Pub Date : 2022-01-01DOI: 10.18772/26180197.2022.v4n2a3
Jacobus Venter, Sashen Murugan, A. Bentley
Background: Cannabis has been decriminalised for private use in South Africa in September 2018. This act may potentially lead to an increase of undesirable effects from cannabis exposures. Objectives: To describe the demographics and characteristics of reported cannabis exposure cases from June 2015 to June 2019. Methods: This was a retrospective, observational, cross-sectional study of reported cannabis exposures reported to the Poisons Information Helpline of the Western Cape (PIHWC). Data included: demographics; circumstances of exposure; route of exposure; symptom profile and changes in the number of reports made to the PIHWC from June 2015 to June 2019. Results: A total of 106 database entries were identified. The most common age groups were 20–59 years old (52.8%) followed by under 12 years old (27.3%). There was a threefold increase in cases reported during the period 06/2018 – 06/2019, compared the period 06/2015 – 06/2016. Accidental overuse (40.6%), substance abuse (26.4%) and intentional self-harm (19.8%) were the most reported circumstances of exposure. The most common route of exposure was oral (66.0%) followed by inhalation (26.4%). Central nervous system (75.5%) and gastrointestinal (20.8%) symptoms were commonly reported. Central nervous system symptoms were more commonly reported in children 12 years and younger (p=0.001) compared to those over 12 years. Conclusion: During the study period undesired effects of cannabis were commonly reported after accidental exposures and oral ingestions. Children 12 years and younger are more likely to report neurological symptoms.
{"title":"An observational study of cannabis exposures reported to the Poison Information Helpline of the Western Cape","authors":"Jacobus Venter, Sashen Murugan, A. Bentley","doi":"10.18772/26180197.2022.v4n2a3","DOIUrl":"https://doi.org/10.18772/26180197.2022.v4n2a3","url":null,"abstract":"Background: Cannabis has been decriminalised for private use in South Africa in September 2018. This act may potentially lead to an increase of undesirable effects from cannabis exposures. Objectives: To describe the demographics and characteristics of reported cannabis exposure cases from June 2015 to June 2019. Methods: This was a retrospective, observational, cross-sectional study of reported cannabis exposures reported to the Poisons Information Helpline of the Western Cape (PIHWC). Data included: demographics; circumstances of exposure; route of exposure; symptom profile and changes in the number of reports made to the PIHWC from June 2015 to June 2019. Results: A total of 106 database entries were identified. The most common age groups were 20–59 years old (52.8%) followed by under 12 years old (27.3%). There was a threefold increase in cases reported during the period 06/2018 – 06/2019, compared the period 06/2015 – 06/2016. Accidental overuse (40.6%), substance abuse (26.4%) and intentional self-harm (19.8%) were the most reported circumstances of exposure. The most common route of exposure was oral (66.0%) followed by inhalation (26.4%). Central nervous system (75.5%) and gastrointestinal (20.8%) symptoms were commonly reported. Central nervous system symptoms were more commonly reported in children 12 years and younger (p=0.001) compared to those over 12 years. Conclusion: During the study period undesired effects of cannabis were commonly reported after accidental exposures and oral ingestions. Children 12 years and younger are more likely to report neurological symptoms.","PeriodicalId":75326,"journal":{"name":"Wits journal of clinical medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86974145","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 : 2022-01-01DOI: 10.18772/26180197.2022.v4n3a9
G. Maimela
{"title":"Strengthening Health Systems for mitigating Climate Change: Responding to Climate Change as Public Health Professionals","authors":"G. Maimela","doi":"10.18772/26180197.2022.v4n3a9","DOIUrl":"https://doi.org/10.18772/26180197.2022.v4n3a9","url":null,"abstract":"","PeriodicalId":75326,"journal":{"name":"Wits journal of clinical medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89621313","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 : 2022-01-01DOI: 10.18772/26180197.2022.v4n2a6
Ruchikas Mehta, Amina Daude, E. Variava
Elevated homocysteine levels are associated with venous and arterial thrombosis. This report describes two patients with low vitamin B12 levels due to pernicious anaemia and elevated homocysteine levels, one of whom presented with an arterial thrombosis (cerebrovascular event) and another with venous thrombosis (deep vein thrombosis) without any other apparent cause for their presentation. Although not routinely recommended, it may be of value to screen patients with unexplained arterial or venous thrombotic events for elevated homocysteine levels. However, the paradox remains, that while hyperhomocysteinemia is associated with an increased risk of thrombosis, therapeutic strategies that lower homocysteine levels do not reduce the risk of thrombotic events.
