Pub Date : 2020-01-01DOI: 10.36303/sagp.2020.1.0002
L. Brand, S. Steyn, D. Wolmarans
{"title":"Taking the 'sauer' out of sauerkraut : a rapid update on the pathophysiology and treatment of gastro-oesophageal reflux disease","authors":"L. Brand, S. Steyn, D. Wolmarans","doi":"10.36303/sagp.2020.1.0002","DOIUrl":"https://doi.org/10.36303/sagp.2020.1.0002","url":null,"abstract":"","PeriodicalId":21867,"journal":{"name":"South African General Practitioner","volume":"14 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74250987","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01DOI: 10.36303/sagp.2020.1.4.0039
J. Markram
Unintended pregnancies are very common, and it is estimated that almost 45% of all pregnancies in 2011 in the USA were not planned.1 In South Africa, the situation could even be worse as it is common knowledge that we have a very high teenage pregnancy rate. It puts the already overburdened health system under enormous pressure. The social and financial pressure of an unintended or even unwanted pregnancy can be devastating to a family and even more so to a single mother. It has been reported that the unintended pregnancy rate in Botswana is 52% and that only 22% had ever used emergency contraception (EC).2
{"title":"Emergency contraception for the South African healthcare professional","authors":"J. Markram","doi":"10.36303/sagp.2020.1.4.0039","DOIUrl":"https://doi.org/10.36303/sagp.2020.1.4.0039","url":null,"abstract":"Unintended pregnancies are very common, and it is estimated that almost 45% of all pregnancies in 2011 in the USA were not planned.1 In South Africa, the situation could even be worse as it is common knowledge that we have a very high teenage pregnancy rate. It puts the already overburdened health system under enormous pressure. The social and financial pressure of an unintended or even unwanted pregnancy can be devastating to a family and even more so to a single mother. It has been reported that the unintended pregnancy rate in Botswana is 52% and that only 22% had ever used emergency contraception (EC).2","PeriodicalId":21867,"journal":{"name":"South African General Practitioner","volume":"38 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89054120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01DOI: 10.36303/SAGP.2020.1.0001
A. Marais, E. Osuch
Insomnia is an important public health burden and is the most ubiquitous sleep disorder in the general population, requiring accurate diagnosis and effective treatment. Sleep hygiene and cognitive behavioural therapy form the foundation of management. In addition, various pharmacological entities are at hand to augment insomnia disorder. Acute insomnia requires short-term management with appropriately indicated hypnotic agents, while chronic sleeping difficulties benefit more from antidepressants. This article informs the reader about the currently available sleeping agents in South Africa, and may not include more effective or potent agents used in other parts of the world that are not yet accessible for local prescription.
{"title":"Insomnia : what is currently available","authors":"A. Marais, E. Osuch","doi":"10.36303/SAGP.2020.1.0001","DOIUrl":"https://doi.org/10.36303/SAGP.2020.1.0001","url":null,"abstract":"Insomnia is an important public health burden and is the most ubiquitous sleep disorder in the general population, requiring accurate diagnosis and effective treatment. Sleep hygiene and cognitive behavioural therapy form the foundation of management. In addition, various pharmacological entities are at hand to augment insomnia disorder. Acute insomnia requires short-term management with appropriately indicated hypnotic agents, while chronic sleeping difficulties benefit more from antidepressants. This article informs the reader about the currently available sleeping agents in South Africa, and may not include more effective or potent agents used in other parts of the world that are not yet accessible for local prescription.","PeriodicalId":21867,"journal":{"name":"South African General Practitioner","volume":"136 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75778603","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01DOI: 10.36303/sagp.2020.1.1.0010
N. Schellack, N. Shirindza, T. Mokoena
Conjunctivitis affects many people across the globe, significantly disturbing the quality of life of the people who are affected. Conjunctivitis can be divided into infectious and noninfectious causes. Viruses and bacteria are the most common infectious causes. Some of the most commonly diagnosed allergic diseases include atopic dermatitis, rhinitis, allergic conjunctivitis and sinusitis. Other conditions, such as eosinophilic oesophagitis, the prevalence of which is on the rise, are being diagnosed across all continents, except for Africa. Allergic conjunctivitis is an allergic disease characterised by inflammation of the conjunctiva caused by airborne allergens; it presents as itching, excessive lacrimation, discharge and pink eye. Usually it is associated with other allergic conditions such as allergic rhinitis and bronchial asthma. Allergic conjunctivitis is further divided into acute, seasonal allergic conjunctivitis (SAC) and perennial allergic conjunctivitis (PAC). Bacterial conjunctivitis, caused by bacterial and viral pathogens, may include three major categories: hyperacute bacterial conjunctivitis, acute conjuncitivis and chronic conjunctivitis. The diagnosis is primarily clinical. This article provides an overview of these conditions and their current management options.
