Pub Date : 2023-01-01DOI: 10.18772/26180197.2023.v5n1a5
Liam Lorentz, N. Mahomed, T. Pillay
{"title":"MRI findings of children with suspected hypoxic ischaemic injury at a Tertiary Academic Hospital in Johannesburg, South Africa","authors":"Liam Lorentz, N. Mahomed, T. Pillay","doi":"10.18772/26180197.2023.v5n1a5","DOIUrl":"https://doi.org/10.18772/26180197.2023.v5n1a5","url":null,"abstract":"","PeriodicalId":75326,"journal":{"name":"Wits journal of clinical medicine","volume":"106 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79255708","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 : 2023-01-01DOI: 10.18772/26180197.2023.v5n1a11
{"title":"Wits Department of Surgery BERT MYBURGH RESEARCH FORUM","authors":"","doi":"10.18772/26180197.2023.v5n1a11","DOIUrl":"https://doi.org/10.18772/26180197.2023.v5n1a11","url":null,"abstract":"","PeriodicalId":75326,"journal":{"name":"Wits journal of clinical medicine","volume":"17 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75464482","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 : 2023-01-01DOI: 10.18772/26180197.2023.v5n3a10
Mattushek Stephen, Joseph Troye, Twala Makhaya, Reddy Kuvashan
Abstract Religious or traditional bands are often placed around limbs of children. This practice may lead to the Rubber Band Syndrome, a rare paediatric condition mainly described in Asia. This study presents the first case of Rubber Band Syndrome reported in South Africa. The patient aged 18 months presented with a swollen right hand, a circumferential scar on the wrist and a discharging sinus. Under general anaesthesia, debridement revealed a yellow rubber band deep to the wrist flexors and neurovascular bundles. This was removed without repair of these structures. At 3-month follow up, function of the right hand was completely restored.
{"title":"Rubber Band Syndrome: A Rare Orthopaedic Condition in South Africa","authors":"Mattushek Stephen, Joseph Troye, Twala Makhaya, Reddy Kuvashan","doi":"10.18772/26180197.2023.v5n3a10","DOIUrl":"https://doi.org/10.18772/26180197.2023.v5n3a10","url":null,"abstract":"Abstract Religious or traditional bands are often placed around limbs of children. This practice may lead to the Rubber Band Syndrome, a rare paediatric condition mainly described in Asia. This study presents the first case of Rubber Band Syndrome reported in South Africa. The patient aged 18 months presented with a swollen right hand, a circumferential scar on the wrist and a discharging sinus. Under general anaesthesia, debridement revealed a yellow rubber band deep to the wrist flexors and neurovascular bundles. This was removed without repair of these structures. At 3-month follow up, function of the right hand was completely restored.","PeriodicalId":75326,"journal":{"name":"Wits journal of clinical medicine","volume":"28 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134887732","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 : 2023-01-01DOI: 10.18772/26180197.2023.v5n3a6
Eitzaz Sadiq, Louis Kroon, Naeem Brey, Andre Mochan
Abstract Reperfusion therapy in acute ischaemic stroke, namely intravenous thrombolysis and mechanical thrombectomy, have traditionally had strict time-based eligibility criteria. Recent advances in diagnostic and imaging modalities have resulted in a more dynamic view of eligibility for these therapies. The time clock concept may soon be superseded by the “tissue clock” concept, where accurate identification of the extent of the salvageable penumbra has been shown to result in favourable outcomes well beyond the traditional time limits in carefully selected patients. However in a low-middle income country like South Africa, the social, economic and geographic barriers to an effective acute stroke management service are often overwhelming. In this review we provide an update on the current evidence guiding management of acute ischaemic stroke, with a particular emphasis on the challenges faced in resource-constrained regions.
{"title":"The Management of Acute Ischaemic Stroke – A Review and South African Perspective","authors":"Eitzaz Sadiq, Louis Kroon, Naeem Brey, Andre Mochan","doi":"10.18772/26180197.2023.v5n3a6","DOIUrl":"https://doi.org/10.18772/26180197.2023.v5n3a6","url":null,"abstract":"Abstract Reperfusion therapy in acute ischaemic stroke, namely intravenous thrombolysis and mechanical thrombectomy, have traditionally had strict time-based eligibility criteria. Recent advances in diagnostic and imaging modalities have resulted in a more dynamic view of eligibility for these therapies. The time clock concept may soon be superseded by the “tissue clock” concept, where accurate identification of the extent of the salvageable penumbra has been shown to result in favourable outcomes well beyond the traditional time limits in carefully selected patients. However in a low-middle income country like South Africa, the social, economic and geographic barriers to an effective acute stroke management service are often overwhelming. In this review we provide an update on the current evidence guiding management of acute ischaemic stroke, with a particular emphasis on the challenges faced in resource-constrained regions.","PeriodicalId":75326,"journal":{"name":"Wits journal of clinical medicine","volume":"46 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134887733","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 : 2023-01-01DOI: 10.18772/26180197.2023.v5n2a7
Wilhelm Herbst, G. Paget
Anti-neutrophil cytoplasmic antibody (ANCA) vasculitis is defined as a systemic autoimmune disease limited to small calibre vasculature, associated with the presence of myeloperoxidase or proteinase 3. After receiving Pfizer BioNTech COVID-19 vaccine a 77-year-old woman of Jehovah's Witness faith presented with renal limited anti-MPO-AAV with underlying iron deficiency anaemia. Treatment was initiated with corticosteroids, iron repletion, Epoetin-beta, renal replacement therapy, plasma exchange with albumin, and cyclophosphamide with successful clearance of ANCA vasculitis. Although Jehovah's Witnesses may refuse transfusion of cellular blood products, they accept and expect alternative effective medical care.