{"title":"Vitamin B12 deficiency and hyperhomocysteinemia: A description of two cases with thrombosis","authors":"Ruchikas Mehta, Amina Daude, E. Variava","doi":"10.18772/26180197.2022.v4n2a6","DOIUrl":"https://doi.org/10.18772/26180197.2022.v4n2a6","url":null,"abstract":"Elevated homocysteine levels are associated with venous and arterial thrombosis. This report describes two patients with low vitamin B12 levels due to pernicious anaemia and elevated homocysteine levels, one of whom presented with an arterial thrombosis (cerebrovascular event) and another with venous thrombosis (deep vein thrombosis) without any other apparent cause for their presentation. Although not routinely recommended, it may be of value to screen patients with unexplained arterial or venous thrombotic events for elevated homocysteine levels. However, the paradox remains, that while hyperhomocysteinemia is associated with an increased risk of thrombosis, therapeutic strategies that lower homocysteine levels do not reduce the risk of thrombotic events.","PeriodicalId":75326,"journal":{"name":"Wits journal of clinical medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75034740","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 : 2022-01-01DOI: 10.18772/26180197.2022.v4n3a2
K. McCutcheon, A. Vachiat, P. Manga
{"title":"Climate Change and Cardiovascular Disease in Africa","authors":"K. McCutcheon, A. Vachiat, P. Manga","doi":"10.18772/26180197.2022.v4n3a2","DOIUrl":"https://doi.org/10.18772/26180197.2022.v4n3a2","url":null,"abstract":"","PeriodicalId":75326,"journal":{"name":"Wits journal of clinical medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82409014","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 : 2022-01-01DOI: 10.18772/26180197.2022.v4n2a1
Lara Nicole Goldsteini, Peter Beskyd, M. Wells
Introduction: South Africa has a high prevalence of trauma causing a significant healthcare and financial burden. Various scoring systems have been developed to guide trauma team activation (TTA). To date, however, there are no standardised criteria for TTA. The aim of this preliminary study was to analyse the practice of clinical judgement TTA when compared to the American College of Surgeons Committee on Trauma (ACS-COT) TTA guideline and the Loma Linda Rule for TTA. Methods: This was a retrospective analysis of trauma registry data over a one-year period from a Level 1 trauma centre in South Africa. Results: There were 9207 trauma patients that presented to the Emergency Department during the 1-year study period. The prevalence of trauma team activation by clinical judgement was 9.4%. Only 407 patients (48%) of the clinical judgement TTAs fulfilled the ACS-COT guidelines for TTA. Using the Loma Linda Rule, 456 patients (53.8%) of the clinical judgement TTAs fulfilled TTA criteria. Despite the over-triage by the clinical judgement TTA, almost two-thirds of the TTA patients were admitted to the intensive care or high care units. Conclusions: This preliminary study showed that TTA using healthcare provider clinical judgement resulted in trauma team over-activation when compared to the ACS-COT guideline and the Loma Linda Rule. Over-activation of the trauma team consumes valuable resources and potentially endangers those patients who actually need TTA and cannot receive it. Implementation of a standardised TTA tool could potentially aid in the optimisation of patient care and appropriate resource utilisation.
