined below (Table I).1 Causes of magnesium deficiency Dietary intake of magnesium may be low, particularly among women.9 Reports estimate that at least 60 % of Americans do not consume the recommended daily amount of magnesium,10,11 while in South Africa the figure is approximately 50 %.12 Soil used for agriculture, is becoming increasingly deficient in essential minerals and the magnesium content in fruit and vegetables has decreased by 20-30 % over the last 60 years.10 keywords: chronic; deficiency; dietary; fatigue; intake; journal; levels; magnesium; years cache: safpj-4902.pdf plain text: safpj-4902.txt item: #310 of 732 id: safpj-4903 author: Greeff, Oppel B.W.; van Tonder, Jacob John; Naidu, Kershlin; McMaster, Alicia; van Tonder, Alet; Mothilal, Rashem title: A practical guide to the interpretation of PK/PD profiles of longer-acting analogue insulins. Part two: Insulin degludec vs. insulin glargine U300 date: 2018-08-28 words: 6213 flesch: 49 summary: Published glucose clamp data on IDeg and Gla- 300 In the previous part of this series on the interpretation of glucose clamp studies, six main aspects of glucose clamp studies to consider when interpreting results were suggested: (1) clamp methodology, (2) duration of glucose clamp study, (3) study population, (4) dose of study insulin, (5) glucose infusion rate and (6) plasma insulin concentration. Therefore, the use of reasonable insulin doses at steady-state conditions are regarded as the most appropriate for use in glucose clamp studies.13 Multiple concentrations of study insulin are usually investigated during glucose clamp studies. keywords: clamp; diabetes; gla-300; glucose; glucose clamp; ideg; insulin; plasma; studies; study; type cache: safpj-4903.pdf plain text: safpj-4903.txt item: #311 of 732 id: safpj-4904 author: Ogunbanjo, Gboyega A. title: National Health Insurance Bill: Is it implementable in its current form? date: 2018-08-28 words: 1009 flesch: 55 summary: e. Passing back savings: With the implementation of the NHI, it means that medical aid schemes will have to pass back savings to members, if a member uses a designated service provider. According to the 2017 NHI White Paper, NHI will cost R256 billion in the 2025/2026 financial year at 2010 prices. keywords: bill; nhi; schemes cache: safpj-4904.pdf plain text: safpj-4904.txt item: #312 of 732 id: safpj-4905 author: Diabetes of South Africa Type 2 Diabetes Guidelines Expert Committee, Society for Endocrinology Metabolism and title: Chapter 29: Male sexual dysfunction in type 2 diabetes date: 2018-08-28 words: 4162 flesch: 49 summary: Due to variability in laboratory values the same laboratory should be used for measurement.25 Testosterone levels should be measured towards the end of the injection interval (trough level) regardless of the preparation and levels below the normal range should receive dosing at shorter injection intervals; for testosterone levels above the normal range extension of the injection interval or dose reduction must be considered.34 Concerns exist about a link between prostate cancer and testosterone therapy: recent evidence fails to support this concern or that TTh is associated with growth of subclinical prostatic lesions.35,36 It is still recommended that patients undergo prostate assessment prior to commencement of therapy, including a PSA and digital rectal examination (DRE). Morgentaler A, Khera M, Maggi M, Zitzmann M. Commentary: who is a candidate for testosterone therapy? keywords: diabetes; dysfunction; erectile; hypogonadism; levels; male; men; study; testosterone; therapy; type cache: safpj-4905.pdf plain text: safpj-4905.txt item: #313 of 732 id: safpj-4906 author: Mampuya, F. K.; Steinberg, W. J.; Raubenheimer, J. E. title: Risk factors and HIV infection among patients diagnosed with deep vein thrombosis at a regional/tertiary hospital in Kimberley, South Africa date: 2018-08-28 words: 5629 flesch: 63 summary: at a hospital in Johannesburg reported an HIV prevalence of 84% in patients presenting with DVT.9 Olubanwo reported a prevalence of 79.4% in a retrospective study on all DVT cases admitted to a hospital in Mthatha over a one-year period.18 Our results as well as the literature show that HIV prevalence in DVT patients is higher compared with the prevalence of HIV in the general population.6 The high prevalence of HIV among known DVT patients may well indicate that the relative risk of developing DVT when being HIV-positive is much higher than in the HIV- negative group, as shown by Govender et al.19 HIV prevalence The yearly percentage of patients with unknown HIV status among the patients with DVT varied from 18.4% in 2010 to 3.9% in 2013. A study by Jong et al. showed that initiation of antiretroviral therapy improves the markers of endothelial cell activation, coagulation and natural anticoagulation in South African HIV-infected individuals.22 A similar study done in Denmark confirmed the result and demonstrated the improvement in cardiovascular risk.23 There has been some decline in HIV prevalence in patients with DVT at KHC during the five-year study period, dropping from 64.7% in 2010 to 52.9% in 2014. keywords: dvt; factors; hiv; patients; prevalence; risk; south; status; study; vein cache: safpj-4906.pdf plain text: safpj-4906.txt item: #314 of 732 id: safpj-4907 author: Seedat, R. Y.; Sujee, M.; Ismail, W.; Vallybhai, N. Y.; Cassim, M. I.; Khan, S.; Solwa, A.; Joubert, G. title: Allergic rhinitis in medical students at the University of the Free State date: 2018-08-28 words: 3984 flesch: 53 summary: Allergic rhinitis can adversely affect quality of life.3 A study on the concerns of patients with allergic rhinitis in the primary care setting in South Africa found that the symptoms affected sleep in 76.6% of sufferers and that 85.2% felt miserable due to their allergic rhinitis.4 Allergic rhinitis has also been shown to affect learning in schoolchildren,5 but there are few studies on the effect of allergic rhinitis in university students. The Author(s) RESEARCH South African Family Practice 2018; 60(4):121–125 https://doi.org/10.1080/20786190.2018.1437869 Open Access article distributed under the terms of the Creative Commons License [CC BY-NC 3.0] http://creativecommons.org/licenses/by-nc/3.0 Allergic rhinitis in medical students at the University of the Free State RY Seedata*  , M Sujeeb, W Ismailb, NY Vallybhaib, MI Cassimb, S Khanb, A Solwab and G Joubertc a Department of Otorhinolaryngology, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa b School of Medicine, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa cDepartment of Biostatistics, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa *Corresponding author, email: SeedatRY@ufs.ac.za Background: Allergic rhinitis, the most common form of chronic rhinitis, can adversely affect quality of life. keywords: allergy; nasal; participants; rhinitis; students; study; symptoms; treatment cache: safpj-4907.pdf plain text: safpj-4907.txt item: #315 of 732 id: safpj-4908 author: Steyn, Carrien; Govender, Indiran; Ndimande, John Velaphi title: An exploration of the reasons women give for choosing legal termination of pregnancy at Soshanguve Community Health Centre, Pretoria, South Africa date: 2018-08-28 words: 5705 flesch: 59 summary: This act allowed for safe, effective, affordable and acceptable methods of TOP.4 Utilisation of the TOP services increased significantly after this, to the extent that 7% of pregnant women in South Africa legally terminated their pregnancies in 2012.3 The demographic characteristics of women who chose TOP have been studied locally and internationally. Reasons women give for abortion: a review of the literature. keywords: africa; data; family; participants; pregnancies; pregnancy; reasons; south; study; termination; women cache: safpj-4908.pdf plain text: safpj-4908.txt item: #316 of 732 id: safpj-4909 author: Lines, D. title: Neuromuscular blocking agents - when is the block deep enough? And how to safely reverse the neuromuscular blocker date: 2018-08-28 words: 4490 flesch: 49 summary: The benefits of deep neuromuscular block for the duration of laparoscopic procedures have centred on patient benefits and perceived improved surgical access. Madsen et al.6 put forward a suggestion that there is data to support routine use of deep neuromuscular block for laparoscopic surgery whilst Kopman et al.7 argued that insufficient evidence exists. keywords: block; conditions; neostigmine; nmb; ratio; reversal; sugammadex; tof; use cache: safpj-4909.pdf plain text: safpj-4909.txt item: #317 of 732 id: safpj-4910 author: Ellis, Chris title: Saint’s Triad, Occam’s Razor and Hickam’s Dictum date: 2018-10-23 words: 854 flesch: 53 summary: I find that many more diagnoses have become available to us in the last few decades and I am presented with a list of diagnoses for a patient from diabetes, hypertension, dyslipidaemia, hypothyroidism through to osteoporosis and general anxiety disorder (both mine and the patient’s). The opposing view to this complexity theory comes partly under the aphorism “common diseases occur commonly” and one should look for the simple explanation first. keywords: patient; saint; triad cache: safpj-4910.pdf plain text: safpj-4910.txt item: #318 of 732 id: safpj-4911 author: Makola, Nkatoko Freddy; Magongwa, Nicholus Malesela; Matsaung, Boikgantsho; Schellack, Gustav; Schellack, Natalie title: Managing athlete’s foot date: 2018-10-23 words: 4003 flesch: 50 summary: Topical nystatin may be used for mucocutaneous candidiasis, such as oropharyngeal and vulvovaginal thrush, but is not effective against tinea infections (including tinea pedis). Keywords: athlete’s foot, tinea pedis, dermatophyte, fungal infection, allylamines, azole antifungals, griseofulvin, terbinafine S Afr Fam Pract 2018;60(5):37-4138 The page number in the footer is not for bibliographic referencingwww.tandfonline.com/oemd 38 Diagnosis of tinea pedis Tinea pedis can be diagnosed through different clinical methods.12 keywords: athlete; azoles; clinical; dermatophyte; feet; foot; fungal; infection; pedis; skin; tinea; tinea pedis; treatment cache: safpj-4911.pdf plain text: safpj-4911.txt item: #319 of 732 id: safpj-4912 author: Janse van Rensburg, Dina C.; Jansen van Rensburg, Audrey; Kalmeier, Gehart; Viljoen, Carel T.; Ramagole, Dimakatso A.; Schwellnus, Martin P. title: The use of skeletal muscle relaxants in musculoskeletal injuries: what is the evidence? date: 2018-10-23 words: 7771 flesch: 54 summary: Galer BS, Rowbotham M, Perander J, Devers A, Friedman E. Topical diclofenac patch relieves minor sports injury pain: Results of a multicenter controlled clinical trial. Studies report that pain have a tendency to inhibit rather than facilitate voluntary reflex contractile function.30-34 Sports injury: In the recent consensus statement on pain management in elite athletes by the International Olympic Committee, a sports injury is defined as a new or recurring musculoskeletal complaint incurred during competition or training that require medical attention, regardless of the potential absence from competition or training.35 Engebretsen et al.36 have previously suggested the definition of a sports injury should require restricted activity for at least one day. keywords: acute; anti; barkin; botulinum; clin; combination; drugs; e.g.; evidence; injuries; injury; management; med; medications; muscle; nsaids; number; pain; relaxants; review; smrs; sports; study; syndrome; therapy; toxin; treatment; use cache: safpj-4912.pdf plain text: safpj-4912.txt item: #320 of 732 id: safpj-4913 author: Naidoo, Mergan; von Pressentin, Klaus B.; Ras, Tasleem; Torlutter, Michele title: Mastering your Fellowship date: 2018-10-23 words: 5854 flesch: 52 summary: (3 marks) 3.2 Were study participants sampled in an appropriate way? The study sample should be described in sufficient detail so that other researchers can determine if it is comparable to their population of interest.” 3.2 Were study participants sampled in an appropriate way? keywords: age; care; data; factors; family; hypertension; information; marks; patient; population; sample; size; study cache: safpj-4913.pdf plain text: safpj-4913.txt item: #321 of 732 id: safpj-4914 author: Rossouw, T. M.; Theron, A. J.; Anderson, R. title: Practical approach to diagnosis and management of primary immunodeficiency diseases date: 2018-10-23 words: 5897 flesch: 38 summary: This is followed by a consideration of prophylactic and therapeutic options and, finally, by a brief overview of gene therapy and gene-editing strategies that may offer alternatives to, or eventually replace, stem cell therapy. This test identifies newly-formed, immature T-cells which are absent in most forms of SCID, as well as conditions associated with very low numbers of T-lymphocytes.18 However, the test is costly and only available on request in South Africa.10 Having excluded abnormalities of cell numbers, either persistent or cyclical, as well as cell morphology, second-tier evaluation of suspected abnormalities of innate immunity, specifically those affecting neutrophils, should be directed at assays of the protective functions of phagocytic cells. keywords: antibody; cell; deficiencies; diagnosis; diseases; disorders; gene; hsct; immunodeficiency; infections; patients; pids; syndrome; therapy cache: safpj-4914.pdf plain text: safpj-4914.txt item: #322 of 732 id: safpj-4915 author: Searyoh, K.; Lubbe, D. title: Complications of rhinosinusitis date: 2018-10-23 words: 1703 flesch: 32 summary: Infections of the floor of the frontal sinus may also spread directly to the orbit and cause orbital complications. It is worth noting that in children, orbital complications may be painless. keywords: abscess; complications; sinus; sinuses; sinusitis; spread cache: safpj-4915.pdf plain text: safpj-4915.txt item: #323 of 732 id: safpj-4916 author: Tshifularo, Mashudu title: Grommets and swimmers ear date: 2018-10-23 words: 2263 flesch: 60 summary: They are to improve middle ear ventilation, hearing improvement and drainage when eutascian tube is blocked in otitis media with effusion. Selection criteria Randomised controlled trials recruiting children (0-17 years) with ventilation tubes and assessing the effect of water precautions (Avoidance or swimming/bathing restrictions) and mechanical (earplugs, moulds, swim seal, hats, bands) and review articles on the recent same topics. keywords: children; ear; grommets; swimming; water cache: safpj-4916.pdf plain text: safpj-4916.txt item: #324 of 732 id: safpj-4917 author: Mash, Bob title: SAAFP moving forward date: 2018-10-23 words: 1063 flesch: 48 summary: Linked with the video and part of the Academy’s advocacy plan is the publication of a policy brief on “how family physicians strengthen district health services”.4 The two-page document is intended for use with managers at national, provincial or district levels to clearly explain the role of the family physician and the evidence for their impact and contribution to health care. The participants enjoyed the chance to network, socialise, debate and share their experiences as family physicians. keywords: care; family; health; physicians cache: safpj-4917.pdf plain text: safpj-4917.txt item: #325 of 732 id: safpj-4918 author: Schellack, Natalie; Masuku, Palesa; Mogale, Kgarebe; Mokwele, Nelly; Skosana, Phumzile title: Hands on management of muscle pain and injuries date: 2018-10-23 words: 7736 flesch: 50 summary: After the person is exposed to an extrinsic risk (e.g., not wearing the correct shoes), an injury will occur.10 Classification of sports injuries Sports injuries are generally classified as acute or traumatic and chronic/overuse regardless of the affected structure.12 Acute or traumatic injuries include sprains, cuts, fractures and concussions. Figure 6: Management of sports injuries using the PRICE principle Sports injuries are commonly accompanied by muscle pain. keywords: acute; factors; figure; gel; injuries; injury; management; muscle; non; pain; patient; skin; sports; sports injuries; sprains; swelling; table; therapy; topical; treatment cache: safpj-4918.pdf plain text: safpj-4918.txt item: #326 of 732 id: safpj-4921 author: Grema, B. A.; Aliyu, I.; Michael, G. C.; Musa, A.; Fikin, A.G.; Abubakar, B. M.; Olusegun, S. title: Typhoid ileal perforation in a semi-urban tertiary health institution in north-eastern Nigeria date: 2018-10-23 words: 5025 flesch: 49 summary: Typhoid ileal perforation in a semi-urban tertiary health institution 171 The mortality rate of typhoid ileal perforation ranged from 9% to 43%;31 22% mortality was recorded in this study; this figure was similar to those of Adesunkanmi and Ajao31 but higher than those of Edino et al.7 and the 10.9% reported by Anyanwu et al.25 Easy access to health facilities and late presentation to hospital might have contributed to this disparity. Typhoid ileal perforation is a very serious complication of typhoid fever and remains a significant surgical problem in developing countries like Nigeria, where it is associated with higher mortality and morbidity, due to lack of adequate clean drinking water, poor sanitation and lack of access to health facilities in remote areas and delays in hospital presentation. keywords: cases; days; fever; health; hospital; nigeria; number; perforation; study; surgery; total; typhoid cache: safpj-4921.pdf plain text: safpj-4921.txt item: #327 of 732 id: safpj-4922 author: Nair, A.; Steinberg, W. J.; Habib, T.; Saeed, H.; Raubenheimer, J. E. title: Prevalence of healthcare-associated infection at a tertiary hospital in the Northern Cape Province, South Africa date: 2018-10-23 words: 5358 flesch: 45 summary: The third prevalence survey of healthcare associated infections in acute hospitals Republic of Ireland. The manage- ment and control of hospital acquired infection in Acute NHS Trusts in England [Internet]. keywords: africa; data; factors; hcai; healthcare; hospital; infection; patients; prevalence; risk; south; study; survey cache: safpj-4922.pdf plain text: safpj-4922.txt item: #328 of 732 id: safpj-4923 author: Uchenna, Charles; Govender, Indiran title: Knowledge, attitudes and practices of doctors at Jubilee Hospital, Tshwane District, regarding the syndromic management guidelines for sexually transmitted infections date: 2018-10-23 words: 5560 flesch: 55 summary: Knowledge, attitudes and practices of doctors at Jubilee Hospital, Tshwane District, regarding the syndromic management guidelines for sexually transmitted infections Knowledge, attitudes and practices of doctors at Jubilee Hospital, Tshwane District, regarding the syndromic management guidelines for sexually transmitted infections Charles Uchenna and Indiran Govender* Department of Family Medicine and Primary Health Care, Sefako Makgatho Health Sciences University, Pretoria, South Africa *Corresponding author, email: indiran.govender@gmail.com Background: Sexually transmitted infections (STIs) are a public health problem globally, but especially so in sub-Saharan Africa. Aim: To determine the knowledge, attitudes and practices of doctors working in Jubilee District Hospital, Metsweding region, Tshwane, regarding the STI syndromic management (SM) guidelines. keywords: africa; doctors; guidelines; health; knowledge; management; practices; respondents; south; stis; study cache: safpj-4923.pdf plain text: safpj-4923.txt item: #329 of 732 id: safpj-4924 author: Lekalakala-Mokgele, Eucebious title: Death and dying: elderly persons’ experiences of grief over the loss of family members date: 2018-10-23 words: 4415 flesch: 61 summary: Conclusions: The response to death of the elderly affirms that it cannot be assumed that multiple death experiences establish their readiness or ability to handle these experiences and to grieve successfully. This affirms that it cannot be assumed that multiple death experiences establish their readiness or ability to handle these experiences and to grieve successfully. keywords: anxiety; death; dying; experiences; family; grief; grieving; members; participants; study cache: safpj-4924.pdf plain text: safpj-4924.txt item: #330 of 732 id: safpj-4925 author: Ntshabele, Reabetswe; Perumal, Rubeshan; Padayatchi, Nesri title: Rural medicine and ‘home stay’: a medical student’s experience date: 2018-11-30 words: 3044 flesch: 51 summary: The use of concepts such as home stay may be the compromise that is necessary to generate the sense of identification and belonging that drives the intention to return to a community as a practitioner.4 The consequences of failing to allow for an immersive rural experience are also clear: without rural exposure, the vast majority of medical students from non-rural backgrounds are unlikely to take on the challenge of rural medical practice, even the most altruistic among them.5–7 The way forward Furthermore, it presents the highly personal and developmental journey that decentralised and, in particular, rural medical training can offer. keywords: experience; health; medicine; patients; rural; south; students cache: safpj-4925.pdf plain text: safpj-4925.txt item: #331 of 732 id: safpj-4926 author: Mortazavi, S. M.J.; Mortazavi, S A.R. title: Comment on ‘Cell phone use and ill health: is there a definite relationship?’ date: 2018-11-30 words: 1527 flesch: 54 summary: The Author(s) LETTER TO THE EDITOR South African Family Practice 2018; 60(6):212–213 https://doi.org/10.1080/20786190.2018.1432140 Open Access article distributed under the terms of the Creative Commons License [CC BY-NC 3.0] http://creativecommons.org/licenses/by-nc/3.0 Comment on ‘Cell phone use and ill health: is there a definite relationship?’ SMJ Mortazavia  and SAR Mortazavib* a Fox Chase Cancer Center, Philadelphia, PA, USA b School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran *Corresponding author, email: S.M.Javad.Mortazavi@fccc.edu Prof Gboyega A Ogunbanjo, in his editorial entitled ‘Cell phone use and ill health: is there a definite relationship?’, published in South African Family Practice, has addressed the possible link between mobile phone use and adverse health effects such as cancer. The main concerns regarding the evidence presented in this paper about possible association of mobile phone use with cancer are discussed. keywords: exposure; mortazavi; phone cache: safpj-4926.pdf plain text: safpj-4926.txt item: #332 of 732 id: safpj-4928 author: Tshitenge, S. T.; Nlisi, K.; Setlhare, V.; Ogundipe, R. title: Knowledge, attitudes and practice of healthcare providers regarding contraceptive use in adolescence in Mahalapye, Botswana date: 2018-11-30 words: 5413 flesch: 44 summary: Wong LP, Atefi N, Majid HA, et al. Prevalence of pregnancy experi- ences and contraceptive knowledge among single adults in a low socioeconomic suburban community in Kuala Lumpur, Malaysia. BMC Public Health. Although three-quarters of respondents strongly agreed (median = 5, [IQR 5–6]) that they were comfortable with prescribing contraceptives to adolescents, only 23% of the respondents very much prescribed or always prescribed contraceptives to adolescents. keywords: adolescents; contraceptive; hcps; health; knowledge; methods; practice; providers; respondents; study; use cache: safpj-4928.pdf plain text: safpj-4928.txt item: #333 of 732 id: safpj-4929 author: Ellis, Chris title: Sutton’s law, Phaeochromocytomas and Zebras date: 2018-11-30 words: 839 flesch: 62 summary: As one approaches diagnostic certainty, he says, the useful information returned by diagnostic tests approaches zero. On this same subject of clinical reasoning, I would like to believe that we follow sequences and strive to be logical in our investigations, bloods tests and imaging. keywords: medicine; sutton; tests cache: safpj-4929.pdf plain text: safpj-4929.txt item: #334 of 732 id: safpj-4930 author: von Pressentin, Klaus B.; Naidoo, Margan; Mayanja, Frederick; Ras, Tasleem title: Mastering your Fellowship date: 2018-11-30 words: 4751 flesch: 56 summary: The authors situated the issue of blunt chest trauma within the context of trauma being a major burden of disease in South Africa, as well as within the context of a resource- constrained health system where patients with such injuries require significant resources in their diagnostic and therapeutic work-up. Patients were admitted to the TICU via the resuscitation area and received diagnostic work- up and surgical intervention(s) prior to TICU admission. keywords: children; circumcision; consent; family; intervention; marks; patient; question; study; trauma cache: safpj-4930.pdf plain text: safpj-4930.txt item: #335 of 732 id: safpj-4931 author: Wolmarans, De Wet; Brand, Sarel J.; Brand, Linda title: All headaches are not equal: A review of migraine as a state of brain dysfunction date: 2018-11-30 words: 7747 flesch: 47 summary: Paracetamol (acetaminophen) with or without an antiemetic for acute migraine headaches in adults. General principles:46 • Consider if frequent attacks require acute medication more than twice per week, the duration of an attack is longer than 24 hours, in case of medication failure or overuse and in uncommon migraine variants with the risk for permanent neurologic injury; • Administer daily to reduce the frequency, severity, and duration of attacks and to increase response to acute therapy; • May be given as intermittent therapy when headaches recur in a predictable pattern (e.g. exercise-induced/menstrual migraine); • Drug selection is primarily based on the side effect profiles and comorbid conditions; response is unpredictable and a 2–3 month trial is necessary to achieve benefit, while maximal benefit is typically observed following 6 months of treatment;59 • Start with low doses, titrate until therapeutic effect or side-effects become intolerable; • Overuse of acute headache treatments will interfere with the effects of preventive treatment;59 • Continue prophylaxis for at least 6–12 months after headache frequency and severity have diminished, gradually taper or discontinue; • Propranolol, timolol, divalproex sodium, topiramate, as well as Botulinum toxin serotype A (BoNT-A) and CGRP-antagonists are the only FDA approved prophylactic agents,63,64 while numerous other drugs from diverse pharmacological classes have also been used successfully (see below). keywords: acute; aura; cgrp; drugs; effects; et al; headache; hours; migraine; pain; patients; receptor; review; serotonin; treatment; trigeminovascular; use cache: safpj-4931.pdf plain text: safpj-4931.txt item: #336 of 732 id: safpj-4932 author: Engler, D.; Makola, F.; Magongwa, N. M. title: Atopic Dermatitis date: 2018-11-30 words: 4535 flesch: 46 summary: A complex interaction of immune cells mediates AD skin lesions. No evidence has however been reported in favour of AD management with regards to probiotics, dietary supplements, botanical extracts and homoeopathy.9 Figure 4 depicts factors such as temperature, indoor heating, humidity, and UV-light exposure influencing the prevalence of AD. keywords: atopic; atopic dermatitis; barrier; cells; dermatitis; disease; factors; management; patients; skin; th2; therapy; treatment; use cache: safpj-4932.pdf plain text: safpj-4932.txt item: #337 of 732 id: safpj-4933 author: Muntingh, George L.; Viljoen, Michelle title: A "site" for sore eyes date: 2018-11-30 words: 3000 flesch: 43 summary: When compared to placebo, the use of antibiotic eye drops is associated with improved rates of clinical and microbiological remission.4 A broad-spectrum topical antibiotic is recommended. Furthermore, not all eye infections will react to antibiotic eye drops. keywords: antibiotic; conjunctivitis; corneal; drops; endophthalmitis; eye; herpes; keratitis; patient; simplex; treatment cache: safpj-4933.pdf plain text: safpj-4933.txt item: #338 of 732 id: safpj-4934 author: van Zyl, R. L. title: Prophylaxis - A key component in malaria control date: 2018-11-30 words: 2369 flesch: 46 summary: As such, the patients should be informed of the various options available in the form of preventative measures and chemoprophylaxis.1 Patients should be advised on the ‘ABC’ of malaria prevention, which include A: Awareness and Assessment of malaria risk; B: Avoidance of mosquito Bites; C: Compliance with Chemoprophylaxis, when indicated; D: Early Detection of malaria disease; E: Effective treatment.2 Malaria transmission Of the 91 countries reporting indigenous malaria cases in 2016, fourteen countries in sub-Saharan Africa and India suffered 80% of the global malaria burden, along with 356 000 of the 445 000 global malaria-associated deaths.2 Common adverse effects reported for this combination are gastric intolerance (usually subside), mouth ulcers and stomatitis.1,10 Ideally, pregnant women and young children should be discouraged from entering a malaria area due to the increased risk of being infected and the dire consequences Figure 1: Malaria transmission areas in South Africa.1 S Afr Fam Pract 2018;60(6):14-1616 keywords: africa; area; malaria; mosquito; patients; risk; south cache: safpj-4934.pdf plain text: safpj-4934.txt item: #339 of 732 id: safpj-4935 author: Ogunbanjo, Gboyega A. title: Air pollution and child health: What can health care professionals do? date: 2018-11-30 words: 863 flesch: 50 summary: Ambient air pollution (AAP) alone imposes enormous costs on the global economy, amounting to more than US$5 trillion in total welfare losses in 2013.1 In addition, the WHO reports that although air pollution is a global problem, the burden of disease attributable to particulate matter in air is heaviest in low- and middle-income countries (LMICs), particularly in the WHO African, South-East Asia, Eastern Mediterranean and Western Pacific regions. LMICs in these regions – especially the African region – have the highest levels of exposure to HAP due to the widespread use of polluting fuels and technologies for basic daily needs, such as cooking, heating and lighting.2 Poverty is correlated with high exposure to environmental health risks and can also compound the damaging health effects of air pollution, by limiting access to information, treatment and other health care resources. keywords: air; children; health; pollution cache: safpj-4935.pdf plain text: safpj-4935.txt item: #340 of 732 id: safpj-4936 author: Ford, Thornton; Potgieter, Johané; Van der Walt, Jana; Van Schalkwyk, Monette; Van Lill, Maresa; Joubert, Gina title: Community-acquired pneumonia in patients admitted to National District Hospital in Bloemfontein: guideline adherence date: 2018-11-30 words: 1668 flesch: 42 summary: Patients admitted with CAP to the casualty department only and patients with a suspected hospital-acquired pneumonia were excluded. Conclusion: The adherence of health professionals to the treatment guideline for suspected CAP patients is poor. keywords: cap; community; patients; pneumonia; study cache: safpj-4936.pdf plain text: safpj-4936.txt item: #341 of 732 id: safpj-4938 author: Ogunfowora, Olusoga Babatunde; Ogunlesi, Tinuade Adetutu; Ayeni, Victor Ayodeji title: Factors associated with clinical outcomes among neonates admitted with acute bilirubin and hypoxic-ischaemic encephalopathies at a tertiary hospital in south-west Nigeria date: 2019-10-28 words: 6373 flesch: 54 summary: dDAMA threat: disruption of clinical care due to attempts to discharge baby against medical discharge Serious neonatal illnesses 179 Overall, 32 (40.0%) babies had both social and facility-related challenges, while 25 (31.2%) had neither social nor facility- related challenges of care. Factors associated with clinical outcomes among neonates admitted with acute bilirubin and hypoxic-ischaemic encephalopathies at a tertiary hospital in south-west Nigeria Factors associated with clinical outcomes among neonates admitted with acute bilirubin and hypoxic-ischaemic encephalopathies at a tertiary hospital in south-west Nigeria Olusoga Babatunde Ogunfowora , Tinuade Adetutu Ogunlesi* and Victor Ayodeji Ayeni Department of Paediatrics, Olabisi Onabanjo University Teaching Hospital, Sagamu, Nigeria *Corresponding author, email: tinuade_ogunlesi@yahoo.co.uk Background: Babies who are delivered outside hospital are most at risk of serious illnesses such as perinatal asphyxia and severe hyperbilirubinaemia. keywords: abe; babies; bilirubin; care; challenges; facility; health; hie; hospital; hours; neonatal; referral; study cache: safpj-4938.pdf plain text: safpj-4938.txt item: #342 of 732 id: safpj-4939 author: Wolmarans, D.; Steyn, S. F.; Brand, L. title: Rhinosinusitis and allergy: a relationship of random meetings date: 2019-10-28 words: 2950 flesch: 41 summary: Meltzer EO, et al. Rosenfeld RM, et al. keywords: allergy; ars; effects; nasal; rhinitis; rhinosinusitis; treatment cache: safpj-4939.pdf plain text: safpj-4939.txt item: #343 of 732 id: safpj-4940 author: Ellis, Chris title: Gardening as a prescription date: 2019-10-28 words: 967 flesch: 70 summary: Gardens can be horizontal or vertical or on the roof or on your small verandah. Gardening as a prescription for individual everyday living also has both physical and mental benefits. keywords: benefits; gardening; soil cache: safpj-4940.pdf plain text: safpj-4940.txt item: #344 of 732 id: safpj-4941 author: Davids, M. R.; Chothia, M. Y. title: Chronic kidney disease for the primary care clinician date: 2019-10-28 words: 4458 flesch: 53 summary: Controlling the epidemic of cardiovascular disease in chronic renal disease: What do we know? The Author(s) REVIEW Introduction There is a global epidemic of chronic kidney disease (CKD), with approximately one in ten adults affected.1 A systematic review of the CKD burden in sub-Saharan Africa by Stanifer et al. estimated the prevalence at 13.9%.2 Like most other countries, South Africa is also experiencing an increasing disease burden. keywords: africa; cardiovascular; chronic; ckd; diabetic; disease; gfr; kidney; nephrol; nephropathy; patients; renal; risk; south cache: safpj-4941.pdf plain text: safpj-4941.txt item: #345 of 732 id: safpj-4942 author: Govender, I.; Rangiah, S.; Okonta, H. I. title: Management of upper gastrointestinal bleeding date: 2019-10-28 words: 3004 flesch: 42 summary: Causes Acute UGIB is classified into two broad categories viz non-variceal and variceal, with the former being more common and including oesophagitis, oesophageal ulcers, oesophageal cancer, Mallory- Weis tear, gastritis, gastric ulcer, gastric cancer, Dieulafoy’s lesion, vascular ectasias (angiodysplasia), duodenal ulcer, aorto-enteric fistula, haemobilia and haemosuccus pancreaticus.8 South African Family Practice 2019; 61(5):15-18 Open Access article distributed under the terms of the Creative Commons License [CC BY-NC-ND 4.0] http://creativecommons.org/licenses/by-nc-nd/4.0 Management of upper gastrointestinal bleeding I Govender,1 S Rangiah,2 HI Okonta3 1 Department of Family Medicine, Kalafong Hospital and University of Pretoria, South Africa 2 Department of Family Medicine, University of KwaZulu-Natal, South Africa 3 Department of Family Medicine, Sefako Makgatho Health Sciences University, South Africa Corresponding author, email: indiran.govender@gmail.com This paper will describe the common symptoms, signs and causes of upper gastrointestinal bleeding. keywords: bleeding; blood; disease; gastric; gastrointestinal; management; patients; risk; score; ugib; variceal cache: safpj-4942.pdf plain text: safpj-4942.txt item: #346 of 732 id: safpj-4943 author: Naidoo, M.; Von Pressentin, K. B.; Ras, T.; Mabuza, H. title: Mastering your Fellowship date: 2019-10-28 words: 5742 flesch: 51 summary: The National TB Guidelines recommend the cessation of TB treatment and other potentially toxic drugs (cotrimoxazole) and advocate admission and monitoring of such patients until the ALT < 100 IU/l. One may then re-challenge the patient with individual TB drugs starting with RIF as follows: • Start Rifampicin 10 mg/kg/day (max 600 mg/ day) • Repeat ALT on day 3 • If normal, add Isoniazid 5  mg/kg/day (max 300  mg/ day) on day 4 to 6 • Repeat ALT on day 7 • If normal, add Ethambutol 15mg/kg/day on day 8–10 • Check ALT on day 10 • If normal consider Pyrazinamide 25 mg/kg/day The consensus statement from the HIV clinicians’ society suggests the replacement of standard TB treatment with MOX, EMB and STR in cases of DILI but the 2014 National Department of Health TB guidelines takes a conservative approach and suggests that we stop all treatment and allow the liver to recover before challenging with a single drug. In this case, children below six years is the high-risk group for TB infection. keywords: authors; case; district; family; health; hiv; marks; medicine; patients; series; south; study cache: safpj-4943.pdf plain text: safpj-4943.txt item: #347 of 732 id: safpj-4944 author: Govender, I.; Okonta, H. I.; Rangiah, S.; Nzaumvila, D. title: Management of the patient with chronic obstructive airway disease (COPD) in a primary health care context date: 2019-10-28 words: 3943 flesch: 40 summary: ◊ Patients with severe renal impairment: The use of ULTIBRO BREEZHALER is not recommended for these patients. Oxygen saturation should be determined to identify COPD patients in need of supplemental oxygen. keywords: breezhaler; chest; copd; disease; dyspnoea; exacerbation; lung; patients; risk; ultibro cache: safpj-4944.pdf plain text: safpj-4944.txt item: #348 of 732 id: safpj-4945 author: Mash, Bob title: National Health Insurance – a Bill too far? date: 2019-10-28 words: 955 flesch: 51 summary: He reiterated the argument for change due to the enormous inequities in our provision of health care and use of resources in South Africa. The essential ingredients of NHI include access for all to a defined package of care with no payment at the point of use.2 Payment for health care would come from a combination of payroll taxes, personal income tax, reallocation of medical scheme tax credits and other taxes. keywords: health; nhi; south cache: safpj-4945.pdf plain text: safpj-4945.txt item: #349 of 732 id: safpj-4946 author: Meyer, J. C.; Matlala, M.; Chigome, A. title: Mental health care - a public health priority in South Africa date: 2019-10-28 words: 5299 flesch: 49 summary: Being adequately prepared and equipped with knowledge to meet the specific needs of adolescents with mental health challenges, is one step in the right direction of ensuring the wellbeing of this group of young people in whom mental illness is poorly detected and sub-optimally treated.27 Suicide due to mental health disorders Suicide is a global health challenge with economic and societal consequences.31-33 Over 800 000 suicide-related deaths occurred in 2012 globally with suicide being the second leading cause of death for young people aged between 15 and 29 years.34 Furthermore, PHC practitioners can play an important role in mental health awareness and reducing stigma associated with mental health disorders.6 Sub-optimal adherence to medicines used in the treatment of mental health disorders in particular, remains a challenge, and side-effects from antipsychotic medicines are known to have a negative impact on adherence rates.45,47 Additionally, patients on multiple antipsychotic medicines, and those on other chronic medicines as well, may also experience more side-effects as compared to those on monotherapy.45 To ensure patient safety, the GP can work with the pharmacist, who can provide counselling on the safe and effective use of medication, monitor adverse drug reactions and prevent possible medication-related problems.50 Because of the significant short- and long-term morbidity associated with adolescent mental illness, creating awareness, improved screening, detection and treatment of mental illness is a priority.30 This can be achieved through an integrated healthcare system, providing medical and mental health care at primary and secondary level.30 Table I. Summary of pharmacological treatment options for mental disorders16,35,44 Mental disorder Pharmacological management options Major depressive disorder Post-traumatic stress disorder during pregnancy Tricyclic and tetracyclic anti-depressants Tricyclics: • keywords: africa; anxiety; bipolar; care; depressive; disorders; health; illness; patients; public; services; south; stigma; suicide; treatment cache: safpj-4946.pdf plain text: safpj-4946.txt item: #350 of 732 id: safpj-4947 author: van Zyl, P. M.; Brisley, C.; Halberg, L.; Matthysen, M.; Toerien, M.; Joubert, G. title: The use, knowledge and attitudes regarding hormonal contraceptive products of female first-year students in a Faculty of Health Sciences date: 2019-10-28 words: 6505 flesch: 50 summary: Eisenberg et al.20 reported that women who selected IUDs and implants were more likely to have accurate knowledge concer- ning the effectiveness of their method of contraception, while Table 5: Participants’ confidence in discussing hormonal contraception and sexual issues with different parties Factor With a doctor With patients With fellow students With friends n % n % n % n % Hormonal contraception: n = 258 n = 258 n = 256 n = 259 I will not be able to 17 6.6 17 6.6 13 5.1 13 5.0 I will discuss A quarter (25.4%, n = 16) each reported that their partner was either neutral about hormonal contraception use or they did not know how their partner felt about this. keywords: contraception; contraceptives; emergency; health; hormonal; knowledge; participants; population; products; south; students; study; use cache: safpj-4947.pdf plain text: safpj-4947.txt item: #351 of 732 id: safpj-4948 author: McGregor, Richard Gavin; Ross, Andrew John; Zihindula, Ganzamungu title: The socioeconomic impact of rural-origin graduates working as healthcare professionals in South Africa date: 2019-10-28 words: 5674 flesch: 51 summary: December 2017 Location No. % Work locations of all UYDF graduates in December 2017 (n = 337): Internship 42 13 Rural areas 187 56 Public hospitals 45 13 Private hospital 27 8 Specialising 11 3 NGOs 8 2 No post/locum 8 2 Studying 4 1 Unemployed 2 1 Deceased 3 1 Total 337 100 Work locations of UYDF graduates who had completed their work-back obligations in December 2017 (n = 145): Rural areas 91 63 Public hospitals* 27 19 Private hospitals* 15 10 Specialising* 4 3 NGOs 8 6 Total 145 100 Professional qualifications of UYDF graduates (n = 337) Specialty Audiologist 4 Biomedical technologist 15 4 Clinical associate 1 0 Dentist 4 1 Dental therapist 10 3 Dietitian 11 3 Environmental Health 1 0 Doctor 113 34 Nurse 40 12 Nutritionist 1 0 Occupational therapist 8 2 Optometrist 14 4 Orthotist 1 0 Pharmacist 31 9 Psychologist 7 2 Physiotherapist 29 9 Radiographer 29 9 Social worker 14 4 Speech therapist 4 1 Total 337 100 Source: MacGregor15*—these are not in rural areas. Although not guaranteed, the vast majority of UYDF graduates have been able to find employment upon graduation because of their professional qualification and understanding of the local language and culture. keywords: 2019; africa; education; employment; family; graduates; healthcare; origin; rural; south; study; uydf; work cache: safpj-4948.pdf plain text: safpj-4948.txt item: #352 of 732 id: safpj-4949 author: Fasola, O. E.; Alao, A. O.; Ibisola, B. A.; Obimakinde, A. M.; Odekunle, I. C. title: Knowledge and perception of Family Medicine among medical students at University of Ibadan, Nigeria date: 2019-10-28 words: 5001 flesch: 48 summary: The final-year (sixth year) medical stu- dents who had been exposed to a total of eight weeks of Family Medicine clerkship in addition to Family Medicine core lectures obviously demonstrated better knowledge of Family Medicine compared with the fifth-year medical students who had four weeks’ clerkship and the fourth-year medical students who were yet to undergo a clinical clerkship posting in Family Medicine. Section B: knowledge of Family Medicine specialty 20. keywords: family; family medicine; ibadan; knowledge; medical; medicine; nigeria; students; study; university; year cache: safpj-4949.pdf plain text: safpj-4949.txt item: #353 of 732 id: safpj-4952 author: Govender, I.; de Villiers, M. title: Optimising the learning environment for undergraduate students in the Department of Family Medicine at Sefako Makgatho Health Sciences University date: 2019-09-04 words: 7275 flesch: 50 summary: model.22 Consequently, taking all these developments into consideration (change in the university’s structure and student dissatisfaction), the aim of this study was to investigate student perceptions of their learning environment in undergraduate family medicine teaching at SMU, in order to optimise the students’ learning environment experience. To reach this aim we had the following objective, namely to determine student perceptions of their learning activities, facilitators, academic self-perceptions, learn- ing atmosphere and social self-perceptions. keywords: course; dreem; environment; family; health; learning; mean; medical; medicine; perception; score; self; students; study; teaching cache: safpj-4952.pdf plain text: safpj-4952.txt item: #354 of 732 id: safpj-4953 author: Steyn, S. F.; Brand, L.; Wolmarans, D. title: Exercise, illness and drug use: guiding principles for approaching a complex triad date: 2019-09-04 words: 7527 flesch: 44 summary: As the Na+/K+-pump is responsible for the adequate concentration of Ca2+ in the sarcoplasmic reticulum of muscle cells, inhibition of the pump results in inhibited muscle fibre contractility, which accelerates and exacerbates muscle fatigue.41 Exhaustive exercise may also induce temporary immunosuppression due to the increased synthesis and release of cortisol.42 However, although an S Afr Fam Pract 2019;61(4):14-1816 The page number in the footer is not for bibliographic referencingwww.tandfonline.com/oemd 16 immediate anti-inflammatory response is often observed as a result of HIT, this may over time also contribute to increased tissue ROS-production3,43 in itself eliciting an inflammatory response and thereby undermining the potential beneficial effect of acute anti-inflammatory responses. Increased risk of hospital admission for dehydration or heat-related illness after initiation of medicines: a sequence symmetry analysis. keywords: blood; cardiac; cardiovascular; conditions; damage; drug; effects; exercise; function; hit; illness; increase; individuals; inflammation; inflammatory; intensity; med; muscle; patients; physiol; rate; risk; training cache: safpj-4953.pdf plain text: safpj-4953.txt item: #355 of 732 id: safpj-4954 author: Ellis, Chris title: I got burnt once (IGBO) date: 2019-09-04 words: 775 flesch: 63 summary: I set up the eye tray with the Meibomian clamp and fine curette and put anaesthetic eye drops in the patient’s eye. PERIPHERALIA The page number in the footer is not for bibliographic referencingwww.tandfonline.com/ojfp 36 Decision-making in general practice is a complicated affair and seems to be one of those skills that get more difficult as one gains more experience and knowledge. keywords: eye; patient cache: safpj-4954.pdf plain text: safpj-4954.txt item: #356 of 732 id: safpj-4955 author: Kathrada, F. title: A ‘look’ into conjunctivitis date: 2019-09-04 words: 3744 flesch: 42 summary: Acute viral conjunctivitis is most commonly caused by adenoviruses and allergic conjunctivitis is usually caused by seasonal pollens. Allergic conjunctivitis is also treated symptomatically with topical antihistamine/mast cell stabiliser preparations. keywords: acute; allergic; bacterial; conjunctivitis; contact; diagnosis; discharge; eye; herpes; ophthalmol; patanol; patients; topical; treatment cache: safpj-4955.pdf plain text: safpj-4955.txt item: #357 of 732 id: safpj-4956 author: Ker, J. A.; Outhoff, K. title: Burning issues in the prevention of heart failure date: 2019-09-04 words: 1834 flesch: 48 summary: Heart failure has many various causes and complicated pathophysiological pathways, but essentially the greatest contributors to the risk of developing heart failure remain traditional cardiovascular risk factors which include hypertension, diabetes mellitus, elevated cholesterol, smoking, unhealthy life- style, obesity and lack of exercise.4 The development of heart failure generally proceeds in stages. The life-time risk of developing heart failure at age 40 years is about 20% for both men and women.2 Ageing populations and improved treatment of acute cardiovascular events are contributing to the predicted 25% increase in heart failure in the next 20 years.3 Patients who suffer from heart failure have a poor overall prognosis and have high rates of hospital admissions and medical care costs. keywords: blood; failure; heart; meta; pressure; risk cache: safpj-4956.pdf plain text: safpj-4956.txt item: #358 of 732 id: safpj-4957 author: Marais, A.; Leuschner, M. title: The sore throat: a clinical approach to tonsillopharyngitis date: 2019-09-04 words: 2491 flesch: 49 summary: However, these drugs provide restricted and often unsatisfactory pain relief.17 Administration of a single low dose corticosteroid, such as 10 mg dexamethasone, has been shown to provide significant and sustained pain relief in both adults and children above 5 years with acute sore throat. Thomas M, Del Mar C, Glasziou P. How effective are treatments other than antibiotics for acute sore throat? keywords: acute; group; patients; sore; streptococcal; symptoms; throat; tonsillopharyngitis; treatment cache: safpj-4957.pdf plain text: safpj-4957.txt item: #359 of 732 id: safpj-4958 author: von Pressentin, K. B.; Naidoo, M.; Mabuza, L. H.; Mash, R. J.; Ras, T. title: Mastering your Fellowship date: 2019-09-04 words: 4704 flesch: 55 summary: The theme for this edition is child health. 