Scielo RSS <![CDATA[SAMJ: South African Medical Journal]]> http://www.scielo.org.za/rss.php?pid=0256-957420090003&lang=en vol. 99 num. 3 lang. en <![CDATA[SciELO Logo]]> http://www.scielo.org.za/img/en/fbpelogp.gif http://www.scielo.org.za <![CDATA[<b>A jaw for a tooth</b>: <b>the human rights cost of the Gaza invasion</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0256-95742009000300001&lng=en&nrm=iso&tlng=en http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0256-95742009000300002&lng=en&nrm=iso&tlng=en <![CDATA[<b>Misinformation and lack of knowledge hinder cervical cancer prevention</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0256-95742009000300003&lng=en&nrm=iso&tlng=en <![CDATA[<B>Complaints against doctors</B>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0256-95742009000300004&lng=en&nrm=iso&tlng=en <![CDATA[<b>Knees, Comrades and sample size</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0256-95742009000300005&lng=en&nrm=iso&tlng=en <![CDATA[<B>'Loose cannon' letlape says he was 'misinterpreted'</B>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0256-95742009000300006&lng=en&nrm=iso&tlng=en <![CDATA[<B>Cholera</B>: <B>getting the basics right</B>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0256-95742009000300007&lng=en&nrm=iso&tlng=en <![CDATA[<B>'Ethical' tariffs to be scrapped by may</B>: <B>HPCSA</B>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0256-95742009000300008&lng=en&nrm=iso&tlng=en <![CDATA[<b>Pitfalls of administering drugs via nasogastric tubes</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0256-95742009000300009&lng=en&nrm=iso&tlng=en <![CDATA[<b>Key facts on male circumcision</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0256-95742009000300010&lng=en&nrm=iso&tlng=en <![CDATA[<B>Intramyocardial tuberculosis</B>: <B>a rare underdiagnosed entity</B>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0256-95742009000300011&lng=en&nrm=iso&tlng=en <![CDATA[<b>Roads, partings and port wine</b>: <b>destinies of Russian intelligentsia</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0256-95742009000300012&lng=en&nrm=iso&tlng=en <![CDATA[<B>EM (Max) Sandler (31/05/1920 - 3/07/2008)</B>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0256-95742009000300013&lng=en&nrm=iso&tlng=en <![CDATA[<B>Eric John Sanders</B>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0256-95742009000300014&lng=en&nrm=iso&tlng=en <![CDATA[<b>Book Reviews</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0256-95742009000300015&lng=en&nrm=iso&tlng=en <![CDATA[<b>Early detection of infant hearing loss in South Africa</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0256-95742009000300016&lng=en&nrm=iso&tlng=en <![CDATA[<b>Community assault</b>: <b>the cost of rough justice</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0256-95742009000300017&lng=en&nrm=iso&tlng=en <![CDATA[<b>From 'playstation thumb' to 'cellphone thumb'</b>: <b>the new epidemic in teenagers</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0256-95742009000300018&lng=en&nrm=iso&tlng=en <![CDATA[<b>High rate of adverse events following circumcision of young male adults with the Tara KLamp technique</b>: <b>a randomised trial in South Africa</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0256-95742009000300019&lng=en&nrm=iso&tlng=en BACKGROUND: The Tara KLamp (TK) device has been claimed to enable circumcisions to be performed safely and easily in medical and non-medical environments. Published evaluation studies have been conducted among young children only. METHODS: Following a randomised controlled trial (RCT) on 3 274 participants on the impact of male circumcision on HIV transmission, 69 control group members participated in this male circumcision methods trial and were randomised to a forceps-guided (FG) group and a TK group, and circumcised. RESULTS: Of the 166 men asked to participate, 97 declined, most (94) refusing circumcision by the TK technique; 34 men were randomised to the FG group and 35 to the TK group, and 32 and 24 patients were circumcised by the FG and TK methods respectively, of whom 29 and 19 respectively attended the post-circumcision visit. All 12 adverse event sheets corresponded to the TK group (p<0.001) and circumcisions by the TK method. Less favourable outcomes were associated with the TK method, including any sign of an adverse event (37% v. 3%; p=0.004), delayed wound healing (21% v. 3%; p=0.004) and problems