Pub Date : 2022-01-01DOI: 10.18772/26180197.2022.v4n3a12
Francois Engelbrecht, C. Wright, C. Vogel
{"title":"Living with climate health risks – opportunities and challenges in southern Africa","authors":"Francois Engelbrecht, C. Wright, C. Vogel","doi":"10.18772/26180197.2022.v4n3a12","DOIUrl":"https://doi.org/10.18772/26180197.2022.v4n3a12","url":null,"abstract":"","PeriodicalId":75326,"journal":{"name":"Wits journal of clinical medicine","volume":"17 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80154542","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.v4n2a4
Michelle Marx, Byron Ter Morshuizen, M. Venter, Tahir Dawood
Background: Infection prevention and control (IPC) preparation and how it relates to the use and reuse of personal protective Equipment (PPE), as well as behavioural changes among doctors has been an area of interest for researchers since the Severe Acute Respiratory Syndrome and Middle East Respiratory Syndrome outbreaks. The aim of this study is to describe the role of IPC practices of doctors at a large urban public hospital in South Africa during the SARS-CoV-2 pandemic of 2020. Methods: A cross-sectional survey was performed on doctors from the general medical and surgical disciplines of the hospital. All levels of staff were interviewed using an anonymous voluntary self-administered questionnaire administered over a 4-week period. Results: We determined that the majority of the participants (87.5%) were involved in the care of COVID-19 patients. Internal Medicine participants were more likely to work in a respiratory ward compared to their surgical counterparts. Of the surveyed sample, 90.4% indicated that they received formal IPC training during the COVID-19 pandemic. Contrasting this, only half (52.9%) felt prepared to apply these principles when working with COVID-19 patients. Almost all respondents (90.0%) surveyed reported using PPE. Of the respondents using PPE, 94.4% were reusing their PPE. From the total sample population, 95.2% reported implementing behavioural changes. Conclusion: Although the majority of doctors surveyed were involved in the care of COVID-19 patients, almost half did not feel prepared to deal with COVID-19 patients despite training being made available. The study also showed a disparity in behavioural changes by health professionals in the medical and surgical departments. The study highlights the importance of targeted ongoing IPC training across departments.
{"title":"Infection control practices of medical practitioners at a large urban public hospital in South Africa during the SARS-COV-2 Pandemic","authors":"Michelle Marx, Byron Ter Morshuizen, M. Venter, Tahir Dawood","doi":"10.18772/26180197.2022.v4n2a4","DOIUrl":"https://doi.org/10.18772/26180197.2022.v4n2a4","url":null,"abstract":"Background: Infection prevention and control (IPC) preparation and how it relates to the use and reuse of personal protective Equipment (PPE), as well as behavioural changes among doctors has been an area of interest for researchers since the Severe Acute Respiratory Syndrome and Middle East Respiratory Syndrome outbreaks. The aim of this study is to describe the role of IPC practices of doctors at a large urban public hospital in South Africa during the SARS-CoV-2 pandemic of 2020. Methods: A cross-sectional survey was performed on doctors from the general medical and surgical disciplines of the hospital. All levels of staff were interviewed using an anonymous voluntary self-administered questionnaire administered over a 4-week period. Results: We determined that the majority of the participants (87.5%) were involved in the care of COVID-19 patients. Internal Medicine participants were more likely to work in a respiratory ward compared to their surgical counterparts. Of the surveyed sample, 90.4% indicated that they received formal IPC training during the COVID-19 pandemic. Contrasting this, only half (52.9%) felt prepared to apply these principles when working with COVID-19 patients. Almost all respondents (90.0%) surveyed reported using PPE. Of the respondents using PPE, 94.4% were reusing their PPE. From the total sample population, 95.2% reported implementing behavioural changes. Conclusion: Although the majority of doctors surveyed were involved in the care of COVID-19 patients, almost half did not feel prepared to deal with COVID-19 patients despite training being made available. The study also showed a disparity in behavioural changes by health professionals in the medical and surgical departments. The study highlights the importance of targeted ongoing IPC training across departments.","PeriodicalId":75326,"journal":{"name":"Wits journal of clinical medicine","volume":"34 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90414387","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.v4n2a7
M.R.R. Adam, RP Lebese, L. Mbodi
We present a case of a patient who had a vulvectomy for large genital warts that could not be primarily closed but was successfully managed with a modified approach of the vacuum dressing until it was closed, allowed to heal, with a cosmetically acceptable outcome to the satisfaction of both the team and the patient.