2. SAQ (short answer question): The family physician’s role as leader and champion of clinical governance within the domain of child health As a district family physician, you have seen the need in the district to ensure that children below six years are tested for tuberculosis for their appropriate management. 2.1 As a clinical leader overseeing clinical governance in the district, discuss how you would coordinate the relevant team members, indicating the role of each to address this need? keywords: authors; candidate; child; children; clinical; family; health; management; marks; mother; south; study cache: safpj-4958.pdf plain text: safpj-4958.txt item: #360 of 732 id: safpj-4959 author: von Pressentin, Klaus B. title: On being relationship-centred date: 2019-09-04 words: 1025 flesch: 49 summary: Mash R, Malan Z, Von Pressentin K, Blitz J. Strengthening primary health care through primary care doctors: the design of a new national Postgraduate Diploma in Family Medicine. We exert our influence through others in the healthcare team, as our numbers as family physicians are low (both within the local team and on a national scale); this makes us dependent on these relationships in order to achieve what we are striving towards: enhancing the quality of care, role modelling the principles of our discipline, and strengthening the local healthcare system. keywords: care; family; health cache: safpj-4959.pdf plain text: safpj-4959.txt item: #361 of 732 id: safpj-4960 author: Family Practice, SA title: Professor Gboyega Adebola Ogunbanjo date: 2019-09-04 words: 582 flesch: 35 summary: He was Editor-in-Chief: South African Family Practice Journal; Editor: Transactions Journal of the Colleges of Medicine of South Africa (CMSA); overseas editorial adviser: Until his death, he was Chief Specialist, Full Professor and Academic Head: Department of Family Medicine and Primary Health Care, Sefako Makgatho Health Sciences University. keywords: family; medicine; university cache: safpj-4960.pdf plain text: safpj-4960.txt item: #362 of 732 id: safpj-4962 author: Ross, Andrew J.; Ndayishimiye, Egide title: A review of the management and outcome of patients admitted with cryptococcal meningitis at a regional hospital in KwaZulu-Natal province date: 2019-09-04 words: 5464 flesch: 58 summary: Gender differences in HIV disease progression and treatment outcomes among HIV patients one year after starting antiretroviral treatment (ART) in Dar es Salaam, Tanzania. Cryptococcal meningitis associated with tuberculosis in HIV infected patients. keywords: ccm; cd4; count; cryptococcal; fisher; hiv; meningitis; patients; test cache: safpj-4962.pdf plain text: safpj-4962.txt item: #363 of 732 id: safpj-4963 author: Nyalunga, S. L.N.; Ndimande, J. V.; Ogunbanjo, G. A.; Masango-Makgobela, A.; Bogongo, T. title: Perceptions of community health workers on their training, teamwork and practice: a cross-sectional study in Tshwane district, Gauteng, South Africa date: 2019-09-04 words: 5749 flesch: 55 summary: Perceptions of community health workers on their training, teamwork and practice: a cross-sectional study in Tshwane district, Gauteng, South Africa. Perceptions of community health workers on their training, teamwork and practice: a cross-sectional study in Tshwane district, Gauteng, South Africa. keywords: chws; community; community health; district; health; practice; services; south; study; teamwork; training; tshwane; workers cache: safpj-4963.pdf plain text: safpj-4963.txt item: #364 of 732 id: safpj-4965 author: Green, R. J. title: Management of paediatric asthma date: 2019-07-15 words: 1787 flesch: 56 summary: Asthma control Asthma control means the extent to which the effects of asthma can be seen in the patient, or have been reduced or removed by treatment.4 Recent Global Initiative for Asthma (GINA) guidelines have suggested that monitoring of asthma control is essential in all asthmatics.4 (See Figure 1 for GINA assessment of asthma control.) GINA assessment of asthma control and future risk4 S Afr Fam Pract 2019;61(3):41-4542 keywords: asthma; children; control; ics; therapy; use cache: safpj-4965.pdf plain text: safpj-4965.txt item: #365 of 732 id: safpj-4966 author: Osuch, E.; Marais, A. title: To clot, or not to clot – Antithrombotic therapy is the question date: 2019-07-15 words: 6157 flesch: 42 summary: Available agents include unfractionated heparin, low molecular weight heparins, fondaparinux, vitamin K antagonists, direct thrombin inhibitors, direct factor Xa inhibitors, and other agents at various stages of development.31 Table 2. Summary of available anticoagulant drugs Anticoagulants • Unfractionated heparins • heparin • Low molecular weight heparins (LMWH) • enoxaparin (Clexane®) • dalteparin (Fragmin®) • nadroparin (Fraxiparine®) • fondaparinux (Arixtra®) • Vitamin K antagonists • warfarin • Non-vitamin K antagonists ▫ Direct thrombin inhibitors (DTIs) ▪ Oral direct thrombin inhibitors • dabigatran (Pradaxa®) keywords: acute; agents; anticoagulants; aspirin; bleeding; clot; direct; drugs; factor; heparin; infarction; inhibitors; patients; plasminogen; platelet; risk; therapy; thrombin; use cache: safpj-4966.pdf plain text: safpj-4966.txt item: #366 of 732 id: safpj-4967 author: Naidoo, M.; von Pressentin, K. B.; Ras, T.; Steinberg, H. title: Mastering your Fellowship date: 2019-07-15 words: 5942 flesch: 56 summary: The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: guidelines for reporting observational studies. A 56-year-old male presents to emergency centre with a history of severe retrosternal chest pain for the last one hour. keywords: answer; authors; candidate; data; district; emergency; family; hospital; learning; medicine; patient; research; study; teaching cache: safpj-4967.pdf plain text: safpj-4967.txt item: #367 of 732 id: safpj-4968 author: van Eyk, A. D. title: Pharmacotherapeutic Options for Ophthalmic Conjunctivitis date: 2019-07-15 words: 3652 flesch: 43 summary: Topical eye drops and ointments are preferred to oral agents in the treatment of more severe bacterial and allergic conjunctivitis while oral agents are used in the treatment of conjunctivitis caused by Herpes simplex, Herpes zoster, Chlamydia trachomatis and Neisseria gonorrhoeae. Treatment is usually topical eye drops or ointments except in the cases of herpes, chlamydial and gonococcal infections where topical, oral and in some instances IV or IM medications are indicated. keywords: bacterial; conjunctivitis; daily; days; drops; eye; feb; oral; topical; treatment cache: safpj-4968.pdf plain text: safpj-4968.txt item: #368 of 732 id: safpj-4969 author: Ellis, Chris title: The Truth date: 2019-07-15 words: 956 flesch: 58 summary: Ask, true for whom?” “True for whom” is one of the enigmas in medical practice when giving information to patients and when helping patients make decisions. “If falsehood, like truth, had only one face,” said Michelle De Montaigne in the 16th century, “we would be in better shape. keywords: patient; truth cache: safpj-4969.pdf plain text: safpj-4969.txt item: #369 of 732 id: safpj-4970 author: Govender, Indiran title: The silent epidemic among clinicians – Stress and Burnout date: 2019-07-15 words: 1005 flesch: 61 summary: Stress among medical doctors working in public hospitals of the Ngaka Modiri Molema District (Mafikeng Health Region), North West Province. The candidates who give up everything else to concentrate on their studies, to extend their medical knowledge and competence at the expense of other compartments (aspects) to their lives, such as hobbies, sport, family, friends, spiritual activities, etc., are the candidates with typical type A personality traits. keywords: burnout; health; stress cache: safpj-4970.pdf plain text: safpj-4970.txt item: #370 of 732 id: safpj-4971 author: Govender, I.; Tumbo, J. title: The management of snakebites in South Africa date: 2019-07-15 words: 5248 flesch: 40 summary: Neurotoxins that block muscarinic receptors have also been described in mamba venom.3,7 Snakes responsible for this syndrome include: Neurotoxic cobras (Anchieta’s Egyptian cobra, banded or snouted cobra and Cape cobra) and Mambas (black mamba, common, eastern green, white mouthed mamba and green mambas).3,5 Clinical features of neurotoxic snake bites: Necrosis/ gangrene may result.3,7 Snakes responsible for this syndrome include: The major adders (puff adder, gaboon adder), spitting cobras (Mozambique and black-necked spitting cobra) and the rinkhals (Hemachatus haemachatus).3,5 Clinical features of cytotoxic snake bites: Swelling begins early, often within 10–30 minutes and may become extensive, involving the entire limb and adjacent areas of the trunk, especially in children. keywords: africa; antivenom; bite; blood; cobra; effects; hours; management; patient; snake; snakebite; south; swelling; syndrome; treatment cache: safpj-4971.pdf plain text: safpj-4971.txt item: #371 of 732 id: safpj-4972 author: van Rensburg, R.; Reuter, H. title: An overview of analgesics - anticonvulsants, antidepressants, and other medications (Part 3) date: 2019-07-15 words: 4421 flesch: 52 summary: Conversely, neuropathic pain is succinctly defined as “pain caused by a lesion or disease of the somatosensory nervous system.”1 There are several causes of neuropathic pain, and it can arise from the central or peripheral nervous system. keywords: anticonvulsants; antidepressants; chronic; drug; evidence; internet; neuropathic; pain; patients; pregabalin; review; treatment; use cache: safpj-4972.pdf plain text: safpj-4972.txt item: #372 of 732 id: safpj-4973 author: Weyer, J.; Blumberg, Lucille title: Management of rabies date: 2019-07-15 words: 3387 flesch: 52 summary: Management of rabies virus exposures and prevention of the disease Rabies virus infections can be prevented in almost 100% of exposed persons through timeous postexposure prophylaxis (PEP). Each case of exposure to a potentially rabid animal needs to be assessed and rabies PEP provided based on the risk assessment and likelihood of rabies exposure. keywords: africa; animal; dog; exposure; human; pep; rabies; rig; south cache: safpj-4973.pdf plain text: safpj-4973.txt item: #373 of 732 id: safpj-4974 author: of South Africa (NOFSA), National Osteoporosis Foundation title: Pharmacotherapy of osteoporosis date: 2019-07-15 words: 18003 flesch: 35 summary: Specific therapeutic agents used in osteoporosis are usually classified as inhibitors of bone resorption (anticatabolics), stimulators of bone formation (anabolics), or dual action agents (Table IX). Chapter 11:103-145 Table IX: Drugs currently used to treat osteoporosis Inhibitors of bone resorption: anticatabolics Calcium/vitamin D Estrogen/progestins Estrogen analogues, selective estrogen receptor modulators (SERMS), testosterone • raloxifene • tibolone • phyto-estrogens • testosterone Bisphosphonates • alendronate • ibandronate • risedronate • zoledronate Calcitonins Stimulators of bone formation: anabolics Parathyroid hormone Drugs with dual and/or complex actions on bone Strontium ranelate Vitamin D metabolites (calcitriol/alfacalcidol) keywords: bisphosphonates; bmd; bone; calcium; data; dose; effects; estrogen; fracture; fracture risk; increase; non; number; osteoporosis; patients; pth; ranelate; risk; strontium; studies; treatment; use; vitamin; women; years cache: safpj-4974.pdf plain text: safpj-4974.txt item: #374 of 732 id: safpj-4975 author: Steyn, L. title: Focus on: Orphenadrine citrate as a muscle relaxant date: 2019-07-15 words: 1330 flesch: 44 summary: The Author(s) PRODUCT FOCUS The term “skeletal muscle relaxants” represents a broad group of drugs that are structurally and pharmacologically diverse.1 Skeletal muscle relaxants are used to treat both spasticity and local musculoskeletal spasms.1 These two conditions differ in their aetiology, with spasticity originating centrally more as a result of a motor neuron disorder, while local musculoskeletal spasms occur peripherally and more as a result of trauma or muscle strain.1 For this reason, centrally-acting (e.g. baclofen) and peripherally-acting skeletal muscle relaxants (e.g. orphenadrine, cyclobenzaprine) cannot be used interchangeably. Witenko C, Moorman-Li R, Motycka C, Duane K, Hincapie-Castillo J, Leonard P, Valaer C. Considerations for the appropriate use of skeletal muscle relaxants for the management of acute low back pain. keywords: citrate; muscle; norflex; orphenadrine; relaxants; use cache: safpj-4975.pdf plain text: safpj-4975.txt item: #375 of 732 id: safpj-4978 author: Govender, R. D.; Al-Shamsi, S.; Regmi, D. title: Weight bias and eating behaviours of persons with overweight and obesity attending a general medical practice in Durban, South Africa date: 2019-07-15 words: 5035 flesch: 54 summary: Research has shown that persons with a much higher level of internalised weight bias are likely to cope by refusing to diet, overeating or they display disordered eating behaviour12 and the participants in this study seemed to have coped with weight bias in a similar way. This study aimed to assess psychosocial constructs such as weight bias affecting the eating behaviours of persons with overweight and obesity attending a general practice in South Africa Methods: An observational study was conducted at a private general medical practice situated in a peri-urban area of Durban, KwaZulu-Natal, South Africa. keywords: africa; behaviours; bias; bmi; eating; obesity; overweight; participants; south; study; weight cache: safpj-4978.pdf plain text: safpj-4978.txt item: #376 of 732 id: safpj-4980 author: Gaqavu, Mthetheleli Mbongeni; Mash, Robert title: The perceptions of general practitioners on National Health Insurance in Chris Hani district, Eastern Cape, South Africa date: 2019-07-15 words: 7059 flesch: 59 summary: The public healthcare system caters for 84% of the population and spends 4.2% of gross domestic product (GDP), while private health care looks after 16% of the population and spends a further 4.1% of GDP.1 Expenditure on health care is therefore inequitably distrib- uted and, despite spending 8.3% of GDP, South Africa still has a high burden of disease and health outcomes that are not com- mensurate with this expenditure. (OS) GPs mentioned the problem of staff attitudes in the public sector as a major barrier to quality health care, which needed urgent attention: keywords: africa; care; district; doctors; gps; health; insurance; medical; national; nhi; practice; primary; public; south cache: safpj-4980.pdf plain text: safpj-4980.txt item: #377 of 732 id: safpj-4982 author: Rampersad, K.; Rangiah, S.; Kendon, M. title: Compliance with local diabetic guidelines at a district hospital in KwaZulu-Natal, South Africa date: 2019-04-29 words: 4590 flesch: 48 summary: The demographic profile of patients with type 2 DM and the compliance of doctors to the guidelines were determined. Methods: Five hundred records of patients with type 2 DM were selected from the medical outpatients’ department (MOPD) by systematic sampling. keywords: africa; blood; complications; diabetes; examination; guidelines; patients; south; study; type; urine cache: safpj-4982.pdf plain text: safpj-4982.txt item: #378 of 732 id: safpj-4983 author: von Pressentin, Klaus B.; Naidoo, Mergan; Ras, Tasleem; Steinberg, Hannes title: Mastering your Fellowship date: 2019-04-29 words: 6219 flesch: 55 summary: The theme for this edition is ophthalmology (eye health). Evidence for integrating eye health into primary health care in Africa: a health systems strengthening approach. keywords: authors; care; eye; eye health; family; health; marks; patient; question; research; review; study; system cache: safpj-4983.pdf plain text: safpj-4983.txt item: #379 of 732 id: safpj-4984 author: van Eyk, A. D. title: Treatment of bacterial respiratory infections date: 2019-04-29 words: 4774 flesch: 49 summary: Keywords: Bacterial respiratory tract infections, Upper respiratory tract infections, Lower respiratory tract infections, Pneumonia, Otitis Media Treatment of bacterial respiratory infections 9 The page number in the footer is not for bibliographic referencingwww.tandfonline.com/oemd 9 abnormalities, immunological abnormalities, pain >  48 hours, children in day care or siblings of children that attend day care facilities.6 Treatment options include amoxicillin, amoxicillin- clavulanic acid, cephalosporins or macrolides/azalides, and treatment duration is 5 or 7 days (Table I).1,4-7,12,14-16 Acute Pharyngotonsillitis (APT) The Author(s) REVIEW Acute Respiratory Tract Infections (ARTIs) Acute respiratory tract infections (ARTIs) are one of the most common reasons for consultation with a general practitioner on an outpatient basis.1-3 ARTIs can be classified further into upper- and lower respiratory tract infections.4 Acute otitis media (AOM), pharyngotonsillitis, acute bacterial rhinosinusitis and the common cold form part of upper respiratory tract infections (URTIs), while acute bronchitis, acute exacerbations of chronic bronchitis and pneumonia form part of lower respiratory tract infections (LRTIs).1-5 The causes of most URTIs and acute bronchitis are viral in nature, with bacteria responsible for less than 10% of these infections.1-3,5-9 The causes of pneumonia may be viral or bacterial in nature.10,11 Clinical signs and symptoms of URTIs are varied and include cough, fever, nasal congestion, otalgia, facial pain, sore throat, headache and fatigue.1-3,6,7 Acute LRTIs (presenting symptoms 21 days) usually have cough as a presenting symptom together with other symptoms including fever, dyspnoea, and tachypnoea.10 Although acute URTIs and acute bronchitis are mostly viral in nature and are self-limiting diseases, antibiotics are in many instances inappropriately prescribed by health care providers in the mistaken belief that these agents decrease the time span of the illness, improve symptoms and prevent further complications. keywords: acute; amoxicillin; days; hours; infections; pneumoniae; tract; treatment cache: safpj-4984.pdf plain text: safpj-4984.txt item: #380 of 732 id: safpj-4985 author: Naidoo, M. title: An approach to acute pulmonary embolism in the primary emergency care environment date: 2019-04-29 words: 3254 flesch: 46 summary: The ASH guideline evaluated 53 studies and provided a summary of evidence of the various South African Family Practice 2019; 61(2):35-39 Open Access article distributed under the terms of the Creative Commons License [CC BY-NC-ND 4.0] http://creativecommons.org/licenses/by-nc-nd/4.0 An approach to acute pulmonary embolism in the primary emergency care environment M Naidoo Discipline of Family Medicine, School of Nursing and Public Health, University of KwaZulu-Natal Pulmonary embolism (PE) is a common emergency presenting among high risk patients. Bova and colleagues14 developed a predication model for intermediate risk patients using a combination of parameters listed in Table 4. keywords: acute; care; clinical; diagnosis; embolism; high; patients; pulmonary; risk cache: safpj-4985.pdf plain text: safpj-4985.txt item: #381 of 732 id: safpj-4986 author: Ker, J. A.; Outhoff, K. title: Burning issues in blood pressure control date: 2019-04-29 words: 2436 flesch: 51 summary: Key words: Blood pressure, hypertension, single pill combination, early blood pressure control, treatment persistence, legacy effects of rapid control Burning issues in blood pressure control 25 This article discusses the current evidence- based treatment guidelines and pressing temporal issues in optimal blood pressure control. keywords: blood; combination; control; hypertension; pressure; trial cache: safpj-4986.pdf plain text: safpj-4986.txt item: #382 of 732 id: safpj-4987 author: Quan, C. title: Morphine spinals: ICU or ward? date: 2019-04-29 words: 1371 flesch: 56 summary: The incidence of respiratory depression correlates with the dose of intrathecal morphine. If a patient does not have any risk factors for respiratory depression and receives low dose intrathecal morphine (< 300 μg), it would seem that the risk for respiratory depression is the same or even less than the same patient receiving parenteral opioids. keywords: analgesia; depression; intrathecal; morphine cache: safpj-4987.pdf plain text: safpj-4987.txt item: #383 of 732 id: safpj-4988 author: Keene, A. title: Perioperative Management of Pacemakers (PM) and Implantable Cardioverter Defibrillators (ICD) in South Africa date: 2019-04-29 words: 4423 flesch: 52 summary: Intraoperative magnet use is currently underutilised and may have advantages to changing PM and ICD settings in patients who may otherwise have had the CIED functions switched off. PM-on protocol will avoid inadvertent development of R-on-T phenomenon and implies that magnet application is possible if the situation of oversensing caused by EMI develops. keywords: anti; application; figure; icd; icds; magnet cache: safpj-4988.pdf plain text: safpj-4988.txt item: #384 of 732 id: safpj-4989 author: Sethusa, M. E. title: The elderly with a fractured hip – analgesia date: 2019-04-29 words: 1397 flesch: 47 summary: Scurrah A, Shiner C, Stevens J, Faux S. Regional nerve blockade for early analgesic management of elderly patients with hip fracture–a narrative review. Pure sensory nerve block like the lateral femoral cutaneous nerve block does preserve motor function, but alone it is inadequate to treat hip fracture pain. keywords: assessment; fracture; hip; management; pain; patients cache: safpj-4989.pdf plain text: safpj-4989.txt item: #385 of 732 id: safpj-4990 author: Beeton, A. title: A practical approach to perioperative anticoagulation date: 2019-04-29 words: 2476 flesch: 42 summary: The following guidelines apply to postoperative resumption of anticoagulation: • Stable clot is generally present 8 hours after surgery in systemically healthy patients (longer with organ dysfunction) • Can resume the anticoagulant 1 tmax before this following surgery with low bleeding risk • Higher bleeding risk surgery ▪ Lower thrombotic risk patients – delay for up to 48 hours (mechanical prophylaxis) ▪ Higher thrombotic risk – delay until bleeding risk is considered acceptable but bridge with LMWH, commenced > 6 hours postoperatively • Resuming warfarin ▪ If bridging indicated preoperatively, bridging also indicated postoperatively until INR is in target range Implications for regional anaesthesia and pain therapy Anticoagulation in acute coronary syndromes, percutaneous coronary interventions (PCI), stents and stable coronary artery disease Commencement of anticoagulation for postoperative prophylaxis rarely poses challenges beyond choice of an appropriate drug and dose for the patient demographic and health profile and timing of initiation, based on surgical bleeding risk. keywords: anticoagulation; bleeding; drug; inr; risk; surgery; warfarin cache: safpj-4990.pdf plain text: safpj-4990.txt item: #386 of 732 id: safpj-4991 author: Lundgren, A. C. title: Two medicolegal issues of concern date: 2019-04-29 words: 700 flesch: 41 summary: A person in charge of a health establishment, where a person has been declared dead and the cause of death appears to be due to unnatural causes must: (a) Immediately notify the South African Police Service and the Service of such death; (b) Preserve, provide access to and or make available of all the relevant medical paraphernalia, exhibits and applicable specimens, especially biological fluid specimens in the case of suspected toxicology cases; (c) Ensure access to and availability of all the deceased’s full medical records including laboratory and investigative reports; (d) Not hand over the body or items referred to in paragraphs (b) and (c) to an undertaker; 2. The Author(s) NW REFRESHER COURSE Unnatural Deaths: are we signing them off as “natural” deaths? Health Professions Amendment Act No 29 of 20071: “Death of a person undergoing a procedure of therapeutic, diagnostic or palliative nature or of which any aspect of such procedure has been a contributory cause, shall not be deemed to be a death from natural causes as contemplated in the Inquests Act, 1959, or the Births, Marriages and Deaths Registration Act, 1963”. keywords: act; death cache: safpj-4991.pdf plain text: safpj-4991.txt item: #387 of 732 id: safpj-4992 author: Kay, J. title: A Practical Approach to Anaesthesia for the Child with Musculoskeletal Disease date: 2019-04-29 words: 2050 flesch: 46 summary: Muscle diseases almost always affect the cardiac and respiratory systems, and energy metabolic processes are frequently also involved. Most children suffering from CP will have an increase in muscle tone and much of the surgical work done involves mitigating the effects of spasticity.1 Main Areas of Concern Neurological System and Sensation • Many CP children have impaired vision or hearing. keywords: anaesthesia; care; children; disease; disorders; muscle cache: safpj-4992.pdf plain text: safpj-4992.txt item: #388 of 732 id: safpj-4993 author: Anamourlis, P. C. title: Opioid Free Anaesthesia: a paradigm shift date: 2019-04-29 words: 3446 flesch: 50 summary: Postoperative opioid analgesic practice in this group of at-risk patients is of particular concern, as the administration of intravenous opioids has been shown to significantly increase the risk of elderly arthroplasty patients developing POCD.20 Krenk et al.23 showed that fast track set ups that disallow for prolonged hospital stays and utilise opioid-sparing or opioid-free practice, avoids the development of delirium post operatively and hence reduces the risk of POCD and mortality.23 Acute tolerance/hyperalgesia The more opioids given intraoperatively, the more the postoperative analgesic requirements: this is termed the ‘opioid paradox’ and can be explained through acute tolerance and neuroadaptive processes caused by short acting opioids or chronic opioid use. This calls into question the added value of opioid use at all, since the use of opioids have such potential for adverse events postoperatively. keywords: anaesthesia; ibw; ofa; opioid; pain; patients; postoperative; surgery; tolerance; use cache: safpj-4993.pdf plain text: safpj-4993.txt item: #389 of 732 id: safpj-4994 author: Mogane, P. title: Difficult paediatric airway date: 2019-04-29 words: 5073 flesch: 45 summary: The main finding was that FOB-SAD and VL have similar rates of first attempt success in children with difficult airways. Many methods exist for evaluating and predicting difficult airway in adults; no comparable methods have been forthcoming in children. keywords: airway; anaesthesia; attempts; children; difficult; figure; intubation; management; paediatric; patient; plan; tracheal; use; ventilation cache: safpj-4994.pdf plain text: safpj-4994.txt item: #390 of 732 id: safpj-4995 author: Leonard, T. G.A. title: Peripartum Cardiomyopathy date: 2019-04-29 words: 4827 flesch: 43 summary: While the exact number of patients who died due to cardiomyopathy is unclear it does remain a significant contributor towards maternal morbidity and mortality. This may explain the association between preeclampsia and multiple gestations with PPCM.4,5 Abnormal autoimmune response and inflammation Circulating auto-antibodies to the myocardium have been reported in up to 50% of patients with PPCM. keywords: anaesthesia; bromocriptine; cardiac; cardiomyopathy; delivery; failure; heart; management; patients; peripartum; ppcm; pregnancy; ventricular cache: safpj-4995.pdf plain text: safpj-4995.txt item: #391 of 732 id: safpj-4996 author: Moutlana, H. J. title: Smoking and Vaping: is there a difference? date: 2019-04-29 words: 2506 flesch: 44 summary: Some studies have shown an increase in heart rate after e-cigarette use, whereas some found no changes in heart rate.15 In addition to nicotine, there are other potentially harmful components of e-cigarettes like carbonyls, including aldehydes, which may alter heart rate, blood pressure and cardiac contractility.15 Respiratory system The use of e-cigarettes results in upper and lower respiratory tract irritation, bronchitis, cough and emphysema.15 The upper respiratory infection-like symptoms caused by e-cigarettes have been associated with propylene glycol, which is a constituent of e-cigarettes.16 Haematological system E-cigarette vapour extracts were shown to enhance platelet activation (aggregation and adhesion).15 Gastrointestinal system E-cigarettes may cause throat and mouth irritation as well as induce nausea and vomiting.15 Immune system and wound healing E-cigarettes may lead to inflammatory induction,15 upregulation of certain inflammatory markers and acute phase reactants.3 E-cigarettes also reduce immune efficiency.15 Smoking cessation A study looking e-cigarettes versus nicotine patches for perioperative smoking cessation, found that e-cigarettes are a feasible tool and acceptable aid for perioperative smoking cessation. For the purpose of this review, tobacco cigarette smoking will be referred to as cigarette smoking, whereas vaping will refer to the use of e-cigarettes. keywords: cigarettes; effects; health; nicotine; smoke; smoking; system; tobacco; vaping cache: safpj-4996.pdf plain text: safpj-4996.txt item: #392 of 732 id: safpj-4997 author: Witt, J. title: CPR: ABC or CAB date: 2019-04-29 words: 2949 flesch: 50 summary: In 1960, he published his now famous article describing ‘closed-chest cardiac massage’ – so named because prior to this direct cardiac massage through an open chest had been the mainstay of cardiac arrest management.6 A flurry of investigations and publications followed, which suggested a compression rate of 60 to 80 per minute, and a compression depth of 4 to 5 centimetres paired together with artificial respiration, as well as defibrillation and administration of vasopressors as the optimal approach to resuscitation.7 A few years later, in 1966, the first CPR guidelines were published and quickly spread worldwide.8 Of note is that even at this early stage of modern CPR the danger of delay in initiation of resuscitation was clearly recognised as a poor prognosticating factor.9 In 1957, Safar published the ‘ABC of Resuscitation’ which subsequently informed the stepwise approach of ‘Airway- Breathing-Circulation’ by which CPR would be performed into the 21st century.10 Up until 2005, this approach emphasised opening of the airway followed by assessment of breathing, rescue breaths as required, and then a circulatory assessment usually in the form of a pulse check, followed by chest compressions as required. They found that starting chest compressions first resulted in quicker restoration of coronary perfusion pressure and more chance of successful defibrillation.11 At the time, the Netherlands was the only country following this approach, briefly adopting the ABC approach to fall in line with European Resuscitation Council (ERC) guidelines before reverting to CAB with the 2005 ERC guidelines. keywords: airway; approach; arrest; cardiac; cardiopulmonary; chest; compressions; cpr; resuscitation cache: safpj-4997.pdf plain text: safpj-4997.txt item: #393 of 732 id: safpj-4998 author: Ellis, Chris title: The out-and-about consultation date: 2019-04-29 words: 820 flesch: 75 summary: Apparently up to fifty percent of legal cases against doctors are initiated due to comments by other doctors, nurses or medical personnel. “Never believe what a patient tells you to the detriment of a brother physician” said Sir William Osler “even though you may think it to be true”. keywords: rule; shopping cache: safpj-4998.pdf plain text: safpj-4998.txt item: #394 of 732 id: safpj-4999 author: Vally, M.; Kathrada, F. title: Understanding Alzheimer disease date: 2019-04-29 words: 6245 flesch: 54 summary: Ballard C, Gauthier S, Corbett A, et al. Ryman DC, Acosta-Baena N, Aisen PS, et al. keywords: adas; alzheimer; alzheimer disease; change; cholinesterase; cibic; cognitive; dementia; disease; donepezil; et al; memantine; memory; neurol; neurology; patients; plus; point; risk; study; symptoms cache: safpj-4999.pdf plain text: safpj-4999.txt item: #395 of 732 id: safpj-5000 author: Snyman, J. R.; Medlen, C. E. title: Brand innovator versus multisource cefpodoxime in respiratory tract infections: A comparative study date: 2019-04-29 words: 4021 flesch: 44 summary: Many clinical studies of oral cephems performed between 1988 and 1992 revealed the consistent effectiveness of the so-called third generation molecules against the pathogens commonly associated with community-acquired respiratory tract infections.16-19 However, a clinical diagnosis of infection and the ensuing improvement of symptoms after the use of any empirically prescribed antimicrobial agent is not proof of efficacy, because it could have been a viral infection, which would have cleared up in any case. The aim of antibiotic treatment is to maximise antibacterial activity (clinical effectiveness) while preventing recurrence of infection and the development of resistant pathogens.1,2 Furthermore, there is reason to doubt, as an analysis conducted at the Institute of Microbiology, University of Genoa, Italy, demonstrated that some generic formulations of another cephalosporine antimicrobial agent i.e. ceftriaxone failed to achieve the required Pharmacokinetic/Pharmacodynamic (PK/ PD) outcomes to ensure clinical efficacy.3 keywords: cefpodoxime; cepodem; cure; generic; infections; internet; orelox; patients; sep; study; tract; treatment cache: safpj-5000.pdf plain text: safpj-5000.txt item: #396 of 732 id: safpj-5001 author: van Rensburg, R.; Reuter, H. title: An overview of analgesics: opioids, tramadol, and tapentadol (Part 2) date: 2019-04-29 words: 6105 flesch: 57 summary: Molecular studies have identified different mu receptor subtypes, and have suggested that this variability may be due to differential functional activation by opioids, as well as the receptor subtype localizations in the body.27 Place in therapy: Cancer pain The management of cancer pain is universally recommended to include a multimodal approach,28 encompassing not only multiple pharmacological modalities (if needed), but also including patient education and social structure support. In moderate to severe pain strong opioids may be added, but there is no preference between morphine, oxycodone, and hydromorphone. keywords: acute; analgesic; cancer; cancer pain; chronic; drugs; effects; feb; internet; management; mar; opioids; pain; receptor; reuptake; review; studies; tapentadol; tramadol; use cache: safpj-5001.pdf plain text: safpj-5001.txt item: #397 of 732 id: safpj-5002 author: von Pressentin, Klaus B. title: Growing the discipline of family medicine as a counterculture date: 2019-04-29 words: 1331 flesch: 54 summary: The page number in the footer is not for bibliographic referencingwww.tandfonline.com/ojfp 5 EDITORIAL Growing the discipline of family medicine as a counterculture I would like to start this editorial with a word of thanks. A read through the editorials since the journal’s birth in 1980 (available from: http://www.safpj.co.za) informed me of the innovative thinking behind building the discipline of family medicine and primary care over the past few decades. keywords: care; family; health; medicine; south; university cache: safpj-5002.pdf plain text: safpj-5002.txt item: #398 of 732 id: safpj-5003 author: Dahan-Farkas, N.; Vally, M. title: The use of emergency hormonal contraception in South Africa: current and future perspectives date: 2019-04-29 words: 2359 flesch: 49 summary: Emergency hormonal contraceptives (EC) are safe methods that can be used to prevent unwanted pregnancies if they are used within an exact time period.2,3 Indications and types of emergency hormonal contraception Emergency hormonal contraceptives should be used in the following situations: after having unprotected sexual intercourse, when a woman has improperly used regular contraceptives, in the event of sexual assault, or in situations where a condom has broken, slipped, or has been used incorrectly.3,4 The available methods of emergency hormonal contraception in South-Africa include levonorgestrel (LNG) or the combined estrogen and levonorgestrel/norgestrel method commonly known as the Yuzpe method.5 LNG is a synthetic progestin which is administered orally as a single dose of 1.5 mg or it can be taken in two doses of 0.75 mg each within 12 hours. South African Family Practice 2019; 61(2):46-48 Open Access article distributed under the terms of the Creative Commons License [CC BY-NC-ND 4.0] http://creativecommons.org/licenses/by-nc-nd/4.0 The use of emergency hormonal contraception in South Africa: current and future perspectives N Dahan-Farkas, M Vally Division of Pharmacology, Department of Pharmacy and Pharmacology, School of Therapeutic Sciences, Faculty of Health Sciences, University of Witwatersrand, South Africa Corresponding author: keywords: acetate; contraception; contraceptives; emergency; hours; levonorgestrel; ulipristal; yuzpe cache: safpj-5003.pdf plain text: safpj-5003.txt item: #399 of 732 id: safpj-5004 author: Chonco, F. M.; Rangiah, S. title: Susceptibility to hepatitis B infection, hepatitis B/HIV co-infections and hepatitis B immunity in HIV-positive patients starting HAART in Durban, South Africa date: 2019-04-29 words: 3283 flesch: 47 summary: Discussion The high prevalence of hepatitis B susceptible patients (69.8%) with a higher prevalence in adults than children demonstrated in this cohort was due to lack of HBV B vaccination of people born before the inclusion of hepatitis B vaccine in the South African EPI.9,11 Even though routine screening is carried out in South Africa for hepatitis B at the initiation of HAART, vacci- nation of the susceptible HIV-infected patient is not routine. Co-infected patients have increased risk of fatal liver disease, specifically cirrhosis and death due to liver cancer.2,4,5,9 Although the current first-line highly active antiretroviral therapy (HAART) regimen covers HBV infection, drug resistance of both HIV and HBV is a threat to this treatment.4,10 Preventing HIV-infected patients from getting HBV infection therefore remains critical for the future management of HIV/HBV co-infection. keywords: africa; hbv; hepatitis; hiv; infection; patients; south cache: safpj-5004.pdf plain text: safpj-5004.txt item: #400 of 732 id: safpj-5008 author: None title: safpj-5008 date: None words: 594 flesch: 43 summary: Social media use by health professionals: To do or not to do?. Social media is seen by today’s practitioners as a work tool because of easy access to smart phones, tablets and other electronic gadgets.3,4 The workplace benefits from the use of group-based communication are immense; work interaction groups on WhatsApp are commonly used by professionals to communicate availability for shift work, traffic issues and pictures of patients for obtaining second opinions from colleagues – hence the list is endless.4 However, challenges are also associated with some of these platforms because they may not be secure and messages could be sent to wrong recipients, thus compromising privacy and confidentiality.4 Social media also presents a challenge of blurring boundaries.1,4 Therefore, there is a need for health professionals to acquaint themselves with the recently released guidelines by the HPCSA that deal extensively with SM in terms of its effect on confidentiality, patient and practitioner relationship, and the health professional’s image. keywords: health; media; social cache: safpj-5008.htm plain text: safpj-5008.txt item: #401 of 732 id: safpj-5011 author: Potgieter, Francois; Kapp, Paul; Coetzee, Francois title: Factors influencing post-partum women’s choice of an implantable contraceptive device in a rural district hospital in South Africa date: 2018-11-30 words: 6255 flesch: 54 summary: Can you think of anything that will influence other women to choose the implant? It showed a 50.0% decrease in ImplanonNXT® uptake from 48 to 24 units per month over a 16-month period.5 This initial acceptance by postpartum women and the sub- sequent rapid decline begs the question as to what factors influ- enced their decision. keywords: choice; contraceptive; device; factors; implanon; implantable; method; south; study; use; women cache: safpj-5011.pdf plain text: safpj-5011.txt item: #402 of 732 id: safpj-5012 author: Adeniji, A. A.; Mabuza, L. H. title: ‘Telephone Triage’: a possible means of managing the after-hours patient load at primary health care facilities in South Africa date: 2018-11-30 words: 4781 flesch: 55 summary: The choice of advice has a direct bearing on the envisaged Figure 2: Conventional triage pyramid with telephone triage care as the base. Effective appointment systems have the goal of matching demand with capacity so that resources are better utilised and patient waiting times are minimised.7 What is telephone triage? keywords: africa; care; emergency; health; healthcare; hours; patients; primary; south; system; telephone; triage cache: safpj-5012.pdf plain text: safpj-5012.txt item: #403 of 732 id: safpj-5013 author: Ross, Andrew; Naidoo, S. S.; Dlamini, Siyabonga title: An evaluation of the medical internship programme at King Edward VIII hospital, South Africa in 2016 date: 2018-11-30 words: 5223 flesch: 47 summary: Teaching and supervision are considered by the HPCSA to be at the core of intern training and an emphasis is placed on ensuring that these components are adequately provided when the inspection visits are conducted.4 In addition to the inspections by the HPCSA each department is expected to have monthly documented meetings with the interns so that issues relating to teaching and supervision can be discussed. King Edward VIII hospital (KEH) is an HPCSA accredited training hospital, which has been training interns for many years. keywords: hospital; hours; hpcsa; interns; internship; medicine; supervision; teaching; training cache: safpj-5013.pdf plain text: safpj-5013.txt item: #404 of 732 id: safpj-5014 author: Orrie, S.; Motsohi, T. title: Challenges experienced by healthcare workers in managing patients with hearing impairment at a primary health care setting: a descriptive case study date: 2018-11-30 words: 4742 flesch: 46 summary: This is a valuable skill as deaf patients recognise the use of basic signing as a genuine attempt by the HCW to achieve good communication, furthering the development of a therapeutic bond.17 According to the literature, both phys- icians and Deaf patients consider sign language interpreters (SL-Is) as the gold standard of communication with Deaf patients.3,18 A team approach was another common strategy. Furthermore, language is essential to developing a therapeutic relationship with a patient, yet the language barrier between deaf patients and hearing healthcare workers is one of the main challenges to access to health care.10,4,5 Those patients who have sign language (SL) as their first language are most disadvantaged and could potentially benefit most from a SL interpreter service at healthcare facilities. keywords: care; communication; deaf; hcws; health; healthcare; hearing; interpreters; language; patients; south cache: safpj-5014.pdf plain text: safpj-5014.txt item: #405 of 732 id: safpj-5015 author: Motswaledi, Hendrick M. title: Allergic skin conditions - causes, clinical features and treatment date: 2018-11-30 words: 2387 flesch: 49 summary: Allergic skin conditions include urticaria and angio-oedema, allergic contact dermatitis, atopic dermatitis, hand dermatitis, photo- allergic reactions and phototoxic reactions. Allergic contact dermatitis is a delayed type hypersensitivity reaction that is elicited when the skin or mucous membranes South African Family Practice 2018; 60(6):34-37 Open Access article distributed under the terms of the Creative Commons License [CC BY-NC-ND 4.0] http://creativecommons.org/licenses/by-nc-nd/4.0 Allergic skin conditions - causes, clinical features and treatment Hendrick M. Motswaledi Department of Dermatology, Sefako Makgatho Health Sciences University *Corresponding author, email: motswaledi1@webmail.co.za Abstract Allergic skin conditions are caused by allergens. keywords: allergic; atopic; contact; dermatitis; reactions; skin; urticaria cache: safpj-5015.pdf plain text: safpj-5015.txt item: #406 of 732 id: safpj-5016 author: Ojo, O. S.; Malomo, S. O.; Egunjobi, A. O.; Jimoh, A. O.A.; Olowere, M. O. title: Quality of primary care physicians’ communication of diabetes self-management during medical encounters with persons with diabetes mellitus in a resource-poor country date: 2018-11-30 words: 7954 flesch: 52 summary: Thus, training of primary care physicians on diabetes self-management education is recommended because of the key role these physicians play in diabetes management in resource-poor countries. Keywords: diabetes self-management, patient–physician communication, primary care physicians, resource-poor countries, Nigeria Introduction Globally, the number of people with diabetes mellitus (DM) is rising at an alarming rate and is expected to exceed 629 million by 2045.1 According to the International Diabetes Fed- eration (IDF), one in every 20 Nigerians currently has DM.1 keywords: care; communication; diabetes; diabetes self; domain; management; mean; patients; physicians; practice; primary; quality; score; self; study cache: safpj-5016.pdf plain text: safpj-5016.txt item: #407 of 732 id: safpj-5019 author: None title: safpj-5019 date: None words: 3314 flesch: 45 summary: In the few studies conducted, researchers noted that senior medical students had accurate expectations and good perceptions of PAs.10 That only seven participants were aware of their future supervisory role with regard to ClinAs is not surprising as, despite training at the same institution, medical students are not formally presented with the ClinAs’ role in the health-care system, their scope of practice or their requirement to be supervised by a medical doctor. Keywords: Clinical associate; bachelor of clinical medical practice; clinical supervision; doctors; medical students; ClinA. Introduction For the first time in South African history, medical doctors are responsible for the clinical work of another cadre of health professional. keywords: clinas; clinical; health; medical; practice; pretoria; role; scope; students cache: safpj-5019.htm plain text: safpj-5019.txt item: #408 of 732 id: safpj-5022 author: None title: safpj-5022 date: None words: 4989 flesch: 47 summary: Further review of VTE prophylaxis guidelines to include newly registered anticoagulants, as well as methods to improve the completion and acceptance of RAMs may balance the current under- and overprescribing amongst the different VTE risk categories. The accuracy of VTE risk ratings performed by admitting nursing staff remains in question. keywords: africa; data; guidelines; hospital; patients; prophylactic; prophylaxis; risk; south; study; thromboembolism; venous; vte cache: safpj-5022.htm plain text: safpj-5022.txt item: #409 of 732 id: safpj-5023 author: None title: safpj-5023 date: None words: 4430 flesch: 46 summary: Wayne and colleagues showed a statistically significant correlation between student perceptions of the learning environment and actual test scores performance in a United States medical school.5 Similar to Bannister and colleagues, we understand the ‘learning environment’ to be a combination of physical, emotional, psychological, organisational and social experiences that students have while engaging in their studies.6 The training of FPs in the South African context is rooted in a deep understanding of the socio-cultural demands placed on the health system.7 Although relatively new in medical education,8 the development of postgraduate FM training programmes has followed a thorough process that has resulted in a consensus-driven, broadly accepted curriculum.1 While the standard quantitative evaluations (unpublished routinely collected programme data) raised issues mainly related to programme management and student performance, and are driven by institutional imperatives, the qualitative approach was able to identify experiential aspects from the perspectives of students and educators, providing a more grounded understanding of their experiences. keywords: cape; experiences; family; learning; medicine; participants; programme; registrars; south; students; training cache: safpj-5023.htm plain text: safpj-5023.txt item: #410 of 732 id: safpj-5026 author: None title: safpj-5026 date: None words: 3663 flesch: 51 summary: However, the quality of care received by mothers and newborns in low-resource settings is often poor.1 This is collaborated by Nesbitt and colleagues who found that the quality of routine and emergency intrapartum and postnatal care was generally poor.2 However, this is taking place despite the existence of the World Health Organization (WHO) guidelines, which recommend the provision of quality postnatal care to mothers and newborns.3 It is widely acknowledged that quality of care includes multiple levels from patient to health system, and other dimensions such as safety and efficiency.1 It has been documented that adhering to clinical practice guidelines may improve midwives’ knowledge, clinical skills and attitudes when providing postnatal care.7 Literature suggests that a ‘skilled attendant’ is essential in the provision of quality postnatal care to mothers and keywords: care; facilities; health; malawi; midwives; mothers; postnatal; quality; study cache: safpj-5026.htm plain text: safpj-5026.txt item: #411 of 732 id: safpj-5028 author: None title: safpj-5028 date: None words: 1875 flesch: 53 summary: There is an urgent need to address barriers of access to legal abortion services in the scope of the CTOP Act in public health facilities, especially in second-trimester abortion. It is a legislative demand that abortion services in the scope of the CTOP Act should be accessible and available to all women in South Africa. keywords: abortion; act; health; south; trimester cache: safpj-5028.htm plain text: safpj-5028.txt item: #412 of 732 id: safpj-5029 author: None title: safpj-5029 date: None words: 4257 flesch: 48 summary: Usage of smart devices amongst medical practitioners in Universitas Academic Hospital. https://doi.org/10.4102/safp.v62i1.5029 Original Research Usage of smart devices amongst medical practitioners in Universitas Academic Hospital Yeyang Xu, Zoë Francis, Khayam Saleem, Siphamandla Sambujana, Keitumetse Molise, Boitumelo Molise, Nicholas Pearce, Gina Joubert Received: 26 Sept. 2019; Accepted: 29 Nov. 2019; Published: 04 Feb. 2020 Copyright: © 2020. keywords: applications; department; devices; health; patient; practitioners; respondents; study; surgery; usage; use cache: safpj-5029.htm plain text: safpj-5029.txt item: #413 of 732 id: safpj-5030 author: None title: safpj-5030 date: None words: 5794 flesch: 37 summary: The framework addressed the three components of quality assessment, namely, accreditation, assessment and quality assurance. The first step to ensure quality assessment is to identify a clear outcome. keywords: assessment; documents; education; framework; health; homepage; internet; programme; quality; review; south; training; undergraduate cache: safpj-5030.htm plain text: safpj-5030.txt item: #414 of 732 id: safpj-5031 author: None title: safpj-5031 date: None words: 1189 flesch: 55 summary: Key high-level milestones in Dr Jaffe’s account locate the beginning of academic family medicine in 1958 when the Cape of Good Hope and Witwatersrand regions formally established faculties linked to the Royal College of General Practitioners in the United Kingdom, the first appointment of a professor of family medicine in 1967 at the University of Pretoria and the establishment of the SAAFP in 1980. Keywords: family medicine; history; COPC; academic medicine; SAAFP. keywords: africa; family; medicine; south cache: safpj-5031.htm plain text: safpj-5031.txt item: #415 of 732 id: safpj-5032 author: None title: safpj-5032 date: None words: 2730 flesch: 55 summary: Abstract Introduction Decade of action for road safety Risk factors for road traffic injuries in South Africa Trends of road traffic injuries in South Africa Pedestrians as road users in South Africa South African road traffic injuries: Where do we stand? Recommendations for prevention of road traffic injuries Conclusion Acknowledgements References About the Author(s) Keywords: road traffic injury (RTI); World Health Organization (WHO); South Africa (SA); low income; middle income; high income; gross domestic product (GDP). keywords: africa; factors; injuries; risk; road; rtis; safety; south; traffic cache: safpj-5032.htm plain text: safpj-5032.txt item: #416 of 732 id: safpj-5033 author: None title: safpj-5033 date: None words: 5167 flesch: 50 summary: As from the 2014 first-year cohort, the calculation of the merit point score used in the selection of BCMP students at UP included additional points for rural students on the basis of their rural origin and rural schooling. Both these measures reduce the chances of urban students displacing rural students from the selection list. keywords: africa; bcmp; health; medical; participants; practice; south; students; study; surveys cache: safpj-5033.htm plain text: safpj-5033.txt item: #417 of 732 id: safpj-5034 author: None title: safpj-5034 date: None words: 4692 flesch: 52 summary: In addition, the positive perceptions of FM could also have been influenced by the richness of data obtained from doctors from Cuba who have been more exposed to FM; whereas FM doctors themselves were excluded from the study. They note the role of FM discipline in district hospitals, its support of primary health- care and its ability to fill the gaps in the healthcare system, including surgical skills. keywords: africa; care; discipline; district; doctors; family; health; hospital; medicine; participants; south; study cache: safpj-5034.htm plain text: safpj-5034.txt item: #418 of 732 id: safpj-5035 author: None title: safpj-5035 date: None words: 5868 flesch: 53 summary: The strict adherence to BP measurement protocols by trained staff has been shown to result in manual BP measurements that correlate much better with ambulatory readings.21 Therefore, the relevance of adequate training and retraining of health workers on BP measurement guidelines cannot be understated. The reason for the lower usual-care BP values in the index study may be attributed to non-adherence to BP measurement guidelines. keywords: arm; blood; bp measurement; care; care bp; guideline; measurement; mmhg; patients; pressure; protocol; study; treatment cache: safpj-5035.htm plain text: safpj-5035.txt item: #419 of 732 id: safpj-5036 author: None title: safpj-5036 date: None words: 4647 flesch: 55 summary: Conclusion: HIV status, food security and exposure to cigarette smoke, as components of living conditions, showed an association with TB treatment outcomes in the selected sample; in the sense HIV infection reduced the cure rate, increased the death and default rates of TB patients in the same sample. Good food security increased the cure rate of TB patients, but exposure to cigarette smoke decreased the cure rate and increased the death rate amongst respondents having TB treatment in the current survey. keywords: food; health; hiv; outcomes; patients; rate; respondents; study; treatment; tuberculosis cache: safpj-5036.htm plain text: safpj-5036.txt item: #420 of 732 id: safpj-5039 author: None title: safpj-5039 date: None words: 6935 flesch: 40 summary: https://doi.org/10.1016/j.amepre.2016.07.014 Liao Y, Siegel PZ, White S, Dulin R, Taylor A. Improving actions to control high blood pressure in Hispanic communities – Racial and ethnic approaches to community health across the U.S. Project, 2009–2012. Medical subject headings (MeSH) terms included ‘community based participatory research’, ‘hypertension action research’, ‘hypertension’, ‘community hypertension awareness’, ‘participatory action research’, ‘action research’, ‘community hypertension management’, ‘community blood pressure management’ and ‘hypertension implementation research’. keywords: action; care; cbpr; community; control; health; hypertension; implementation; intervention; management; participatory; prevention; primary; research; review; studies; study cache: safpj-5039.htm plain text: safpj-5039.txt item: #421 of 732 id: safpj-5040 author: None title: safpj-5040 date: None words: 4294 flesch: 52 summary: However, both studies found similar rates of overweight children in the same age group (11.8% vs. 13%).8 In this study, 14.4% prevalence of overweight in children aged 6 weeks to 5 months is a cause for concern. Kelly R. Gate Department of Family Medicine, University of KwaZulu-Natal, Durban, South Africa Nompumelelo G. Mfeka-Nkabinde Department of Family Medicine, University of KwaZulu-Natal, Durban, South Africa Kantharuben Naidoo Department of Family Medicine, University of KwaZulu-Natal, Durban, South Africa Citation Gate KR, Mfeka-Nkabinde NG, Naidoo K. An assessment of nutritional status in children of rural, northern KwaZulu-Natal province. keywords: africa; age; childhood; children; health; malnutrition; nutritional; obesity; overweight; south; study; years cache: safpj-5040.htm plain text: safpj-5040.txt item: #422 of 732 id: safpj-5042 author: None title: safpj-5042 date: None words: 4808 flesch: 55 summary: The coexistence of substance use and HIV has negative consequences on the continuity of HIV care.9 Substance use has a complex relationship with HIV and has a detrimental effect on transmission, linkage to care, adherence to treatment and retention in care. The growing culture of substance use amongst PLWH is a serious threat adding to the human immunodeficiency virus (HIV) epidemic and is likely to compromise the continuity of HIV care. keywords: africa; alcohol; care; hiv; lifetime; people; phc; plwh; prevalence; south; study; substance; substance use; use cache: safpj-5042.htm plain text: safpj-5042.txt item: #423 of 732 id: safpj-5043 author: None title: safpj-5043 date: None words: 4472 flesch: 45 summary: Nevertheless, these studies coupled up with studies on the factors influencing the use of contraceptive methods, also called ‘determinants of contraceptive use’, could provide a comprehensive guide to policy makers and programme implementers in reproductive health. Contraceptive competence is the ability of an individual woman or couple to use contraceptive methods; it comprises woman’s age, couple’s or woman’s level of education, occupation, etc. Attitudes or beliefs about contraceptive use are considered to be of great importance regarding contraceptive intention or evaluation. keywords: africa; contraceptive; district; family; health; hospital; methods; planning; research; south; study; use; women cache: safpj-5043.htm plain text: safpj-5043.txt item: #424 of 732 id: safpj-5044 author: Ellis, Chris title: Writing therapy date: 2019-03-08 words: 853 flesch: 71 summary: Writing therapy has now been more formalised as “expressive writing” or “written disclosure therapy” and research is beginning to show that it may help for a variety of conditions from anxiety and depression to improvement in blood pressure and asthma.2 Writing Therapy: keywords: patients; therapy; writing cache: safpj-5044.pdf plain text: safpj-5044.txt item: #425 of 732 id: safpj-5045 author: Van Rensburg, R.; Reuter, H. title: An overview of analgesics: NSAIDs, paracetamol, and topical analgesics date: 2019-03-08 words: 3880 flesch: 48 summary: The postulated mechanism for its peripheral effects is indirect COX inhibition, while the central effects are thought to be mediated by modulation of descending pain inhibition pathways. Pain is distinct from nociception, the latter being defined as the transmission of noxious stimuli to the brain, and the numerous processes that drive this transmission.1 Pain is then accordingly described as perceiving nociception, whether arising from the nociceptors (nociceptive pain), the nerve itself (neuropathic pain), or a combination of the two (mixed pain). keywords: action; analgesics; cox; dec; drugs; effects; inhibition; internet; nsaids; pain; paracetamol; topical cache: safpj-5045.pdf plain text: safpj-5045.txt item: #426 of 732 id: safpj-5046 author: Outhoff, K. title: Depression in doctors: A bitter pill to swallow date: 2019-03-08 words: 3811 flesch: 43 summary: Doctors may fear naming, blaming and shaming, sanctions and job loss.7 An American survey of 2106 women doctors revealed that although almost 50% believed they had met the criteria for mental illness, they had not sought treatment because they felt “they could manage independently, had limited time, were fearful of reporting it to a medical licensing board, and because they believed that a diagnosis was embarrassing or shameful,”24 supporting the view that fewer professions stigmatise mental health disorders more prominently than medicine.25 While some institutions offer free confidential professional mental health access, this may inadvertently be another potential source of stigmatisation. Rossouw L, Seedat S, Emsley RA, Suliman S, Hagemeister D. The prevalence of burnout and depression in medical doctors working in the Cape Town Metropolitan Municipality community healthcare clinics and district hospitals of the Provincial Government of the Western Cape: a cross-sectional study. keywords: burnout; depression; doctors; general; health; prevalence; risk; self; stress; suicide; symptoms; treatment cache: safpj-5046.pdf plain text: safpj-5046.txt item: #427 of 732 id: safpj-5047 author: Marais, A.; Osuch, E.; Steenkamp, V.; Ledwaba, L. title: Important pharmacogenomic aspects in the management of HIV/AIDS date: 2019-03-08 words: 3481 flesch: 43 summary: Barco E, Nóvoa S. The pharmacogenetics of HIV treatment: a practical clinical approach. The presence of SNP rs28399454, rs28399433 and rs3745274 variant alleles in HIV positive African patients has shown almost a doubling in the plasma concentration of efavirenz when present. keywords: african; doi; drug; hiv; metabolism; patients; plasma; pmcid; polymorphisms; south; studies; treatment cache: safpj-5047.pdf plain text: safpj-5047.txt item: #428 of 732 id: safpj-5048 author: Naidoo, Mergan; von Pressentin, Klaus B.; Ras, Tasleem; Steinberg, Hannes title: Mastering your Fellowship date: 2019-03-08 words: 6016 flesch: 56 summary: The finding that not all patients who present to the ED following self-harm receive a psychiatric assessment or referral is consistent with international practices.30 Likewise, a smaller proportion of CSU patients, compared to other patients, received a psychiatric assessment. The lack of psychiatric assessment is worrying given that a greater proportion of CSU patients compared to other self-harm patients reported a history of self-harm. keywords: authors; care; csu; family; harm; health; marks; medicine; patients; self; study cache: safpj-5048.pdf plain text: safpj-5048.txt item: #429 of 732 id: safpj-5049 author: Motswaledi, H. M. title: Common dermatological conditions in the HIV patient date: 2019-03-08 words: 2473 flesch: 46 summary: In HIV, it may cause disseminated cutaneous disease and HIV patients tend to have recurrent episodes.3 It presents as painful vesicles following a dermatome. It is caused by a poxvirus and is common in HIV patients. keywords: disease; figure; hiv; infections; lesions; patients; skin; syphilis; treatment cache: safpj-5049.pdf plain text: safpj-5049.txt item: #430 of 732 id: safpj-5050 author: Mash, Bob title: Changes to the South African Family Practice Journal date: 2019-03-08 words: 744 flesch: 54 summary: Dr von Pressentin is a family physician at Mossel Bay District Hospital, he has a PhD in Family Medicine and has experience as the Assistant Editor of the African Journal of Primary Health Care and Family Medicine. Before signing off I would also like to draw your attention to the annual National Family Practitioner Conference that will be held in Midrand from 23–25 August 2019. keywords: academy; editor; journal cache: safpj-5050.pdf plain text: safpj-5050.txt item: #431 of 732 id: safpj-5051 author: Bongongo, T.; Ndimande, J. V.; Ogunbanjo, G. A.; Masango-Makgobela, A. T.; Nyalunga, S. N.; Govender, I. title: Awareness of the Ward Based Outreach Team and the services offered by the programme in the Tshwane health district, South Africa date: 2019-03-08 words: 3357 flesch: 63 summary: The services of WBOT were admired and a recommendation was made in the direction of extending these services in order to accommodate community health needs.9 Considering the scarcity of the WBOT literature focused on com- munities or households, this study revolved around the aware- ness of communities or households regarding the WBOT programme, in the Tshwane health district of South Africa. They noted during their interviews that respondents expressed their gratitude that the programme has reduced the distance between the health facilities and their homes,9 because health care was brought to their homes.3,9 Respondents also admired the fact that patients with chronic diseases received their medication at home through the programme and would love to see community health workers bringing with them basic medications such as vitamins.9 In the North West province of South Africa, an assessment prior to initiation of the programme was undertaken. keywords: awareness; care; community; health; households; programme; south; tshwane; wbot cache: safpj-5051.pdf plain text: safpj-5051.txt item: #432 of 732 id: safpj-5053 author: None title: safpj-5053 date: None words: 1951 flesch: 44 summary: Topical nasal decongestant oxymetazoline (0.05%) provides relief of nasal symptoms for 12 hours. Treating acute rhinitis and exacerbations of chronic rhinitis – A role for topical decongestants? keywords: acute; congestion; decongestants; nasal; oxymetazoline; rhinitis; south; symptoms cache: safpj-5053.htm plain text: safpj-5053.txt item: #433 of 732 id: safpj-5054 author: Ali, R. Omed; Ross, A. J.; Nkabinde, T. C. title: Knowledge of final-year medical students at the University of KwaZulu-Natal about family medicine, and long-term career choices date: 2019-03-08 words: 5852 flesch: 55 summary: The study was conducted by FM department members and, despite being anonymous, some responses may have been influenced by both performance and social desirability bias, especially so regarding the role of FPs in Table 3: Positive and negative perceptions of final year medical students concerning family medicine Positive perceptions of family medicine Negative perceptions of family medicine Focus on preventive aspects Personality or passion not suited to FM Second career option if first choice not attainable Practically still only curative/ palliative Focus on primary care and integration Not a real specialty Important for future of health system Irrelevant in Durban/urban areas Gives experience, respect and competence Boring or not challenging Beneficial to rural hospitals Requires vast knowledge or too challenging Reduce admission time compared with specialties Key to PHC. Ozcakir A, Yaphe J, Ercan I. Perceptions of family medicine and career choice among first year medical students: a cross-sectional survey in a Turkish medical school. keywords: care; career; family; fps; health; medicine; phc; primary; south; students; study; year cache: safpj-5054.pdf plain text: safpj-5054.txt item: #434 of 732 id: safpj-5055 author: Shayo, Flavia Strato; Mash, Bob title: Modifiable factors within the prevention of mother-to-child transmission programme associated with failure to prevent HIV transmission in the Onandjokwe district of Namibia date: 2019-03-08 words: 5457 flesch: 45 summary: Mother-to-child transmission has been virtually eliminated in high-income countries and demonstrates that the use of appropriate antiretroviral (ARV) medication during pregnancy and breastfeeding can reduce the risk of vertical transmission to less than 5%.3 Cuba, a low-income country, has demonstrated that it is possible to eliminate HIV infection in children through the Prevention of Mother-To-Child Trans- mission (PMTCT) programme, as it became the first country cer- tified by the World Health Organization (WHO) in 2015 to have done so.4 To date four more countries (Thailand, Belarus, Armenia and Moldova) have been validated by the WHO.5 Elim- inating new HIV infections among children through the PMTCT programme has been shown to be cost-effective as it decreases morbidity and mortality, the psychological burden of HIV, as well as economic costs to both individuals and society.6 The PMTCT programme has been proven to effectively reduce the risk of transmitting HIV infection from mothers to their babies, even in low-resource settings.7,8 The benefit of using a short-term combination of triple ARVs in pregnant mothers and single-dose nevirapine in exposed infants was shown to sig- nificantly decrease the chance of a mother transmitting HIV to her baby.9 WHO guidelines for PMTCT in 2013 and 2015 rec- ommended starting life-long Highly Active Anti-Retroviral Therapy (HAART) in all HIV-positive pregnant and breastfeeding mothers and to offer nevirapine to their babies throughout the breastfeeding period.9,10 Adoption of the new 2016 WHO guide- line recommendations to treat everyone who tests HIV-positive is expected to further reduce the chance that children born to HIV-positive mothers will be HIV infected because of earlier initiation of ARV and attainment of viral suppression.10,11 Pre- vention of new infections through the PMTCT programme will not only save the life of the baby, but will keep the mother alive by giving her the treatment she needs, and protect other children in the family from being orphaned. Modifiable factors within the prevention of mother-to-child transmission programme associated with failure to prevent HIV transmission in the Onandjokwe district of Namibia Modifiable factors within the prevention of mother-to-child transmission programme associated with failure to prevent HIV transmission in the Onandjokwe district of Namibia Flavia Strato Shayo and Bob Mash* Division of Family Medicine and Primary Care, Stellenboch University, Stellenbosch, South Africa *Corresponding author, email: rm@sun.ac.za Background: Ending new paediatric HIV infections continues to be a global health priority. keywords: art; care; child; children; factors; health; hiv; mother; pmtct; programme; study; transmission cache: safpj-5055.pdf plain text: safpj-5055.txt item: #435 of 732 id: safpj-5057 author: Benedict, M. O.A.; van Loggerenberg, C. J.; Steinberg, W. J. title: The profile of deliberate self-poisoning cases presenting at the emergency department of Pelonomi Regional Hospital, Bloemfontein date: 2019-03-08 words: 5767 flesch: 54 summary: This result differs from a Unites States (US) study where the rate was found to be higher in the age group 15–19 years.17 However, similar results were found in the United Kingdom (UK),15 where the majority of DSP patients were younger than 30 years, and in Oman18 and India20 where DSP occurred in the age group 20–30 years. A study done in the UK24 on DSP showed that paracetamol and paracetamol-containing com- pounds were implicated in about 50% of the cases while 41% of DSP patients ingested paracetamol and non-steroidal anti- inflammatory drugs in the Oman study.18 About 10% of the patients used ARVs for their DSP attempt. keywords: cases; department; dsp; emergency; hospital; n =; patients; pelonomi; poisoning; regional; self; south; study cache: safpj-5057.pdf plain text: safpj-5057.txt item: #436 of 732 id: safpj-5060 author: None title: safpj-5060 date: None words: 3961 flesch: 51 summary: The questionnaire had the following sections: demographic as well as professional data; challenges facing IMCI-trained professional nurses in implementing the IMCI strategy; perceived challenges of IMCI-trained professional nurses on IMCI strategy implementation; and recommendations for improving IMCI strategy implementation. Table 5 presents the recommendations to improve IMCI strategy implementation. keywords: challenges; childhood; health; illness; imci; implementation; management; nurses; respondents; strategy cache: safpj-5060.htm plain text: safpj-5060.txt item: #437 of 732 id: safpj-5062 author: Gabriels, Gary; Irhuma, Mohamed title: The potential impact of dietary supplement adulteration on patient assessment and treatment from a healthcare provider’s perspective date: 2019-12-09 words: 4601 flesch: 36 summary: The further burden of vigilance is the reality and probability of ongoing changes in dietary supplement products due to aggres- sive marketing4, and thus the possibility of these products’ com- position frequently changing. The ‘pledge’, however, is intended to be an ethical code for all phys- icians, and by extension for the broader healthcare profession.1 The purpose via its implementation is to strengthen the respect- ive healthcare professions, with determination to maintain the highest standard of health care for patients.1 The pledge makes it a mandatory responsibility to teach and provide knowl- edge to the next generation of physicians.3 Its importance lies in sharing1 and in continued teaching and knowledge3 acquisition, the more so with specific reference to keeping abreast of the prevailing landscape of dietary supplement consumption, and the impact this could have on the health/well-being of the phys- ician and patient. keywords: consumption; doping; effects; healthcare; lifestyle; nutritional; patient; physician; practitioner; products; supplements; treatment cache: safpj-5062.pdf plain text: safpj-5062.txt item: #438 of 732 id: safpj-5063 author: Ker, J. A.; Outhoff, K. title: Burning issues in acute heart failure management date: 2019-12-09 words: 2390 flesch: 46 summary: In fact, in-hospital mortality of acute heart failure can be greater than that of acute myocardial infarction, and mortality remains high for more than a year after discharge compared to stable outpatient heart failure.3 Early readmission within 30–90 days after discharge is common, affecting almost one quarter of acute heart failure patients. The heart itself has a structural or functional abnormality leading to elevated intracardiac pressures or reduced cardiac output at rest or during effort.1 Importantly, acute heart failure may comprise distinct entities with different pathophysiologies, treatments and clinical outcomes. keywords: diuretic; failure; heart; mortality; patients cache: safpj-5063.pdf plain text: safpj-5063.txt item: #439 of 732 id: safpj-5064 author: de Wet, H. title: European osteoporosis pharmacological guidelines confirm current recommended treatment whilst answering important management questions date: 2019-12-09 words: 2614 flesch: 37 summary: Who to treat? Benefits of pharmacologic therapies outweigh risks in post- menopausal women at high fracture risk, especially those who have sustained recent fracture.5 High fracture risk patients are defined as those with T-scores of -2.5 or less at either the femoral neck, total hip or lumbar spine, or T-scores of -1.0 to -2.5 with a 10-year fracture risk probability of ≥ 20% for a major osteoporotic fracture or ≥ 3% for a hip fracture based on the FRAX® tool.5 Physicians may be unsure regarding appropriate screening, identifying patients at high fracture risk, especially imminent fracture risk, appropriate treatment initiation and duration of treatment, as well as when to institute “drug holidays”. keywords: fracture; hip; osteoporosis; patients; risk; treatment; women cache: safpj-5064.pdf plain text: safpj-5064.txt item: #440 of 732 id: safpj-5065 author: Greenstein, L.; Abraham, A.; Tipping, B. title: Treating complexity in the older adult - the role of the geriatric giants date: 2019-12-09 words: 3832 flesch: 48 summary: The aim is to prevent common complications and keep older patients as safely mobile as possible for as long as possible. Tipping B, Kalula S, Badri M. The burden and risk factors for adverse drug events in older patients--a prospective cross-sectional study. keywords: care; dementia; drug; falls; geriatric; giants; immobility; incontinence; med; patients; pressure; review; risk; use cache: safpj-5065.pdf plain text: safpj-5065.txt item: #441 of 732 id: safpj-5066 author: Ellis, Chris title: The spiritual construction of depression date: 2019-12-09 words: 845 flesch: 52 summary: On further enquiry they have partially fulfilled the criteria for clinical depression but whether the loss of faith has caused the depression or is a manifestation of the depression itself was never clear. Along the same lines, in 1967, the psychologist Maddi proposed the concept of the existential neurosis of modern life that alienates patients from both themselves and society. keywords: depression; life cache: safpj-5066.pdf plain text: safpj-5066.txt item: #442 of 732 id: safpj-5067 author: Moodley, I. title: An HIV-free generation: review of prevention strategies date: 2019-12-09 words: 6414 flesch: 57 summary: Voluntary medical male circumcision (VMMC) There is a substantial body of evidence that VMMC can reduce the risk of heterosexually acquired HIV infection in men by approximately 60%.7 The trials carried out in Kisumu, Kenya Akai District, and Uganda showed at least a 53%, 51% and 60% reduction in risk of acquiring HIV infection, respectively.13 These results support findings published in 2005 from the South Africa Intervention Trial, sponsored by the French National Agency for Research on AIDS, which demonstrated at least a 60% reduction in HIV infection among men who were circumcised.13 WHO/ UNAIDS recommendations emphasise that VMMC should be considered an efficacious intervention for HIV prevention in countries and regions with heterosexual epidemics, high HIV and low male circumcision prevalence.13 Male circumcision provides only partial protection, and therefore should be only An HIV-free generation: review of prevention strategies 17 The page number in the footer is not for bibliographic referencingwww.tandfonline.com/oemd 17 one element of a comprehensive HIV-prevention package which includes the provision of HIV testing and counselling services; treatment for sexually transmitted infections; the promotion of safer sex practices; the provision of male and female condoms when requested and promotion of their correct and consistent use.12,13 Prevention of mother-to-child transmission (PMTCT) of HIV PMTCT is perhaps the most dramatic and effective of HIV- prevention interventions. While there are many limitations inherent in attempting to evaluate the effectiveness of interventions aimed at HIV prevention, data from various surveillance systems indicate that current interventions are probably not yet having a significant impact on the epidemic at the continental or even the local level.3,5 Despite the fact that levels of AIDS awareness are extremely high,3 getting people to change their behaviour is difficult. keywords: adherence; africa; health; hiv; people; prep; prevention; south; study; treatment; use; women cache: safpj-5067.pdf plain text: safpj-5067.txt item: #443 of 732 id: safpj-5068 author: Govender, I. title: Health care is all about relationships date: 2019-12-09 words: 716 flesch: 46 summary: Relationships hold a central position in medical education and are critical for achieving favourable learning outcomes.2 Canadian family physicians have reported better learning outcomes in their longitudinal clerkship training where preceptors develop engaging and trusting relationships with their students. Effective leadership is embodied in relationships that need to be developed with staff and patients. keywords: leadership; learning; relationship cache: safpj-5068.pdf plain text: safpj-5068.txt item: #444 of 732 id: safpj-5069 author: von Pressentin, K. B.; Naidoo, M.; Ras, T.; Torlutter, M. title: Mastering your Fellowship date: 2019-12-09 words: 8067 flesch: 53 summary: • Education – does it challenge existing knowledge or thinking This study describes an evaluation of a programme which aimed to educate and support rural district hospital doctors when providing anaesthesia, often within limited support. • Evaluation – given the above, how would I score or evaluate the usefulness of this study to my practice This survey may be useful to the district health system, especially when reviewing the support systems available to rural district hospital doctors. keywords: anaesthesia; care; district; doctors; family; hospital; marks; pain; patient; programme; question; research; section; spinal; study; support cache: safpj-5069.pdf plain text: safpj-5069.txt item: #445 of 732 id: safpj-5070 author: Mash, Robert; Malan, Zelra; Blitz, Julia; Edwards, Jill title: Improving the quality of clinical training in the workplace: implementing formative assessment visits date: 2019-12-09 words: 5833 flesch: 37 summary: Comments: Are you adequately supported in preparing for the FCFP exams? Comments: Have you identified any other issues about the educational experience and how were these resolved? Comments: 270 South African Family Practice 2019; 61(6):264–272 Visitor use: Highlights & recommendations based on the registrar interview: Appendix C: Observation of clinical training Background information Visitors please view and comment where required: Area Comment Evidence of learning outcomes Y/N Clarity of expected learning outcomes Y/N Evidence of preparation Y/N Acceptable quality teaching resources Y/N Appropriateness of educational style Y/N Appropriate involvement of the registrar Y/N Appropriate learner-centredness Y/N Visitor’s summary & recommendations: Improving the quality of clinical training in the workplace 271 Appendix D: Developmental goals and planning Date of visit: Name of clinical trainer: Name of visiting family physician: General comments on highlights and successes or areas that need improvement Specific goals for the next year 1. 2. 3. 4. 5. Actions to be taken to achieve these goals Plan of action By whom? Improving the quality of clinical training in the workplace: implementing formative assessment visits Improving the quality of clinical training in the workplace: implementing formative assessment visits Robert Masha*, Zelra Malana, Julia Blitza and Jill Edwardsa,b aDivision of Family Medicine and Primary Care, Stellenbosch University, Stellenbosch, South Africa bRoyal College of General Practitioners, London, United Kingdom *Corresponding author, email: rm@sun.ac.za Family physicians have a key role to play in strengthening district health services in South Africa. keywords: assessment; care; family; feedback; learning; registrars; south; trainers; training; visit; workplace cache: safpj-5070.pdf plain text: safpj-5070.txt item: #446 of 732 id: safpj-5071 author: Haskins, J. Lyn; Phakathi, Sifiso A.; Grant, Merridy; Horwood, Christiane M. title: Integrating services for impact and sustainability: a proof-of-concept project in KwaZulu-Natal, South Africa date: 2019-12-09 words: 5657 flesch: 52 summary: However, at follow-up, although 153/289 (58.2%) of mothers did not receive any maternal services, among those who did receive maternal services mothers reported having received up to five different maternal health services (p = 0.047) as shown in Figure 3. Policy-makers support integration within health services that brings together services and activities that share common objectives.6–8 In South Africa, when patients come to a primary health care (PHC) clinic, health workers should provide the patient with a complete package of preven- tative, promotive and curative care. keywords: africa; baseline; care; child; clinic; follow; health; hiv; integration; intervention; mothers; services; south; study cache: safpj-5071.pdf plain text: safpj-5071.txt item: #447 of 732 id: safpj-5073 author: Bongongo, T.; Ndimande, J. V.; Tumbo, J. title: An assessment of erectile dysfunction among male diabetics attending Temba Community Health Centre, Pretoria date: 2019-12-09 words: 3904 flesch: 49 summary: An assessment of erectile dysfunction among male diabetics attending Temba Community Health Centre, Pretoria An assessment of erectile dysfunction among male diabetics attending Temba Community Health Centre, Pretoria T Bongongo* , JV Ndimande and J Tumbo Department of Family Medicine & PHC/Sefako Makgatho Health Sciences University, Pretoria, South Africa *Corresponding author, email: bongongotombo@gmail.com Introduction: Erectile dysfunction is common among men with diabetic mellitus and has a negative effect on their quality of life. Erectile dysfunction was assessed among diabetic clients with and without myocardial ischaemic disease and erectile dysfunction appeared to be more prevalent in myocardial ischaemic and, thus, in coronary artery disease. keywords: diabetes; diabetics; dysfunction; frequency; health; mellitus; participants; study; temba cache: safpj-5073.pdf plain text: safpj-5073.txt item: #448 of 732 id: safpj-5074 author: Mbambo, S. W.; Tlou, B.; Dlungwane, T. P. title: Factors associated with physical activity amongst patients with hypertension in two community health centres in uMgungundlovu health district, KwaZulu-Natal, 2018 date: 2019-12-09 words: 4705 flesch: 52 summary: Keywords: physical activity level, hypertension, exercise, non-communicable diseases Introduction Hypertension (HPT) is the leading risk factor for morbidity and mortality, causing an estimated 9.4 million deaths worldwide.1 HPT or raised blood pressure is the most widely recognised risk factor for cardiovascular disease, cerebrovascular disease and end-stage renal disease.2,3 HPT accounts for at least 45% of heart disease-related mortality and 51% of stroke- related mortality.4,5 HPT is often referred to as a silent killer; about 50% of people with raised blood pressure are not aware of it because they are experiencing no symptoms.6 This predisposes them to the dangers of stroke and cardiovas- cular disease.6 The prevalence of HPT continues to increase and is estimated to rise by 60% by 2025.7 The primary preven- tion of hypertension has become a global public health challenge.7 Physical activity (PA) is a cost-effective, practical, natural and effective way of controlling HPT.2,8 Regular PA is a key com- ponent of lifestyle therapy for the primary prevention and treatment of hypertension.2,8 Studies have demonstrated the beneficial effects of exercise on HPT with reductions in both sys- tolic and diastolic blood pressure with as much as 5–7 mmHg reductions in those with hypertension.9–12 The findings are comparable to a study conducted in Kigali, Rwanda conducted amongst clients with HPT, which also found that participants with less education displayed higher PA than those with high levels of educations.24 One possible explanation could be that par- ticipants with low levels of education were primarily engaged in physically strenuous jobs, hence they reported high physical activity levels. keywords: activity; exercise; factors; health; hpt; hypertension; levels; participants; patients; physical; study cache: safpj-5074.pdf plain text: safpj-5074.txt item: #449 of 732 id: safpj-5075 author: Rogers, Mampho Mochaoa; Mfeka-Nkabinde, Gloria; Ross, Andrew title: An evaluation of male learners’ knowledge, attitudes and practices regarding sexual and reproductive health in rural northern KwaZulu-Natal province date: 2019-12-09 words: 6973 flesch: 52 summary: An evaluation of male learners’ knowledge, attitudes and practices regarding sexual and reproductive health in rural northern KwaZulu-Natal province An evaluation of male learners’ knowledge, attitudes and practices regarding sexual and reproductive health in rural northern KwaZulu-Natal province Mampho Mochaoa Rogersa,b* , Gloria Mfeka-Nkabindeb and Andrew Rossb aBethesda Hospital, Department of Health, Ubombo, South Africa bDiscipline of Family Medicine, School of Nursing and Public Health, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa *Corresponding author, email: mamphomr@gmail.com Background: With a disparate HIV prevalence among young men and women, high rates of teenage pregnancies and a lack of responsible fatherhood, issues of reproductive health among young people need to be urgently addressed. According to the United Nations, reproductive health and well-being should encompass the following: all pregnancies should be intended, all births should be healthy and sexual activity should be free of coercion or violence and infection.9,10 Young women are at a higher risk for HIV acquisition than men due to a complex combination of biological, behavioural, struc- tural and sociocultural factors that have resulted in high rates of new infections.11,12 Due to the disproportionately high preva- lence of HIV in young women, research has focused on this population, often to the exclusion of young men. keywords: africa; attitudes; health; hiv; knowledge; male; men; participants; practices; reproductive; school; sex; south; study; women; years cache: safpj-5075.pdf plain text: safpj-5075.txt item: #450 of 732 id: safpj-5076 author: Govender, I.; Steyn, C.; Maphasha, O.; Abdulrazak, A. T. title: A profile of Caesarean sections performed at a district hospital in Tshwane, South Africa date: 2019-12-09 words: 5612 flesch: 54 summary: In sub-Saharan Africa CS figures remained mainly unchanged from 1990 to 2014.7 It was also seen that target CS rates were met in sub-Saharan Africa between 2010 and 2011.17 No. % Stillbirth 1 0.1 Neonate transferred to tertiary care (indication not recorded) 1 0.1 Neonate admitted for morbidity 36 3.4 Table 2: Indications for CS in 2015 Emergency CS Elective CS Indications No. keywords: africa; age; anaesthesia; caesarean; css; elective; emergency; neonatal; rate; south; study; women cache: safpj-5076.pdf plain text: safpj-5076.txt item: #451 of 732 id: safpj-5077 author: Mash, Robert; Steyn, Herma; Bello, Muideen; von Pressentin, Klaus; Rossouw, Liezel; Hendricks, Gavin; Fouche, Germarie; Stapar, Dusica title: The quality of feedback from outpatient departments at referral hospitals to the primary care providers in the Western Cape: a descriptive survey date: 2019-12-09 words: 7131 flesch: 51 summary: Another feature is the extent of gatekeeping and to what extent patients must go through primary care to access other levels. Primary care acts as the gatekeeper to sec- ondary care. keywords: care; coordination; data; family; feedback; health; hospital; information; letter; patients; physicians; primary; quality; referral cache: safpj-5077.pdf plain text: safpj-5077.txt item: #452 of 732 id: safpj-5079 author: None title: safpj-5079 date: None words: 11297 flesch: 53 summary: A third great transition seems to be sweeping the globe, changing how healthcare is financed and how health