{"title":"An overview of allergic and bacterial conjunctivitis","authors":"N. Schellack, N. Shirindza, T. Mokoena","doi":"10.36303/sagp.2020.1.1.0010","DOIUrl":"https://doi.org/10.36303/sagp.2020.1.1.0010","url":null,"abstract":"Conjunctivitis affects many people across the globe, significantly disturbing the quality of life of the people who are affected. Conjunctivitis can be divided into infectious and noninfectious causes. Viruses and bacteria are the most common infectious causes. Some of the most commonly diagnosed allergic diseases include atopic dermatitis, rhinitis, allergic conjunctivitis and sinusitis. Other conditions, such as eosinophilic oesophagitis, the prevalence of which is on the rise, are being diagnosed across all continents, except for Africa. Allergic conjunctivitis is an allergic disease characterised by inflammation of the conjunctiva caused by airborne allergens; it presents as itching, excessive lacrimation, discharge and pink eye. Usually it is associated with other allergic conditions such as allergic rhinitis and bronchial asthma. Allergic conjunctivitis is further divided into acute, seasonal allergic conjunctivitis (SAC) and perennial allergic conjunctivitis (PAC). Bacterial conjunctivitis, caused by bacterial and viral pathogens, may include three major categories: hyperacute bacterial conjunctivitis, acute conjuncitivis and chronic conjunctivitis. The diagnosis is primarily clinical. This article provides an overview of these conditions and their current management options.","PeriodicalId":21867,"journal":{"name":"South African General Practitioner","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78438974","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Globally more than 1 billion people have hypertension and it is predicted that because of ageing populations and increasing sedentary lifestyles, this figure will rise to about 1.5 billion by 2025. Elevated blood pressure (BP) is the leading cause of premature death and morbidity due to stroke and ischemic heart disease. Hypertension is also a major risk factor for heart failure, atrial fibrillation, chronic kidney disease, peripheral arterial disease and cognitive decline. This article discusses the current evidencebased treatment guidelines and pressing temporal issues in optimal blood pressure control.
{"title":"Burning issues in blood pressure control","authors":"J. Ker, K. Outhoff","doi":"10.4102/SAFP.V61I2.4986","DOIUrl":"https://doi.org/10.4102/SAFP.V61I2.4986","url":null,"abstract":"Globally more than 1 billion people have hypertension and it is predicted that because of ageing populations and increasing sedentary lifestyles, this figure will rise to about 1.5 billion by 2025. Elevated blood pressure (BP) is the leading cause of premature death and morbidity due to stroke and ischemic heart disease. Hypertension is also a major risk factor for heart failure, atrial fibrillation, chronic kidney disease, peripheral arterial disease and cognitive decline. This article discusses the current evidencebased treatment guidelines and pressing temporal issues in optimal blood pressure control.","PeriodicalId":21867,"journal":{"name":"South African General Practitioner","volume":"18 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81753766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Children younger than 7 years are at increased risk of otitis media because of their immature immune systems and poorly functioning eustachian tubes that normally ventilate the middle ear space and equalize pressure with the external environment. More than 80% of children have at least one episode of acute otitis media (AOM) before the age of 3 years and 40% experience six or more recurrences by the time they are 7 years old. 1 By the age of 3 years, approximately 7% of children undergo surgery for tympanostomy tube insertion for a range of otitis media issues, most commonly for chronic otitis media with effusion (OME), recurrent acute AOM, and acute otitis media that persists despite antibiotic therapy. 2 However, tympanostomy tube insertion is associated with risks and remains a controversial practice especially in children with OME of less than three months’ duration and in children with recurrent AOM. Adverse effects associated with tympanostomy tube insertion include those associated with anaesthesia and its complications (laryngospasm, bronchospasm), as well as tube related sequelae such as recurrent (7%) or persistent (16–26%) otorrhoea, blockage of the tube lumen (7%), granulation tissue (4%), premature extrusion of the tube (4%), tympanostomy tube displacement into the middle ear (0.5%) and persistent perforation of the tympanic membrane (1%–6%). 3 This article offers guidance for family practitioners wishing to optimize health outcomes in children potentially requiring tympanostomy tube placement.