{"title":"The Innovative use of modified vacuum dressing in post vulvectomy wound","authors":"M.R.R. Adam, RP Lebese, L. Mbodi","doi":"10.18772/26180197.2022.v4n2a7","DOIUrl":"https://doi.org/10.18772/26180197.2022.v4n2a7","url":null,"abstract":"We present a case of a patient who had a vulvectomy for large genital warts that could not be primarily closed but was successfully managed with a modified approach of the vacuum dressing until it was closed, allowed to heal, with a cosmetically acceptable outcome to the satisfaction of both the team and the patient.","PeriodicalId":75326,"journal":{"name":"Wits journal of clinical medicine","volume":"14 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72676926","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.v4n2a2
A. Ajayi, M. Venter, Michelle Wong
Background: A definitive diagnosis of respiratory pathology is often elusive without tissue biopsy. Bronchoscopy is indispensable to visualise and sample endobronchial lesions and lung parenchyma. Objectives: To describe the practise of fibreoptic bronchoscopy at Chris Hani Baragwanath Academic Hospital (CHBAH). Outcomes include patient demographics, as well as indications and findings of fibreoptic bronchoscopy. To define possible associations between demographic characteristics and final diagnosis. Methods: Retrospective record review of patients who had undergone fibreoptic bronchoscopy at CHBAH over a 8-year period (2011–2018). Results: Bronchoscopy records were retrieved for 830 patients. Two thirds of patients were male; the mean age of patients was 56.1 (+/−13.3) years. Human Immunodeficiency virus (HIV) status was reported in 74%. Twenty-two percent of this population was seropositive for HIV (median CD4 count 233 cells/mm3, IQR: 85–434 cells/mm3). Most were performed for suspected endobronchial lesions (52%), and 12% for pulmonary infiltrates. The most common final diagnosis was lung malignancy in 39% of patients. Squamous cell carcinoma was identified in 43%, followed by adenocarcinoma (31%). Women and HIV positive patients were less likely to be diagnosed with malignancy compared to men and HIV negative patients. The complication rate for bronchoscopy was 2%. Conclusion: Suspected endobronchial lesions were the most common indication for bronchoscopy, and the most common diagnosis was primary lung cancer. Bronchoscopy is a useful tool in the diagnosis of respiratory disease with a low complication rate.