systems are organised; hence, actors are calling for health system transformation rather than health system strengthening to achieve UHC. This can only be achieved through the engagement of health system actors involved in policymaking and implementation. keywords: actors; africa; challenges; district; facility; health; health system; implementation; level; need; nhi; phc; policy; public; resources; round; south; sub; system; uhc; work cache: safpj-5079.htm plain text: safpj-5079.txt item: #453 of 732 id: safpj-5081 author: None title: safpj-5081 date: None words: 4937 flesch: 44 summary: Professional bodies in HIC such as the American Geriatric Society, British Geriatric Society and Australian Society for Geriatric Medicine have advocated for the inclusion of geriatric medicine in the UG medical curriculum of their countries.10,11,12 These bodies of specialist geriatricians have developed and proposed minimum core competencies for geriatric medical education, many of which are derived from recommendations of the International Association of Gerontology and Geriatrics (IAGG), a non-governmental organisation that aims to promote training in geriatric care globally (Online Appendix 1).10,11,12,13,14,15 This study only examined the planned and delivered geriatric curriculum as captured on the LOOOP platform as of July 2019. keywords: africa; assessment; care; curriculum; geriatric; health; learning; medical; medicine; patients; south; students; study; teaching cache: safpj-5081.htm plain text: safpj-5081.txt item: #454 of 732 id: safpj-5082 author: None title: safpj-5082 date: None words: 6307 flesch: 53 summary: p = 50% (because there was no previous study on the incidence of missed prediabetes diagnosis among primary care patients who had previously been seen by doctors) q = 1–p = 50%. Whilst few studies have been conducted on this topic in developed countries,19,22,29,30 there is a paucity of studies on the magnitude of missed prediabetes diagnosis amongst primary care patients in Nigeria. keywords: blood; care; clinic; factors; family; glucose; nigeria; opportunities; patients; physicians; prediabetes; primary; respondents; risk; screening; study cache: safpj-5082.htm plain text: safpj-5082.txt item: #455 of 732 id: safpj-5083 author: None title: safpj-5083 date: None words: 6780 flesch: 49 summary: (Mthobisi, 24 years, black African) Understanding of voluntary medical male circumcision in KwaZulu-Natal Human immunodeficiency virus prevention and medical circumcision Participants in this study expressed accurate knowledge about the partial protection offered by VMMC against HIV infection. Previous studies have shown that medical male circumcision could prevent female-to-male transmission of HIV infection by up to 60%. keywords: african; black; circumcision; data; health; hiv; male; men; participants; south; study; understanding; vmmc; years cache: safpj-5083.htm plain text: safpj-5083.txt item: #456 of 732 id: safpj-5084 author: None title: safpj-5084 date: None words: 1193 flesch: 57 summary: While Ebrahim and Mirhagi imply in their article that not achieving target times is a marker of inappropriate assignation of red triage category to patients, we would argue that achievement of target times is a poor marker of true acuity because it is so heavily influenced by the availability of resources and patient load. Another important point raised is the concern that the physiological Triage Early Warning Score (TEWS) may be overly sensitive in leading to assignation of Red triage category. keywords: meyer; patients; south; triage cache: safpj-5084.htm plain text: safpj-5084.txt item: #457 of 732 id: safpj-5086 author: None title: safpj-5086 date: None words: 1645 flesch: 37 summary: Finally, PCPs can play an important role in continuing the management of patients with pre-eclampsia, because such patients may have elevated BP in the puerperium and may need to continue their antihypertensive medications; some are likely to develop cardiovascular problems later in life and therefore need at least yearly medical reviews to ensure that they have not developed chronic hypertension, cardiomyopathy and/or diabetes mellitus. Introduction In South Africa, severe hypertension in pregnancy (SHP) is the most common direct cause of maternal mortality.1 keywords: africa; care; health; patient; south cache: safpj-5086.htm plain text: safpj-5086.txt item: #458 of 732 id: safpj-5089 author: None title: safpj-5089 date: None words: 2892 flesch: 43 summary: Articular pain in comparison to non-articular pain is more diffuse and present in both active and passive movements, while non-articular pain is usually localised to the affected structure (e.g. muscle, tendon, bursa, fascia, nerve or bone) and usually limits active rather than passive movements. Keywords: osteoarthritis; rheumatoid arthritis; primary care doctor; non-steroidal anti-inflammatory drugs. keywords: arthritis; clinical; disease; figure; joint; knee; management; osteoarthritis; pain; rheumatoid cache: safpj-5089.htm plain text: safpj-5089.txt item: #459 of 732 id: safpj-5090 author: None title: safpj-5090 date: None words: 2158 flesch: 37 summary: Abstract Background Methods Results Discussion Conclusion Acknowledgements References About the Author(s) Oliver van Hecke Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom Renier Coetzee School of Pharmacy, Faculty of Natural Science, University of the Western Cape, Cape Town, South Africa Citation Van Hecke O, Coetzee R. Establishing a pharmacist–prescriber partnership in publicly funded primary healthcare clinics to optimise antibiotic prescribing in the Western Cape: An exploratory study. https://doi.org/10.4102/safp.v62i1.5090 Scientific letters Establishing a pharmacist–prescriber partnership in publicly funded primary healthcare clinics to optimise antibiotic prescribing in the Western Cape: An exploratory study Oliver van Hecke, Renier Coetzee Received: 21 Jan. 2020; Accepted: 20 Apr. 2020; Published: 22 June 2020 Copyright: keywords: ams; antibiotic; care; community; health; prescribing; primary cache: safpj-5090.htm plain text: safpj-5090.txt item: #460 of 732 id: safpj-5091 author: None title: safpj-5091 date: None words: 7187 flesch: 54 summary: Methodology Study design and setting A qualitative, explorative and descriptive design was used to understand the challenges mothers faced during the emergency transfer of their critically ill neonates, and to inquire from Advanced Life Support (ALS) paramedics and neonatologists on what was better needed to prepare paramedics to deal with accompanying mothers during such emergency transfers. The pre-hospital transfer environment is characterised by adverse weather conditions, excessive noise and bumps, warning alarms of the equipment, restricted lighting and limited cabin space all of which heightens the anxiety of accompanying mothers. keywords: baby; care; data; emergency; focus; group; health; hospital; interview; mothers; neonatal; paramedics; participant; process; transfer cache: safpj-5091.htm plain text: safpj-5091.txt item: #461 of 732 id: safpj-5092 author: None title: safpj-5092 date: None words: 2762 flesch: 50 summary: ‘Rifampicin-resistant tuberculosis’ is used as a general term to encompass all the forms of RR-TB, including multidrug-resistant TB (MDR-TB) and extensively drug-resistant TB (XDR-TB). A policy supporting decentralised and deinstitutionalised drug-resistant TB (DR-TB) treatment provision at lower levels of the health system was introduced in 2011; however, largely because of complicated regimens, including daily injectables, implementation has varied. keywords: drugs; patients; regimen; rifampicin; tuberculosis cache: safpj-5092.htm plain text: safpj-5092.txt item: #462 of 732 id: safpj-5094 author: None title: safpj-5094 date: None words: 1483 flesch: 53 summary: Who is covered by National Health Insurance? All South African citizens, permanent residents, refugees and inmates will be covered by the NHI. How will National Health Insurance be funded? Money for the NHI fund will be collected from the following sources: Reallocation of medical scheme tax credits. keywords: health; insurance; national; nhi cache: safpj-5094.htm plain text: safpj-5094.txt item: #463 of 732 id: safpj-5095 author: None title: safpj-5095 date: None words: 2678 flesch: 46 summary: Hypertension in pregnancy is defined as a clinical systolic BP ≥ 140 mmHg or diastolic BP ≥ 90 mmHg, based on the average of at least two measurements taken at least 15 minute apart, using the same arm.1,2,3 Patients presenting with pre-HT (BP = 135/85–139/89) should have their BP repeated within 2 h and if BP is still at borderline, they should be asked to return within 3–7 days.1 Assessment of patients with hypertensive disorders in pregnancy A detailed history and examination of the patient is warranted at first presentation. Patients with any of these findings during history and examination should be started on prophylactic aspirin (75 mg - 162 mg) in early pregnancy with maximum benefits in preventing PE realised when initiated < 16 weeks of gestation.1,2,4,5 All pregnant women should also be started on elemental calcium, minimum 500 mg daily, as prophylaxis for PE.1,2,5,6,7,8 Table 1 provides investigations that are to be carried out at various antenatal visits.1,2,3 TABLE 1: Recommended investigations during antenatal care. keywords: care; disorders; guidelines; level; management; patient; pregnancy; south cache: safpj-5095.htm plain text: safpj-5095.txt item: #464 of 732 id: safpj-5096 author: None title: safpj-5096 date: None words: 1250 flesch: 49 summary: I bemoan, once again, our tardy response to the 2010 Lancet report and the slow transition of learning into the primary care context.10 Curricular design and the presence of generalist primary care faculty in core teaching have crucial influences on career choices of medical students and young doctors.11 Revising medical curricula takes time; consequently, we should start by making the most of the short stints of undergraduate exposure to our primary care context. Medical students and registrars are encouraged to offer their perspectives on family medicine and on their experiences as consumers of primary care curricular offerings. keywords: afr; care; family; health; primary cache: safpj-5096.htm plain text: safpj-5096.txt item: #465 of 732 id: safpj-5099 author: None title: safpj-5099 date: None words: 5212 flesch: 55 summary: Establishes a good doctor–patient relationship Shows genuine respect, compassion, sensitivity, rapport, empathy; establishes trust; and attends to patient’s comfort. The study aimed to increase the awareness of healthcare professionals (HCPs) about their attitudes towards intoxicated patients, whereas the title suggests that the aim of the study was to assess HCP perceptions of alcohol-intoxicated patients. keywords: candidate; care; evidence; examination; family; findings; marks; medicine; patient; question; south; study cache: safpj-5099.htm plain text: safpj-5099.txt item: #466 of 732 id: safpj-5104 author: None title: safpj-5104 date: None words: 3597 flesch: 55 summary: Attitudes and actions of asthma patients on regular maintenance therapy: The Global Initiative for Asthma 2019 recommendation for mild asthma – A critique. keywords: asthma; control; daily; gina; ics; inflammation; laba; patients; symptoms; treatment cache: safpj-5104.htm plain text: safpj-5104.txt item: #467 of 732 id: safpj-5108 author: None title: safpj-5108 date: None words: 3386 flesch: 47 summary: Keywords: breastfeeding; exclusive breastfeeding enablers; qualitative approach; teenage mothers; breastfeeding education. Conclusion: Health professionals and policy makers could learn from these enablers and use them to promote exclusive breastfeeding practices amongst teenage mothers in Ghana. keywords: breastfeeding; data; education; family; ghana; milk; mothers; participants; teenage cache: safpj-5108.htm plain text: safpj-5108.txt item: #468 of 732 id: safpj-5109 author: None title: safpj-5109 date: None words: 5398 flesch: 50 summary: Results of total SEGUE scores The total SEGUE scores of the 64 pairs of matched student consultations showed a significant improvement over the 5 months studied (Table 2). For medical students, lower scores for ‘Ending the session by summarising and clarifying the plan’ than for other subscales have been reported.21 Similarly, BCMP students had their lowest scores in the ‘End the encounter’ subscale. keywords: care; consultation; group; intervention; learning; medical; patient; person; practice; scores; segue; skills; students; study; year cache: safpj-5109.htm plain text: safpj-5109.txt item: #469 of 732 id: safpj-5111 author: None title: safpj-5111 date: None words: 3392 flesch: 45 summary: Mental capacity is not associated with any socio-demographic variable apart from advancing age, but little is known about the effects of ageing on the capacity of patients with SMI.8 Concern exists regarding the reliability of capacity assessments in individuals with SMI. Abstract Introduction Health-related values and capacity assessment The role of the treating clinician The pragmatic approach End-of- life care preferences in people with serious mental illness Acknowledgements References About the Author(s) Carla Kotze Department of Psychiatry, Weskoppies Psychiatric Hospital, University of Pretoria, Pretoria, South Africa Johannes L. Roos Department of Psychiatry, Weskoppies Psychiatric Hospital, University of Pretoria, Pretoria, South Africa Citation Kotze C, Roos JL. keywords: capacity; care; decision; end; life; making; patient; treatment cache: safpj-5111.htm plain text: safpj-5111.txt item: #470 of 732 id: safpj-5112 author: None title: safpj-5112 date: None words: 5958 flesch: 50 summary: Secondly, by describing the presence and extent of clinical features of perinatal asphyxia in neonates referred from MPH to Groote Schuur Hospital (GSH) or Mowbray Maternity Hospital (MMH) as suspected perinatal asphyxia. Keywords: hypoxic ischaemic encephalopathy; perinatal asphyxia; perinatal care; district healthcare; quality of care. keywords: antenatal; asphyxia; babies; care; cases; district; factors; hospital; mortality; mothers; mph; neonatal; perinatal; study cache: safpj-5112.htm plain text: safpj-5112.txt item: #471 of 732 id: safpj-5115 author: None title: safpj-5115 date: None words: 2438 flesch: 51 summary: Mild cases can be managed at home with self-isolation, symptomatic treatment and follow-up if the disease worsens. Observed case fatality is between 0.5% and 4%, but may be overestimated as mild cases are not always counted. keywords: care; case; contact; coronavirus; covid-19; infection; people cache: safpj-5115.htm plain text: safpj-5115.txt item: #472 of 732 id: safpj-5116 author: None title: safpj-5116 date: None words: 3033 flesch: 47 summary: Hospital and laboratory staff or relatives who had contact with a confirmed VHF patient and developed symptoms within 3 weeks are included.3,9 Management of viral haemorrhagic fever patients In this article, we will provide an approach to a patient with viral haemorrhagic fevers in a primary healthcare setting. keywords: africa; days; diagnosis; disease; fever; haemorrhagic; patients; south; vhf; virus cache: safpj-5116.htm plain text: safpj-5116.txt item: #473 of 732 id: safpj-5117 author: None title: safpj-5117 date: None words: 1680 flesch: 50 summary: Introduction Five billion people lack access to safe surgical care worldwide and the greatest burden of unmet surgical need lies in low- and middle-income countries.1 Improved access to timely, safe and affordable surgical care for all is a global health priority.2 National surgical planning has been declared an imperative in South Africa, although little priority has been given to this by government policymakers.3,4 Emergency and essential surgical care at the district hospital The World Health Organization has identified EESC as key components of universal health coverage and the DH as the first point of access to surgical care.5 The World Bank published Disease Control Priorities, a textbook which identified 44 cost-effective EESC procedures; 28 of which are recommended as DH procedures.6 The bulk of surgical care in South Africa is delivered at regional and tertiary hospitals. keywords: africa; care; faculty; health; sciences; south; university cache: safpj-5117.htm plain text: safpj-5117.txt item: #474 of 732 id: safpj-5118 author: None title: safpj-5118 date: None words: 4447 flesch: 53 summary: We sought to understand the availability, functionality and access of BP machines at the points of care within primary care facilities in Tororo district, Uganda. The checklist was used to collect data on availability and functionality of BP machines within their organisational arrangements. keywords: care; facilities; health; hypertension; machines; patients; providers; study; uganda; years cache: safpj-5118.htm plain text: safpj-5118.txt item: #475 of 732 id: safpj-5123 author: None title: safpj-5123 date: None words: 3147 flesch: 43 summary: The diagnosis of conventional respiratory pathogen does not rule out SARS-CoV-2 infection.12 Common complications of coronavirus disease 201915: Overall, pneumonia is the most common complication in COVID-19 patients. Abstract Background Clinical presentation of coronavirus disease keywords: cases; clinical; coronavirus; cov-2; covid-19; disease; health; infection; management; patients; sars cache: safpj-5123.htm plain text: safpj-5123.txt item: #476 of 732 id: safpj-5124 author: None title: safpj-5124 date: None words: 5324 flesch: 43 summary: Although the incidence of ADHD is comparable in both white and African Americans in the United States (US), fewer children of the latter were diagnosed and treated, which may be because of the complex barriers extending from the home to the health care system.7 Factors such as education and awareness programmes, cultural and public perceptions, physician characteristics, parent knowledge and attitude or perception and various environmental exposures may influence access to and the quality of care that children with ADHD receive.8 Poor or inadequate commitment by parents to ADHD management will result in inadequate treatment adherence to pharmacological and non-pharmacological therapies, or even its discontinuation.9 Parental commitment to treatment may, in turn, be influenced by several factors, including knowledge of and attitude to ADHD, socio-economic status, stress, coping mechanisms and cultural factors.4,10 Parental knowledge of ADHD may be influenced by multiple psycho-socio-cultural factors, including educational level, race, culture, stigma, access to the Internet and mental health services.19 Bussing et al. suggested that cultural variations may affect ADHD knowledge in the US,1 although this was not borne out in a later study.16 keywords: adhd; attention; children; deficit; disorder; health; hyperactivity; knowledge; misconceptions; parents; study; treatment cache: safpj-5124.htm plain text: safpj-5124.txt item: #477 of 732 id: safpj-5126 author: None title: safpj-5126 date: None words: 2642 flesch: 59 summary: A study conducted in Cape Town showed a 6.1% HIV rate in stroke patients, of which 91% of patients were under 46 years old.12 There is a growing trend of younger patients presenting with HIV and stroke in South Africa. https://doi.org/10.7196/SAMJ.2019.v109i2.00009 Sajjad A, Felix JF, Ikram MA, Tiemeier H. A systematic evaluation of stroke surveillance studies in low- and middle-income countries. keywords: africa; data; patients; risk; rural; south; stroke; study; years cache: safpj-5126.htm plain text: safpj-5126.txt item: #478 of 732 id: safpj-5128 author: None title: safpj-5128 date: None words: 4217 flesch: 51 summary: The outpatient department (OPD) of a district hospital is critical to provide ambulatory care to patients, a significant proportion of whom attend for the management of chronic non-communicable diseases.11 As tobacco use is a major risk factor for adverse health outcomes, the promotion of tobacco use cessation, especially smoking cessation, is a clinical and policy imperative. Keywords: tobacco users; outpatient; family medicine; tobacco quit attempts; motivations and barriers of cessation. keywords: africa; attempts; cessation; health; participants; patients; quit; south; study; tobacco; use; users cache: safpj-5128.htm plain text: safpj-5128.txt item: #479 of 732 id: safpj-5131 author: None title: safpj-5131 date: None words: 4474 flesch: 48 summary: TABLE 5: Participants’ physical activity practices. Knowledge, attitudes and practices of hospital-based staff regarding physical activity at a private hospital in Johannesburg. keywords: activity; health; hospital; knowledge; participants; physical; practices; public; south; staff; study cache: safpj-5131.htm plain text: safpj-5131.txt item: #480 of 732 id: safpj-5136 author: None title: safpj-5136 date: None words: 3821 flesch: 52 summary: TABLE 2: Severity of brain injury. The aim of this study was to describe the incidence of cervical spine injury (CSI) in patients with a traumatic brain injury (TBI). keywords: brain; csi; imaging; injuries; injury; patients; spine; study; tbi; trauma cache: safpj-5136.htm plain text: safpj-5136.txt item: #481 of 732 id: safpj-5138 author: None title: safpj-5138 date: None words: 1004 flesch: 54 summary: In Cape Town, family physicians are not only on the front line in terms of primary and district hospital care, but have been instrumental in providing leadership and helping the health services to reorganise and decongest. Family physicians have been engaging in case investigation and contact tracing. keywords: family; health; physicians cache: safpj-5138.htm plain text: safpj-5138.txt item: #482 of 732 id: safpj-5140 author: None title: safpj-5140 date: None words: 1484 flesch: 53 summary: What is a contracting unit for primary health care? What is a contracting unit for primary health care? keywords: care; health; services; standards cache: safpj-5140.htm plain text: safpj-5140.txt item: #483 of 732 id: safpj-5141 author: None title: safpj-5141 date: None words: 7044 flesch: 52 summary: All necessary infection and prevention control measures should be implemented: The patient must wear a surgical mask and be evaluated in a single room or, ideally, the separate area of the emergency centre identified for emergency care of COVID-19 patients for urgent attention. Oxygen therapy is likely to be the single most effective supportive measure in COVID-19 patients overall. keywords: africa; anaesthetic; answer; care; covid-19; data; family; guidelines; marks; patient; rate; section; south; spinal; study cache: safpj-5141.htm plain text: safpj-5141.txt item: #484 of 732 id: safpj-5144 author: None title: safpj-5144 date: None words: 616 flesch: 57 summary: Since writing this CPD article (https://doi.org/10.4102/safp.v62i1.5115), there have been a few changes in the guidelines for primary care management and some new information on COVID-19 (coronavirus infectious disease - 2019). Checking oxygen saturation is therefore a useful part of the assessment. keywords: min; oxygen cache: safpj-5144.htm plain text: safpj-5144.txt item: #485 of 732 id: safpj-5145 author: None title: safpj-5145 date: None words: 2441 flesch: 48 summary: The careful selection of a limited number of essential medicines leads to better medicine management and improved quality of care. The essential drugs programme is a branch of the affordable medicines directorate responsible for the selection and review of essential medicines (done by the NEMLC) and the rational use of medicines.14 keywords: africa; eml; health; medicines; national; south; stgs cache: safpj-5145.htm plain text: safpj-5145.txt item: #486 of 732 id: safpj-5149 author: None title: safpj-5149 date: None words: 4915 flesch: 48 summary: The verbal and written feedback from the research participants included insightful information about how they believed that caregiver stress was impacting their health. Traumatic stress: The effects of overwhelming experience on mind, body, and society. keywords: abi; brain; caregiver; coping; depression; family; health; injury; members; participants; research; stress; study cache: safpj-5149.htm plain text: safpj-5149.txt item: #487 of 732 id: safpj-5152 author: None title: safpj-5152 date: None words: 2587 flesch: 45 summary: In a free market, vaccine prices are usually determined by their societal benefits as well as governments’ willingness to pay for them,3 leading to differential pricing systems, where wealthier nations generally pay more. The database reports vaccine prices paid by various governments across the world. keywords: companies; covid-19; health; pandemic; price; research; south; vaccine cache: safpj-5152.htm plain text: safpj-5152.txt item: #488 of 732 id: safpj-5153 author: None title: safpj-5153 date: None words: 6396 flesch: 51 summary: However, women’s views and experiences regarding uptake of family planning methods in Malawi have not been explored. At community level, awareness and education of family planning methods is required to actively inform all people in society so that they support a woman’s family planning needs. keywords: contraception; family; family planning; health; healthcare; malawi; methods; planning; services; study; use; women; workers cache: safpj-5153.htm plain text: safpj-5153.txt item: #489 of 732 id: safpj-5154 author: None title: safpj-5154 date: None words: 4414 flesch: 44 summary: The complaint of ‘itch’ is often prominent in acute allergic rhinitis and patients may also report itching of the palate and eyes (sometimes with tears). TABLE 1: Distinguishing acute allergic rhinitis symptoms. keywords: acute; africa; allergic; allergy; asthma; decongestants; exacerbations; nasal; patients; rhinitis; symptoms cache: safpj-5154.htm plain text: safpj-5154.txt item: #490 of 732 id: safpj-5155 author: None title: safpj-5155 date: None words: 6386 flesch: 55 summary: Community health care workers 2020 Why do community health workers volunteer? keywords: care; community; data; experiences; hbcws; health; healthcare; home; lack; need; participants; patients; study; support; workers cache: safpj-5155.htm plain text: safpj-5155.txt item: #491 of 732 id: safpj-5164 author: None title: safpj-5164 date: None words: 2330 flesch: 47 summary: Chief amongst these aetiologies include the occurrence of ectopic pregnancy (EP) and the presence of an adnexal mass.1,2 Ectopic pregnancy refers to the implantation of a fertilised ovum outside the uterine cavity, of which the majority are located in the fallopian tubes;3 other locations include ovaries and the abdominal cavity. Ectopic pregnancy. keywords: case; cystic; hcg; pain; patient; pregnancy; teratoma cache: safpj-5164.htm plain text: safpj-5164.txt item: #492 of 732 id: safpj-5165 author: None title: safpj-5165 date: None words: 4471 flesch: 50 summary: The approach is limited because of under-reporting of the number of sexual partners by the patients, which results in healthcare workers (HCWs) issuing fewer notifications and referral slips.14,15 Under-reporting occurs because of the reluctance to openly discuss sexual issues, the biological nature and characteristics of the STIs and the fear of moral judgement.1,16 Failure to inform sexual partners of their exposure to STIs increases the risk of transmission to other sexual partners who remain asymptomatic, and continuous infection of new partners and re-infections.17 The effective treatment and control of STIs depend on screening to detect and treat STIs amongst the sexual partners of the patients with STI. This study assessed the perceived use of patient-initiated PN by using referral slips and measured the level of acceptability of provider-initiated PN by using short message service (SMS) to the personal mobile phones of sexual partners. keywords: acceptability; drivers; minibus; notification; partner; provider; referral; sms; sti; stis; taxi; use cache: safpj-5165.htm plain text: safpj-5165.txt item: #493 of 732 id: safpj-5166 author: None title: safpj-5166 date: None words: 3375 flesch: 43 summary: Keywords: Medical education; family medicine; primary care; clinical training; learning environment; leadership; clinical trainer; clinical teaching; workplace based learning. Abstract Family physicians are expected to build the capacity of the primary care team and to provide clinical training to students, but often lack the educational expertise and a supportive learning environment. keywords: care; environment; family; health; learning; online; students; training; workplace cache: safpj-5166.htm plain text: safpj-5166.txt item: #494 of 732 id: safpj-5168 author: None title: safpj-5168 date: None words: 4248 flesch: 55 summary: Du Pisanie Division of Family Medicine and Primary Care, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa Carla Swart Division of Family Medicine and Primary Care, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa Ella van der Merwe Division of Family Medicine and Primary Care, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa Citation Mash R, Du Pisanie L, Swart C, Van der Merwe E. Evaluation of household assessment data collected by community health workers in Cape Town, South Africa. https://doi.org/10.4102/safp.v62i1.5168 Original Research Evaluation of household assessment data collected by community health workers in Cape Town, South Africa Robert Mash, Louiso Du Pisanie, Carla Swart, Ella van der Merwe Received: 26 June 2020; Accepted: 18 Sept. 2020; Published: 03 Dec. 2020 Copyright: © 2020. keywords: assessment; cape; care; chws; community; data; health; household; south; town cache: safpj-5168.htm plain text: safpj-5168.txt item: #495 of 732 id: safpj-5169 author: None title: safpj-5169 date: None words: 4212 flesch: 52 summary: Methods: A quality improvement approach was used to conduct a baseline assessment of HIV viral suppression in paediatric patients and other process measures, implement a clinical mentorship intervention and evaluate its effectiveness. Porter Madwaleni Hospital, Elliotdale, South Africa Maresa du Plessis Madwaleni Hospital, Elliotdale, South Africa Citation Porter JD, Porter MNM, Du Plessis M. Not yet 90-90-90: A quality improvement approach to human immunodeficiency virus viral suppression in paediatric patients in the rural Eastern Cape, South Africa. keywords: art; care; clinical; clinics; data; health; hiv; months; paediatric; patients; south; suppression cache: safpj-5169.htm plain text: safpj-5169.txt item: #496 of 732 id: safpj-5179 author: None title: safpj-5179 date: None words: 8006 flesch: 48 summary: Abstract Introduction What is severe asthma? Severe asthma in South Africa: keywords: africa; asthma; care; children; control; diagnosis; gina; global; health; management; patients; prevalence; risk; south; south africa; symptoms; therapy; treatment; use cache: safpj-5179.htm plain text: safpj-5179.txt item: #497 of 732 id: safpj-5185 author: None title: safpj-5185 date: None words: 366 flesch: 54 summary: In memorial: Andre Marais *1976 – †2020 About the Author(s) Indiran Govender Department of Family Medicine, University of Pretoria and Kalafong Hospital, Pretoria, South Africa Citation Govender I. Tribute to Dr Andre Marais: 1976–2020. It is with profound grief that I write this obituary for my dear friend Dr Andre Marais. keywords: andre; marais cache: safpj-5185.htm plain text: safpj-5185.txt item: #498 of 732 id: safpj-5187 author: None title: safpj-5187 date: None words: 4939 flesch: 43 summary: This allows for the initiation of timely treatment and prevention of further loss of hearing, where possible.5 With the extensive use of potential ototoxic medication because of the high rates of HIV and TB in South Africa, it would be expected that ototoxicity monitoring and management are a standardised part of best practice procedure, conducted in accordance with South Africa-specific guidelines. Ototoxicity monitoring involves a specific set of audiology guidelines to be followed to ensure early detection of a hearing loss from ototoxic medication. keywords: africa; articles; hearing; knowledge; loss; monitoring; ototoxicity; patients; research; south; studies; study cache: safpj-5187.htm plain text: safpj-5187.txt item: #499 of 732 id: safpj-5190 author: None title: safpj-5190 date: None words: 7140 flesch: 50 summary: 2013;1(2):142–151. https://doi.org/10.1016/j.jaip.2012.09.002 Djokic-Gallagher J, Rosher P, Oliveira G, Walker J. A double-blind, randomised study comparing the skin hydration and acceptability of two emollient products in atopic eczema patients with dry skin. Results: Regular moisturising with an oil-based emollient remains the mainstay of AE treatment. keywords: africa; allergy; atopic; atopic dermatitis; atopic eczema; children; dermatol; disease; eczema; flares; management; paediatric; patients; pimecrolimus; skin; south; south africa; tcss; topical; treatment cache: safpj-5190.htm plain text: safpj-5190.txt item: #500 of 732 id: safpj-5192 author: None title: safpj-5192 date: None words: 1140 flesch: 50 summary: Abstract The book – Connected Lives: Families, households, health and care in South Africa (edited by Nolwazi Mkhwanazi and Lenore Manderson)1 – is about some of the core business of family medicine. In primary healthcare, and family medicine in particular, the context of the person being treated is central. keywords: book; care; families cache: safpj-5192.htm plain text: safpj-5192.txt item: #501 of 732 id: safpj-5193 author: None title: safpj-5193 date: None words: 4804 flesch: 53 summary: The majority of burns are managed at the primary healthcare or district healthcare level by generalists, who only occasionally manage burns patients, often with limited training in the management of such patients.20,21 As a result, we were not able to replace the panellist who accepted the questionnaire but did not return it. Abstract Introduction Setting Methods Panel recruitment Overview of the Delphi process Results Discussion Limitations Conclusion Acknowledgements References About the Author(s) Shelley L. Wall Pietermaritzburg Burn Service, Pietermaritzburg Metropolitan Department of Surgery, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa Developing Research, Innovation, Localization and Leadership (DRILL), College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa Nikki L. Allorto Pietermaritzburg Burn Service, Pietermaritzburg Metropolitan Department of Surgery, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa Verusia Chetty Developing Research, Innovation, Localization and Leadership (DRILL), College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa Discipline of Physiotherapy, School of Health Sciences, University of KwaZulu-Natal, Durban, South Africa Citation Wall SL, Allorto NL, Chetty V, Reaching consensus on an analgesia protocol for paediatric burn patients in a resource-scarce South African community. keywords: africa; analgesia; burn; children; consensus; delphi; expert; management; pain; patients; protocol; resource; round cache: safpj-5193.htm plain text: safpj-5193.txt item: #502 of 732 id: safpj-5194 author: None title: safpj-5194 date: None words: 2463 flesch: 50 summary: More than myalgia: An unusual presentation of exertional rhabdomyolysis. Keywords: rhabdomyolysis; exertional rhabdomyolysis; myalgia; physical activity; skeletal muscle damage. keywords: africa; diagnosis; exercise; exertional; history; patient; rhabdomyolysis; urine cache: safpj-5194.htm plain text: safpj-5194.txt item: #503 of 732 id: safpj-5195 author: None title: safpj-5195 date: None words: 5726 flesch: 48 summary: There appears to be an increasing trend towards suicidal behaviour in the past 15 years, and this calls for preventative intervention.5 Suicidal behaviour encompasses suicidal ideation, deliberate self-harm and completed suicide.6 Suicidal ideation has been identified as an important precursor of completed suicides, and young people with suicidal ideation have a higher risk of committing suicide than those without ideation.7,8 Similarly, Montier et al. (2019) reported that about half of students with suicidal ideation transitioned to suicidal plans, whilst one-quarter progressed to suicide attempts.9 This finding is consistent with the results of previous studies.34,35 A Canadian study reported a higher prevalence of suicidal ideation amongst people with chronic diseases, and the risk increased with the number of comorbidities.34 Similarly, Ferro et al.35 reported a higher risk of suicidal ideations amongst patients with mental illness. keywords: africa; body; college; factors; health; ideation; participants; plans; prevalence; risk; south; students; study; suicidal; suicide cache: safpj-5195.htm plain text: safpj-5195.txt item: #504 of 732 id: safpj-5196 author: None title: safpj-5196 date: None words: 3254 flesch: 48 summary: This outbreak also led to clusters of COVID-19 cases in a local nursing home and an outpatient dialysis unit of the hospital campus resulting in 17 cases.9 Tygerberg hospital in the Western Cape and Morningside Mediclinic in Gauteng were amongst those hospitals that had increased number of staff members with infections in Tygerberg to date, recording a total of four staff member deaths.10 Timeous management of a COVID-19 suspect or case is important in preventing an outbreak. The following measures were implemented to allay staff anxiety, to prevent primary infection in patients and staff members and to empower and facilitate confidence amongst members of staff. keywords: covid-19; health; healthcare; hospital; members; patients; pretoria; staff; workers cache: safpj-5196.htm plain text: safpj-5196.txt item: #505 of 732 id: safpj-5198 author: None title: safpj-5198 date: None words: 4540 flesch: 47 summary: Pharmacotherapy of chronic obstructive pulmonary disease: Therapeutic considerations with a focus on inhaled corticosteroids. 2020;62(1), a5198. https://doi.org/10.4102/safp.v62i1.5198 Open Forum Pharmacotherapy of chronic obstructive pulmonary disease: Therapeutic considerations with a focus on inhaled corticosteroids Elvis M. Irusen, Thandeka D. Malange Received: 21 July 2020; Accepted: 22 Oct. 2020; Published: 08 Dec. 2020 Copyright: © 2020. keywords: copd; corticosteroids; disease; effects; ics; med; pneumonia; pulmonary; study; therapy; triple cache: safpj-5198.htm plain text: safpj-5198.txt item: #506 of 732 id: safpj-5202 author: None title: safpj-5202 date: None words: 2810 flesch: 53 summary: This CPD article highlights that first aid should include cooling the burn with cool running tap water up to 3-hours post injury (Burnshield may be used if cool running water is not available); removal of all blisters facilitates accurate assessment of the burn size and depth; formulas exist for the resuscitation of acute burn injuries of more than 10% – 15% total body surface area and prophylactic antibiotics should not be administered to patients with acute burns as the prevention of infection should lie with good wound care (including good wound cleaning and the use of topical antimicrobial dressings). Whilst silver sulphadiazine has long been associated with burn wound care, it is shown to be associated with poorer healing outcomes compared with other options.10 keywords: analgesia; burn; care; dressing; fluid; pain; resuscitation; use; wound cache: safpj-5202.htm plain text: safpj-5202.txt item: #507 of 732 id: safpj-5203 author: None title: safpj-5203 date: None words: 2032 flesch: 47 summary: The aim of this article is to provide the primary care practitioner with up to date information on the management of chronic pain. Keywords: chronic pain; non-cancer pain; primary care; case study; management of chronic pain. keywords: care; chronic; diagnosis; interventions; management; pain; patient cache: safpj-5203.htm plain text: safpj-5203.txt item: #508 of 732 id: safpj-5204 author: None title: safpj-5204 date: None words: 1024 flesch: 50 summary: In New York City, Latino and black people have been twice as likely to die from COVID-19 as white people have. In Washington, DC, black people make up 45% of COVID-19 cases but 79% of deaths. keywords: covid-19; healthcare; people cache: safpj-5204.htm plain text: safpj-5204.txt item: #509 of 732 id: safpj-5208 author: None title: safpj-5208 date: None words: 5726 flesch: 61 summary: Keywords: Fellowship of the College of Family Physicians of South Africa (FCFP [SA]) examination; family medicine registrars; registrars; residency; primary care; child health. The theme for this edition is child health. keywords: authors; care; children; clinic; community; data; family; health; hiv; mark; mother; study cache: safpj-5208.htm plain text: safpj-5208.txt item: #510 of 732 id: safpj-5214 author: None title: safpj-5214 date: None words: 1124 flesch: 56 summary: Primary care providers or health establishments will require an information platform that includes registration of patients and will need to submit this information to the Fund’s Health Patient Registration System. The Bill does not define a minimum number of registered patients per provider. keywords: care; health; patients cache: safpj-5214.htm plain text: safpj-5214.txt item: #511 of 732 id: safpj-5216 author: None title: safpj-5216 date: None words: 2403 flesch: 45 summary: How are research questions chosen? Roles of researchers and clinicians Co-ordination, communication and meetings Involvement of the Department of Health Types of research questions and methods Data management Dissemination of results Funding Initial projects The way forward Acknowledgement References About the Author(s) Robert Mash Division of Family Medicine and Primary Care, Faculty of Medicine and Health Sciences, University of Stellenbosch, Cape Town, South Africa Citation Mash R. Establishing family physician research networks in South Africa. 