{"title":"Grommets - an update on common indications for tympanostomy tube placement","authors":"K. Outhoff","doi":"10.4102/SAFP.V59I3.4684","DOIUrl":"https://doi.org/10.4102/SAFP.V59I3.4684","url":null,"abstract":"Children younger than 7 years are at increased risk of otitis media because of their immature immune systems and poorly functioning eustachian tubes that normally ventilate the middle ear space and equalize pressure with the external environment. More than 80% of children have at least one episode of acute otitis media (AOM) before the age of 3 years and 40% experience six or more recurrences by the time they are 7 years old. 1 By the age of 3 years, approximately 7% of children undergo surgery for tympanostomy tube insertion for a range of otitis media issues, most commonly for chronic otitis media with effusion (OME), recurrent acute AOM, and acute otitis media that persists despite antibiotic therapy. 2 However, tympanostomy tube insertion is associated with risks and remains a controversial practice especially in children with OME of less than three months’ duration and in children with recurrent AOM. Adverse effects associated with tympanostomy tube insertion include those associated with anaesthesia and its complications (laryngospasm, bronchospasm), as well as tube related sequelae such as recurrent (7%) or persistent (16–26%) otorrhoea, blockage of the tube lumen (7%), granulation tissue (4%), premature extrusion of the tube (4%), tympanostomy tube displacement into the middle ear (0.5%) and persistent perforation of the tympanic membrane (1%–6%). 3 This article offers guidance for family practitioners wishing to optimize health outcomes in children potentially requiring tympanostomy tube placement.","PeriodicalId":21867,"journal":{"name":"South African General Practitioner","volume":"24 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87018806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2015-01-13DOI: 10.36303/sagp.2020.3.0014
A. Kopke, O. Greeff
Gout is a painful, inflammatory disease that affects more men than women. The incidence of gout has increased substantially over the past few decades, as evidenced by information from the Rochester project. Some of the risk factors for the development of gout include: increased ethanol intake, high dietary purine consumption, obesity and the use of certain drugs, such as diuretics. Another important risk factor for the development of gout is hyperuricaemia. Hyperuricaemia results from an imbalance between the rate of production and excretion of uric acid in the body. An excess of uric acid thus builds up in the body, supersaturating body fluids and leading to the formation of monosodium urate crystals. These crystals accumulate in tissue and around joints, leading to an acute gout attack. Gout can be divided into four phases, namely symptomatic hyperuricaemia, acute gout attacks or recurrent gout, intercritical gout and chronic tophaceous gout. Various treatment options are available for gout, and the treatment for each gout patient is determined by the stage of the disease. Non-steroidal anti-inflammatory drugs (NSAIDs), corticosteroids, corticotropin and colchicine are used for the treatment of acute gout attacks. Allopurinol and probenecid are used for long-term hypouricaemic therapy, while NSAIDs and colchicine are prescribed for the prophylaxis of future gout attacks. All of these treatments have side effects, ranging from mild to life-threatening in nature. There is a need for novel gout therapies that have fewer side effects but are still as effective.