{"title":"A comprehensive evaluation of bronchoscopy at a large urban public hospital in South Africa","authors":"A. Ajayi, M. Venter, Michelle Wong","doi":"10.18772/26180197.2022.v4n2a2","DOIUrl":"https://doi.org/10.18772/26180197.2022.v4n2a2","url":null,"abstract":"Background: A definitive diagnosis of respiratory pathology is often elusive without tissue biopsy. Bronchoscopy is indispensable to visualise and sample endobronchial lesions and lung parenchyma. Objectives: To describe the practise of fibreoptic bronchoscopy at Chris Hani Baragwanath Academic Hospital (CHBAH). Outcomes include patient demographics, as well as indications and findings of fibreoptic bronchoscopy. To define possible associations between demographic characteristics and final diagnosis. Methods: Retrospective record review of patients who had undergone fibreoptic bronchoscopy at CHBAH over a 8-year period (2011–2018). Results: Bronchoscopy records were retrieved for 830 patients. Two thirds of patients were male; the mean age of patients was 56.1 (+/−13.3) years. Human Immunodeficiency virus (HIV) status was reported in 74%. Twenty-two percent of this population was seropositive for HIV (median CD4 count 233 cells/mm3, IQR: 85–434 cells/mm3). Most were performed for suspected endobronchial lesions (52%), and 12% for pulmonary infiltrates. The most common final diagnosis was lung malignancy in 39% of patients. Squamous cell carcinoma was identified in 43%, followed by adenocarcinoma (31%). Women and HIV positive patients were less likely to be diagnosed with malignancy compared to men and HIV negative patients. The complication rate for bronchoscopy was 2%. Conclusion: Suspected endobronchial lesions were the most common indication for bronchoscopy, and the most common diagnosis was primary lung cancer. Bronchoscopy is a useful tool in the diagnosis of respiratory disease with a low complication rate.","PeriodicalId":75326,"journal":{"name":"Wits journal of clinical medicine","volume":"33 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74110639","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.v4n3a5
Ashraf Coovadia, M. Chersich, A. le Roux, C. Wright
{"title":"Climate Change and the Health of Children in Southern Africa – The Time to Act is Now","authors":"Ashraf Coovadia, M. Chersich, A. le Roux, C. Wright","doi":"10.18772/26180197.2022.v4n3a5","DOIUrl":"https://doi.org/10.18772/26180197.2022.v4n3a5","url":null,"abstract":"","PeriodicalId":75326,"journal":{"name":"Wits journal of clinical medicine","volume":"26 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79077087","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.v4n2a5
D. Naidoo, A. Mochan
INTRODUCTION October 1, 2021, marked the 50th anniversary of the very first computed tomography (CT) scan of a patient. The scan was performed at Atkinson Morley’s Hospital in Wimbledon, London, revealing for the very first time a direct live image of the human brain. The unfortunate patient, a 41-year-old woman, harbored a brain tumor which the scan, although grainy, clearly and unequivocally revealed.(1) (Fig. 1) This image has come to capture imagination in much the same way as that of Mrs. Röntgen’s hand in 1895. Unlike the controversy surrounding the invention of the MRI,(2) Godfrey Hounsfield is the indisputable inventor of the clinical CT scan. Nevertheless, two South Africans who both completed their undergraduate degrees in South Africa, made seminal and original contributions toward the foundational theory and clinical development of the CT scan. This South African contribution is today, 50 years on, rarely acknowledged, let alone celebrated, by even South Africans themselves: in a widely circulated South African online article commemorating the 50th anniversary of the CT scan, no mention was made of the South African connection.(3) This brief vignette aims to tell the story of the CT scan and the South Africans central to its development, which came to completely revolutionise the practice of neurology and neurosurgery and, shortly thereafter, of medicine itself.
{"title":"Celebrating 50 years of the first human CT scan: The untold South African connection","authors":"D. Naidoo, A. Mochan","doi":"10.18772/26180197.2022.v4n2a5","DOIUrl":"https://doi.org/10.18772/26180197.2022.v4n2a5","url":null,"abstract":"INTRODUCTION October 1, 2021, marked the 50th anniversary of the very first computed tomography (CT) scan of a patient. The scan was performed at Atkinson Morley’s Hospital in Wimbledon, London, revealing for the very first time a direct live image of the human brain. The unfortunate patient, a 41-year-old woman, harbored a brain tumor which the scan, although grainy, clearly and unequivocally revealed.