2020;62(1), a5216 https://doi.org/10.4102/safp.v62i1.5216 Open Forum Establishing family physician research networks in South Africa Robert Mash Received: 21 Aug. 2020 keywords: data; family; health; network; physicians; research cache: safpj-5216.htm plain text: safpj-5216.txt item: #512 of 732 id: safpj-5217 author: None title: safpj-5217 date: None words: 4860 flesch: 50 summary: South Africa has implemented different strategies to improve mental health care within the country but there has not been a focus on routine screening at PHC facilities. Keywords: depression; screening; mental health; PHQ-9; primary care; primary healthcare. keywords: africa; care; depression; events; features; health; life; participants; patients; phc; pretoria; screening; south; study cache: safpj-5217.htm plain text: safpj-5217.txt item: #513 of 732 id: safpj-5221 author: None title: safpj-5221 date: None words: 3566 flesch: 51 summary: The COVID-19 information sheet comprises the natural history, risk factors for and symptoms of deterioration in the condition of patients, and what to do and where to seek help if patient observes clinical deterioration. The article concludes by highlighting an important safety net for COVID-19 patients and the attending clinician. keywords: cases; condition; coronavirus; covid-19; disease; health; information; news; patients; result; south cache: safpj-5221.htm plain text: safpj-5221.txt item: #514 of 732 id: safpj-5222 author: None title: safpj-5222 date: None words: 2942 flesch: 44 summary: Studies have shown that nasal prong oxygen (NPO) was the preferred method of respiratory support for patients in acute respiratory distress syndrome with COVID-19.5 The clinical condition in older patients can change within a day, and studies amongst older patients have identified delirium as a sign of acute illness.6 The nursing staff within the LTCF are dementia trained staff. Nutritional management of COVID-19 patients in a rehabilitation unit. keywords: care; covid-19; delirium; disease; hospital; oxygen; patients; residents; staff; treatment cache: safpj-5222.htm plain text: safpj-5222.txt item: #515 of 732 id: safpj-5224 author: None title: safpj-5224 date: None words: 2781 flesch: 54 summary: Scabies patients can experience itch up to a month after successful treatment. Oral ivermectin in scabies patients: A comparison with 1% topical lindane lotion. keywords: crusted; disease; figure; ivermectin; mites; patients; scabies; skin; treatment cache: safpj-5224.htm plain text: safpj-5224.txt item: #516 of 732 id: safpj-5225 author: None title: safpj-5225 date: None words: 2212 flesch: 45 summary: The OSCE examination, which previously consisted of the use of SPs and laptops (showing clinical images and laboratory results), was modified to avoid exposure of the SP to many students and students touching the same computers. However, students from distributed training sites come to the main campus for the final examination, an Individualised Process Assessment (IPA), which is like the traditional ‘long case’. keywords: assessment; covid-19; department; health; medicine; programme; students cache: safpj-5225.htm plain text: safpj-5225.txt item: #517 of 732 id: safpj-5226 author: None title: safpj-5226 date: None words: 3944 flesch: 44 summary: Disability and accessing healthcare Across the globe, people with disabilities experience challenges in all aspects of life, including access to healthcare services, devices, required medication and support.4,5,6 These challenges are compounded in low- and middle-income countries (LMICs) where factors such as poverty, poverty-related diseases, inefficient healthcare systems, training and equipment, inaccessible transportation systems, corruption, political instability, and negative attitudes towards disability occur.4,5,7,8,9 Despite the fact that there is a very well-established relationship between disability and poverty,46 the issue of disability in relation to COVID-19 is seldom mentioned as a consideration in debates about healthcare access and resource allocation.47 We have argued elsewhere that an aspect of the violence against people with disabilities lies in the continuing invisibility of disability in public discourse,48 leading to daily struggles for people with disabilities to gain access to employment, education and healthcare. keywords: accessing; africa; caregivers; challenges; covid-19; disabilities; disability; healthcare; jul; mckinney; pandemic; people; services; south cache: safpj-5226.htm plain text: safpj-5226.txt item: #518 of 732 id: safpj-5233 author: None title: safpj-5233 date: None words: 6377 flesch: 49 summary: (5 marks) Were the criteria and process used to select primary studies for inclusion in the review appropriate? Were the criteria and process used to select primary studies for inclusion in the review appropriate? keywords: authors; candidate; care; family; health; hearing; impairment; marks; patient; primary; question; research; review; studies; study cache: safpj-5233.htm plain text: safpj-5233.txt item: #519 of 732 id: safpj-5235 author: None title: safpj-5235 date: None words: 1060 flesch: 51 summary: For example, web-meetings, home delivery of medication by community health workers,1 telephonic consultations or people visiting hospitals via video links.2 Our ability for adaptive leadership has been tested, as practitioners and practices were forced to continually reorganise and solve service-delivery problems.3 Interestingly, a global study by the World Organisation of Family Doctors did not show a relationship between the strength of primary care systems in different countries and the impact of the epidemic.4 Maybe the public health interventions (e.g. lockdown, case investigation, contact tracing, community screening and testing, isolation and quarantine) were more proactive in containing or suppressing the epidemic, whilst primary care was more reactive. The integration of public health and primary care responses may also have been an important factor, particularly within a community-oriented primary care (COPC) approach.5 Systems that had implemented key components of this COPC approach were able to build on these, such as teams of community health workers serving delineated geographical areas, and the functional integration of facility-based and community-based primary health care providers.1 keywords: care; community; fam; family; health; mash cache: safpj-5235.htm plain text: safpj-5235.txt item: #520 of 732 id: safpj-5236 author: None title: safpj-5236 date: None words: 5184 flesch: 43 summary: Nnabuike C. Ngene Department of Obstetrics and Gynaecology, Faculty of Health Sciences, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa Department of Obstetrics and Gynaecology, Leratong Hospital, Krugersdorp, South Africa Ghadah Daef Department of Obstetrics and Gynaecology, Faculty of Health Sciences, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa Department of Obstetrics and Gynaecology, Klerksdorp Hospital, Klerksdorp, South Africa Citation Ngene NC, Daef G. Transient gestational hypertension and pre-eclampsia: https://doi.org/10.4102/safp.v63i1.5236 Scientific letters Transient gestational hypertension and pre-eclampsia: keywords: blood; care; eclampsia; hospital; hypertension; laboratory; mmhg; monitoring; patient; pregnancy; tgh; weeks cache: safpj-5236.htm plain text: safpj-5236.txt item: #521 of 732 id: safpj-5238 author: None title: safpj-5238 date: None words: 2492 flesch: 49 summary: This can only be achieved by the following: firstly, further PC training for staff members at primary care; secondly, system adjustments to ensure supportive care and PC is integrated into all care pathways; and, finally, closer collaboration between the tertiary, secondary and primary care healthcare providers. This makes primary care providers central to provide supportive care and PC to patients and families. keywords: care; disease; health; kidney; palliative; patients; renal; south cache: safpj-5238.htm plain text: safpj-5238.txt item: #522 of 732 id: safpj-5240 author: None title: safpj-5240 date: None words: 2958 flesch: 47 summary: Also, health facilities are obliged to complete an individual notification form for each TOP performed under CTOP Act.6 Offenses and penalties Therefore, in terms of the law, healthcare providers who are not directly involved with the abortion procedure cannot use their beliefs as a reason for not assisting a woman seeking abortion services with information and appropriate referrals. The following changes were amended6: Empower a MEC to designate facilities that could provide abortion services. keywords: abortion; act; africa; ctop; health; pregnancy; south; termination cache: safpj-5240.htm plain text: safpj-5240.txt item: #523 of 732 id: safpj-5241 author: None title: safpj-5241 date: None words: 1403 flesch: 53 summary: 2020;62(1), a5241. https://doi.org/10.4102/safp.v62i1.5241 Opinion National Health Insurance unpacked: Part 4: Remuneration of practitioners Robert Mash Received: 09 Oct. 2020; Accepted: 09 Oct. 2020; Published: 04 Nov. 2020 Copyright: © 2020. Introduction This four-part series in the South African Family Practice journal unpacks the details of National Health Insurance (NHI) as proposed in the NHI Bill that went before Parliament in July 2019.1 keywords: care; health; providers; remuneration cache: safpj-5241.htm plain text: safpj-5241.txt item: #524 of 732 id: safpj-5242 author: None title: safpj-5242 date: None words: 2918 flesch: 58 summary: Initiative for Sub-District Support – Kwik Skwiz 8: What is the role of the doctor visiting primary health care clinics? The role of the visiting doctor in primary care clinics. keywords: clinic; community; doctor; health; healthcare; phc; role; system cache: safpj-5242.htm plain text: safpj-5242.txt item: #525 of 732 id: safpj-5244 author: None title: safpj-5244 date: None words: 3029 flesch: 37 summary: These benefits emphasise the need for medical students to apply empathic communication skills during their interactions with patients. Medical students could learn how to accept this vulnerability by acknowledging that these feelings are part of the process of becoming a doctor.7 Students need to be encouraged to focus intentionally on empathic communication skills during their clinical practice. keywords: communication; learning; patients; practice; skills; students; study cache: safpj-5244.htm plain text: safpj-5244.txt item: #526 of 732 id: safpj-5249 author: None title: safpj-5249 date: None words: 6240 flesch: 53 summary: Previous studies have suggested that pain management in paediatric patients is not prioritised by HCPs, mainly because of a lack of both knowledge and expertise amongst HCPs.33,34 HCPs managing minor trauma patients completed a closed-ended questionnaire which indicated the patients’ demographics, diagnosis and analgesia prescribed. keywords: age; analgesia; collection; data; emergency; hcps; management; online; pain; patients; study; trauma; triage cache: safpj-5249.htm plain text: safpj-5249.txt item: #527 of 732 id: safpj-5250 author: Office, Editorial title: Acknowledgement to reviewers date: 2020-12-23 words: 756 flesch: 36 summary: This goal will not be possible without a strong network of peer reviewers. A workshop on peer review was held during the 2019 annual SAAFP conference, and we hope to facilitate a similar workshop in 2021. keywords: journal; peer; practice; review; reviewer; south cache: safpj-5250.pdf plain text: safpj-5250.txt item: #528 of 732 id: safpj-5251 author: None title: safpj-5251 date: None words: 9648 flesch: 55 summary: Continuity of care refers to ongoing care with the same practitioner, or sometimes a small team, that extends beyond specific episodes of illness or disease.8 Transitional care is another term that refers to a set of actions designed to ensure the coordination of healthcare as patients transfer between different locations or different levels of care.9 Good continuity of primary care can contribute to better sequential coordination as more accurate and comprehensive information may be available. According to the SATS, patients that are triaged as red need to be seen immediately, orange within 10 min, yellow within an hour, green within 4-h and blue (dead on arrival) within 2-h.23 Patients triaged as green could often be treated equally well in primary care and therefore a reduction in inappropriate referrals from PCFs should translate into a reduction in the proportion of patients triaged as ‘green’. keywords: app; care; coordination; data; district; doctors; erdh; feedback; health; hospital; information; patients; primary; referral; referring; study; vula cache: safpj-5251.htm plain text: safpj-5251.txt item: #529 of 732 id: safpj-5253 author: None title: safpj-5253 date: None words: 3484 flesch: 46 summary: The mean age of hospitalised COVID-19 positive patients was 55.5 ± 14 years and the mean age of hospitalised patients who died from COVID-19 was much higher than that of recovered patients. The high rate of COVID-19 mortality was the cumulative effect of the sudden surge in the infection rate during the peak of the epidemic, coupled with high hospitalisation of COVID-19 patients, putting additional pressure on bed and oxygen availability in the hospital. keywords: age; clinical; covid-19; health; hospital; outcomes; patients; south; study cache: safpj-5253.htm plain text: safpj-5253.txt item: #530 of 732 id: safpj-5260 author: None title: safpj-5260 date: None words: 4971 flesch: 56 summary: Although the sample size is relatively adequate (reasonable studies, n ≥ 1000), methodological limitations that are inherent in suicide studies are applicable in this research as well: (1) the use of time of death as a proxy for the time of suicide for some forms of suicide may result in inaccuracies. This threat to validity is not confined to our study alone, but pervades suicide studies. keywords: age; day; death; females; gender; health; males; peri; pretoria; study; suicide; time; urban cache: safpj-5260.htm plain text: safpj-5260.txt item: #531 of 732 id: safpj-5266 author: None title: safpj-5266 date: None words: 3175 flesch: 54 summary: Ongoing profuse bleeding following Ellavi UBT insertion and inflation required the next step in the management bundle to be implemented immediately, as well as in the case of bleeding not considerably decreased within 15 min of insertion. Mpumlwana V. A case series of post-partum haemorrhage managed using Ellavi uterine balloon tamponade in a rural regional hospital. keywords: balloon; case; ellavi; ellavi ubt; hospital; patients; ubt; use cache: safpj-5266.htm plain text: safpj-5266.txt item: #532 of 732 id: safpj-5269 author: None title: safpj-5269 date: None words: 3272 flesch: 46 summary: Keywords: point-of-care ultrasound; emergency ultrasound; emergency care; emergency department; emergency medicine; critical care; primary care; prehospital care. Prospective study of accuracy and outcome of emergency ultrasound for abdominal aortic aneurysm over two years. keywords: africa; care; data; department; emergency; exams; pocus; point; study; ultrasound; use cache: safpj-5269.htm plain text: safpj-5269.txt item: #533 of 732 id: safpj-5271 author: None title: safpj-5271 date: None words: 5315 flesch: 51 summary: Our study also revealed that the most common form of violence women experienced across the different reporting cut-off points (from 1 year, 6 months and 3 months) was emotional or psychological in nature (31%). Abstract Introduction Methods Findings Discussion Conclusion Acknowledgements References About the Author(s) Lignet Chepuka Department of Adult Health, Faculty of Nursing Health Studies, Kamuzu College of Nursing, University of Malawi, Blantyre, Malawi Chimwemwe Kwanjo-Banda Department of Adult Health, Faculty of Nursing Health Studies, Kamuzu College of Nursing, University of Malawi, Blantyre, Malawi Ursula Kafulafula Department of Midwifery, Faculty of Midwifery Studies, Kamuzu College of Nursing, University of Malawi, Blantyre, Malawi Anthony Sefasi Department of Mental Health, Faculty of Community Health Studies, Kamuzu College of Nursing, University of Malawi, Blantyre, Malawi Genesis Chorwe-Sungani Department of Mental Health, Faculty of Community Health Studies, Kamuzu College of Nursing, University of Malawi, Blantyre, Malawi Citation Chepuka L, Kwanjo-Banda C, Kafulafula U, Sefasi A, Chorwe-Sungani G. Prevalence and associated factors of intimate partner violence amongst women attending prevention of mother to child transmission services in Blantyre, Malawi. keywords: child; depression; factors; health; hiv; intimate; ipv; malawi; participants; partner; pmtct; relationship; study; violence; women cache: safpj-5271.htm plain text: safpj-5271.txt item: #534 of 732 id: safpj-5272 author: Office, Editorial title: Table of Contents Vol 62, No 1 (2020) date: 2020-12-23 words: 3624 flesch: 7 summary: Vol 62, No 1 : Part 3| a5093 | 13 August 2020 217 219 222 223 231 237 244 Original Research Quit attempts among current tobacco users attending the outpatient department of Dr Yusuf Dadoo district hospital, South Africa Arlette I. Bokoro, Elizabeth Reji, Olufemi B. Omole South African Family Practice | Vol 62, No 1 : Part 3| a5128 | 17 August 2020 Original Research Acute stroke in the emergency department: A chart review at KwaZulu-Natal hospital Steve G. Feris, Bavani Naicker South African Family Practice | Vol 62, No 1 : Part 3| a5126 | 20 August 2020 Original Research Influence of patients’ living conditions on tuberculosis treatment outcomes in a South African health sub-district Tombo Bongongo, Hendry van der Heever, Doudou K. Nzaumvila, Christian N.S. Saidiya South African Family Practice | Vol 62, No 1 : Part 3| a5036 | 25 August 2020 Original Research What we need is health system transformation and not health system strengthening for universal health coverage to work: Perspectives from a National Health Insurance pilot site in South Africa Janet Michel, Brigit Obrist, Till Bärnighausen, Fabrizio Tediosi, Di McIntryre, David Evans, Marcel Tanner South African Family Practice | Vol 62, No 1 : Part 3| a5079 | 03 September 2020 Original Research Knowledge and misconceptions of parents of children with attention-deficit hyperactivity disorder at a hospital in South Africa Neelkant R. Rajcumar, Saeeda Paruk South African Family Practice | Vol 62, No 1 : Part 3| a5124 | 03 September 2020 Is this the new norm? Debrah Mohale, Kebogile E. Mokwena South African Family Practice | Vol 62, No 1 : Part 4| a5122 | 10 December 2020 Scientific letters A description of events surrounding the index COVID-19 diagnosis in a staff member at Kalafong Provincial Tertiary Hospital in Gauteng, South Africa Indiran Govender, Keorapetse A.O. Masilo, Olga M. Maphasha, Sello Matjila South African Family Practice | Vol 62, No 1 : Part 4| a5196 | 16 November 2020 Scientific letters A classic case suggestive of an unruptured ectopic pregnancy with unexpected finding of a unilateral dermoid cyst intraoperatively: A case report Matthew A. Benedict, Anthonio O. Adefuye South African Family Practice | Vol 62, No 1 : Part 4| a5164 | 09 December 2020 Open Forum Acute allergic rhinitis Robin J. Green, Andre van Niekerk, Marinda McDonald, Raymond Friedman, Charles Feldman, Guy Richards, Fatima Mustafa South African Family Practice | keywords: african; article; care; cpd; family practice; health; mash; primary; research; south; vol cache: safpj-5272.pdf plain text: safpj-5272.txt item: #535 of 732 id: safpj-5274 author: None title: safpj-5274 date: None words: 4953 flesch: 50 summary: Abstract Introduction Methods Findings Discussion Conclusion Acknowledgements References About the Author(s) Robert Mash Division of Family Medicine and Primary Care, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa Carmen Christian Department of Economics, Faculty of Economics and Management Sciences, University of the Western Cape, Bellville, South Africa Ruvimbo V. Chigwanda Division of Social and Behavioural Sciences, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa Citation Mash R, Christian C, Chigwanda RV. Alternative mechanisms for delivery of medication in South Africa: keywords: adherence; africa; cape; care; chronic; delivery; dispensing; health; mechanisms; medication; patients; review; south cache: safpj-5274.htm plain text: safpj-5274.txt item: #536 of 732 id: safpj-5275 author: None title: safpj-5275 date: None words: 4917 flesch: 36 summary: Specialist training units abroad offer interpersonal communication training as an essential component in training. We therefore undertook a paper-based and online survey of registrars and specialists in the public and private sectors to gauge their opinions regarding interpersonal communication training in South Africa. keywords: africa; communication; issues; neurology; patients; registrars; skills; south; specialists; training; undergraduate cache: safpj-5275.htm plain text: safpj-5275.txt item: #537 of 732 id: safpj-5277 author: None title: safpj-5277 date: None words: 3241 flesch: 40 summary: The causes of secondary HT can be broadly subdivided into endocrine, renovascular, renal parenchymal, vascular and other (Table 1).4,9,10,11 TABLE 1: Endocrine and other causes of secondary hypertension. However, 5% – 15% have secondary HT, which is defined as HT because of an underlying cause.4,5 Hypertension is a serious medical condition requiring timely and sustained treatment. keywords: adrenal; africa; diagnosis; endocrine; hypertension; paraganglioma; patients; pheochromocytoma; ppgl; south; testing cache: safpj-5277.htm plain text: safpj-5277.txt item: #538 of 732 id: safpj-5278 author: None title: safpj-5278 date: None words: 2457 flesch: 45 summary: Abstract Background The formulation of hand sanitisers The toxicity of hand sanitiser The risk of other infections because of the excessive application of hand sanitiser Conclusion Acknowledgements References About the Author(s) Olive Khaliq Department of Obstetrics and Gynecology, Women’s Health and HIV Research Group, Nelson Mandela School of Medicine, Faculty of Clinical Medicine, University of KwaZulu-Natal, Durban, South Africa Princess Z. Mkhize Department of Obstetrics and Gynecology, Women’s Health and HIV Research Group, Nelson Mandela School of Medicine, Faculty of Clinical Medicine, University of KwaZulu-Natal, Durban, South Africa Jagidesa M. Moodley Department of Obstetrics and Gynecology, Women’s Health and HIV Research Group, Nelson Mandela School of Medicine, Faculty of Clinical Medicine, University of KwaZulu-Natal, Durban, South Africa Citation Khaliq O, Mkhize PZ, Moodley JM. They stated that even a small amount of alcohol can cause alcohol poisoning in children and this was accountable for confusion, vomiting and drowsiness and in severe cases, respiratory arrest and death.6 Mahmood et al. mentioned that the AAPCC, 2020 recognised that the quantity of hand sanitisers should be considered before they can be supplied.6 The following measures can be taken to prevent inadvertent harmful effects of hand sanitisers: Promotion of frequent hand washing with soap and water over hand sanitiser in children and having handwashing facilities readily accessible to children should be considered education and training of children on how to use hand sanitiser recommendations to Departments of Education and public health providers to put caution signs next to sanitiser dispensers and to install eye washing devices to immediately deal with an inadvertent eye touching or accidental eye spraying by children Parents and the general public should be provided with information regarding safety measures specific for children on the dangers of hand sanitisers. keywords: alcohol; children; ethanol; hand; health; medicine; sanitisers; use cache: safpj-5278.htm plain text: safpj-5278.txt item: #539 of 732 id: safpj-5279 author: None title: safpj-5279 date: None words: 2271 flesch: 55 summary: Keywords: shoulder pain; shoulder stiffness; primary care; guidelines; traumatic shoulder pain; spontaneous shoulder pain; referred shoulder pain. The multitude of physical tests taught in medical school for the assessment of chronic shoulder pain, whilst useful in narrowing down the diagnosis, may not be able to confirm a specific diagnosis in isolation.3 For this reason, these guidelines group painful shoulder pathologies into four broad categories: traumatic shoulder pain (history of a fall, motor vehicle accident, assault, sports injury, etc.) spontaneous shoulder pain with no red flag symptoms shoulder pain associated with red flag symptoms (fever, mass or tumour on the shoulder, loss of weight associated with limited range of motion) shoulder pain with a history of prior shoulder surgery (patient has had surgery on that shoulder before). keywords: cape town; care; faculty; health sciences; pain; shoulder; university cache: safpj-5279.htm plain text: safpj-5279.txt item: #540 of 732 id: safpj-5280 author: None title: safpj-5280 date: None words: 2302 flesch: 37 summary: Abstract Introduction Pathophysiology History Examination Investigations Management Definitive management Acknowledgements References About the Author(s) Indiran Govender Department of Family Medicine, School of Health Sciences, University of Pretoria, Pretoria, South Africa Selvandran Rangiah Department of Family Medicine, School of Public Health, University of KwaZulu-Natal, Durban, South Africa Tombo Bongongo Department of Family Medicine, School of Medicine, Sefako Makgatho Health Sciences University, Ga-Rankuwa, South Africa Philemon Mahuma Department of Family Medicine, School of Health Sciences, University of Pretoria, Pretoria, South Africa Citation Govender I, Rangiah S, Bongongo T, Mahuma P. A primary care approach to abdominal pain in adults. https://doi.org/10.4102/safp.v63i1.5280 CPD Article A primary care approach to abdominal pain in adults Indiran Govender, Selvandran Rangiah, Tombo Bongongo, Philemon Mahuma Received: 10 Feb. 2021; Accepted: 15 Feb. 2021; Published: 10 Mar. 2021 Copyright: © 2021. keywords: abdominal; acute; approach; care; examination; history; management; pain; wall cache: safpj-5280.htm plain text: safpj-5280.txt item: #541 of 732 id: safpj-5281 author: None title: safpj-5281 date: None words: 2990 flesch: 51 summary: Abstract South Africa envisages a community-orientated approach to primary health care (PHC). Available from: https://scholar.google.co.za/scholar?hl=en&as_sdt=0%2C5&q=South-African-Health-Reforms-2009-2014&btnG= Keegan K, Tollman S. A perspective on primary health care in South Africa: Primary health care: keywords: africa; care; community; copc; doctors; family; health; implementation; south cache: safpj-5281.htm plain text: safpj-5281.txt item: #542 of 732 id: safpj-5282 author: None title: safpj-5282 date: None words: 5534 flesch: 52 summary: The risk factors and health system preparedness and response may resonate with the challenges experienced in primary health care, as district teams need to respond in a collaborative manner to address the burden of malaria. The evidence for the use of zinc, vitamin C and vitamin D supplementation for patients with mild disease does not exist and should be a focus for future primary care studies. keywords: candidate; care; disease; examination; factors; family; health; history; marks; medicine; patient; primary; risk; study cache: safpj-5282.htm plain text: safpj-5282.txt item: #543 of 732 id: safpj-5285 author: None title: safpj-5285 date: None words: 3015 flesch: 47 summary: Recent research on mood state responses during COVID-19 reported an inverse iceberg profile in an international sample.10 Characterising mood responses in a SA general population sample could prepare clinicians for possible presentations of mental health concerns in general practice. Mood responses to COVID-19: keywords: covid-19; fatigue; health; mental; mood; profile; responses; sample; scale; scores cache: safpj-5285.htm plain text: safpj-5285.txt item: #544 of 732 id: safpj-5286 author: None title: safpj-5286 date: None words: 866 flesch: 54 summary: This may pave the way for a new approach to healthcare and development in mining communities.5 The personal protective equipment (PPE) corruption debacle had a significant impact on senior family physicians and other senior clinicians. Family physicians at the forefront. keywords: care; covid-19; family; health cache: safpj-5286.htm plain text: safpj-5286.txt item: #545 of 732 id: safpj-5287 author: None title: safpj-5287 date: None words: 764 flesch: 50 summary: The South African Family Practice Journal encourages more continuing professional development (CPD) articles written by family physicians for all doctors working in the field of family medicine and primary care. We hope to encourage students to take an interest in the discipline of family medicine even before they qualify and to hopefully form interest groups in family medicine and primary health care at their universities. keywords: family; medicine; south cache: safpj-5287.htm plain text: safpj-5287.txt item: #546 of 732 id: safpj-5290 author: None title: safpj-5290 date: None words: 3367 flesch: 52 summary: Previous studies showed an increase in preterm delivery, low birthweight and small for gestational age babies, which is in contrast to findings from our study.34,35 Although the literature on teenage pregnancy is controversial, there is agreement that teenage pregnancies have a high risk of developing obstetric complications. Abstract Introduction Material and method Results Discussion Limitation of study Conclusion Acknowledgements References About the Author(s) Olaolu I. Ogunwale Department of Family Medicine, Faculty of Health Sciences, University of KwaZulu-Natal, Durban, South Africa Selvandran Rangiah Department of Family Medicine, Faculty of Health Sciences, University of KwaZulu-Natal, Durban, South Africa Citation Ogunwale OI, Rangiah S. Profile and obstetric outcome of teenage pregnancies compared with pregnant adults at a district hospital in KwaZulu-Natal. keywords: adults; africa; antenatal; care; complications; health; obstetric; outcome; pregnancy; risk; study; teenagers cache: safpj-5290.htm plain text: safpj-5290.txt item: #547 of 732 id: safpj-5293 author: None title: safpj-5293 date: None words: 4288 flesch: 52 summary: Patients had access to information that was previously reserved for the medical profession and this empowered patients to participate in decision-making.2 It is the ethical practicing of healthcare that is the main motivation behind SDM. An efficient booking system for patients could contribute to structuring the time per patient for clinicians. keywords: clinicians; decision; disease; family; health; making; medicine; patients; preference; sdm; shared; south; study cache: safpj-5293.htm plain text: safpj-5293.txt item: #548 of 732 id: safpj-5297 author: None title: safpj-5297 date: None words: 2162 flesch: 48 summary: Exploring the impact of COVID-19 pandemic lockdown on informal settlements in Tshwane Gauteng Province, South Africa. One very controllable factor that is often overlooked is the poor disposal of litter and waste management and its adverse effects on public health. keywords: covid-19; disease; health; internet; public; south; waste cache: safpj-5297.htm plain text: safpj-5297.txt item: #549 of 732 id: safpj-5299 author: None title: safpj-5299 date: None words: 2514 flesch: 53 summary: A number of case studies4,8 have shown derangements of whole blood clotting time and standard coagulation tests (PT, PTT, INR and fibrinogen); however, there have been no direct comparisons of coagulation tests with VEA in the setting of boomslang bites. The use of thromboelastography (TEG) and rotational thromboelastometry (ROTEM) has become a standard in many trauma units and can be useful to support patients with boomslang envenomation with specific blood products.6 Antivenom is the definitive treatment for boomslang bites. keywords: antivenom; bite; boomslang; case; clotting; patient; rotem; time cache: safpj-5299.htm plain text: safpj-5299.txt item: #550 of 732 id: safpj-5302 author: None title: safpj-5302 date: None words: 4370 flesch: 55 summary: With the precise intention of expanding substance abuse studies to areas other than cities, the purpose of this study was to determine the prevalence of substance abuse, as well as explore the associations between substance abuse and a range of demographic variables among learners in a rural school district of Free State Province, South Africa. References Myers B, Fakier N, Louw J. Stigma, treatment beliefs, and substance abuse treatment use in historically disadvantaged communities. keywords: abuse; africa; data; health; learners; prevalence; rural; sample; school; south; study; substance; substance abuse; use cache: safpj-5302.htm plain text: safpj-5302.txt item: #551 of 732 id: safpj-5304 author: None title: safpj-5304 date: None words: 3465 flesch: 46 summary: Principle 2: Unstable patients are at high risk of awareness Awareness is an unavoidable risk of anaesthetising unstable patients: it is necessary to maintain a lighter plane of anaesthesia to prevent cardiovascular collapse. Failure to perform a laparotomy occurs because there is either a failure to recognise hypovolaemia or because there is a reluctance to proceed to theatre in unstable patients. keywords: anaesthesia; blood; district; hospitals; patients; pregnancy; resuscitation; surgery; theatre cache: safpj-5304.htm plain text: safpj-5304.txt item: #552 of 732 id: safpj-5306 author: None title: safpj-5306 date: None words: 2437 flesch: 37 summary: Abstract The range and severity of developmental delays vary, and a systematic approach to ensuring early detection for early intervention is essential. In this article, the authors describe a clinical approach to developmental delay within resource-constrained environments of South Africa. keywords: africa; assessment; children; delay; developmental; health; history; screening; south; surveillance cache: safpj-5306.htm plain text: safpj-5306.txt item: #553 of 732 id: safpj-5307 author: None title: safpj-5307 date: None words: 2815 flesch: 45 summary: Substance abuse is prevalent across all social, racial, cultural, religious and gender spheres.7 Many research studies have reported the link between substance abuse and various physical and mental health problems, communicable diseases, intimate partner violence, child abuse, road traffic accidents and deaths from avoidable causes.8,9 Treatment, care and rehabilitation of substance abuse place a heavy burden on overstretched public health systems.6 The Prevention of and Treatment for Substance Abuse Act No. 70, 2008 provides a comprehensive national response for the combating of substance abuse through prevention, early intervention, treatment and re-integration programme. Managing substance abuse within the PHC context could improve access and the outcome of care.12 There is growing evidence of integrated management of substance abuse in PHC settings being more cost-effective than non-integrated care.11,13 Similar to chronic medical conditions, managing substance abuse requires long-term, continuous care, and PHC settings are well suited for these circumstances.14 Figure 1 shows the theoretical framework of substance abuse management in the PHC context. keywords: abuse; alcohol; care; healthcare; management; phc; prevention; primary; providers; screening; substance cache: safpj-5307.htm plain text: safpj-5307.txt item: #554 of 732 id: safpj-5308 author: None title: safpj-5308 date: None words: 5753 flesch: 63 summary: The ESI showed that 48% of red category patients were admitted to ICU, whilst the rest were admitted to the wards.8,19 High acuity patients were usually admitted to ICU/high care; however, these patients experienced delays in receiving treatment. keywords: acuity; data; emergency; hospital; patients; red; resources; study; time; triage cache: safpj-5308.htm plain text: safpj-5308.txt item: #555 of 732 id: safpj-5311 author: None title: safpj-5311 date: None words: 2276 flesch: 47 summary: Dipstick assay to identify leprosy patients who have an increased risk of relapse. Type II leprosy reaction (T2R), also called erythema nodosum leprosum (ENL), these are usually seen in lepromatous leprosy cases believed to be induced by circulating immune-complex mediated factors. keywords: disease; figure; leprosy; patients; signs; skin; treatment cache: safpj-5311.htm plain text: safpj-5311.txt item: #556 of 732 id: safpj-5316 author: None title: safpj-5316 date: None words: 3597 flesch: 52 summary: Abstract Introduction HIV biomarkers reflect evolving HIV infection The evolution of EIA testing for HIV has narrowed the window period for screening and diagnosing HIV infection Measuring the performance of an HIV test Rapid HIV tests HIV self-testing Conclusion Acknowledgements References About the Author(s) Avania Bangalee Department of Medical Virology, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa Tshwane Academic Division, National Health Laboratory Services, Tshwane, South Africa Sachin Bhoora Department of Chemical Pathology, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa Rivak Punchoo Tshwane Academic Division, National Health Laboratory Services, Tshwane, South Africa Department of Chemical Pathology, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa Citation Bangalee A, Bhoora S, Punchoo R. Evaluation of serological assays for the diagnosis of HIV infection in adults. keywords: aids; antibodies; assays; diagnosis; enzyme; generation; health; hiv; infection; testing; tests cache: safpj-5316.htm plain text: safpj-5316.txt item: #557 of 732 id: safpj-5318 author: None title: safpj-5318 date: None words: 5046 flesch: 49 summary: Healthcare providers’ knowledge, attitudes and practices towards medical male circumcision and their understandings of its partial efficacy in HIV prevention: The long-term efficacy of medical male circumcision against HIV acquisition. keywords: africa; circumcision; data; healthcare; hiv; male; participants; perceptions; south; study; understanding; vmmc; workers cache: safpj-5318.htm plain text: safpj-5318.txt item: #558 of 732 id: safpj-5319 author: None title: safpj-5319 date: None words: 6957 flesch: 49 summary: Candidate acknowledges and reflects on his or her own personal values regarding mental health patients. Establishes a good doctor–patient relationship The competent candidate acts within the ethical framework (respects autonomy, justice, non-maleficence and beneficence). keywords: authors; candidate; care; depression; family; health; marks; patients; phc; primary; question; research; screening; south; study cache: safpj-5319.htm plain text: safpj-5319.txt item: #559 of 732 id: safpj-5321 author: None title: safpj-5321 date: None words: 757 flesch: 56 summary: Over the last few weeks, I have been visiting rural district hospitals in the Western Cape, where we are training registrars in family medicine. The conference will be fully virtual, which will enable many more people to attend. keywords: district; family; medicine cache: safpj-5321.htm plain text: safpj-5321.txt item: #560 of 732 id: safpj-5326 author: None title: safpj-5326 date: None words: 6760 flesch: 52 summary: Thus, this study focused on exploring condom use promotion and reasons of condom use amongst young adults in Vhembe district. Conclusion: To effectively promote condom use, a multidisciplinary team approach involving nurses, lay counsellors and peer educators need to be strengthened at local primary health facilities in order to facilitate the distribution of condoms and educate young adults on consistent condom use. keywords: adults; condom; condom use; data; district; facilities; healthcare; hiv; information; participants; prevention; providers; study; use; vhembe; years cache: safpj-5326.htm plain text: safpj-5326.txt item: #561 of 732 id: safpj-5327 author: None title: safpj-5327 date: None words: 3586 flesch: 56 summary: The objectives were to describe the spectrum of head injuries seen at a rural ED; to measure the contributions of IPV, road traffic incidents and non-intentional trauma; to find relationships between modes of injury and type of head injury sustained; and to evaluate severity of patients presenting with head injuries. The ED patient register was used to identify head injury patients who were treated within the study period. keywords: burden; data; head; injuries; injury; patients; study; trauma cache: safpj-5327.htm plain text: safpj-5327.txt item: #562 of 732 id: safpj-5329 author: None title: safpj-5329 date: None words: 1201 flesch: 56 summary: Primary health care systems (PRIMASYS): Case study from South Africa But how does this theme align with our National Department of Health’s plans for the future of family medicine and primary care in South Africa? keywords: family; fps; health; south cache: safpj-5329.htm plain text: safpj-5329.txt item: #563 of 732 id: safpj-5334 author: None title: safpj-5334 date: None words: 4057 flesch: 44 summary: Methods: This was a quantitative, observational, survey-based study targeted at medical doctors working in both the public as well as the private healthcare sector in University of KwaZulu-Natal (UKZN). Methods This was a quantitative, observational survey-based study targeted at medical doctors working in both the public and private healthcare sector at hospital level in KZN. keywords: barriers; covid-19; doctors; face; medical; pandemic; patient; south; telemedicine cache: safpj-5334.htm plain text: safpj-5334.txt item: #564 of 732 id: safpj-5336 author: None title: safpj-5336 date: None words: 4343 flesch: 38 summary: This study aimed to determine the knowledge and perceptions of intern medical doctors in Bloemfontein regarding antibiotic prescribing and stewardship and their perceptions on the usefulness of different educational activities for learning about antibiotic-related topics. Materials and methods Study design, population and sampling This was a cross-sectional study. The knowledge and perceptions regarding antibiotic stewardship of the interns rotating at the Bloemfontein Academic Complex. keywords: abr; antibiotic; health; interns; knowledge; prescribing; respondents; stewardship; study cache: safpj-5336.htm plain text: safpj-5336.txt item: #565 of 732 id: safpj-5337 author: None title: safpj-5337 date: None words: 4272 flesch: 43 summary: [HIV], Tuberculosis [TB], etc.), and the distance of community to healthcare facilities also have a great influence on the child nutritional status.17 The theatrical framework for child malnutrition under the age of 5 years was adopted by UNICEF in 1990.6 It highlighted both basic and underlying causes of malnutrition, which includes the roles of inadequate dietary intake and healthcare received during childhood. Fortified blended foods and lipid-based nutrient supplements are examples of supplementary foods.32 In 1994, South Africa introduced a multi-sectorial Integrated Nutrition Programme (INP), which includes the Departments of Health, Social Development and Agriculture to address malnutrition.34 Therapeutic foods These foods are used in the treatment of severe acute malnutrition, which are specially designed for use in the stabilisation and rehabilitation phases in an inpatient setting, and ready-to-use therapeutic foods are used in the rehabilitation phase, usually in an outpatient setting.19 Feeding formulas, such as F-75 and F-100 therapeutic milk, are an example of therapeutic foods.32 In 2010, the nutritional therapeutic Programme (NTP) was launched to address malnutrition as a therapeutic measure.34 Prevention The manifestation of malnutrition can be multifaceted; however, the most frequent determinants of child malnutrition include poor dietary quality, suboptimal child-caring practices and repeated childhood infections.2 keywords: africa; age; care; children; community; factors; food; health; healthcare; household; level; malnutrition; south; years cache: safpj-5337.htm plain text: safpj-5337.txt item: #566 of 732 id: safpj-5341 author: None title: safpj-5341 date: None words: 3088 flesch: 48 summary: Preparedness level of frontline healthcare professionals in Tshwane regarding the COVID-19 pandemic. Keywords: preparedness level; frontline healthcare professionals; Tshwane; coronavirus 2019 pandemic. keywords: covid-19; frontline; health; healthcare; pandemic; preparedness; survey; tshwane cache: safpj-5341.htm plain text: safpj-5341.txt item: #567 of 732 id: safpj-5342 author: None title: safpj-5342 date: None words: 1524 flesch: 52 summary: Learning outcomes were first developed to guide training programmes when the speciality was recognised in 2007. In 2021, the discipline of Family Medicine in South Africa presents an updated set of programmatic learning outcomes for the training of specialist family physicians, which defined what family physicians should be able to do at the end of their 4 years of postgraduate training. keywords: family; learning; outcomes; physicians; south; training cache: safpj-5342.htm plain text: safpj-5342.txt item: #568 of 732 id: safpj-5344 author: None title: safpj-5344 date: None words: 2479 flesch: 47 summary: She tested positive for the rapid antigen test for SARS COVID-19 and the nasopharyngeal swab for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). According to a survey conducted on HIV care in 65 South African primary care facilities, the fear of contracting COVID-19 was the main reason for not visiting healthcare facilities during the lockdown period.5 keywords: art; covid-19; healthcare; hiv; impact; lockdown; pandemic; people; sars cache: safpj-5344.htm plain text: safpj-5344.txt item: #569 of 732 id: safpj-5345 author: None title: safpj-5345 date: None words: 2505 flesch: 41 summary: Keywords: vaccine hesitancy; vaccines; public health; COVID-19; vaccine acceptance; immunisation; South Africa. Broadly, drivers of decreased confidence in COVID-19 vaccines include several factors. keywords: africa; covid-19; health; hesitancy; internet; jun; south; vaccine cache: safpj-5345.htm plain text: safpj-5345.txt item: #570 of 732 id: safpj-5346 author: None title: safpj-5346 date: None words: 6543 flesch: 44 summary: Keywords: explanatory model; medical male circumcision; primary health care; voluntary medical male circumcision; HIV prevention; HIV/AIDS. The development of an explanatory model for voluntary medical male circumcision in KwaZulu-Natal, South Africa. keywords: africa; circumcision; context; data; factors; health; hiv; kzn; male; model; south; south africa; study; understanding; uptake; vmmc cache: safpj-5346.htm plain text: safpj-5346.txt item: #571 of 732 id: safpj-5355 author: None title: safpj-5355 date: None words: 2382 flesch: 43 summary: Collaboration in early childhood intervention services in Gauteng. Abstract Introduction Describing the context in which early intervention is located Benefit of integration of services Promoting early intervention at primary healthcare level Conclusion Acknowledgements References About the Author(s) Pragashnie Govender Discipline of Occupational Therapy, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa Vasantha Govender Department of Paediatric Neurology, KwaZulu-Natal Children’s Hospital, Durban, South Africa Department of Paediatric Neurology, Inkosi Albert Luthuli Central Hospital, Durban, South Africa Deshini Naidoo Discipline of Occupational Therapy, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa Citation Govender P, Govender V, Naidoo D. Developmental delay in a resource-constrained environment: An approach to early intervention. keywords: care; children; developmental; early; health; healthcare; intervention; south cache: safpj-5355.htm plain text: safpj-5355.txt item: #572 of 732 id: safpj-5357 author: None title: safpj-5357 date: None words: 4710 flesch: 38 summary: Risk assessment and categorisation After history and examination (and when appropriate, test result reviewed) Clinical investigations Most surgeries performed in the district hospitals are minor or moderately complex, and up to ASA-3 risk category patients, where there is an experienced Diplomate.23,24,25,26,27 Routine laboratory tests are therefore not warranted, except when indicated by findings on history and examination, and the complexity of surgery. keywords: africa; airway; anaesthesia; assessment; care; district; health; management; neck; patients; perioperative; preanaesthetic; risk; south; surgery cache: safpj-5357.htm plain text: safpj-5357.txt item: #573 of 732 id: safpj-5358 author: None title: safpj-5358 date: None words: 6231 flesch: 51 summary: Reorganisation of primary care services during COVID-19 in the Western Cape, South Africa: Perspectives of primary care nurses. https://doi.org/10.4102/safp.v63i1.5358 Original Research Reorganisation of primary care services during COVID-19 in the Western Cape, South Africa: Perspectives of primary care nurses Talitha Crowley, Danine Kitshoff, Frances de Lange-Cloete, Justine Baron, Santel de Lange, Cornelle Young, Tonya Esterhuizen, Ian Couper Received: 02 July 2021; Accepted: 22 Sept. 2021; Published: 24 Nov. 2021 Copyright: © 2021. keywords: africa; cape; care; covid-19; health; healthcare; nurses; pandemic; participants; patients; primary; reorganisation; services; south; years cache: safpj-5358.htm plain text: safpj-5358.txt item: #574 of 732 id: safpj-5359 author: None title: safpj-5359 date: None words: 8512 flesch: 46 summary: For this reason we developed a typology for describing the pandemic readiness of health facilities (proactive, reactive and lagging), which was underpinned by the research team’s reflections according to the health-systems building blocks. It could be a useful categorisation for describing health facility readiness during future pandemics and for managers to tailor their support to individual facilities. keywords: care; covid-19; district; facilities; facility; hcws; health; healthcare; management; maternity; pandemic; participants; pretoria; research; study; support; team cache: safpj-5359.htm plain text: safpj-5359.txt item: #575 of 732 id: safpj-5361 author: None title: safpj-5361 date: None words: 6491 flesch: 48 summary: Abstract Introduction Methods Results Discussion Strengths and limitations Conclusion Acknowledgements References About the Author(s) Sophia E. Marsh Department of Pharmacy, Faculty of Health Sciences, Nelson Mandela University, Gqeberha, South Africa Ilse Truter Department of Pharmacy, Faculty of Health Sciences, Nelson Mandela University, Gqeberha, South Africa Citation Marsh SE, Truter, I. Improving health-related quality of life instrument translation into South African languages. https://doi.org/10.4102/safp.v63i1.5361 Original Research Improving health-related quality of life instrument translation into South African languages Sophia E. Marsh, Ilse Truter Received: 09 July 2021; Accepted: 08 Sept. 2021; Published: 08 Nov. 2021 Copyright: © 2021. keywords: africa; health; hiv; hrqol; instruments; language; life; quality; research; review; south; south africa; studies; study; translation; use; versions cache: safpj-5361.htm plain text: safpj-5361.txt item: #576 of 732 id: safpj-5362 author: None title: safpj-5362 date: None words: 852 flesch: 52 summary: I am delighted to report that Dr Sheena Mathew, who is in private practice in Cape Town, has agreed to coordinate our advocacy for family physicians in the private sector. The other model looked at the workforce for primary care, where it only considered the need for family physicians in district-level clinical specialist