{"title":"Hyperuricaemia and gout","authors":"A. Kopke, O. Greeff","doi":"10.36303/sagp.2020.3.0014","DOIUrl":"https://doi.org/10.36303/sagp.2020.3.0014","url":null,"abstract":"Gout is a painful, inflammatory disease that affects more men than women. The incidence of gout has increased substantially over the past few decades, as evidenced by information from the Rochester project. Some of the risk factors for the development of gout include: increased ethanol intake, high dietary purine consumption, obesity and the use of certain drugs, such as diuretics. Another important risk factor for the development of gout is hyperuricaemia. \u0000 \u0000Hyperuricaemia results from an imbalance between the rate of production and excretion of uric acid in the body. An excess of uric acid thus builds up in the body, supersaturating body fluids and leading to the formation of monosodium urate crystals. These crystals accumulate in tissue and around joints, leading to an acute gout attack. \u0000 \u0000Gout can be divided into four phases, namely symptomatic hyperuricaemia, acute gout attacks or recurrent gout, intercritical gout and chronic tophaceous gout. Various treatment options are available for gout, and the treatment for each gout patient is determined by the stage of the disease. Non-steroidal anti-inflammatory drugs (NSAIDs), corticosteroids, corticotropin and colchicine are used for the treatment of acute gout attacks. Allopurinol and probenecid are used for long-term hypouricaemic therapy, while NSAIDs and colchicine are prescribed for the prophylaxis of future gout attacks. \u0000 \u0000All of these treatments have side effects, ranging from mild to life-threatening in nature. There is a need for novel gout therapies that have fewer side effects but are still as effective.","PeriodicalId":21867,"journal":{"name":"South African General Practitioner","volume":"21 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2015-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75816871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2012-06-09DOI: 10.36303/sagp.2022.3.4.0140
N. Schellack, Hannalie C Meyer
Attention deficit-hyperactivity disorder (ADHD) involves the academic, social and family functioning of the child. Prevalence of the disorder is approximately 5.3% worldwide and occurs mostly in boys. The consequences of ADHD may be substance abuse and other personality disorders, e.g. delinquency. Research has indicated that drug or behavioural interventions may decrease the rate of conduct and personality disorders. Diet therapy may include polyunsaturated fatty acids (fish oil) and iron supplements in children with low ferritin levels, which may improve ADHD symptoms. Drug therapy that involves stimulants (methylphenidate) has been proven to be effective with a good safety profile. However, concerns have been raised about cardiac, psychiatric and growth sideeffects. The nonstimulants (atomoxetine) have no abuse potential and reduce insomnia. They also have a better effect on growth in children. Other therapies include antidepressants and α 2 agonists. It is important to treat each patient using individualised therapy. The role of the pharmacist is important to monitor and minimise side-effects.
{"title":"The management of attention-deficit hyperactivity disorder in children: updated 2022","authors":"N. Schellack, Hannalie C Meyer","doi":"10.36303/sagp.2022.3.4.0140","DOIUrl":"https://doi.org/10.36303/sagp.2022.3.4.0140","url":null,"abstract":"Attention deficit-hyperactivity disorder (ADHD) involves the academic, social and family functioning of the child. Prevalence of the disorder is approximately 5.3% worldwide and occurs mostly in boys. The consequences of ADHD may be substance abuse and other personality disorders, e.g. delinquency. Research has indicated that drug or behavioural interventions may decrease the rate of conduct and personality disorders. Diet therapy may include polyunsaturated fatty acids (fish oil) and iron supplements in children with low ferritin levels, which may improve ADHD symptoms. Drug therapy that involves stimulants (methylphenidate) has been proven to be effective with a good safety profile. However, concerns have been raised about cardiac, psychiatric and growth sideeffects. The nonstimulants (atomoxetine) have no abuse potential and reduce insomnia. They also have a better effect on growth in children. Other therapies include antidepressants and α 2 agonists. It is important to treat each patient using individualised therapy. The role of the pharmacist is important to monitor and minimise side-effects.","PeriodicalId":21867,"journal":{"name":"South African General Practitioner","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2012-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74351701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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