(1) (Fig. 1) This image has come to capture imagination in much the same way as that of Mrs. Röntgen’s hand in 1895. Unlike the controversy surrounding the invention of the MRI,(2) Godfrey Hounsfield is the indisputable inventor of the clinical CT scan. Nevertheless, two South Africans who both completed their undergraduate degrees in South Africa, made seminal and original contributions toward the foundational theory and clinical development of the CT scan. This South African contribution is today, 50 years on, rarely acknowledged, let alone celebrated, by even South Africans themselves: in a widely circulated South African online article commemorating the 50th anniversary of the CT scan, no mention was made of the South African connection.(3) This brief vignette aims to tell the story of the CT scan and the South Africans central to its development, which came to completely revolutionise the practice of neurology and neurosurgery and, shortly thereafter, of medicine itself.","PeriodicalId":75326,"journal":{"name":"Wits journal of clinical medicine","volume":"54 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85198940","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.v4n2a8
R. Pswarayi, James Pattinson, Gabriela Hyman
The aetiology of hollow visceral myopathy remains poorly understood despite the review of histology and is often misdiagnosed. It is characterized by impaired intestinal function and motility in absence of mechanical obstruction, which may be familial (transmitted by a dominant or recessive gene) or sporadic. Familial visceral myopathy is a rare hereditary myopathic degeneration of both gastrointestinal (and urinary tracts) that causes chronic intestinal obstruction. Typically, it presents after the first decade of life with symptoms of abdominal distension, abdominal pain, vomiting, constipation, and diarrhoea. It is, therefore, a rare cause of chronic intestinal pseudo-obstruction. Secondary chronic intestinal pseudo-obstruction is typically managed by treating the underlying condition, however, decompression by colostomy or tube gastrostomy/enterostomy/caecostomy may be performed; this also allows for feeding and irrigation of the alimentary tract. This case study emphasizes the atypical presentation of hollow visceral myopathy and the importance of thorough investigations, the various findings during surgery (including a para-duodenal volvulus), and the different approaches to decompression of the intestinal tract that may be considered for such a patient.
{"title":"Hollow Visceral Myopathy: Diagnosis and Management","authors":"R. Pswarayi, James Pattinson, Gabriela Hyman","doi":"10.18772/26180197.2022.v4n2a8","DOIUrl":"https://doi.org/10.18772/26180197.2022.v4n2a8","url":null,"abstract":"The aetiology of hollow visceral myopathy remains poorly understood despite the review of histology and is often misdiagnosed. It is characterized by impaired intestinal function and motility in absence of mechanical obstruction, which may be familial (transmitted by a dominant or recessive gene) or sporadic. Familial visceral myopathy is a rare hereditary myopathic degeneration of both gastrointestinal (and urinary tracts) that causes chronic intestinal obstruction. Typically, it presents after the first decade of life with symptoms of abdominal distension, abdominal pain, vomiting, constipation, and diarrhoea. It is, therefore, a rare cause of chronic intestinal pseudo-obstruction. Secondary chronic intestinal pseudo-obstruction is typically managed by treating the underlying condition, however, decompression by colostomy or tube gastrostomy/enterostomy/caecostomy may be performed; this also allows for feeding and irrigation of the alimentary tract. This case study emphasizes the atypical presentation of hollow visceral myopathy and the importance of thorough investigations, the various findings during surgery (including a para-duodenal volvulus), and the different approaches to decompression of the intestinal tract that may be considered for such a patient.","PeriodicalId":75326,"journal":{"name":"Wits journal of clinical medicine","volume":"76 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83308696","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.v4n3a8
Akshay Manga, Denis Dartchiev, E. Variava
{"title":"Healthcare and Climate Change: A South African Health Professionals’ Perspective","authors":"Akshay Manga, Denis Dartchiev, E. Variava","doi":"10.18772/26180197.2022.v4n3a8","DOIUrl":"https://doi.org/10.18772/26180197.2022.v4n3a8","url":null,"abstract":"","PeriodicalId":75326,"journal":{"name":"Wits journal of clinical medicine","volume":"68 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85731996","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.v4n3a7
Mf Chersich, G. Maimela, DP Lakhoo, I. Solarin, C. Parker, F. Scorgie
{"title":"Climate change impacts on maternal and new-born health in Africa: Intervention options","authors":"Mf Chersich, G. Maimela, DP Lakhoo, I. Solarin, C. Parker, F. Scorgie","doi":"10.18772/26180197.2022.v4n3a7","DOIUrl":"https://doi.org/10.18772/26180197.2022.v4n3a7","url":null,"abstract":"","PeriodicalId":75326,"journal":{"name":"Wits journal of clinical medicine","volume":"22 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79144794","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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