teams. keywords: family; physicians; practice cache: safpj-5362.htm plain text: safpj-5362.txt item: #577 of 732 id: safpj-5364 author: None title: safpj-5364 date: None words: 6839 flesch: 52 summary: Esaadi M, Paruk F, Cassim B. Prevalence and clinical risk factors for morphometric vertebral fractures in older subjects in KwaZulu-Natal. However, in the abstract they state that the study was undertaken to compare the demographic profile, clinical risk factors and bone mineral density (BMD) in subjects aged 60 years and over with and without morphometric VFs. keywords: authors; examination; factors; family; hospital; injuries; interest; management; marks; pain; primary; question; risk; study; vfs cache: safpj-5364.htm plain text: safpj-5364.txt item: #578 of 732 id: safpj-5367 author: None title: safpj-5367 date: None words: 2630 flesch: 48 summary: The data on sexual assault cases at Sinawe TCC were compared with a time-matched control group from 2014 to 2020. The objective of this study was to access the effect of the COVID-19 pandemic on sexual assault cases admitted at Sinawe TCC in Mthatha Regional hospital compared with time-matched control group from 2014. keywords: access; assault; cases; covid-19; pandemic; services; violence; women cache: safpj-5367.htm plain text: safpj-5367.txt item: #579 of 732 id: safpj-5372 author: None title: safpj-5372 date: None words: 1687 flesch: 59 summary: The global situation regarding cervical cancer is briefly discussed and a family physician’s approach to the procedure and the response to laboratory findings is documented. In a commitment to the global eradication of cervical cancer, the World Health Organization (WHO) launched an initiative in November 2020, involving 194 countries. keywords: africa; cancer; health; patient; screening; south cache: safpj-5372.htm plain text: safpj-5372.txt item: #580 of 732 id: safpj-5374 author: None title: safpj-5374 date: None words: 3029 flesch: 49 summary: Psychological correlates of sedentary screen time behaviour among children and adolescents: A narrative review. Abstract Introduction Screen time and the vision of children Screen time and the physical health of children Screen time and mental well-being of children Conclusion Acknowledgements References About the Author(s) Alvin J. Munsamy Discipline of Optometry, School of Health Sciences, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa Verusia Chetty Department of Physiotherapy, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa Suvira Ramlall Department of Psychiatry, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa Citation Munsamy AJ, Chetty V, Ramlall S. Screen-based behaviour in children is more than meets the eye. keywords: adolescents; behaviour; children; effects; eye; health; screen; time cache: safpj-5374.htm plain text: safpj-5374.txt item: #581 of 732 id: safpj-5375 author: None title: safpj-5375 date: None words: 1012 flesch: 42 summary: The challenge facing low and middle-income countries (LMICs) is the apparent ‘capitalisation’ of vaccine supply where wealthier nations have greater purchasing powers resulting in vaccine surpluses capable of immunising their populations several times. International leaders must play their role in breaking down the financial barriers to equitable distribution of vaccine supply while supporting and strengthening safe vaccine manufacturing in LMICs to ensure quality and efficacy. keywords: covid-19; vaccination; vaccine cache: safpj-5375.htm plain text: safpj-5375.txt item: #582 of 732 id: safpj-5377 author: None title: safpj-5377 date: None words: 4025 flesch: 47 summary: Younger age, minimal work experience and attendance of two or more hours of suicide prevention training were associated with higher knowledge of suicide assessment. Self-confidence and knowledge of suicide assessment and prevention amongst first-line health professionals in Nelson Mandela Bay, South Africa. keywords: assessment; health; healthcare; knowledge; line; participants; prevention; professionals; self; study; suicidal; suicide cache: safpj-5377.htm plain text: safpj-5377.txt item: #583 of 732 id: safpj-5379 author: None title: safpj-5379 date: None words: 225 flesch: 49 summary: Note: DOI of original article: https://doi.org/10.4102/safp.v62i1.5110 Correction Erratum: Burden of caring for children living with human immunodeficiency virus in a semi-rural South African community Stacy Maddocks, Verusia Chetty Published: 16 Nov. 2021 Copyright: © 2021. About the Author(s) Stacy Maddocks Discipline of Physiotherapy, School of Health Sciences, University of KwaZulu-Natal, Durban, South Africa Verusia Chetty Discipline of Physiotherapy, School of Health Sciences, University of KwaZulu-Natal, Durban, South Africa Citation Maddocks S, Chetty V. Erratum: Burden of caring for children living with human immunodeficiency virus in a semi-rural South African community. keywords: south cache: safpj-5379.htm plain text: safpj-5379.txt item: #584 of 732 id: safpj-5381 author: None title: safpj-5381 date: None words: 6709 flesch: 59 summary: Craig E, Bland R, Reilly J. Objectively measured physical activity levels of children and adolescents in rural South Africa: High volume of physical activity at low intensity. Physical activity levels in urban-based South African learners: A cross-sectional study of 7348 participants. keywords: activity; africa; age; behaviour; children; girls; health; learners; levels; physical; school; south; study; urban cache: safpj-5381.htm plain text: safpj-5381.txt item: #585 of 732 id: safpj-5390 author: None title: safpj-5390 date: None words: 5784 flesch: 44 summary: Cuban medical training for South African students: A mixed-methods study. South African medical schools: Current state of selection criteria and medical students’ demographic profile. keywords: african; cuban; data; experiences; fmgs; graduates; medical; participants; south; students; study; support; training; transition cache: safpj-5390.htm plain text: safpj-5390.txt item: #586 of 732 id: safpj-5392 author: None title: safpj-5392 date: None words: 5176 flesch: 42 summary: Future studies amongst undergraduate students may explore alternative options of questionnaire distribution or alternative methodologies to encourage participation.20 Conclusion and recommendations The good knowledge about hereditary diseases and the positive attitudes towards family medical history seen in this study, especially amongst Health Sciences students, was poorly reflected by the performance of practices regarding early preventative measures, such as screenings. Significant differences were seen in the knowledge of Health Science students compared to students from other faculties regarding knowledge that they had a greater chance of being diagnosed with these diseases if a family member already had the disease (82.2% of other respondents; Health Sciences 95.7%; p = 0.0002), awareness of lifestyle changes that could improve their health (78.1% of other respondents; Health Sciences 93.1%; p = 0.0002), knowledge of hereditary diseases can improve the quality of life (90.0% of other respondents; Health Sciences 98.3%; p = 0.0069), knowledge of possible medical complications because of family medical history (66.7% of other respondents; Health Sciences 90.5%; p < 0.0001), knowledge of early detection methods to pursue (41.7% of other respondents; Health Sciences 58.1%; keywords: diseases; faculties; family; health; health sciences; history; knowledge; respondents; sciences; students; study cache: safpj-5392.htm plain text: safpj-5392.txt item: #587 of 732 id: safpj-5393 author: None title: safpj-5393 date: None words: 4776 flesch: 41 summary: However, there are limited evidence-based intervention strategies to guide the management of patients with aggressive and violent behaviour in acute hospital settings.1 Violence and aggression comprise a wide range of behaviours or actions, which can potentially cause harm, hurt or injury by someone to another person.2 Violent and aggressive patients have the intention to dominate another person; as such, they express anger, defensive behaviour, verbal abuse, derogatory remarks, threats or non-verbal gestures.2 Patients can express a wide range of violent and aggressive behaviours in the ECs. Ntandazo Puzi Department of Psychiatry, Faculty of Health Sciences, Walter Sisulu University, Mthatha, South Africa Department of Psychiatry, Faculty of Health Sciences, Cecilia Makiwane Hospital, East London, South Africa Citation Adeniyi OV, Puzi N. Management approach of patients with violent and aggressive behaviour in a district hospital setting in South Africa. keywords: act; aggression; behaviour; care; health; management; patients; person; south; use; violence cache: safpj-5393.htm plain text: safpj-5393.txt item: #588 of 732 id: safpj-5394 author: None title: safpj-5394 date: None words: 2841 flesch: 48 summary: By 2030, NCDs will account for five times as many deaths as communicable diseases in low- and middle-income countries.15,16 Challenges of tackling non-communicable diseases in South Africa Abstract Introduction Challenges of tackling non-communicable diseases in South Africa Evidence for lifestyle factors underlying non-communicable diseases Underlying principles of lifestyle medicine Training of health care practitioners in lifestyle medicine Launch of South African Lifestyle Medicine Association Conclusion Acknowledgements References About the Author(s) Dave R. Glass Private Obstetrics/Gynaecology Practitioner, Port Shepstone, South Africa Citation Glass DR, Lifestyle medicine: A positive approach to stemming the tide of non-communicable diseases in South Africa. keywords: africa; communicable; diseases; health; interventions; lifestyle; medicine; ncds; south cache: safpj-5394.htm plain text: safpj-5394.txt item: #589 of 732 id: safpj-5395 author: None title: safpj-5395 date: None words: 6316 flesch: 45 summary: Open-ended questions were used to explore factors that both motivate and demotivate medical officers participation in CPD activities. Many theories have been proposed to describe and conceptualise learning in the medical profession in order to apply these educational principles to develop CPD activities. keywords: activities; cpd; data; development; eswatini; factors; health; learning; medical; participants; participation; practice; practitioners; professional; years cache: safpj-5395.htm plain text: safpj-5395.txt item: #590 of 732 id: safpj-5396 author: None title: safpj-5396 date: None words: 1058 flesch: 54 summary: Watch COVID-19 vaccine video at: https://youtu.be/KVnNeZnSOwY.7 References Karrim S. COVID-19 in South Africa: The South African Health Products Regulatory Authority has investigated all deaths that occurred after vaccination and has not yet found any evidence to link them to the vaccination.3 In South Africa vaccination is also recommended in pregnant women after the first trimester.4 It is likely that COVID-19 is here to stay, and the future of this pandemic may depend on what additional variants emerge to drive new waves of infection. keywords: covid-19; family; south; vaccine cache: safpj-5396.htm plain text: safpj-5396.txt item: #591 of 732 id: safpj-5398 author: None title: safpj-5398 date: None words: 5849 flesch: 50 summary: It appears that there are other patients who have also missed their appointments at the referral hospital: Based on the information given, what is your comprehensive three stage assessment of this patient? Similarly, semi-elective and elective services, such as a colposcopy service at the referral hospital, may also have been affected by the de-escalated health services to decongest health facilities (in the scenario description above, it is stated that there are other patients who have also missed their appointments at the referral hospital). keywords: cancer; candidate; care; data; examination; family; health; marks; patient; research; screening; south; study; women cache: safpj-5398.htm plain text: safpj-5398.txt item: #592 of 732 id: safpj-5400 author: None title: safpj-5400 date: None words: 662 flesch: 60 summary: This report of an uncommon but significant clinical event shows one of the hazards of veterinary field work, the harm that can be done to a patient by a doctor issuing a cancer warning from a single investigation, and the need to ensure that patients are clearly referred for further care when necessary. Accidental self-inoculation with oil based veterinary vaccines: Case reports. keywords: inoculation; vaccine cache: safpj-5400.htm plain text: safpj-5400.txt item: #593 of 732 id: safpj-5402 author: None title: safpj-5402 date: None words: 4693 flesch: 43 summary: Although there were significant increases in lamotrigine and levetiracetam consumption, the consumption was considerably less compared with sodium valproate consumption. As shown in Table 1, sodium valproate consumption increased by 3.3% (p = 0.255), 7.8% (p = 0.255) and 1.5% (p = 0.701) for the province, urban and rural areas, respectively; however, these increases were not statistically significant. keywords: cape; change; consumption; health; lamotrigine; levetiracetam; patients; policy; sodium; study; use; valproate cache: safpj-5402.htm plain text: safpj-5402.txt item: #594 of 732 id: safpj-5405 author: None title: safpj-5405 date: None words: 935 flesch: 50 summary: A survey was held amongst South African Academy of Family Physicians (SAAFPs) members to explore the needs and suggestions for activities for this special interest group, which is named Next5 (see Figure 1, which depicts the logo and slogan of this group, as approved by the ETC). From the President’s desk: Next5 – A new South African Academy of Family Physicians initiative (‘You didn’t come this far, to only come this far’). keywords: family; health; south cache: safpj-5405.htm plain text: safpj-5405.txt item: #595 of 732 id: safpj-5407 author: None title: safpj-5407 date: None words: 4134 flesch: 45 summary: Abstract Introduction Methods Results Discussion Conclusion Acknowledgements References About the Author(s) Dikonketjo M.P. Moeti Department of Family Medicine and Primary Health Care, Faculty of Health Sciences, Sefako Makgatho Health Sciences University, Pretoria, South Africa Indiran Govender Department of Family Medicine and Primary Health Care, Faculty of Health Sciences, Sefako Makgatho Health Sciences University, Pretoria, South Africa Tombo Bongongo Department of Family Medicine and Primary Health Care, Faculty of Health Sciences, Sefako Makgatho Health Sciences University, Pretoria, South Africa Citation Moeti DMP, Govender I, Bongongo T. Early removal of etonogestrel subcutaneous contraceptive implant at a community health centre in Pretoria. https://doi.org/10.4102/safp.v64i1.5407 Project Research Number: 53/2019 Original Research Early removal of etonogestrel subcutaneous contraceptive implant at a community health centre in Pretoria Dikonketjo M.P. Moeti, Indiran Govender, Tombo Bongongo Received: 09 keywords: africa; contraceptive; etonogestrel; health; implant; insertion; participants; removal; south; study; women cache: safpj-5407.htm plain text: safpj-5407.txt item: #596 of 732 id: safpj-5410 author: None title: safpj-5410 date: None words: 2605 flesch: 40 summary: Keywords: point of care ultrasound; capacity-building; education; primary care; healthcare delivery. However, until such a time as the establishment of an accredited PoCUS programme by the CFPSA, the use of PoCUS falls outside of the scope of practice of family physicians and primary care practitioners, and the use thereof should be regarded as a delict. keywords: act; care; family; health; pocus; south; ultrasound; use cache: safpj-5410.htm plain text: safpj-5410.txt item: #597 of 732 id: safpj-5413 author: None title: safpj-5413 date: None words: 2547 flesch: 46 summary: The use of vagal manoeuvres in narrow complex tachyarrhythmias in primary care. https://doi.org/10.4102/safp.v64i1.5413 CPD Article The use of vagal manoeuvres in narrow complex tachyarrhythmias in primary care Shane D. Murphy, Michele Torlutter Received: 27 Sept. 2021; Accepted: 13 Nov. 2021; Published: 26 Jan. 2022 Copyright: keywords: care; heart; manoeuvre; patient; sinus; svt; tachycardia; use; valsalva cache: safpj-5413.htm plain text: safpj-5413.txt item: #598 of 732 id: safpj-5414 author: None title: safpj-5414 date: None words: 6238 flesch: 52 summary: Such a framework should be application-based and practice-oriented which can assist in addressing unfamiliarity with public health ethics in general and can extend the capacity for decision-making. Following this approach, he identified four values for public health ethics, which also have people and relationship as commonality. keywords: agree; community; ethics; ethics framework; framework; geriatric; health; health ethics; healthcare; principles; ranking; south; statements cache: safpj-5414.htm plain text: safpj-5414.txt item: #599 of 732 id: safpj-5416 author: None title: safpj-5416 date: None words: 337 flesch: 48 summary: About the Author(s) Indiran Govender Department of Family Medicine, Sefako Makgatho Health Sciences University, Ga-Rankuwa, South Africa Selvandran Rangiah Department of Family Medicine, Faculty of Health Sciences, University of KwaZulu-Natal, Durban, South Africa Ramprakash Kaswa Department of Family Medicine, Faculty of Health Sciences, Walter Sisulu University, Umtata, South Africa Doudou Nzaumvila Department of Family Medicine, Sefako Makgatho Health Sciences University, Ga-Rankuwa, South Africa Citation Govender I, Rangiah S, Kaswa R, Nzaumvila D. Erratum: Malnutrition in children under the age of 5 years in a primary health care setting. Instead of ‘Department of Family Medicine, Faculty of Sciences, University of Pretoria, Pretoria, South Africa’, it should be ‘Department of Family Medicine, Sefako Makgatho Health Sciences University, Ga-Rankuwa, South Africa’. keywords: health; sciences cache: safpj-5416.htm plain text: safpj-5416.txt item: #600 of 732 id: safpj-5418 author: None title: safpj-5418 date: None words: 6207 flesch: 57 summary: Keywords: obesity; overweight; BMI; sickness absenteeism; health workers. Furthermore, obesity is associated with both single and multimorbidity23 as well as permanent work loss, which includes disability pension and premature death.24 Therefore, monitoring sickness absenteeism that is linked to excess weight-related conditions provides indirect information about both physical and mental health and is therefore a useful way of evaluating the functional health, including those of health workers. keywords: absenteeism; africa; bmi; body; employees; employment; health; health workers; hospital; leave; obesity; overweight; prevalence; sickness; south; study; workers cache: safpj-5418.htm plain text: safpj-5418.txt item: #601 of 732 id: safpj-5419 author: None title: safpj-5419 date: None words: 2579 flesch: 46 summary: A values-driven approach to vaccine hesitancy conversations. The aim of this study was to offer a values-driven approach to vaccine hesitancy conversations. keywords: approach; cape; conversations; health; hesitancy; vaccination; vaccine; values cache: safpj-5419.htm plain text: safpj-5419.txt item: #602 of 732 id: safpj-5428 author: None title: safpj-5428 date: None words: 7512 flesch: 52 summary: Psychosocial impact of COVID-19 on healthcare workers This superordinate theme focuses on the psychosocial impact of COVID-19 healthcare workers who contracted the virus. Challenges faced by healthcare workers at a central hospital in Zimbabwe after contracting COVID-19: An interpretive phenomenological analysis study. keywords: covid-19; experiences; frontline; frontline healthcare; healthcare; healthcare workers; pandemic; participants; research; researchers; stigma; study; support; system; themes; workers cache: safpj-5428.htm plain text: safpj-5428.txt item: #603 of 732 id: safpj-5429 author: None title: safpj-5429 date: None words: 4221 flesch: 51 summary: The public sector must provide primary healthcare treatment for long COVID patients who otherwise might suffer ongoing morbidity because of their symptoms. Similarly, the NICD survey reported that pre-existing obesity was a risk factor for self-reported non-recovery, while these patients with ≥ 4 symptoms during the acute illness were five times more likely to have long COVID symptoms in comparison to those with asymptomatic COVID-19.8 Black Africans were half as likely to self-report non-recovery at 1-month post-hospitalisation in comparison to white patients.8 Globally, long COVID is associated with a range of fluctuating symptoms. keywords: cape; covid; covid-19; months; non; patients; post; south; study; symptoms cache: safpj-5429.htm plain text: safpj-5429.txt item: #604 of 732 id: safpj-5434 author: None title: safpj-5434 date: None words: 8682 flesch: 48 summary: “That is why I stopped the ART”: Patients’ & providers’ perspectives on barriers to and enablers of HIV treatment adherence in a South African workplace programme. The effect of fast-track treatment initiation counselling on ART initiation and viral suppression as partial results of an impact evaluation on the impact of a package of services to improve HIV treatment adherence. keywords: adherence; africa; antiretroviral; counselling; disease; factors; health; hiv; htn; hypertension; knowledge; medication; participants; patients; people; population; south; south africa; studies; study; treatment cache: safpj-5434.htm plain text: safpj-5434.txt item: #605 of 732 id: safpj-5435 author: None title: safpj-5435 date: None words: 5734 flesch: 53 summary: Patients with abnormal CSF glucose might be hypoglycaemic (3.0% of patients) or hyperglycaemic (1.5% of patients). For these reasons, patients presenting with meningeal signs require urgent LPs and immediate antibiotic treatment. keywords: data; files; hiv; lps; meningitis; patients; results; study; symptoms cache: safpj-5435.htm plain text: safpj-5435.txt item: #606 of 732 id: safpj-5441 author: Joseph, K.; Hitchcock, S. A.; Meyer, H. P.; Geyser, M. M.; Becker, P. J. title: Active myofascial trigger points in head and neck muscles of patients with chronic tension-type headache in two primary health care units in Tshwane date: 2016-08-04 words: 1782 flesch: 38 summary: The Author(s) RESEARCH South African Family Practice 2016; 58(4):136–141 http://dx.doi.org/10.1080/20786190.2016.1151641 Open Access article distributed under the terms of the Creative Commons License [CC BY-NC 3.0] http://creativecommons.org/licenses/by-nc/3.0 Investigation of the coexistence of CKD and non-communicable chronic diseases in a PBM company in South Africa WP Meuwesena, JM du Plessisa*, JR Burgera, MS Lubbea and M Cockerana a Medicine Usage in South Africa (MUSA), North-West University, Potchefstroom, South Africa *Corresponding author, email: jesslee.duplessis@nwu.ac.za Background: Chronic kidney disease (CKD) is a public health problem, with increasing global prevalence. This study investigated the coexistence of CKD and non- communicable chronic diseases in the private health sector of South Africa. keywords: africa; chronic; ckd; pain; patients; south cache: safpj-5441.pdf plain text: safpj-5441.txt item: #607 of 732 id: safpj-5442 author: Meuwesen, W. P.; du Plessis, J. M.; Burger, J. R.; Lubbe, M. S.; Cockeran, M. title: Investigation of the coexistence of CKD and non-communicable chronic diseases in a PBM company in South Africa date: 2016-08-04 words: 1782 flesch: 38 summary: The Author(s) RESEARCH South African Family Practice 2016; 58(4):136–141 http://dx.doi.org/10.1080/20786190.2016.1151641 Open Access article distributed under the terms of the Creative Commons License [CC BY-NC 3.0] http://creativecommons.org/licenses/by-nc/3.0 Investigation of the coexistence of CKD and non-communicable chronic diseases in a PBM company in South Africa WP Meuwesena, JM du Plessisa*, JR Burgera, MS Lubbea and M Cockerana a Medicine Usage in South Africa (MUSA), North-West University, Potchefstroom, South Africa *Corresponding author, email: jesslee.duplessis@nwu.ac.za Background: Chronic kidney disease (CKD) is a public health problem, with increasing global prevalence. This study investigated the coexistence of CKD and non- communicable chronic diseases in the private health sector of South Africa. keywords: africa; chronic; ckd; pain; patients; south cache: safpj-5442.pdf plain text: safpj-5442.txt item: #608 of 732 id: safpj-5443 author: Jacobs, Karen; Julyan, Marlene; Lubbe, Martie S.; Burger, Johanita R.; Cockeran, Marike title: Anti-epileptic prescribing patterns in the South African private health sector (2008–2013) date: 2016-08-04 words: 1868 flesch: 42 summary: The Author(s) RESEARCH South African Family Practice 2016; 58(4):148–152 http://dx.doi.org/10.1080/20786190.2016.1151643 Open Access article distributed under the terms of the Creative Commons License [CC BY-NC 3.0] http://creativecommons.org/licenses/by-nc/3.0 More than scales and tape measures needed to address obesity in South Africa R Ramlala and RD Govendera* a Department of Family Medicine, University of KwaZulu-Natal, Durban, South Africa *Corresponding author, email: Govenderr1@ukzn.ac.za Obesity is an emerging public health problem worldwide increasing from 857 million in 1980 to 2.1 billion by 2013. Of these obese women, 30% are aged between 30 and 59 years.2 Recent South African studies show a change in prevalence associated with ethnicity and age.8 Central obesity was found in 42.2% of women and was most prevalent in urban Black African and women of mixed ancestry whereas only 9.2% of the men had central obesity with older and white males having the highest prevalence.8 Overweight and obesity is a major contributor to the global burden of non-communicable diseases (NCDs) and the associated morbidity and mortality.9 In common with other African countries, South Africa (SA) is currently encountering an increasing burden of NCDs associated with overweight and keywords: africa; obesity; overweight; patients; south cache: safpj-5443.pdf plain text: safpj-5443.txt item: #609 of 732 id: safpj-5444 author: Ramlal, R.; Govender, R. D. title: More than scales and tape measures needed to address obesity in South Africa date: 2016-08-04 words: 1868 flesch: 42 summary: The Author(s) RESEARCH South African Family Practice 2016; 58(4):148–152 http://dx.doi.org/10.1080/20786190.2016.1151643 Open Access article distributed under the terms of the Creative Commons License [CC BY-NC 3.0] http://creativecommons.org/licenses/by-nc/3.0 More than scales and tape measures needed to address obesity in South Africa R Ramlala and RD Govendera* a Department of Family Medicine, University of KwaZulu-Natal, Durban, South Africa *Corresponding author, email: Govenderr1@ukzn.ac.za Obesity is an emerging public health problem worldwide increasing from 857 million in 1980 to 2.1 billion by 2013. Of these obese women, 30% are aged between 30 and 59 years.2 Recent South African studies show a change in prevalence associated with ethnicity and age.8 Central obesity was found in 42.2% of women and was most prevalent in urban Black African and women of mixed ancestry whereas only 9.2% of the men had central obesity with older and white males having the highest prevalence.8 Overweight and obesity is a major contributor to the global burden of non-communicable diseases (NCDs) and the associated morbidity and mortality.9 In common with other African countries, South Africa (SA) is currently encountering an increasing burden of NCDs associated with overweight and keywords: africa; obesity; overweight; patients; south cache: safpj-5444.pdf plain text: safpj-5444.txt item: #610 of 732 id: safpj-5445 author: Fernandes, L.; Mokwena, K. E. title: The role of locus of control in nyaope addiction treatment date: 2016-08-04 words: 1851 flesch: 34 summary: Despite a need for effective strategies to enhance EC accessibility as one component of ensuring access to safe and effective contraception, there have been few recent studies on EC in a South African context. Use of EC has been promoted in South Africa, yet uptake among women appears to remain low. keywords: contraception; loc; nyaope; south cache: safpj-5445.pdf plain text: safpj-5445.txt item: #611 of 732 id: safpj-5446 author: Osa-Izeko, O.; Govender, R. D.; Ross, A. J. title: Self-reported knowledge and use of emergency contraception among women presenting for termination of pregnancy date: 2016-08-04 words: 1851 flesch: 34 summary: Despite a need for effective strategies to enhance EC accessibility as one component of ensuring access to safe and effective contraception, there have been few recent studies on EC in a South African context. Use of EC has been promoted in South Africa, yet uptake among women appears to remain low. keywords: contraception; loc; nyaope; south cache: safpj-5446.pdf plain text: safpj-5446.txt item: #612 of 732 id: safpj-5447 author: None title: safpj-5447 date: None words: 3998 flesch: 53 summary: Also, interventions to improve diabetes complication screening in the region are needed and should target the primary healthcare providers. While this study did not measure barriers to routine DM complication screening, several possible reasons such as physical and human resource constraints may explain the study findings.5 keywords: africa; care; complications; data; diabetes; health; primary; screening; south; study; type cache: safpj-5447.htm plain text: safpj-5447.txt item: #613 of 732 id: safpj-5449 author: None title: safpj-5449 date: None words: 3081 flesch: 33 summary: Anxiety disorders are a relatively common cause of palpitations in the modern medicine era, and screening of psychiatric aetiology of palpitation should be part of the assessment. Palpitations: Evaluation and management by primary care practitioners. keywords: arrhythmias; cardiac; care; cause; evaluation; examination; heart; history; palpitations; patients; ventricular cache: safpj-5449.htm plain text: safpj-5449.txt item: #614 of 732 id: safpj-5457 author: None title: safpj-5457 date: None words: 3341 flesch: 46 summary: Open abdominal hysterectomy was performed more commonly than the vaginal route and a frequency of 89.7% was recorded compared to 10.3% of the patients who received vaginal hysterectomy. Das et al. in 2005 found a margin positivity rate of 33.3% in the abdominal route compared to the vaginal route, which had only 3.3% positive margins.11 Based on their findings, they recommended that a vaginal approach be considered for premalignant cervical lesions because of the direct visualisation of the lesion at the time of procedure.11 One hundred percent of abnormal vault cytology was seen in abdominal hysterectomy in our study compared to 0.0% of those who had vaginal hysterectomy. keywords: cytology; follow; hysterectomy; months; patients; rates; recurrence; study; women cache: safpj-5457.htm plain text: safpj-5457.txt item: #615 of 732 id: safpj-5462 author: None title: safpj-5462 date: None words: 4106 flesch: 48 summary: However, in the presence of systemic or local factors that delay wound healing, where possible these factors should be addressed by the appropriate intervention, for example, correcting the nutritional status and anaemia, removing the foreign body or treatment of wound infection. Clinicians should have a basic understanding of the processes of wound healing and wound bed preparation to match the ideal cost-effective dressing to the particular type of wound to be managed. keywords: africa; bed; care; dressings; factors; family medicine; healing; infection; management; medicine; south; wound cache: safpj-5462.htm plain text: safpj-5462.txt item: #616 of 732 id: safpj-5463 author: None title: safpj-5463 date: None words: 4848 flesch: 56 summary: Patients should subsequently be transferred for angiography and revascularisation within 3–24 h. Immediate transfer should be initiated for patients in cardiogenic shock or heart failure, with urgent transfer for those who have failed reperfusion.6 Immediate management of patients with NSTEMI involves risk stratification of patients and tailoring of therapy, both pharmacological and invasive, according to risk category and risk of bleeding. Patients with NSTEMI (73.1%) were more likely to use own transport to reach the hospital than patients with STEMI (45.1%) (OR: 0.3; 95% CI: 0.1–0.7; p = 0.005). keywords: acute; africa; ami; health; hospital; infarction; mortality; myocardial; patients; south; stemi; study; time cache: safpj-5463.htm plain text: safpj-5463.txt item: #617 of 732 id: safpj-5465 author: None title: safpj-5465 date: None words: 738 flesch: 59 summary: Over the last few weeks, the Wonca World Conference was held virtually in Abu Dhabi and although our bid to host the conference in 2025 was not successful, a number of South African family physicians were honoured. Likewise, I am delighted about the emergence of the Next-5 to look after the needs of newly qualified family physicians as they transition from registrar to family physician. keywords: family; prof; south cache: safpj-5465.htm plain text: safpj-5465.txt item: #618 of 732 id: safpj-5467 author: None title: safpj-5467 date: None words: 11582 flesch: 54 summary: District hospitals are often rural and remote, and the recruitment and retention of MOs in these locations are particularly challenging and important.8 Although interns and community service MOs are obligated to spend time in the district health services, there are concerns as to whether the services can retain MOs on a more permanent basis.8,9 Attracting and retaining MOs in district health services is a complex problem. In South Africa, medical officers (MOs) are a key component of service delivery in district health services. keywords: africa; cape; care; district; district health; family; grade; health; health services; hospital; mos; number; physicians; services; south; western; work cache: safpj-5467.htm plain text: safpj-5467.txt item: #619 of 732 id: safpj-5471 author: None title: safpj-5471 date: None words: 4862 flesch: 45 summary: TABLE 1: Profile of study participants. In a study of Angolan women, Qui found the desire to conceive to be a key factor for contraceptive implant discontinuation.28 In another study by Casner, 3% of participants requested removal of their contraceptive implants within six months of insertion because of their desire to conceive.32 Higgins also found in his study that early discontinuation of contraceptive implants was premised on the intention to conceive.33 Lastly, some of the participants provided more than one reason for the removal of the implant. keywords: contraceptive; family; health; implanon; implant; interviews; methods; participants; progestogen; reasons; research; study; use; women cache: safpj-5471.htm plain text: safpj-5471.txt item: #620 of 732 id: safpj-5473 author: None title: safpj-5473 date: None words: 6289 flesch: 48 summary: Keywords: family physicians; human resources; policy; workforce; district health system; district health services. The contribution of family physicians to district health services in South Africa: A national position paper by the South African Academy of Family Physicians. keywords: africa; care; clinical; community; district; family; family physicians; fps; health; hospitals; national; physicians; services; south; system; training cache: safpj-5473.htm plain text: safpj-5473.txt item: #621 of 732 id: safpj-5474 author: Office, Editorial title: Acknowledgement to reviewers date: 2021-12-22 words: 557 flesch: 37 summary: http://www.safpj.co.za Open Access Page 1 of 1 Reviewer Acknowledgement Acknowledgement to reviewers In an effort to facilitate the selection of appropriate peer reviewers for the South African Family Practice journal, we request you take a moment to update your electronic portfolio on https://safpj.co.za for our files, allowing us better access to your areas of interest and expertise, in order to match reviewers with submitted manuscripts. It is good practice as a reviewer to update your personal details regularly to ensure contact with you throughout your professional term as reviewer to the South African Family Practice journal. keywords: access; family; https://safpj.co.za; journal; practice; reviewer cache: safpj-5474.pdf plain text: safpj-5474.txt item: #622 of 732 id: safpj-5476 author: Office, Editorial title: Table of Contents Vol 63 date: 2021-12-30 words: 3356 flesch: 10 summary: SAFP_v63_i1_Contents.indd https://www.safpj.co.za Open Access Table of Contents Scientific letters More than myalgia: An unusual presentation of exertional rhabdomyolysis Matthew O.A. Benedict, Anthonio O. Adefuye South African Family Practice | Vol 63, No 1 : Part 1| a5194 | 13 January 2021 Scientific letters Barriers to access second-trimester abortion: A case report Ramprakash Kaswa South African Family Practice | Vol 63, No 1 : Part 1| a5028 | 27 January 2021 Open Forum Drawing lessons from the standard treatment guidelines and essential medicines list concept in South Africa as the country moves towards national health insurance Velisha A. Perumal-Pillay, Fatima Suleman South African Family Practice | Vol 63, No 1 : Part 1| a5145 | 12 January 2021 Open Forum Severe asthma in South Africa: A literature review and management approach for primary care Huibrecht C. Lion-Cachet, John M.M. Musonda, Olufemi B. Omole South African Family Practice | Vol 63, No 1 : Part 1| a5179 | 29 January 2021 Open Forum A recommended management plan for coronavirus disease 2019–positive geriatric patients based in South African old age homes Christina Eleftheriades South African Family Practice | Vol 63, No 1 : Part 1| a5222 | 08 February 2021 CPD Article Assessment and management of shoulder pain at primary care level Ntambue Kauta, Elma de Vries, Jean-Pierre du Plessis, Ben Grey, Cameron Anley, Basil Vrettos, Robert Dachs, Stephen Roche South African Family Practice | keywords: african; article; care; cpd; family practice; forum; govender; october; primary; research; south; vol cache: safpj-5476.pdf plain text: safpj-5476.txt item: #623 of 732 id: safpj-5478 author: None title: safpj-5478 date: None words: 1102 flesch: 43 summary: Medical education seems to be lagging behind the current capabilities regarding online learning. A challenge for online learning is that future doctors require much more than knowledge and skills; the development of compassion and professionalism is an art that cannot be easily taught online. keywords: learning; medical; online cache: safpj-5478.htm plain text: safpj-5478.txt item: #624 of 732 id: safpj-5479 author: None title: safpj-5479 date: None words: 2597 flesch: 52 summary: Discussion The case report patient did not have immediate access to a specialised hand surgeon with delayed recognition and incorrect management leading to long-term consequences for a patient’s quality of life, function and work.2,4 Serious hand injuries with chronic pain correlate with low quality of life, anxiety and depression.5 Primary care physicians routinely manage patients who sustained traumatic hand injuries but a thorough assessment and subsequent referral to a hand surgeon is imperative in complex hand injuries.2 Karunadasa identified neurological assessment and two views X-rays, as routine assessments, and fundamental care principles for hand injury management.4 Background Research on the leading cause of hand injuries sustained during the COVID-19 pandemic in the United Kingdom showed an increase in injuries related to using machinery.1 Primary care physicians routinely manage patients after sustaining acute hand injuries but timeous referral to hand surgeons when the extent of the injury necessitates further assessment and management is crucial.2 The initial assessment, history taking and physical assessment are vital. keywords: care; finger; hand; injury; management; patient; wound cache: safpj-5479.htm plain text: safpj-5479.txt item: #625 of 732 id: safpj-5481 author: None title: safpj-5481 date: None words: 6734 flesch: 54 summary: Non-randomised studies of the effects of interventions (NRSI) are critical to many areas of healthcare evaluation of public health interventions, but their results may be biased. Designs of NRSI that can be used to evaluate the effects of interventions include observational studies such as cohort studies and case-control studies in which intervention groups are allocated during usual treatment decisions, and non-randomised studies in which the method of allocation is not randomised. keywords: authors; candidate; care; covid-19; family; health; hiv; marks; medicine; non; patient; public; randomised; resistance; study; treatment cache: safpj-5481.htm plain text: safpj-5481.txt item: #626 of 732 id: safpj-5483 author: None title: safpj-5483 date: None words: 8043 flesch: 55 summary: Impact of COVID-19 – Experiences of 5th year medical students at the University of KwaZulu-Natal. 