{"title":"Management of a Jehovah's Witness patient with ANCA-Associated Vasculitis Following Pfizer-BioNTech COVID-19 Vaccine","authors":"Wilhelm Herbst, G. Paget","doi":"10.18772/26180197.2023.v5n2a7","DOIUrl":"https://doi.org/10.18772/26180197.2023.v5n2a7","url":null,"abstract":"Anti-neutrophil cytoplasmic antibody (ANCA) vasculitis is defined as a systemic autoimmune disease limited to small calibre vasculature, associated with the presence of myeloperoxidase or proteinase 3. After receiving Pfizer BioNTech COVID-19 vaccine a 77-year-old woman of Jehovah's Witness faith presented with renal limited anti-MPO-AAV with underlying iron deficiency anaemia. Treatment was initiated with corticosteroids, iron repletion, Epoetin-beta, renal replacement therapy, plasma exchange with albumin, and cyclophosphamide with successful clearance of ANCA vasculitis. Although Jehovah's Witnesses may refuse transfusion of cellular blood products, they accept and expect alternative effective medical care.","PeriodicalId":75326,"journal":{"name":"Wits journal of clinical medicine","volume":"44 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75733938","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 : 2023-01-01DOI: 10.18772/26180197.2023.v5n1a9
Denver Naicker, Edmund Richard Kibuuka, Molebogeng Makamed, C. Mgone, Victor Magumbeze, J. Ouma
{"title":"5 Birds with 1 stone – multiple aneurysms treated with a single craniotomy","authors":"Denver Naicker, Edmund Richard Kibuuka, Molebogeng Makamed, C. Mgone, Victor Magumbeze, J. Ouma","doi":"10.18772/26180197.2023.v5n1a9","DOIUrl":"https://doi.org/10.18772/26180197.2023.v5n1a9","url":null,"abstract":"","PeriodicalId":75326,"journal":{"name":"Wits journal of clinical medicine","volume":"21 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87062190","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 : 2023-01-01DOI: 10.18772/26180197.2023.v5n1a8
Lebohang Nkadimeng, D. Nel, H. Moutlana
{"title":"Delleman syndrome: what does this mean for my anaesthetic?","authors":"Lebohang Nkadimeng, D. Nel, H. Moutlana","doi":"10.18772/26180197.2023.v5n1a8","DOIUrl":"https://doi.org/10.18772/26180197.2023.v5n1a8","url":null,"abstract":"","PeriodicalId":75326,"journal":{"name":"Wits journal of clinical medicine","volume":"25 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80002888","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 : 2023-01-01DOI: 10.18772/26180197.2023.v5n1a2
Ahmed S. Randeree, M. Davies, C. Dayal, A. Ajayi, Z. Cassimjee
{"title":"Histological patterns of kidney disease at Helen Joseph Hospital: a 5-year retrospective review of biopsy diagnoses","authors":"Ahmed S. Randeree, M. Davies, C. Dayal, A. Ajayi, Z. Cassimjee","doi":"10.18772/26180197.2023.v5n1a2","DOIUrl":"https://doi.org/10.18772/26180197.2023.v5n1a2","url":null,"abstract":"","PeriodicalId":75326,"journal":{"name":"Wits journal of clinical medicine","volume":"18 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74560174","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 : 2023-01-01DOI: 10.18772/26180197.2023.v5n3a4
Lumart Wiechers, Gary Sudwarts, Maja Wojno, Victor Mngomezulu
Abstract Background The femoral artery has remained the primary means of vascular access for uterine artery embolisation in the treatment of uterine fibroids. Transradial access for coronary artery catheterization is gaining wider acceptance, with studies in the cardiac literature demonstrating key advantages. The primary objective of this study was to compare the technical success and safety of the transradial approach for uterine artery embolization performed at a single centre in South Africa. Methods Data was obtained from consecutive patients undergoing uterine artery embolisation for the treatment of symptomatic fibroids over a 30-month period. Specifically technical success and patient safety were analysed. Results A total of 496 patients were included in the study. Of these 27 patients had primary contraindications to radial access. The remaining 469 patients who underwent radial artery access, technical success was achieved in 459 cases (97.9%). The primary cause of technical failure was radial artery spasm (9.9%). Mean procedure times were 53.5 minutes ± 15.2 minutes with total screening times of 9.6 ± 9.1 minutes. The mean radiation dose area product was 6321.7 ± 3449.8 cGy.cm 2 . Complications were recorded in 40 (8.5%) patients, of which 7 (1.5%) were major complications. Conclusions This study corroborates evidence that this approach is a safe and effective alternative to the traditional transfemoral route for the treatment of uterine fibroids.