{"title":"An Analysis of Trauma Team Activations at a South African Level One Trauma Centre","authors":"Lara Nicole Goldsteini, Peter Beskyd, M. Wells","doi":"10.18772/26180197.2022.v4n2a1","DOIUrl":"https://doi.org/10.18772/26180197.2022.v4n2a1","url":null,"abstract":"Introduction: South Africa has a high prevalence of trauma causing a significant healthcare and financial burden. Various scoring systems have been developed to guide trauma team activation (TTA). To date, however, there are no standardised criteria for TTA. The aim of this preliminary study was to analyse the practice of clinical judgement TTA when compared to the American College of Surgeons Committee on Trauma (ACS-COT) TTA guideline and the Loma Linda Rule for TTA. Methods: This was a retrospective analysis of trauma registry data over a one-year period from a Level 1 trauma centre in South Africa. Results: There were 9207 trauma patients that presented to the Emergency Department during the 1-year study period. The prevalence of trauma team activation by clinical judgement was 9.4%. Only 407 patients (48%) of the clinical judgement TTAs fulfilled the ACS-COT guidelines for TTA. Using the Loma Linda Rule, 456 patients (53.8%) of the clinical judgement TTAs fulfilled TTA criteria. Despite the over-triage by the clinical judgement TTA, almost two-thirds of the TTA patients were admitted to the intensive care or high care units. Conclusions: This preliminary study showed that TTA using healthcare provider clinical judgement resulted in trauma team over-activation when compared to the ACS-COT guideline and the Loma Linda Rule. Over-activation of the trauma team consumes valuable resources and potentially endangers those patients who actually need TTA and cannot receive it. Implementation of a standardised TTA tool could potentially aid in the optimisation of patient care and appropriate resource utilisation.","PeriodicalId":75326,"journal":{"name":"Wits journal of clinical medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88986185","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 : 2022-01-01DOI: 10.18772/26180197.2022.v4n3a14
{"title":"Tipping points of climate change in Africa","authors":"","doi":"10.18772/26180197.2022.v4n3a14","DOIUrl":"https://doi.org/10.18772/26180197.2022.v4n3a14","url":null,"abstract":"","PeriodicalId":75326,"journal":{"name":"Wits journal of clinical medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91366841","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 : 2022-01-01DOI: 10.18772/26180197.2022.v4n3a6
Farzahna Mohamed, D. Mokgoko, J. Zamparini, V. Naidoo, Lyle Murray, N. Diana, I. Kalla
{"title":"Opening Pandora's box: Climate change, COVID-19 and the rise of a new pandemic","authors":"Farzahna Mohamed, D. Mokgoko, J. Zamparini, V. Naidoo, Lyle Murray, N. Diana, I. Kalla","doi":"10.18772/26180197.2022.v4n3a6","DOIUrl":"https://doi.org/10.18772/26180197.2022.v4n3a6","url":null,"abstract":"","PeriodicalId":75326,"journal":{"name":"Wits journal of clinical medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85997717","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 : 2022-01-01DOI: 10.18772/26180197.2022.v4n2a11
Thandeka Ngcana, J. Geel
Abstract
摘要
{"title":"Department of Paediatrics and Child Health Research Day","authors":"Thandeka Ngcana, J. Geel","doi":"10.18772/26180197.2022.v4n2a11","DOIUrl":"https://doi.org/10.18772/26180197.2022.v4n2a11","url":null,"abstract":"Abstract","PeriodicalId":75326,"journal":{"name":"Wits journal of clinical medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90507747","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 : 2022-01-01DOI: 10.18772/26180197.2022.v4n3a4
U. Subramaney, Samantha Iyaloo, Tejil Morar, Tanesha Nayager, I. Chetty
{"title":"Climate Change and Mental Health implications in South Africa","authors":"U. Subramaney, Samantha Iyaloo, Tejil Morar, Tanesha Nayager, I. Chetty","doi":"10.18772/26180197.2022.v4n3a4","DOIUrl":"https://doi.org/10.18772/26180197.2022.v4n3a4","url":null,"abstract":"","PeriodicalId":75326,"journal":{"name":"Wits journal of clinical medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75420435","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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