2022;64(1), a5483. https://doi.org/10.4102/safp.v64i1.5483 Original Research Impact of COVID-19 – Experiences of 5th year medical students at the University of KwaZulu-Natal Andrew J. Ross Received: 22 Dec. 2021; Accepted: 05 keywords: blocks; covid-19; fgd; health; learning; online; pandemic; students; teaching; time; university; weeks; year cache: safpj-5483.htm plain text: safpj-5483.txt item: #627 of 732 id: safpj-5487 author: None title: safpj-5487 date: None words: 5427 flesch: 54 summary: Methods Study design A cohort of low-risk pregnant women attending primary health care antenatal care eligible for screening using the CWDU-UmA (UmbiflowTM device) were screened. A comparison between those who were screened using CWDU-UmA (study group) and those not screened (control group) was performed. keywords: africa; antenatal; care; control; group; health; neonatal; population; pretoria; risk; screening; south; stillbirths; study; women cache: safpj-5487.htm plain text: safpj-5487.txt item: #628 of 732 id: safpj-5489 author: None title: safpj-5489 date: None words: 6771 flesch: 45 summary: The clinical practice guideline on tobacco smoking cessation for South Africa published in the South African Medical Journal in 2013 acknowledges that successful smoking cessation interventions call for holistic management of patients, including exploring why an individual smokes (stress, depression etc.) as well as addressing the biological consequences of nicotine withdrawal.58 The approach which yields the highest chance of success is one that encompasses biological (e.g. reduction of cravings and withdrawal symptoms pharmacologically), psychological (e.g. motivational interviewing) and social support (e.g. support groups).58 The integrated model of care is considered the gold standard in the dual diagnosis of a mental disorder and substance use disorder.59 This model involves the same clinician or team of clinicians providing both mental health and addiction treatment in a coordinated manner. In a 2010 qualitative study among South African clinicians by Omole et al., possible barriers identified included health system barriers (time constraints, inaccessibility of smoking cessation medications and ineffectual referral systems) and clinician limitations (perceived ineffectiveness of smoking cessation treatments and limited knowledge and skill on evidence-based interventions).55 Primary healthcare providers can reach 80% of tobacco users per year,56 providing an ideal opportunity to screen for mental illness. keywords: african; cessation; disorders; health; illness; interventions; nicotine; people; population; psychiatry; pwmi; quit; review; schizophrenia; smokers; smoking; smoking cessation; south; tobacco; treatment; use cache: safpj-5489.htm plain text: safpj-5489.txt item: #629 of 732 id: safpj-5490 author: None title: safpj-5490 date: None words: 3931 flesch: 44 summary: Abstract Introduction Methods Results Discussion Conclusion Acknowledgements References About the Author(s) Melene Strauss University of Stellenbosch Business School, Bellville, South Africa Renata Schoeman Department of Leadership, University of Stellenbosch Business School, Bellville, South Africa Citation Strauss M, Schoeman R. Patients’ perception of service quality in a healthcare not-for-profit organisation. https://doi.org/10.4102/safp.v64i1.5490 Research Project Registration: Project research number: 15459 Original Research Patients’ perception of service quality in a healthcare not-for-profit organisation Melene Strauss, Renata Schoeman Received: 16 Jan. 2022; Accepted: 14 June 2022; Published: 26 Sept. 2022 Copyright: © 2022. keywords: clinics; healthcare; patients; perception; quality; questionnaire; respondents; service; service quality; study; value cache: safpj-5490.htm plain text: safpj-5490.txt item: #630 of 732 id: safpj-5491 author: None title: safpj-5491 date: None words: 7570 flesch: 51 summary: They also suggested that departments should have a dedicated ‘doctor on call’ to respond to Vula App referrals to improve response times. Specialist advice via the Vula App enabled practitioners to manage patients remotely. keywords: app; care; communication; data; district; hospital; information; participants; patient; referral; study; use; vula; vula app; years cache: safpj-5491.htm plain text: safpj-5491.txt item: #631 of 732 id: safpj-5492 author: None title: safpj-5492 date: None words: 3441 flesch: 48 summary: Other pre-analytical errors such as sample swaps, mislabelling and contamination may also contribute to false PCR results. Fluorogenic probes are used to search for the target DNA sequence which generates a fluorescent signal that increases proportionally to the amount of viral RNA present in the sample. keywords: cov-2; covid-19; infect; laboratory; pcr; rna; sample; sars; test; testing; viral cache: safpj-5492.htm plain text: safpj-5492.txt item: #632 of 732 id: safpj-5493 author: None title: safpj-5493 date: None words: 2955 flesch: 35 summary: Indeed, expression of CB1 (in the differentiated, central cells) and CB2 (predominantly in the basal, non-differentiated sebocytes) receptors has been well-documented in human skin. Disclaimer The views and opinions expressed in this article are those of the author and not necessarily reflect the official policy or position of any affiliated agency of the author. References Stander S, Schmelz M, Metze D, Luger T, Rukwied R. Distribution of cannabinoid receptor 1 (CB1) and 2 (CB2) on sensory nerve fibers and adnexal structures in human skin. keywords: article; cannabinoids; cannabis; cb1; disorders; effects; properties; receptor; skin; topical; treatment cache: safpj-5493.htm plain text: safpj-5493.txt item: #633 of 732 id: safpj-5496 author: None title: safpj-5496 date: None words: 3198 flesch: 44 summary: This article aims to address this gap by providing resources on the effective management of suicidal patients to reduce the intensity and occurrence of suicide and suicidal behaviour. Furthermore, the supply of medication to suicidal patients should be limited to a few days or a few weeks at a time to restrict the amount of drugs available for overdose.25 Patients who show poor response to medications or who persist with suicidal behaviour despite treatment should be referred to a psychiatrist for further management. keywords: attempts; behaviour; care; health; management; patients; primary; risk; self; south; suicide cache: safpj-5496.htm plain text: safpj-5496.txt item: #634 of 732 id: safpj-5501 author: None title: safpj-5501 date: None words: 1298 flesch: 52 summary: You have completed your research and passed the CMSA’s Fellowship of the College of Family Physicians Part B. You have completed your registrar training time. You feel elated until you realise you have to go through all the administration of registering with the Health Professions Council of South Africa (HPCSA) as a specialist. keywords: family; form; hpcsa; south cache: safpj-5501.htm plain text: safpj-5501.txt item: #635 of 732 id: safpj-5503 author: None title: safpj-5503 date: None words: 5244 flesch: 53 summary: The first author and his assistants also used the opportunity to educate diary unexposed patients, their relatives and caregivers about the seizure diary. Keywords: seizure diary; epilepsy; paper diary; electronic diary; seizure frequency; patients who had previous exposure to the seizure diary; unexposed. keywords: diary; epilepsy; exposure; hospital; kimberley; patients; seizure; seizure diary; south; study; use cache: safpj-5503.htm plain text: safpj-5503.txt item: #636 of 732 id: safpj-5504 author: None title: safpj-5504 date: None words: 6121 flesch: 51 summary: The MCQs will be based on the 10 clinical domains of family medicine, the SAQs will be aligned with the five national unit standards and the critical reading section will include evidence-based medicine and primary care research methods. As such, better assessment of trauma care systems in Africa should be a research and health service priority. keywords: authors; care; consensus; delphi; experts; family; health; management; marks; patient; question; research; round; study; trauma cache: safpj-5504.htm plain text: safpj-5504.txt item: #637 of 732 id: safpj-5511 author: None title: safpj-5511 date: None words: 3422 flesch: 46 summary: It can also lead to social unrest, economic decline and violence against women.3 According to the World Health Organization’s (WHOs) Global Health Estimates, more than 1.3 million people died every year because of violence-related injuries, and out of these, about 35.3% died as a result of IPV.4,6 The United Nations continues to lead awareness campaign towards eliminating IPV globally.1 Interpersonal violence is defined by WHO as ‘the deliberate use of force or power, threatened or actual, against oneself or another person or against a group or a community’.7 Epidemiology of interpersonal violence at a regional hospital emergency unit in the Eastern Cape, South Africa S Afr Fam Pract. keywords: africa; data; health; injuries; injury; ipv; patients; south; study; trauma; violence cache: safpj-5511.htm plain text: safpj-5511.txt item: #638 of 732 id: safpj-5514 author: None title: safpj-5514 date: None words: 9258 flesch: 53 summary: https://doi.org/10.1371/journal.pone.0239430 Schneider H, Lehmann U. From community health workers to community health systems: Time to widen the horizon? Building effective relationships across stakeholder platforms by community health workers (CHWs) was directly influenced by the training, capacity building afforded these CHWs by the district health services; and acceptability of CBS. keywords: care; chws; communities; community; community health; data; facility; health; interview; services; sites; study; surveillance; teams; tshwane; workers cache: safpj-5514.htm plain text: safpj-5514.txt item: #639 of 732 id: safpj-5517 author: None title: safpj-5517 date: None words: 2555 flesch: 44 summary: Abstract Introduction Procedure for assisted admissions Improvement in assisted users’ condition during admission Deterioration in assisted users’ condition during admission Refusal of hospital treatment and appeals by assisted users Leave of absence for assisted users Consent to medical treatment by assisted users Advantages and challenges in classifying users as assisted Conclusion Acknowledgements References About the Author(s) Kalpesh Narsi Discipline of Psychiatry, School of Clinical Medicine, University of KwaZulu-Natal, Durban, South Africa Citation Narsi K. Unpacking assisted admissions under the Mental Health Care Act 17 of 2002. The MHCA allows for the care, treatment and rehabilitation of mental healthcare users, who lack the competence to consent but who do not refuse treatment to be managed as assisted users. keywords: act; admission; care; health; treatment; users cache: safpj-5517.htm plain text: safpj-5517.txt item: #640 of 732 id: safpj-5519 author: None title: safpj-5519 date: None words: 1172 flesch: 47 summary: The context of primary care is often dichotomised into either urban versus rural health care, public versus private sector, community health centre versus district hospital, city clinic versus general practitioner practice, or facility-based versus community-based health care. The spectrum of care providers may be viewed as a horizontal line, with providers graded according to their credentials and experience (including community health worker with certificate vs. medical doctor with a degree, medical intern vs. consultant) and whether their disciplinary identity is generalist or specialist. keywords: care; complexity; editorial; family; health cache: safpj-5519.htm plain text: safpj-5519.txt item: #641 of 732 id: safpj-5522 author: None title: safpj-5522 date: None words: 5226 flesch: 47 summary: A study conducted in Nepal found that most caregivers attributed poor practice of complementary feeding to the unavailability of food because of unemployment.27 Social and economic factors are regarded as non-medical determinants of health.28 These factors could impact complementary feeding practices; therefore, there is a need to evaluate socio-economic factors of caregivers prior to developing an intervention to promote appropriate complementary feeding practices. Abstract Background Research methodology Results Discussion Conclusion Acknowledgements References About the Author(s) Mabitsela H. Mphasha Department of Human Nutrition and Dietetics, Faculty of Healthcare Sciences, University of Limpopo, Polokwane, South Africa Gerald Mokubela Department of Human Nutrition and Dietetics, Faculty of Healthcare Sciences, University of Limpopo, Polokwane, South Africa Thendo Ramokotedi Department of Human Nutrition and Dietetics, Faculty of Healthcare Sciences, University of Limpopo, Polokwane, South Africa Thapelo Kgari Department of Human Nutrition and Dietetics, Faculty of Healthcare Sciences, University of Limpopo, Polokwane, South Africa Citation Mphasha MH, Mokubela G, Ramokotedi T, Kgari T. Exploratory study on factors influencing the introduction of complementary feeding amongst caregivers of children between 6 and 24 months of age in Polokwane, Limpopo province. keywords: age; caregivers; children; complementary; data; factors; feeding; food; health; media; months; participants; study cache: safpj-5522.htm plain text: safpj-5522.txt item: #642 of 732 id: safpj-5523 author: None title: safpj-5523 date: None words: 5031 flesch: 47 summary: Abstract Background: Child growth is crucial for nutritional and health status; poor growth may result in stunting. However, child growth and development are a public health problem, with the recent worldwide prevalence of stunting estimated at 144 million children under the age of five (approximately 21.3%).2 Stunting is most prevalent in the poorest and food-insecure nations, including middle-income countries.2 keywords: adherence; caregivers; children; gmp; growth; health; importance; non; participants; sessions; study; years cache: safpj-5523.htm plain text: safpj-5523.txt item: #643 of 732 id: safpj-5527 author: None title: safpj-5527 date: None words: 3786 flesch: 54 summary: Abstract Introduction Methods Results Discussion Conclusion Limitations of the study Acknowledgements References About the Author(s) Makhosazana C. Dlamini Department of Nursing, Faculty of Health Care Sciences, Sefako Makgatho Health Sciences University, Pretoria, South Africa Ellen M. Thobakgale Department of Nursing, Faculty of Health Care Sciences, Sefako Makgatho Health Sciences University, Pretoria, South Africa Indiran Govender Department Family Medicine and Primary Health Care, Faculty of Health Sciences, Sefako Makgatho Health Sciences University, Pretoria, South Africa Citation Dlamini MC, Thobakgale EM, Govender I. Knowledge of final year undergraduate nursing students about HIV and AIDS in Eswatini. https://doi.org/10.4102/safp.v64i1.5527 Original Research Knowledge of final year undergraduate nursing students about HIV and AIDS in Eswatini Makhosazana C. Dlamini, Ellen M. Thobakgale, Indiran Govender Received: 29 Mar. 2022; Accepted: 13 June 2022; Published: 07 Sept. 2022 Copyright: keywords: aids; eswatini; health; hiv; knowledge; nursing; students; study; undergraduate cache: safpj-5527.htm plain text: safpj-5527.txt item: #644 of 732 id: safpj-5528 author: None title: safpj-5528 date: None words: 6133 flesch: 55 summary: Statistical considerations In this study, the knowledge and practice towards HTN control by means of lifestyle modifications were assessed. Effect of diet and salt on hypertension The majority of the participants’ (90.8%) opinions were in agreement with the importance of diet in HTN, and 97.6% agreed that salt reduction aids HTN control. keywords: blood; control; exercise; health; htn; hypertension; knowledge; level; lifestyle; majority; modification; participants; patients; practice; pressure; study cache: safpj-5528.htm plain text: safpj-5528.txt item: #645 of 732 id: safpj-5529 author: None title: safpj-5529 date: None words: 3555 flesch: 44 summary: Abstract Introduction Good basic practice is key to avoiding complications Are preoperative blood tests are required for spinal anaesthesia? However, practitioners providing anaesthesia in this context are usually generalists who practise anaesthesia infrequently and may be unfamiliar with dealing with complications of spinal anaesthesia or with conversion from spinal to general anaesthesia. keywords: anaesthesia; block; bupivacaine; caesarean; district; hypotension; management; needle; pain; section; spinal cache: safpj-5529.htm plain text: safpj-5529.txt item: #646 of 732 id: safpj-5530 author: None title: safpj-5530 date: None words: 2911 flesch: 45 summary: Food allergy in primary care: Management of food allergy. Abstract Introduction Diagnostic approach to food allergies Multidisciplinary collaboration: The role of the registered dietitian Summary Acknowledgements References About the Author(s) Jurgens Staats Department of Family Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa Idonette Van Zyl Department of Nutrition, Faculty of Health Sciences, North-West University, Potchefstroom, South Africa Citation Staats J, Van Zyl I. Adverse reactions to food: Navigating the maze in primary health care. keywords: allergy; clin; diagnosis; food; history; ige; immunol; non; reactions cache: safpj-5530.htm plain text: safpj-5530.txt item: #647 of 732 id: safpj-5532 author: None title: safpj-5532 date: None words: 3698 flesch: 36 summary: Data from an obstetrics article revealed that although the number of deaths related to failed tracheal intubation has lessened considerably over the last three decades, the incidence of failed intubation has stayed roughly steady at between 1:224 and 1:300.6 According to the data, not all occurrences seem to be predictable, nor are they all preventable.7 However, as failed intubation is an emergency and difficult airways are anticipated, early recognition followed by adequate management as soon as humanly possible are paramount to avoid complications, because airway management–related morbidity is still being reported in closed legal claims.8,9 Junior doctors or doctors with limited anaesthetic training and experience are responsible for providing obstetric anaesthesia in the district hospitals.10 Even though tracheal intubation is a core skill for medical interns, training is provided for two months that leads to the lack of this essential skill when they are community service doctors working in district hospitals.10 According to the report from a survey conducted in the United Kingdom in 1995, a supraglottic device laryngeal mask airway was used by 72% of anaesthetists in obstetric anaesthesia to maintain oxygenation when tracheal intubation and face-mask ventilation failed.7,11 They are less invasive tools used for airway management in anaesthesia.22 Since the late 1990s, there has been a gradual increase in the use of SAD to continue anaesthesia when failed intubation is declared.16,22 Supraglottic airway devices are commonly classified into first-generation devices, containing only a breathing lumen (Figure 46,16), and second-generation SADs (Figure 523), which possess an additional channel for drainage of gastric contents.12,22 Second-generation devices are recommended as better rescue devices after failed tracheal intubation, even though they do not provide complete protection against aspiration (Figure 5).6 These devices have features such as drain tubes or compartments for mitigating risk of aspiration to manage regurgitated content,22 and they also provide a better airway seal for positive pressure ventilation.15 FIGURE 4: ‘Can’t intubate, can’t oxygenate’. keywords: airway; anaesthesia; care; devices; failure; figure; health; intubation; management; obstetric; patient; tracheal cache: safpj-5532.htm plain text: safpj-5532.txt item: #648 of 732 id: safpj-5533 author: None title: safpj-5533 date: None words: 3576 flesch: 41 summary: How to navigate the telehealth medicolegal landscape in South Africa Should telehealth consultations be viewed in the same way as physical consultations by healthcare practitioners? Healthcare practitioners who conduct telehealth consultations are held to the same standards of professional practice as HCPs who conduct physical consultations and will be measured against what the reasonable HCP would do under similar circumstances should complaints arise or legal action ensue in this milieu.1 Do not supersede or go above and beyond what you would do during a physical consultation when conducting a telehealth consultation. When a HCP agrees to treat a patient and the latter provides informed consent to be treated, the professional relationship is established according to the updated Booklet 10.1 Booklet 10 further states that telehealth consultations are not a substitute for physical consultations but should resemble them as closely as possible. keywords: africa; consultations; guidelines; hcps; healthcare; patient; practitioners; south; telehealth cache: safpj-5533.htm plain text: safpj-5533.txt item: #649 of 732 id: safpj-5534 author: None title: safpj-5534 date: None words: 2556 flesch: 40 summary: https://doi.org/10.1176/appi.ajp.160.6.1147 Chang-Quan H, Zheng-Rong W, Yong-Hong L, Yi-Zhou X, Qing-Xiu L. Education and risk for late life depression: A meta-analysis of published literature. Indeed, the prevalence of depressive disorders has been further worsened by the coronavirus disease 2019 (COVID-19) pandemic.3 keywords: depression; factors; health; life; lld; management; risk; symptoms cache: safpj-5534.htm plain text: safpj-5534.txt item: #650 of 732 id: safpj-5538 author: None title: safpj-5538 date: None words: 5371 flesch: 48 summary: It is estimated that 7.5 billion syringes and needles are used by diabetic patients, migraines, infertility, arthritis, human immunodeficiency virus (HIV) and other diseases at home every year.3 Sharps waste such as needles, disposable scalpels and blades represent 1% of the total waste and are a major source of disease transmission if not properly managed.1 Sharps waste disposed of in an improper manner in the community raises concerns, as this waste can put people’s health at risk in terms of injury and contracting blood-borne infectious diseases such as HIV and acquired immune deficiency syndrome (AIDS) and viral hepatitis.4 Diabetes affects many people in the world, and 4 million South Africans are estimated to have diabetes and require the use of insulin to manage their condition at home.3 Making Medical Injection Safer (MMIS), a Department of Health project, revealed that syringes and needles frequently end up in municipal landfill sites, where municipal workers and the public are exposed to the risk of getting injured and infected.5 In the study conducted in South Africa, it was mentioned that studies on proper sharps waste disposal have been conducted globally, but the greatest focus has been on sharps waste disposal in a clinical setting rather than in a home setting.3 Disposal of sharps waste from healthcare facilities is extensively regulated, but it is not the same in communities, and yet it poses a public health concern.2 Sharps waste disposal among diabetic patients receiving care in home care settings has been found to be unsatisfactory in many countries.6 Research conducted in India indicated that less than 10% of cases investigated, specific containers were used to dispose of sharps waste.6 The study recommended that healthcare workers must place more emphasis on the awareness of proper sharps waste disposal in order to equip diabetic patients with relevant information regarding sharps waste disposal. keywords: disposal; health; home; knowledge; majority; patients; respondents; sharps; south; study; waste; waste disposal cache: safpj-5538.htm plain text: safpj-5538.txt item: #651 of 732 id: safpj-5540 author: None title: safpj-5540 date: None words: 6293 flesch: 46 summary: This scoping review sought to identify current norms and practices for using seizure diaries to manage epilepsy. The themes identified were types of seizure diaries used in clinical practice, contents and structure of a standardised seizure diary, the use and efficacy of seizure diaries in medicine and challenges relating to using a seizure diary for patient management. keywords: articles; data; diaries; diary; epilepsy; health; information; management; paper; patients; research; review; seizure; seizure diaries; studies; study; use cache: safpj-5540.htm plain text: safpj-5540.txt item: #652 of 732 id: safpj-5544 author: None title: safpj-5544 date: None words: 4273 flesch: 50 summary: Oxygen therapy is prescribed to people who cannot maintain normal blood oxygen saturation while breathing atmospheric air. A quarter of the patients possibly received oxygen therapy unnecessarily. keywords: covid-19; data; faculty; family; flow; medicine; oxygen; patients; prescription; school; study; therapy cache: safpj-5544.htm plain text: safpj-5544.txt item: #653 of 732 id: safpj-5546 author: None title: safpj-5546 date: None words: 873 flesch: 53 summary: At the time of writing this editorial, the new national position paper on the contribution of family physicians to the South African health system was just published.1 The numbers needed to achieve this and to increase the required number of posts for both registrars and family physicians have been analysed. keywords: family; physicians; south cache: safpj-5546.htm plain text: safpj-5546.txt item: #654 of 732 id: safpj-5548 author: None title: safpj-5548 date: None words: 5236 flesch: 55 summary: Therefore, the themes from their responses could be used to generate a quantitative data collection tool that could then be used to collect data from a larger population of primary care nurses, perhaps even beyond the Gauteng province. The MCQs are based on the 10 clinical domains of family medicine, the SAQs are aligned with the five national unit standards and the critical reading section will include evidence-based medicine and primary care research methods. keywords: care; data; eczema; examination; family; findings; health; marks; medicine; question; research; study cache: safpj-5548.htm plain text: safpj-5548.txt item: #655 of 732 id: safpj-5549 author: None title: safpj-5549 date: None words: 1146 flesch: 42 summary: Social media has been useful in surveying public attitudes, identifying infodemics, assessing mental health, detecting or predicting COVID-19 cases, analysing government responses to the pandemic and evaluating quality of health information through prevention educational videos for prevention of COVID-19.4 Health professionals relied on this form of health knowledge because physically meeting and listening to experts was not possible, and unlike the printed media, social media communicated rapidly,5 which was needed in this time of crisis. Social media for communication was effective and allowed for the rapid dissemination of health information during this disaster. keywords: covid-19; information; media; social cache: safpj-5549.htm plain text: safpj-5549.txt item: #656 of 732 id: safpj-5551 author: None title: safpj-5551 date: None words: 4614 flesch: 45 summary: In this study, patients with severe and moderate HA and HB presented earlier with spontaneous bleeds compared with PWH with mild disease, which is similar to what is reported in literature.13 It was observed that moderate HA patients had more spontaneous bleeds and joint complications when compared with severe HA, but these data need to be interpreted with caution, as the clinical information in 41% of patients was incomplete, that is, 7 severe HA, 8 moderate HA and 3 mild HA. Prophylaxis is defined as the regular administration of a haemostatic agents in PWH to improve haemostasis and effectively prevent bleeding.11 Primary prophylaxis is the regular, continuous prophylaxis in the absence of joint disease, documented clinically and/or by imaging and before the second clinically evident joint bleed and before three years of age.11,13 The SA treatment guidelines recommend primary prophylaxis for infants with severe haemophilia, as they have an increased risk of developing haemophilic arthropathy.14 Secondary prophylaxis is the regular continuous prophylaxis commenced after two or more joint bleeds but before there is detectable clinical and/or radiological joint disease.11 In SA, secondary prophylaxis is to be considered for managing chronic synovitis and may be given intermittently prior to activities that may result in bleeding. keywords: bleeding; bleeds; dgmah; diagnosis; haemophilia; inhibitor; joint; moderate; patients; prophylaxis; pwh; severe; study cache: safpj-5551.htm plain text: safpj-5551.txt item: #657 of 732 id: safpj-5554 author: None title: safpj-5554 date: None words: 5469 flesch: 48 summary: Abstract Introduction Methods Results Discussion Conclusion Acknowledgements References Appendix 1: Interview guide About the Author(s) Sherika Hanley Umlazi Clinical Research Site, Centre of the AIDS Research Programme in South Africa, Durban, South Africa Department of Family Medicine, Faculty of Health Sciences, University of KwaZulu-Natal, Durban, South Africa Galaletsang J. Ndlazi Department of Physiotherapy, School of Health Sciences, University of KwaZulu-Natal, Durban, South Africa Stacy T. Maddocks Department of Physiotherapy, School of Health Sciences, University of KwaZulu-Natal, Durban, South Africa Department of Physical Therapy, University of British Columbia, Vancouver, Canada Verusia Chetty Department of Physiotherapy, School of Health Sciences, University of KwaZulu-Natal, Durban, South Africa Citation Hanley S, Ndlazi GJ, Maddocks ST, Chetty V. Perceptions of women enrolled in a cardiovascular disease screening and prevention in HIV study. 2018;30(supppl_2):5–10. https://doi.org/10.1080/09540121.2018.1470308 Patel R, Ratner J, Gore-Felton C, Kadzirange G, Woelk G, Katzenstein D. HIV disclosure patterns, predictors, and psychosocial correlates among HIV positive women in Zimbabwe. keywords: africa; aids; body; care; disease; health; hiv; ischemia; lifestyle; modification; participants; pen; prevention; risk; south; study; women cache: safpj-5554.htm plain text: safpj-5554.txt item: #658 of 732 id: safpj-5557 author: None title: safpj-5557 date: None words: 7619 flesch: 54 summary: The lack of information and knowledge of mental health services offered has been noted in other studies, which may delay help-seeking behaviour in men.19 When asked about the acceptability of depression treatment, participants were open to ‘talk therapy’ but either had no knowledge of antidepressant medication or believed the pharmacological treatment would not be effective. Study participants signed a consent form to participate in the study and were scheduled in advance at a designated time at the medical centre, and the interviews ranged from approximately 10 to 25 min, with the majority lasting for approximately 15 min. Member checking was offered to all participants by giving them the transcripts to make corrections. keywords: africa; depression; health; help; july; lack; men; participant; people; perceptions; problems; seeking; south; study; treatment; years cache: safpj-5557.htm plain text: safpj-5557.txt item: #659 of 732 id: safpj-5559 author: None title: safpj-5559 date: None words: 6633 flesch: 59 summary: The Vhembe district is one of the rural districts in Limpopo Province, South Africa, in which traditional healers are used as the first point of consultation for most ailments, regardless of their causes. Observation and interviews with 15 purposively selected key informants, who are traditional healers, were used to collect data. keywords: aids; clients; data; healers; healing; health; hiv; management; people; study; treatment; years cache: safpj-5559.htm plain text: safpj-5559.txt item: #660 of 732 id: safpj-5560 author: None title: safpj-5560 date: None words: 4938 flesch: 57 summary: The tobacco does not get hot enough to burn, but the heat releases nicotine that can be inhaled into the lungs.1 The World Health Organization (WHO) reports that more men are involved in tobacco use than women. Intention to switch to smokeless tobacco use among South African smokers: Results from the 2007 South African social attitudes survey. keywords: data; health; pretoria; products; risks; smokeless; south; study; tobacco; use; users cache: safpj-5560.htm plain text: safpj-5560.txt item: #661 of 732 id: safpj-5571 author: None title: safpj-5571 date: None words: 3115 flesch: 55 summary: Keywords: breast lump; palpable; primary care; diagnostic guide; age-based approach. It is essential to have an approach to investigating breast lumps that is simple to follow, limiting over investigation and preventing the misdiagnosis of malignant breast lesions. keywords: age; assessment; biopsy; breast; cancer; cape town; lump; patient; risk; ultrasound cache: safpj-5571.htm plain text: safpj-5571.txt item: #662 of 732 id: safpj-5581 author: None title: safpj-5581 date: None words: 4676 flesch: 56 summary: Keywords: village health workers; tuberculosis; TB screening; TB knowledge; VHWs’ services. Discussion The results showed that TB knowledge variables were significantly associated with the use of the services for TB screening, supporting the importance of comprehensive TB knowledge. keywords: community; health; knowledge; lesotho; respondents; screening; services; study; tb screening; vhws cache: safpj-5581.htm plain text: safpj-5581.txt item: #663 of 732 id: safpj-5587 author: None title: safpj-5587 date: None words: 3540 flesch: 48 summary: Men were also against the secretive use of FP methods by their partners, and they felt that they should be included in decision-making regarding FP. These findings suggest a lack of adequate information about FP methods and their risks among men. keywords: africa; family; health; male; men; partners; south; use; women cache: safpj-5587.htm plain text: safpj-5587.txt item: #664 of 732 id: safpj-5590 author: None title: safpj-5590 date: None words: 3604 flesch: 54 summary: While DKA is typically seen in individuals with type 1 DM, studies report that DKA is more common among COVID-19 patients with type 2 DM.9,10,11,12,13 It is unclear whether COVID-19 unmasks DM or triggers stress hyperglycaemia, a transient state of hyperglycaemia that occurs during serious medical illnesses.17 Given the increased incidence and mortality of DKA in COVID-19 patients, it is imperative to investigate the risk factors associated with admission for DKA in order to facilitate early diagnosis and improve clinical outcomes. keywords: africa; covid-19; diabetes; dka; hospital; ketoacidosis; patients; south; study; type cache: safpj-5590.htm plain text: safpj-5590.txt item: #665 of 732 id: safpj-5593 author: None title: safpj-5593 date: None words: 5947 flesch: 54 summary: This means that there was a strong association between shivering and a patient’s employment status, where employed patients experienced shivering more than unemployed patients. Previous studies have already determined the categories of care that patients consider important to consider. keywords: anaesthetic; authors; candidate; examination; family; intern; marks; medicine; patient; question; risk; satisfaction; south; study cache: safpj-5593.htm plain text: safpj-5593.txt item: #666 of 732 id: safpj-5594 author: None title: safpj-5594 date: None words: 1189 flesch: 46 summary: While far from an exhaustive justification for rural FP training and work, the hope is that this short piece might further invigorate the national FP narrative, and maybe even inspire a few rural adventures. Living in this setting is an inescapable and humbling reminder of the difficulties that rural communities face, while sharing work and life with a close-knit community of colleagues and friends here at the hospital has been a formative process in our lives. keywords: family; hospital; rural; training cache: safpj-5594.htm plain text: safpj-5594.txt item: #667 of 732 id: safpj-5595 author: None title: safpj-5595 date: None words: 1855 flesch: 43 summary: Alcohol-based hand sanitisers with moisturisers have the least sensitising and irritancy potential when compared to soaps and synthetic detergents.4,5 As an additional measure to social distancing and all the recommended measures by authorities, most healthcare workers and the general public became engaged in repetitive and aggressive hand sanitising and hand washing practice. The flip side of frequent sanitising and hand washing. keywords: covid-19; dermatitis; hand; hygiene; skin; use; washing cache: safpj-5595.htm plain text: safpj-5595.txt item: #668 of 732 id: safpj-5596 author: None title: safpj-5596 date: None words: 1333 flesch: 42 summary: The digitisation of healthcare records represents a significant step in developing machine learning techniques, a subset of AI systems in which computer software applications are trained to recognise and learn from patterns in existing datasets.7 However, there exist challenges with data quality as well as language and translation barriers, in which cultural metaphors captured in health records as well as user-generated content will have to be ‘deciphered’.8 Primary health care represents the foundation of the health services delivery platform in South Africa and hence should be the focus for next-generation epidemic preparedness.1 Dr Tedros Adhanom Ghebreyesus, the WHO director-general, urged countries to achieve fundamental readiness to use AI technologies in a responsible and sustainable The discipline of family medicine as well as the broader health and higher education systems will require partnerships with AI scholars and big data scientists, centred around key activities such as research collaborations and codesigning curricula for 21st-century primary care professionals.10 As family physicians and primary care providers, we appreciate the need to embrace complexity11 and rethink our approach to the polarity represented by the potential harms vs. benefits of embracing AI. keywords: africa; artificial; health; intelligence; south cache: safpj-5596.htm plain text: safpj-5596.txt item: #669 of 732 id: safpj-5598 author: None title: safpj-5598 date: None words: 7194 flesch: 44 summary: Human resources for health South Africa: HRH strategy for the health sector 2012/13-2016/17 References Department of Health South Africa. keywords: africa; associates; clinas; clinical; health; healthcare; hospitals; medical; participants; practice; professional; sector; south; south africa; stakeholders; study cache: safpj-5598.htm plain text: safpj-5598.txt item: #670 of 732 id: safpj-5602 author: None title: safpj-5602 date: None words: 2603 flesch: 49 summary: Incorporating changes into the culture involves reinforcing the value of successful transition via recruitment, promotion, and new change leaders. Applying a theory of change approach to the evaluation of comprehensive community initiatives: Progress, prospects, and problems. keywords: change; evaluation; management; new; outcomes; project; questions; term cache: safpj-5602.htm plain text: safpj-5602.txt item: #671 of 732 id: safpj-5608 author: None title: safpj-5608 date: None words: 5528 flesch: 52 summary: About a third of stroke patients die within 28 days with recent estimates putting the death toll from stroke at about 25 000 deaths per year.10,11,12 Metabolic risk factors play a major role in the development of atherosclerotic disease, which contribute to developing both ischaemic and haemorrhagic strokes.3,6,7 Stroke prevention should be a key priority in the district health plan and strengthening the primary healthcare system is essential to improve outcomes for stroke patients. keywords: africa; data; department; emergency; health; hospital; management; outcomes; patients; risk; south; stroke; study; symptoms; time cache: safpj-5608.htm plain text: safpj-5608.txt item: #672 of 732 id: safpj-5613 author: None title: safpj-5613 date: None words: 3484 flesch: 43 summary: The increasing number of monkeypox cases outside the endemic region has highlighted the need for effective global capacity building to prevent the spread of the disease and its impact on global health security. FIGURE 2: Probable case of monkeypox case definition. keywords: case; disease; health; homepage; internet; jul; monkeypox; outbreak; smallpox; virus cache: safpj-5613.htm plain text: safpj-5613.txt item: #673 of 732 id: safpj-5614 author: None title: safpj-5614 date: None words: 5929 flesch: 34 summary: TABLE 1: Synopsis of studies included in the narrative review on preoperative patient education. Impact of preoperative patient education on the prevention of postoperative complications after major visceral surgery: The cluster randomized controlled PEDUCAT trial. keywords: cancer; colorectal; education; focus; group; ideas; information; participants; patients; physiotherapy; preoperative; review; session; study; surgery cache: safpj-5614.htm plain text: safpj-5614.txt item: #674 of 732 id: safpj-5616 author: None title: safpj-5616 date: None words: 3493 flesch: 51 summary: Adequate fluid resuscitation in primary care settings can improve the outcome of hospitalised COVID-19 patients. There was a negative correlation between diabetes control and AKI among hospitalised COVID-19 patients. keywords: acute; aki; blood; covid-19; incidence; injury; kidney; patients; south; study cache: safpj-5616.htm plain text: safpj-5616.txt item: #675 of 732 id: safpj-5621 author: None title: safpj-5621 date: None words: 6657 flesch: 50 summary: Prostate cancer health education programmes were targeted primarily at rural community members. Prostate cancer health education methods were diverse, comprehensive, user friendly and culturally sensitive. keywords: african; articles; awareness; cancer; community; education; health; healthcare; knowledge; men; pca; practice; prostate; prostate cancer; psa; review; screening; south; strategies; studies; study cache: safpj-5621.htm plain text: safpj-5621.txt item: #676 of 732 id: safpj-5623 author: None title: safpj-5623 date: None words: 9002 flesch: 58 summary: Several risks have been identified that increase likelihood of developing Type DM among people living with HIV. This implication is reiterated by the WHO,5 which reports an increasing number of Type DM in developing countries such as those in sub-Saharan Africa. keywords: age; art; development; diabetes; duration; factors; hiv; hiv infection; people; risk; studies; study; type; years cache: safpj-5623.htm plain text: safpj-5623.txt item: #677 of 732 id: safpj-5628 author: None title: safpj-5628 date: None words: 6109 flesch: 51 summary: (Participant D, 50–60 years old, male) ‘It’s critical to have family medicine specialist as managers of hospitals, because most times if you have other specialities as managers, their vision gets tunnelled to the needs of that discipline, whereas family physicians find it easy to form a multidisciplinary team and also work as part of the interdisciplinary team.’ Most GPs call themselves ‘family doctors’, with patients tending to regard them as FM specialists. keywords: care; family; fps; health; healthcare; medicine; participant; registrars; role; south; specialists; training; years cache: safpj-5628.htm plain text: safpj-5628.txt item: #678 of 732 id: safpj-5629 author: None title: safpj-5629 date: None words: 6429 flesch: 49 summary: These three criteria are: precipitated by exertion or emotion sited in the anterior chest, neck, shoulders, jaw and left arm prompt relief by rest, relaxation or glyceryl trinitrate spray or trinitrotoluene.3,4,5,6,7 Patients with cardiovascular disease risk factors or typical angina have a high possibility of developing major adverse cardiovascular events (MACE). In the cohort, there were 401 (76.0%) Indian patients and 167 (31.8%) diabetic patients at baseline on referral to IALCH. keywords: angina; cad; category; diabetes; disease; factors; follow; indian; mace; mace morbidity; mace mortality; model; morbidity; mortality; patients; risk; study cache: safpj-5629.htm plain text: safpj-5629.txt item: #679 of 732 id: safpj-5633 author: None title: safpj-5633 date: None words: 5477 flesch: 50 summary: Discussion In this study, the compliance of doctors with diabetic treatment guidelines in the management of diabetic patients in a district hospital is explored. Glycaemic control as measured by HbA1c is the single most important factor in assessing the control in diabetic patients because it has a strong predictive value for diabetic complications and is thus the best indicator of the effectiveness of diabetes care.26 Most of the research on diabetes has shown that diabetic complications are directly related to glycaemic levels and the prevalence of diabetic complications sharply and significantly increase as the glycaemic levels rise.27 keywords: africa; care; compliance; complications; control; diabetes; files; glycaemic; guidelines; health; healthcare; patients; south; study; treatment cache: safpj-5633.htm plain text: safpj-5633.txt item: #680 of 732 id: safpj-5634 author: None title: safpj-5634 date: None words: 9063 flesch: 57 summary: The dietician can now train additional healthcare providers to facilitate diabetes group education sessions.’ A pragmatic clustered randomised control trial demonstrated that group diabetes education delivered by health promoters (mid-level workers) in a guiding style (derived from motivational interviewing) is a cost-effective intervention in the setting.6 Training and resource materials for group diabetes education were developed in this project, and similar materials for asthma and chronic obstructive pulmonary disease (COPD) were developed in the Asthma Guideline Implementation Project.7 keywords: bbcc; cape; care; cig; counselling; diabetes; education; facility; group; health; patients; pec; sessions; staff; training; urban cache: safpj-5634.htm plain text: safpj-5634.txt item: #681 of 732 id: safpj-5635 author: None title: safpj-5635 date: None words: 6021 flesch: 60 summary: The future of virtual patient education and counselling On the one hand, facilitators were surprised that the virtual sessions worked, but on the other hand, remained skeptical about taking this to scale in the public sector. Abstract Introduction Methods Findings Discussion Conclusion Acknowledgements References About the Author(s) Robert J. Mash Division of Family Medicine and Primary Care, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa Joleen Cairncross Division of Family Medicine and Primary Care, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa Citation Mash RJ, Cairncross J. Piloting of virtual group education for diabetes in Cape Town: An exploratory qualitative study S Afr Fam Pract. keywords: care; diabetes; education; facilitators; fgi; great; group; health; patients; people; sessions; south; tablets cache: safpj-5635.htm plain text: safpj-5635.txt item: #682 of 732 id: safpj-5636 author: None title: safpj-5636 date: None words: 2724 flesch: 43 summary: Mental healthcare providers working in biomedical institutions have reported that most of them in ambulatory care settings are exposed to THM.12 Thus, THP is a common practice, and mental healthcare providers must collaborate and learn more about it. Abstract Background: Mental healthcare providers have a negative attitude towards the integration of traditional health medicine (THM) into the mental health system. keywords: healthcare; medicine; nurses; providers; respondents; south; study; system cache: safpj-5636.htm plain text: safpj-5636.txt item: #683 of 732 id: safpj-5640 author: None title: safpj-5640 date: None words: 4323 flesch: 47 summary: Level of patient safety culture among public healthcare professionals in Pretoria. https://doi.org/10.4102/safp.v65i1.5640 Original Research Level of patient safety culture among public healthcare professionals in Pretoria Tombo Bongongo, Indiran Govender, Shango N. Olowa, Nyundu S.J. Phukuta, Doudou K. Nzaumvila Received: 24 Sept. 2022; Accepted: 07 Mar. 2023; Published: 19 May 2023 Copyright: © 2023. keywords: care; culture; district; health; hospital; patient; pretoria; psc; safety; south; study; tshwane cache: safpj-5640.htm plain text: safpj-5640.txt item: #684 of 732 id: safpj-5641 author: None title: safpj-5641 date: None words: 7292 flesch: 48 summary: Private specialist outreach and support improved positivity and optimism in the district: ‘There are patients in other sub-districts that benefit from private specialist outreach, which is quite remarkable.’ (Medical officer 3) Implementation of private specialist outreach and support in other rural district hospitals Private specialist outreach and support was considered to be feasible and practical for implementation in RDHs where PSOS did not exist. keywords: care; district; hospital; lps; outreach; participants; psos; public; rdh; services; specialist; sub; support cache: safpj-5641.htm plain text: safpj-5641.txt item: #685 of 732 id: safpj-5643 author: None title: safpj-5643 date: None words: 8047 flesch: 49 summary: Thematic analysis was carried out to analyse the lived experiences of PWCDs using the four steps of descriptive phenomenology, namely bracketing, intuiting, analysing, and describing.11 In the bracketing phase, the researchers strove to put aside their beliefs and opinions about the management of chronic disease patients during the COVID-19 pandemic to confront data by maintaining a reflexive journal covering possible role conflict and making notes of interest and the use of gatekeepers to ensure neutrality. The psychological impact of the COVID-19 pandemic on chronic disease patients in Dessie town government and private hospitals, Northeast Ethiopia. keywords: africa; chronic; covid-19; data; diseases; experiences; facilities; female; health; healthcare; management; pandemic; participants; patients; pwcds; services; south; study cache: safpj-5643.htm plain text: safpj-5643.txt item: #686 of 732 id: safpj-5644 author: None title: safpj-5644 date: None words: 4477 flesch: 49 summary: This concurs with the findings of previous studies, which show that the majority of MM patients initially consulted a GP outside the haematology unit.23,32,33,34 Therefore, appropriate awareness and knowledge of MM among GPs are essential for early diagnosis and referral of MM cases. In South Africa (SA), the National Cancer Registry indicates that of the 14 616 haematological malignancies reported between 2000 and 2006, MM is diagnosed in about 1543 (10.6%) of the cases.11 In the Eastern Cape province of SA, 3603 incident cases of haematological malignancies were identified between 2004 and 2013 and MM accounted for 465 (13%) of the cases.12 At Steve Biko Academic Hospital, a retrospective study was conducted between May 2005 and September 2008; MM was reported in 6.7% (n = 39) of 582 patients in which protein electrophoresis was performed.13 An earlier study conducted among 145 patients diagnosed with haematological malignancies at Dr George Mukhari Academic Hospital (DGMAH) between January 1998 and December 1998 found that MM accounted for 26% of the cases and most of these patients were referred and diagnosed late (unpublished findings).14 Various efforts have been made to develop standard management protocols for MM;15,16,17 however, the diagnosis and management of MM patients remain a challenge.18 Several factors may have contributed to the challenges, including the late presentation of patients to a healthcare facility,13,19,20 the inadequacy of diagnostic facilities20 and MM patients experiencing multiple consultations in the primary care before being referred to the tertiary facility.20,21,22 Visser et al. keywords: awareness; diagnosis; hospitals; knowledge; level; medical; multiple; myeloma; patients; practitioners; study; table; years cache: safpj-5644.htm plain text: safpj-5644.txt item: #687 of 732 id: safpj-5646 author: None title: safpj-5646 date: None words: 6310 flesch: 51 summary: A medical officer (MO) working in the paediatric clinic alongside primary health care (PHC) nurses commented that she has recently seen a few children with hearing loss as a complication of otitis media (OM). Given that otomicroscopy was used for the first time in this setting, the study could conceivably be amended to address the additional objective of assessing the otologist’s experiences of otomicroscopy in primary health care. keywords: care; data; examination; family; health; marks; media; medicine; otitis; patient; prevalence; primary; question; south; study cache: safpj-5646.htm plain text: safpj-5646.txt item: #688 of 732 id: safpj-5650 author: Office, Editorial title: Acknowledgement to Reviewers date: 2022-12-20 words: 692 flesch: 41 summary: Abdul A. Isaacs Adam K. Asghar Alastair Moodley Amanda Howe Amanze Ikwu Andrea Mendelsohn Andrew Ross Annie A. Temane Anthonio O. Adefuye Antoinette Miric Arun Nair Atiya Mosam Belinda McIntosh Beverley R. Schweitzer Carien Lion-Cachet Celeste Barlow Chantelle C. van der Bijl Chauntelle Bagwandeen Christina Eleftheriades Claire van Deventer Clint Hendrikse Cllive Rangiah Daleen Kriel Dave Glass Dawn V. Ernstzen Don O’Mahony Doudou K. Nzaumvila Duncan Mcguire Edina Amponsah-Dacosta Edith N. Madela-Mntla Egbert E. Wenegieme Elizabeth Reji Elma de Vries Febisola I. Ajudua Francois Coetzee Frederick Mayanja Gerhard B. Theron Gert J.O. Marincowitz Gina Joubert Hamid Saeed Hanneke Brits Hans J. Hendriks Henry I. Okonta Huibrecht C. Lion-Cachet Ian Koller Idah Moyo Innocent K. Besigye Itumeleng Ntatamala John M. Tumbo Jagidesa Moodley James D. Porter Jonathan Witt Kantharuben Naidoo Kebogile E. Mokwena Kenneth Yakubu Kirsty Hedding Langalibalele H. Mabuza Lara Greenstein Lehlohonolo J. Mathibe Leone G. Williams Liesl Visser Liezel Rossouw Lushiku Nkombua Magdelena S. Petkova Mareike Rabe Maria G.C. Giaquinto-Cillier Mariet Eksteen Marietjie van Rooyen Marthinus J. Heystek Mary Kemp Matthew O. Benedict Mergan Naidoo Michele Torlutter Michelle Janse van Rensburg Mohammed I. Datay Morne Visser Mosedi K. Namane Muhammed Vally Nabeela Amien Nalini Govender Narges Malih Nazlie Beckett Neal David Neetha J. Erumeda Nnabuike C. Ngene Ntsiki Mapukata Oladele V. Adeniyi Oliver van Hecke Olufemi B. Omole Oluwafolajimi Fadahun Onida Venter Ozoemena J. Ibeziako Parimalaranie Yogeswaran Paulina M. van Zyl Peter Hodkinson Philippa Scotcher Pius O. Ameh Preesha Premsagar Ramprakash Kaswa Regina M. Thetsane René Krause Acknowledgement to reviewers In an effort to facilitate the selection of appropriate peer reviewers for the South African Family Practice journal, we ask that you take a moment to update your electronic portfolio on https:// safpj.co.za for our files, allowing us better access to your areas of interest and expertise, in order to match reviewers with submitted manuscripts. keywords: https://safpj.co.za; journal; moodley; practice; reviewer; van cache: safpj-5650.pdf plain text: safpj-5650.txt item: #689 of 732 id: safpj-5655 author: None title: safpj-5655 date: None words: 3758 flesch: 44 summary: Keywords: medical interpreter; modes of interpretation; types of medical interpreters; cultural liaison; communication barriers; primary care. What are the types of medical interpreters? keywords: africa; communication; health; healthcare; interpretation; interpreters; language; medical; oct; patient; south; use cache: safpj-5655.htm plain text: safpj-5655.txt item: #690 of 732 id: safpj-5656 author: None title: safpj-5656 date: None words: 5004 flesch: 56 summary: This study identified key factors influencing insulin initiation in patients with T2DM in primary care. Group empowerment and training (GREAT) for diabetes has already been implemented in this setting and additional bespoke sessions on insulin initiation could be added.27 Another innovation during COVID-19 was telehealth support for people with poorly controlled T2DM and affected with COVID-19.28 A similar service could support patients during the initiation of insulin. keywords: cape; care; counselling; data; diabetes; health; initiation; insulin; patients; primary; south; support; type cache: safpj-5656.htm plain text: safpj-5656.txt item: #691 of 732 id: safpj-5658 author: None title: safpj-5658 date: None words: 1564 flesch: 47 summary: Primary health care is being re-engineered by the implementation of the National Health Insurance (NHI), but unfortunately, there is minimal focus on addressing climate changes and health. The recent heat waves in Europe, floods in KwaZulu-Natal and Pakistan, and Hurricane Ian in Florida (United States) are examples of things to come.1,3,4,5 Many aspects of adapting to climate change and reducing its impact can only be addressed by policymakers.7,8,9 Policymakers thus need to understand the impact of climate change on housing, food prices, exposure to severe weather events, vector- and water-borne diseases. keywords: care; change; climate; community; crisis; health cache: safpj-5658.htm plain text: safpj-5658.txt item: #692 of 732 id: safpj-5660 author: None title: safpj-5660 date: None words: 6149 flesch: 51 summary: TABLE 5: Bivariate association between substance use and antiretroviral treatment adherence. The effect of substance uses on antiretroviral treatment adherence in primary health care. keywords: adherence; africa; art; care; health; hiv; non; participants; plwh; south; study; substance; treatment; use; users cache: safpj-5660.htm plain text: safpj-5660.txt item: #693 of 732 id: safpj-5664 author: Amashnee, Saimen; Guinevere, Gordon; Indiran, Govender title: Non-fatal injuries of interpersonal violence at the Leratong Provincial Hospital, South Africa date: 2016-05-01 words: 1733 flesch: 28 summary: The Author(s) RESEARCH Non-fatal injuries of interpersonal violence at the Leratong Provincial Hospital, South Africa Saimen Amashneea, Gordon Guinevereb and Govender Indiranc* aDepartment of Forensic Medicine, Aurum Institute, Johannesburg, South Africa b Forensic Medicine, University of the Witwatersrand, Johannesburg, South Africa c Family Medicine, Sefako Makgatho Health Sciences University, Pretoria, South Africa *Corresponding author, email: indiran.govender@gmail.com Background: Interpersonal violence is a global health issue. Leratong Hospital manages many patients with injuries due to interpersonal violence throughout the year, with an increase in May, November and December. keywords: health; injuries; patient; satisfaction; violence cache: safpj-5664.pdf plain text: safpj-5664.txt item: #694 of 732 id: safpj-5666 author: van der Merwe, J. W.; Rugunanan, M.; Ras, J.; Röscher, E-M; Henderson, B. D.; Joubert, G. title: Patient preferences regarding the dress code, conduct and resources used by doctors during consultations in the public healthcare sector in Bloemfontein, Free State date: 2016-05-01 words: 1880 flesch: 42 summary: The Author(s) RESEARCH South African Family Practice 2016; 58(3):100–107 http://dx.doi.org/10.1080/20786190.2016.1167310 Open Access article distributed under the terms of the Creative Commons License [CC BY-NC-ND 4.0] http://creativecommons.org/licenses/by-nc-nd/4.0 HIV-related knowledge and practices: a cross-sectional study among adults aged 50 years and above in Botswana Njoku Ola Amaa*, Sheila Shaibub and Jacqueline Denise Burnettec aDepartment of Statistics, University of Botswana, Gaborone, Botswana b School of Nursing, University of Botswana, Gaborone, Botswana cSchool of Social Work, University of Columbia, New York, NY, USA *Corresponding author, emails: amano@mopipi.ub.bw, njoku52@gmail.com Background: Older adults in Botswana have been shown to be sexually active and engage in risky sexual activities that make them vulnerable to HIV infection. Conclusion: The study concludes that age-appropriate and culturally relevant education and training of older adults are necessary for the prevention and control of HIV infection. keywords: adults; age; hiv; knowledge; study cache: safpj-5666.pdf plain text: safpj-5666.txt item: #695 of 732 id: safpj-5668 author: Hoffmann, Willem A.; Nortjé, Nico title: Patterns of unprofessional conduct by medical practitioners in South Africa (2007–2013) date: 2016-05-01 words: 1770 flesch: 34 summary: Personal and professional integrity motivates health practitioners to maintain and develop high levels of ethical professional conduct as well as to stay abreast of the latest clinical skills and advances through continuous professional development activities.4 There is an increasing demand by the public to hold health-care providers liable for unprofessional conduct and as such they may lodge a complaint with the Health Professions Council of South Africa (HPCSA). The conversion to the CPD system was to develop the health practitioner as a complete professional, allowing for training in the medical field, ethics, personal health, practice management and medical law.5 Constant reflection and critical self-evaluation moves the onus from the manager to the individual for personal development in all aspects of his/her life.6 In South Africa, health practitioners are required to collect 30 Continuing Education Units (CEU) per year, which include five compulsory ethical discussion points. keywords: africa; health; medical; practitioners; south cache: safpj-5668.pdf plain text: safpj-5668.txt item: #696 of 732 id: safpj-5669 author: Botes, J.; Bezuidenhout, J.; Steinberg, W. J.; Joubert, G. title: The needs and preferences of general practitioners regarding their CPD learning: a Free State perspective date: 2016-05-01 words: 1770 flesch: 34 summary: Personal and professional integrity motivates health practitioners to maintain and develop high levels of ethical professional conduct as well as to stay abreast of the latest clinical skills and advances through continuous professional development activities.4 There is an increasing demand by the public to hold health-care providers liable for unprofessional conduct and as such they may lodge a complaint with the Health Professions Council of South Africa (HPCSA). The conversion to the CPD system was to develop the health practitioner as a complete professional, allowing for training in the medical field, ethics, personal health, practice management and medical law.5 Constant reflection and critical self-evaluation moves the onus from the manager to the individual for personal development in all aspects of his/her life.6 In South Africa, health practitioners are required to collect 30 Continuing Education Units (CEU) per year, which include five compulsory ethical discussion points. keywords: africa; health; medical; practitioners; south cache: safpj-5669.pdf plain text: safpj-5669.txt item: #697 of 732 id: safpj-5670 author: Dube, Faith; Uys, Leana N. title: Integrating mental health care services in primary health care clinics: a survey of primary health care nurses’ knowledge, attitudes and beliefs date: 2016-05-01 words: 1741 flesch: 32 summary: 58(3):119–125 http://dx.doi.org/10.1080/20786190.2016.1191747 Open Access article distributed under the terms of the Creative Commons License [CC BY-NC-ND 4.0] http://creativecommons.org/licenses/by-nc-nd/4.0 Integrating mental health care services in primary health care clinics: a survey of primary health care nurses’ knowledge, attitudes and beliefs Faith Dubea* and Leana Nana Uysa a School of Nursing and Public Health, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa *Corresponding author, emails: nana.dube@kznhealth.gov.za, dube_nana@yahoo.com Background: Nurses are the main providers of care at primary health care (PHC) clinics; the high incidence of mental health problems at these clinics means that PHC nurses are important providers of mental health care. Personal beliefs are shaped by knowledge about mental health and this sets the measure for provision of mental health services by the healthcare worker.14 keywords: care; health; nurses; patients; phc cache: safpj-5670.pdf plain text: safpj-5670.txt item: #698 of 732 id: safpj-5671 author: Reddy, V. V.; Mahomed, O. H. title: Patient experiences with designated service provider medication delivery in a rural general practice in KwaZulu-Natal: a cross-sectional study on HIV patients date: 2016-05-01 words: 1741 flesch: 32 summary: 58(3):119–125 http://dx.doi.org/10.1080/20786190.2016.1191747 Open Access article distributed under the terms of the Creative Commons License [CC BY-NC-ND 4.0] http://creativecommons.org/licenses/by-nc-nd/4.0 Integrating mental health care services in primary health care clinics: a survey of primary health care nurses’ knowledge, attitudes and beliefs Faith Dubea* and Leana Nana Uysa a School of Nursing and Public Health, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa *Corresponding author, emails: nana.dube@kznhealth.gov.za, dube_nana@yahoo.com Background: Nurses are the main providers of care at primary health care (PHC) clinics; the high incidence of mental health problems at these clinics means that PHC nurses are important providers of mental health care. Personal beliefs are shaped by knowledge about mental health and this sets the measure for provision of mental health services by the healthcare worker.14 keywords: care; health; nurses; patients; phc cache: safpj-5671.pdf plain text: safpj-5671.txt item: #699 of 732 id: safpj-5673 author: Onwukwe, Sergius; van Deventer, Claire; Omole, Olu title: Evaluation of the use of oral rehydration therapy in the management of diarrhoea among children under 5: knowledge attitudes and practices of mothers/caregivers date: 2016-03-01 words: 1894 flesch: 37 summary: Function is defined as the manner in which the human hand is able to perform (assume, use, maintain and release) the necessary grips and grasps in a range of activities for task completion against a sensory background.1 Types of firework injuries to the hand The injuries that occur in a firework-injured hand include soft tissue injuries, fractures, burns and traumatic amputations in addition to disruption of the neurovascular supply.2,3 Ground- spinners, sparklers and flares have wicks that are lit, and are the primary culprits of burns and soft tissue injuries. Methods: A retrospective file audit was conducted on patients who had sustained firework injuries between 2009 and 2014 (n = 65) in two hospitals in KwaZulu-Natal (KZN), South Africa. keywords: diarrhoea; firework; hand; injuries; ort cache: safpj-5673.pdf plain text: safpj-5673.txt item: #700 of 732 id: safpj-5674 author: Pilling, T.; Govender, P. title: Profile and management of the firework-injured hand date: 2016-03-01 words: 1894 flesch: 37 summary: Function is defined as the manner in which the human hand is able to perform (assume, use, maintain and release) the necessary grips and grasps in a range of activities for task completion against a sensory background.1 Types of firework injuries to the hand The injuries that occur in a firework-injured hand include soft tissue injuries, fractures, burns and traumatic amputations in addition to disruption of the neurovascular supply.2,3 Ground- spinners, sparklers and flares have wicks that are lit, and are the primary culprits of burns and soft tissue injuries. Methods: A retrospective file audit was conducted on patients who had sustained firework injuries between 2009 and 2014 (n = 65) in two hospitals in KwaZulu-Natal (KZN), South Africa. keywords: diarrhoea; firework; hand; injuries; ort cache: safpj-5674.pdf plain text: safpj-5674.txt item: #701 of 732 id: safpj-5677 author: Minnaar, E.; Grant, C. C.; Fletcher, L. title: Physical activity of children from a small rural town, South Africa date: 2016-03-01 words: 1838 flesch: 40 summary: The collaboration with the Cuban government to train local SA students in Cuban medical facilities was undertaken with the ultimate aim to return to local, rural medical practice.3 The first group of 92 students began their Cuban medical training in 1996.4 The South African–Cuban Medical Collaboration (SACMC) programme entails the recruitment of black, disadvantaged high school graduates from rural provinces in SA for medical training in Cuba. The Author(s) RESEARCH South African Family Practice 2016; 1(1):1–6 http://dx.doi.org/10.1080/20786190.2015.1120935 Open Access article distributed under the terms of the Creative Commons License [CC BY-NC-ND 4.0] http://creativecommons.org/licenses/by-nc-nd/4.0 Physical activity of children from a small rural town, South Africa E Minnaara* , CC Grantb and L Fletcherc a Private Practice General Practitioner, Hennenman, South Africa b Section Sports Medicine, University of Pretoria, Pretoria, South Africa c Department of Statistics, University of Pretoria, Pretoria, South Africa *Corresponding author, email: izetminnaar@gmail.com Introduction: Physical activity plays an integral role in the normal physical, mental, social and cognitive development of children. keywords: activity; children; south; students; study cache: safpj-5677.pdf plain text: safpj-5677.txt item: #702 of 732 id: safpj-5678 author: Motala, M.; van Wyk, J. title: South African–Cuban Medical Collaboration: students’ perceptions of training and perceived competence in clinical skills at a South African institution date: 2016-03-01 words: 1838 flesch: 40 summary: The collaboration with the Cuban government to train local SA students in Cuban medical facilities was undertaken with the ultimate aim to return to local, rural medical practice.3 The first group of 92 students began their Cuban medical training in 1996.4 The South African–Cuban Medical Collaboration (SACMC) programme entails the recruitment of black, disadvantaged high school graduates from rural provinces in SA for medical training in Cuba. The Author(s) RESEARCH South African Family Practice 2016; 1(1):1–6 http://dx.doi.org/10.1080/20786190.2015.1120935 Open Access article distributed under the terms of the Creative Commons License [CC BY-NC-ND 4.0] http://creativecommons.org/licenses/by-nc-nd/4.0 Physical activity of children from a small rural town, South Africa E Minnaara* , CC Grantb and L Fletcherc a Private Practice General Practitioner, Hennenman, South Africa b Section Sports Medicine, University of Pretoria, Pretoria, South Africa c Department of Statistics, University of Pretoria, Pretoria, South Africa *Corresponding author, email: izetminnaar@gmail.com Introduction: Physical activity plays an integral role in the normal physical, mental, social and cognitive development of children. keywords: activity; children; south; students; study cache: safpj-5678.pdf plain text: safpj-5678.txt item: #703 of 732 id: safpj-5681 author: Mashige, Khathutshelo title: Chemical and thermal ocular burns: a review of causes, clinical features and management protocol date: 2016-01-01 words: 3169 flesch: 50 summary: Keywords: acid burns, alkali burns, chemical burns, ocular burns, ocular irrigation Introduction Chemical and thermal ocular burns are among the most frequently reported causes of eye injuries, estimated to account for approximately 8-18% of ocular trauma.1−3 These burns occur through accidents at work, home or during leisure activities;4 tend to be bilateral,5 and are seen more frequently in young males than females.6 Ocular burns in industries can be reduced through occupational health laws which educate workers and promote the use of safety eyewear. keywords: alkali; burns; chemical; corneal; eye; ocular; ophthalmol; radiation; solution; treatment cache: safpj-5681.pdf plain text: safpj-5681.txt item: #704 of 732 id: safpj-5682 author: None title: safpj-5682 date: None words: 1079 flesch: 51 summary: What will your scope of practice be (outpatient, hospital based, family practice, specialised services for women’s What are your main work-related priorities (i.e., flexibility, income level, diversity versus focused practice, scope of practice, managerial involvement, clinical expertise, skills development, wanting office hours)? keywords: family; practice; sector; south cache: safpj-5682.htm plain text: safpj-5682.txt item: #705 of 732 id: safpj-5683 author: None title: safpj-5683 date: None words: 3943 flesch: 49 summary: Keywords: scoping review; coronary artery disease CAD; cardiac scoring systems; major adverse cardiovascular events MACE. They were focused on cardiovascular risk estimation scoring systems for primary prevention and were dedicated to screening and detection of CAD in situations where the clinical evidence was non-specific and patients needed risk stratification. keywords: cad; disease; mace; prevention; research; results; review; risk; scoring; systems cache: safpj-5683.htm plain text: safpj-5683.txt item: #706 of 732 id: safpj-5684 author: None title: safpj-5684 date: None words: 7188 flesch: 51 summary: Theme 3: Recommendations to increase the uptake of voluntary medical male circumcision This theme is a description of what the participants mentioned when they were asked to suggest what could be done to increase VMMC uptake. Section B consisted of three questions: What are the facilitators to VMMC as an HIV prevention strategy in Kavango East region, Namibia? What are the barriers to VMMC as an HIV prevention strategy in the Kavango East region, Namibia? What can be done to improve VMMC uptake in Kavango East region, Namibia? Data saturation was reached at 18 participants, thus no further interviews were conducted. keywords: barriers; circumcision; data; health; hiv; male; men; namibia; participants; prevention; region; research; study; uptake; vmmc; years cache: safpj-5684.htm plain text: safpj-5684.txt item: #707 of 732 id: safpj-5690 author: None title: safpj-5690 date: None words: 4228 flesch: 47 summary: Many programmes rely heavily on specialists from other disciplines in regional or tertiary hospitals who do not fully understand family medicine training programmes. Developing entrustable professional activities for family medicine training in South Africa. keywords: activities; africa; assessment; epas; family; health; medicine; professional; south; training; workplace cache: safpj-5690.htm plain text: safpj-5690.txt item: #708 of 732 id: safpj-5691 author: None title: safpj-5691 date: None words: 2410 flesch: 52 summary: It is also contraindicated in the following conditions: infection at the insertion site, fracture of the bony site, ipsilateral fracture of the extremity, burn at the insertion site, previous intraosseous attempted site, previous attempt in a different location on the same bone, previous intraosseous site less than 48 h, inability to locate landmarks, osteogenesis imperfecta, osteoporosis and osteopetrosis.8,9 Caution should be taken in patients with right to left intracardiac shunts because of the risk of fat or bone marrow emboli.9 Equipment for intraosseous access The equipment required for intraosseous line insertion includes the following: sterile gloves, antiseptic swab (alcohol swab or cotton wool ball soaked in antiseptic solution), fenestrated sterile drape, lignocaine 1%, 5 mL – 10 mL syringe, intraosseous needle device (refer to Figure 111 for sites), spinal needle for neonates, sterile infusion set with intravenous (IV) fluid, adhesive strapping, elastic bandage and padded splint.4,10 FIGURE 1: Mechanical intraosseous devices. Complications Some of the complications that can occur from intraosseous needle insertion include the following: Incomplete penetration of the needle into the medullary space manifested as inability to flush with normal saline solution. keywords: access; bone; figure; health; insertion; line; needle; procedure cache: safpj-5691.htm plain text: safpj-5691.txt item: #709 of 732 id: safpj-5693 author: None title: safpj-5693 date: None words: 1495 flesch: 36 summary: The quadripartite organizations (World Health Organization [WHO], Food and Agriculture Organization of the United Nations [FAO], United Nations Environmental Programme [UNEP] and the World Organization for Animal Health [WOAH]) launched ‘One Health joint plan of action’ in October 2022 to strengthen and address health concerns at the human–animal–plant–environment interface. Available from: https://www.who.int/news/item/17-10-2022-one-health-joint-plan-of-action-launched-to-address-health-threats-to-humans--animals--plants-and-environment Food and Agriculture Organization of the United Nations (FAO), World Organisation for Animal Health (OIE), United Nations Environmental Programme (UNEP), World Health Organization (WHO). keywords: approach; environment; health; organization; world cache: safpj-5693.htm plain text: safpj-5693.txt item: #710 of 732 id: safpj-5694 author: None title: safpj-5694 date: None words: 1318 flesch: 57 summary: Statistics South Africa; 2019 Yet, we have an average gross domestic product (GDP) per capita of $13 526.00 per year (R243 468.00/year or R20 289.00/month).3 There are many countries in the world with a lower GDP per capita than South Africa, and out of 191 countries, we rank number 92.3 Years ago, Wilkinson and Picket argued4 that inequality, and not poverty alone, is the factor that drives poor health outcomes. keywords: africa; health; south; world cache: safpj-5694.htm plain text: safpj-5694.txt item: #711 of 732 id: safpj-5697 author: Office, Editorial title: Table of Contents Vol 64, No 1 (2022) date: 2022-12-31 words: 3182 flesch: -18 summary: ISSN: 2078-6204 (online)South African Family Practice Page i of v Original Research Obesity and sickness absenteeism among health workers in a private hospital in South Africa Therese de Wet, Willem H. Kruger, Gina Joubert South African Family Practice | Vol 64, No 1 : Part 1| a5418 | 03 February 2022 Original Research Two months follow-up of patients with non-critical COVID-19 in Cape Town, South Africa Andrea S. Mendelsohn, Nikhil Nath, Angela De Sá, Klaus B. von Pressentin South African Family Practice | Vol 64, No 1 : Part 1| a5429 | 10 February 2022 Original Research Knowledge, attitudes and practices of men in a South African rural community in relation to exclusive breastfeeding Oscar M. Mabele, Matthew O.A. Benedict, Wilhelm J. Steinberg, Elizabeth Reji, Cornel van Rooyen, Anthonio O. Adefuye South African Family Practice | Vol 64, No 1 : Part 1| a5366 | 11 February 2022 Original Research Building blocks for a public health ethics framework for the geriatric community Laetus O.K. Lategan, Gert J. van Zyl, Willem H. Kruger South African Family Practice | Vol 64, No 1 : Part 1| a5414 | 21 February 2022 Registrars Mastering your fellowship: Part 1, 2022 Klaus B. von Pressentin, Mergan Naidoo, Gert Marincowitz, Tasleem Ras South African Family Practice | Vol 64, No 1 : Part 1| a5481 Vol 64, No 1 : Part 1| a5419 | 31 January 2022 Open Forum Screen-based behaviour in children is more than meets the eye Alvin J. Munsamy, Verusia Chetty, Suvira Ramlall South African Family Practice | Vol 64, No 1 : Part 1| a5374 | 10 February 2022 Original Research Self-confidence and knowledge of suicide assessment and prevention amongst first-line health professionals in Nelson Mandela Bay, South Africa Adeyinka A. Alabi South African Family Practice | Vol 64, No 1 : Part 1| a5377 | 10 January 2022 Original Research Preparedness level of frontline healthcare professionals in Tshwane regarding the COVID-19 pandemic Tombo Bongongo, Indiran Govender, Doudou K. Nzaumvila, Olga M. Maphasha South African Family Practice | Vol 64, No 1 : Part 1| a5341 | 24 January 2022 Original Research Preparedness for paediatric cardiopulmonary resuscitation amongst medical doctors working in primary health care facilities in Cape Town, South Africa Nabeela Amien, Graham Bresick, Katya Evans South African Family Practice | Vol 64, No 1 : Part 1| a5323 | 26 January 2022 Original Research The knowledge, attitudes and practices regarding family history of hereditary diseases amongst undergraduate students at the University of the Free State Lynette J. van der Merwe, Gaby Nel, Caitlin Williams, Swalica Erasmus, Riana Nel, Marize Kolver, Benine van den Heever, Gina Joubert South African Family Practice | Vol 64, No 1 : Part 1| a5392 | 27 January 2022 1 3 4 8 12 16 22 27 35 https://www.safpj.co.za Open Access Table of ContentsPage ii of v Original Research Use of the Vula App to refer patients in the West Coast District: keywords: african; article; care; cpd; family practice; health; practice |; research; south; vol cache: safpj-5697.pdf plain text: safpj-5697.txt item: #712 of 732 id: safpj-5700 author: None title: safpj-5700 date: None words: 6388 flesch: 47 summary: Alenezi F, Almeshari M, Mahida R, Bangash M, Thickett D, Patel J. Incidence and risk factors of acute kidney injury in COVID-19 patients with and without acute respiratory distress syndrome (ARDS) during the first wave of COVID-19: A systematic review and meta-analysis. The postulated reason for severe COVID-19 disease in participants with diabetes mellitus (primarily with poor glycaemic control) is a weakened innate and humoral immunity secondary to chronic hyperglycaemia, resulting in compromised host defence against SARS-CoV-2.13 Diabetes mellitus is associated with low-grade chronic inflammation, making the participant vulnerable to an exaggerated inflammatory response, resulting in ARDS and MOF. keywords: admission; africa; care; clinical; covid-19; data; death; disease; fatality; hospital; mortality; participants; patients; rate; south; study cache: safpj-5700.htm plain text: safpj-5700.txt item: #713 of 732 id: safpj-5702 author: None title: safpj-5702 date: None words: 4142 flesch: 48 summary: From a glucose perspective, insulin therapy in T2DM is therefore aimed at preventing excessive gluconeogenesis, that is, fasting hyperglycaemia with basal insulin and short (or ultra-short) acting insulin to limit the degree of postprandial glucose increases.23 There is no doubt that diabetes is one of the greatest natural disasters of our time. What is the role of basal insulin in type 2 diabetes mellitus? Basal insulin is primarily aimed at suppressing hepatic gluconeogenesis to prevent fasting hyperglycaemia.3,31 keywords: acting; basal; carbohydrate; care; diabetes; glucose; insulin; management; meal; mellitus; south; therapy; type cache: safpj-5702.htm plain text: safpj-5702.txt item: #714 of 732 id: safpj-5705 author: None title: safpj-5705 date: None words: 7230 flesch: 48 summary: It can, therefore, be concluded that pelvic fractures are injuries that contribute to the burden of disease in any country and are one of the causes of years lived with disability (YLDs).11 The management of pelvic fractures should adopt a biopsychosocial model of healthcare and early multidisciplinary intervention that includes a comprehensive rehabilitation programme to improve recovery in patients with pelvic fractures.3 Patients with pelvic fractures will likely recover well and achieve better health outcomes with early, integrated interventions.12 Pelvic fractures are usually concomitant with urological and musculoskeletal injuries.7 The complexity of pelvic fractures poses a challenge in managing patients with such injuries. keywords: approach; care; fractures; health; healthcare; hps; male; management; participant; patients; pelvic; professionals; quality; rehabilitation; study; themes cache: safpj-5705.htm plain text: safpj-5705.txt item: #715 of 732 id: safpj-5712 author: None title: safpj-5712 date: None words: 2049 flesch: 35 summary: Time course Carefully establishing the time course is the first step in hypothetico-deductive reasoning and pragmatic classification of vestibular syndrome (see syndromic approach to vertigo; Table 2)2,3,4.Vertigo is never continuous for more than a few weeks (although it may be episodic). In situations where a patient has vertigo for longer than a week, the clinician should clearly establish whether the patient was actually spinning the entire time (if true, points more to central causes), or was having episodic spinning followed by imbalance. TABLE 2: Common conditions in the vestibular syndromes. Triggers and aggravators At the outset, it is important to differentiate between postural presyncope and positional vertigo – both associated with dizziness upon standing: determine if the dizziness can be provoked when changing position of the head without lowering blood pressure (such as lying down, looking up and rolling over). keywords: dizziness; head; nystagmus; test; vertigo; vestibular cache: safpj-5712.htm plain text: safpj-5712.txt item: #716 of 732 id: safpj-5713 author: None title: safpj-5713 date: None words: 5825 flesch: 50 summary: Policy on quality in health care for South Africa Randomised controlled trial of patient centred care of diabetes in general practice: Impact on current wellbeing and future disease risk. keywords: africa; care; data; diabetes; health; healthcare; hospital; mellitus; participants; patients; public; qoc; quality; south; study; type cache: safpj-5713.htm plain text: safpj-5713.txt item: #717 of 732 id: safpj-5718 author: None title: safpj-5718 date: None words: 1117 flesch: 53 summary: The contribution of family physicians to district health services in South Africa: A national position paper by the South African Academy of Family Physicians. The position article was then presented and discussed with stakeholders such as the Deputy Minister of Health, the National Department of Health (those responsible for primary health care and human resources) and the Chair of the Parliamentary Portfolio Committee on Health.2 keywords: family; health; physicians; south cache: safpj-5718.htm plain text: safpj-5718.txt item: #718 of 732 id: safpj-5720 author: None title: safpj-5720 date: None words: 6193 flesch: 50 summary: Keywords: family physicians; FCFP (SA) examination; family medicine registrars; postgraduate training; national exit examination; child health. The domain covered in this edition is child health. keywords: authors; care; children; community; family; health; information; marks; participants; primary; question; research; south; study; team cache: safpj-5720.htm plain text: safpj-5720.txt item: #719 of 732 id: safpj-5722 author: None title: safpj-5722 date: None words: 2674 flesch: 50 summary: According to a collaborative study by the United Nations International Children’s Emergency Fund (UNICEF) and the International Children’s Palliative Care Network, less than 5% of children with palliative care needs in South Africa, receive it.2 While palliative care can be provided in any setting,3 it is most likely that children will be down referred to facilities nearer home when curative interventions are no longer appropriate. Abstract Background Defining paediatric palliative care Which children require palliative care? Practical application Recommendations Conclusion Acknowledgements References About the Author(s) Julia F. Ambler Umduduzi - Hospice Care for Children, Durban, South Africa Department of Paediatrics, Faculty of Health Sciences, University of KwaZulu-Natal, Durban, South Africa Department of Family Medicine, Faculty of Health Sciences, University of KwaZulu-Natal, Durban, South Africa Christoffel H. Bell Butterfly Palliative Home, Ingwavuma, South Africa Department of Health, Faculty of Family Medicine, Mosvold Hospital, University of KwaZulu-Natal, Ingwavuma, South Africa Citation Ambler JF, Bell CH. keywords: africa; care; child; children; health; palliative; south cache: safpj-5722.htm plain text: safpj-5722.txt item: #720 of 732 id: safpj-5726 author: None title: safpj-5726 date: None words: 2627 flesch: 54 summary: Questions scoring outside this range need to be reviewed by the expert panel and decisions should be made on what action should be taken.7,8 The flaws of questions with low easiness indices include obscure content or content not taught, poorly worded or confusing items, items delivered at the end of a timed test, questions wrongly scored and two choices that are both correct. Abstract Introduction Blueprinting Constructing multiple choice questions Post hoc analysis Standard setting Conclusion Acknowledgements References About the Author(s) Mergan Naidoo College of Family Physicians of South Africa, Discipline of Family Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa Citation Naidoo M. The pearls and pitfalls of setting high-quality multiple choice questions for clinical medicine. keywords: assessment; mcqs; options; questions; setting; standard; test cache: safpj-5726.htm plain text: safpj-5726.txt item: #721 of 732 id: safpj-5728 author: None title: safpj-5728 date: None words: 5850 flesch: 52 summary: The population studied is focused, as these are the glaucoma patients attending eye care services in Limpopo. This can be in partnership with any other services providing eye care in the community such as the private sector, non-governmental organisations (NGOs) and CHWs. keywords: adherence; authors; care; community; examination; eye; family; health; marks; patients; question; south; study cache: safpj-5728.htm plain text: safpj-5728.txt item: #722 of 732 id: safpj-5729 author: None title: safpj-5729 date: None words: 1314 flesch: 43 summary: Not only is it a direct cause of injury, morbidity and death, but women’s health is affected indirectly through unwanted pregnancies and accompanying health risks, as well as mental illness, sexually transmitted diseases, human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS).2,4 In many areas of South Africa, there is limited access to formal psychosocial or medical support for survivors of GBV contributing to psychological trauma and behavioural consequences with an inability to reintegrate into society.2,4 The HIV and AIDS epidemic in sub-Saharan region of Africa is directly related to domestic violence and sexual violence, making women and young girls in particular vulnerable to HIV. February is commonly referred to as the month of love but for many women, February will continue to be a dreadful and distressing period with one woman being raped every 3 h in South Africa (SA). keywords: gender; south; violence; women cache: safpj-5729.htm plain text: safpj-5729.txt item: #723 of 732 id: safpj-5736 author: None title: safpj-5736 date: None words: 5988 flesch: 52 summary: Keywords: seizure diary; epilepsy; paper diary; electronic diary; seizure frequency; participants who had previous exposure to a seizure diary; previously diary-unexposed participants. Fisher et al. described the availability of seizure diaries in various languages for patients’ use20 could assist in overcoming language barriers or poor communication patterns that cause poor management of patients living with epilepsy.38 keywords: caregivers; diary; epilepsy; exposure; new; participants; patients; seizure; seizure diary; study; table; use cache: safpj-5736.htm plain text: safpj-5736.txt item: #724 of 732 id: safpj-5740 author: None title: safpj-5740 date: None words: 3388 flesch: 43 summary: Patients with international normalised ratio greater than 3.0 or platelets less than 20 × 10/L have increased risk of bleeding17 and should be considered for pre-procedure administration of appropriate blood products (fresh frozen plasma, platelets).1,4 Equipment There are several types of central venous catheters and devices, the use of which depends on clinical parameters (acute, subacute, chronic), duration of use (short term, medium term, long term), type of insertion (central or peripheral), location (peripheral or central) and number of lumens (single, double, triple).2 Equipment for central venous catheter placement include the following (see Figure 4): sterile cleansing solution (chlorhexidine) sterile gauze syringes and needle for local anaesthetic and sterile saline flush local anaesthetic – 1% Lidocaine introducer needle with syringe sterile saline scalpel guide wire tissue dilator appropriate suture material with needle sterile gloves sterile dressing central venous access kit (triple-lumen, dual-lumen or large-bore single lumen venous catheter). Contraindications The literature is not clear as to the existence of absolute contraindications for central venous catheter placement, and relative contraindications are dependent on the urgency and accessibility of alternative venous sites.1,4,8 Site-specific contraindications include the following: skin or soft tissue infection at the insertion site anatomical distortion at the site vascular injury proximal or distal to the site of insertion thrombus within the intended vein. keywords: access; catheter; central; figure; health; needle; placement; procedure; site; ultrasound; vein; venous cache: safpj-5740.htm plain text: safpj-5740.txt item: #725 of 732 id: safpj-5744 author: None title: safpj-5744 date: None words: 4334 flesch: 46 summary: Surgical options for such a complication are limited and results often shortlived.3 Rotator cuff tears are another common injury associated with anterior shoulder dislocation, with the rate varying between 7% and 32% commonly affecting patients older than 40 years and rising with advanced age.4 During the index assessment, attention is paid to determining the mechanism of injury (traumatic vs spontaneous or recurrent), excluding associated fractures (greater tuberosity, coracoid process and glenoid fractures) and frank shoulder weakness which could be the result of a rotator cuff tear or a neurological injury. Gottlieb et al. reported a high sensitivity and specificity of point-of-care ultrasound for the assessment of shoulder dislocations.6 Closed reduction techniques for anterior shoulder dislocation The literature lists up to 23 different techniques and 17 modifications of these techniques for a closed reduction of an anterior shoulder dislocation.7,8,9 keywords: assessment; cape government; cape town; dislocation; fractures; health; joint; patient; reduction; shoulder; south africa; surg cache: safpj-5744.htm plain text: safpj-5744.txt item: #726 of 732 id: safpj-5750 author: None title: safpj-5750 date: None words: 1108 flesch: 71 summary: This led me to become a mentor for the Next 5 – an initiative by the South African Academy of Family Physicians (SAAFP) that supports family physicians in their first 5 years after graduating.1 Through the mentorship programme, newly appointed family physicians will benefit from an active process of support and role clarification within their healthcare teams to establish themselves in the health system and mature in all their different roles. Hello compassion, my old friend … Rediscovering my purpose also meant I wanted to help other family physicians avoid a similar experience to mine. keywords: article; author; family cache: safpj-5750.htm plain text: safpj-5750.txt item: #727 of 732 id: safpj-5751 author: None title: safpj-5751 date: None words: 7183 flesch: 35 summary: Long COVID may therefore represent a virus-induced autoimmune process in which autoantibodies act as intermediate pathogenic factors producing the diverse clinical phenotypes associated with Long COVID.35 Severe acute respiratory syndrome coronavirus 2 infection directly disrupts the gut microbiome causing dysbiosis and secondary bacterial infections.36 Dysbiosis has been demonstrated in stool samples from Long COVID patients, revealing significantly diminished levels of beneficial gut microbiome species, causing an imbalanced gut microbe environment at 6 months post-acute COVID-19 infection and associated with increased levels of systemic inflammation. Serological samples from Long COVID patients revealed the presence of herpesvirus DNA: 42.6% EBV, 25% HHV-6 and 32.4% EBV + HHV-6.38 Reactivation of herpesviruses leads to systemic inflammation, immunological dysfunction, and increased virus replication, which may give rise to the distinct clinical phenotypes expressed in Long COVID.39 Emerging evidence suggests that metabolic dysfunction coupled with chronic inflammation may potentiate the onset of Long COVID.40 Blood plasma isolated from Long COVID patients demonstrated dysregulation of several cytokines, lipoproteins and metabolites. keywords: acute; assessment; care; clinical; cov-2; covid; covid-19; disease; fatigue; illness; infection; long; management; med; months; patients; persistent; post; sars; symptoms; syndrome cache: safpj-5751.htm plain text: safpj-5751.txt item: #728 of 732 id: safpj-5759 author: None title: safpj-5759 date: None words: 523 flesch: 43 summary: On the other hand, gender of the respondents, gender of household head and family TB history did not show an association with the utilisation of VHWs’ services for TB screening. The original incorrect wording: Respondents residing in households with a history of TB were more likely to report the use of the services of the VHWs for TB screening relative to their counterparts residing in households without TB history (OR = 1.353, CI: 1.017, 1.800). keywords: lesotho; services cache: safpj-5759.htm plain text: safpj-5759.txt item: #729 of 732 id: safpj-5762 author: None title: safpj-5762 date: None words: 5678 flesch: 54 summary: The massive increase in non-communicable diseases (NCDs) with the impact on personal health and the consequent burden on the healthcare system has resulted in many ECs being inundated with patients presenting at the end of life. The multidisciplinary team should have discussed issues such as patient’s and family’s fears and concerns, advance directives, the patient’s views on resuscitation and dealing with unfinished business much earlier. keywords: authors; candidate; care; casualty; centre; emergency; family; hospital; marks; palliative; patients; population; study cache: safpj-5762.htm plain text: safpj-5762.txt item: #730 of 732 id: safpj-5770 author: None title: safpj-5770 date: None words: 2988 flesch: 48 summary: In 2019, gender affirming hormones were approved by South African National Essential Medicine List Committee (NEMLC) for tertiary-level care, and in October 2021 the Southern Africa HIV Clinicians Society published a GAHC guideline for South Africa. With gender affirming care available within a primary care setting, TGD people are able to access preventative care options and pre-exposure prophylaxis and receive mental health support and appropriate disease screening. keywords: africa; care; gender; health; healthcare; hormone; south; tgd; therapy cache: safpj-5770.htm plain text: safpj-5770.txt item: #731 of 732 id: safpj-5777 author: None title: safpj-5777 date: None words: 1487 flesch: 51 summary: While the research published here does not represent all primary care and primary health care research performed in our context, this editorial analysis does speak to what is published in our journal and as such we are well positioned to interrogate the strengths and weaknesses of the journal’s research and future goals. A multipronged, collective approach is necessary to foster the advancement of primary health care research. keywords: care; family; health; journal; primary; research cache: safpj-5777.htm plain text: safpj-5777.txt item: #732 of 732 id: safpj-5791 author: None title: safpj-5791 date: None words: 1128 flesch: 53 summary: In the public sector, we have published a position article (https://safpj.co.za/index.php/safpj/article/view/5473) on the contribution of family physicians to district health services. We have had numerous engagements with government at both national and provincial levels to deliver our message that family physicians are a key intervention to improve service delivery in health centres and district hospitals. keywords: family; physicians; prof; saafp cache: safpj-5791.htm plain text: safpj-5791.txt