{"title":"Technical Success and Safety of Transradial Uterine Artery Embolisation for Symptomatic Fibroids at a Single Centre in South Africa","authors":"Lumart Wiechers, Gary Sudwarts, Maja Wojno, Victor Mngomezulu","doi":"10.18772/26180197.2023.v5n3a4","DOIUrl":"https://doi.org/10.18772/26180197.2023.v5n3a4","url":null,"abstract":"Abstract Background The femoral artery has remained the primary means of vascular access for uterine artery embolisation in the treatment of uterine fibroids. Transradial access for coronary artery catheterization is gaining wider acceptance, with studies in the cardiac literature demonstrating key advantages. The primary objective of this study was to compare the technical success and safety of the transradial approach for uterine artery embolization performed at a single centre in South Africa. Methods Data was obtained from consecutive patients undergoing uterine artery embolisation for the treatment of symptomatic fibroids over a 30-month period. Specifically technical success and patient safety were analysed. Results A total of 496 patients were included in the study. Of these 27 patients had primary contraindications to radial access. The remaining 469 patients who underwent radial artery access, technical success was achieved in 459 cases (97.9%). The primary cause of technical failure was radial artery spasm (9.9%). Mean procedure times were 53.5 minutes ± 15.2 minutes with total screening times of 9.6 ± 9.1 minutes. The mean radiation dose area product was 6321.7 ± 3449.8 cGy.cm 2 . Complications were recorded in 40 (8.5%) patients, of which 7 (1.5%) were major complications. Conclusions This study corroborates evidence that this approach is a safe and effective alternative to the traditional transfemoral route for the treatment of uterine fibroids.","PeriodicalId":75326,"journal":{"name":"Wits journal of clinical medicine","volume":"71 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134889742","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 : 2023-01-01DOI: 10.18772/26180197.2023.v5n2a4
Yvonne Jonker, F. Motara, M. Moolla
INTRODUCTION Worldwide, emergency department (ED) patient and disease burden is expected to increase over time, escalating the growing demand for healthcare workers (HCWs). In South Africa these challenges are compounded by a lack of resources and lower staff-to-patient ratios compared to developed countries.(1) The increased workload, overcrowding, staff shortages and resource constraints in the ED, can lead to workrelated stress, dissatisfaction and a higher staff turnover. (2–4) This creates additional costs for recruitment, training and employing temporary staff, thus negatively impacting patient outcome and satisfaction.(4) The South African research priorities for 2021–2024 include the need for research on HCW dissatisfaction, burnout, and the retention of staff.(5) The aim of this research was to determine the levels of burnout, job satisfaction, and the intention to leave among ED HCWs and to explore the reasons for employee resignation.
{"title":"Tertiary Hospital ED Turnover: The Key Drivers","authors":"Yvonne Jonker, F. Motara, M. Moolla","doi":"10.18772/26180197.2023.v5n2a4","DOIUrl":"https://doi.org/10.18772/26180197.2023.v5n2a4","url":null,"abstract":"INTRODUCTION Worldwide, emergency department (ED) patient and disease burden is expected to increase over time, escalating the growing demand for healthcare workers (HCWs). In South Africa these challenges are compounded by a lack of resources and lower staff-to-patient ratios compared to developed countries.(1) The increased workload, overcrowding, staff shortages and resource constraints in the ED, can lead to workrelated stress, dissatisfaction and a higher staff turnover. (2–4) This creates additional costs for recruitment, training and employing temporary staff, thus negatively impacting patient outcome and satisfaction.(4) The South African research priorities for 2021–2024 include the need for research on HCW dissatisfaction, burnout, and the retention of staff.(5) The aim of this research was to determine the levels of burnout, job satisfaction, and the intention to leave among ED HCWs and to explore the reasons for employee resignation.","PeriodicalId":75326,"journal":{"name":"Wits journal of clinical medicine","volume":"28 4-5 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75107320","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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