with penis appearance (31% v. 3%; p=0.001). Participants randomised to the TK method were significantly more likely to report bleeding (21% v. 0%; p=0.02), injury to the penis (21% v. 0%; p=0.02), infection (32% v. 0%; p=0.002), swelling (83% v. 0%; p<0.001), and problems with urinating (16% v. 0%; p=0.056). The mean score of self-estimated pain was 9.5 for participants circumcised by TK compared with 6.1 for other participants (adjusted p=0.003). Conclusion. This study provides compelling evidence that strongly cautions against use of the TK method on young adults. <![CDATA[<b>Antimicrobial susceptibility of methicillin-resistant <i>Staphylococcus aureus </i>isolates from South Africa</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0256-95742009000300020&lng=en&nrm=iso&tlng=en OBJECTIVE: Trends in the antibiotic susceptibility of methicillinresistant Staphylococcus aureus (MRSA) are regularly investigated in many countries, but minimal countrywide data are available for South Africa. The aim of this study was to describe the antibiotic susceptibility patterns of MRSA isolates collected in South Africa. DESIGN: Susceptibility testing of 248 MRSA isolates collected from 15 National Health Laboratory Services (NHLS) and 8 private laboratories against 17 antibiotics was performed using the disc diffusion method. Demographic data were collected and correlated with antibiotic resistance patterns. RESULTS: Antibiotic resistance of MRSA to erythromycin, tetracycline, trimethoprim/sulfamethoxazole, gentamicin and ciprofloxacin ranged between 55% and 78%, while all isolates were susceptible to teicoplanin, linezolid, vancomycin and quinopristin/dalfopristin. A significant difference in the resistance pattern of the isolates towards certain antimicrobial agents was identified among adults and children, as well as between isolates collected from the private and NHLS laboratories. CONCLUSION: This is the first extensive report on the antimicrobial susceptibilities of South African MRSA isolates. These data can assist treatment decisions and form a baseline for further surveillance. <![CDATA[<b>Assessing missed opportunities for the prevention of mother-to-child HIV transmission in an Eastern Cape local service area</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0256-95742009000300021&lng=en&nrm=iso&tlng=en OBJECTIVE: Trends in the antibiotic susceptibility of methicillinresistant Staphylococcus aureus (MRSA) are regularly investigated in many countries, but minimal countrywide data are available for South Africa. The aim of this study was to describe the antibiotic susceptibility patterns of MRSA isolates collected in South Africa. DESIGN: Susceptibility testing of 248 MRSA isolates collected from 15 National Health Laboratory Services (NHLS) and 8 private laboratories against 17 antibiotics was performed using the disc diffusion method. Demographic data were collected and correlated with antibiotic resistance patterns. RESULTS: Antibiotic resistance of MRSA to erythromycin, tetracycline, trimethoprim/sulfamethoxazole, gentamicin and ciprofloxacin ranged between 55% and 78%, while all isolates were susceptible to teicoplanin, linezolid, vancomycin and quinopristin/dalfopristin. A significant difference in the resistance pattern of the isolates towards certain antimicrobial agents was identified among adults and children, as well as between isolates collected from the private and NHLS laboratories. CONCLUSION: This is the first extensive report on the antimicrobial susceptibilities of South African MRSA isolates. These data can assist treatment decisions and form a baseline for further surveillance. <![CDATA[<b>Child's play</b>: <b>exposure to household pesticide use among children in rural, urban and informal areas of South Africa</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0256-95742009000300022&lng=en&nrm=iso&tlng=en BACKGROUND: As part of a larger dermatological investigation undertaken in 1999 - 2001 involving the Department of Dermatology, Groote Schuur Hospital (Cape Town, South Africa) and Nottingham University (UK), household pesticide use was investigated among Xhosa-speaking families living in three areas in South Africa (a rural area, an urban township and an informal settlement). OBJECTIVES: The aim was to characterise pesticide use patterns and potential exposures through skin absorption, ingestion and inhalation for this group of South African children. METHODS: A standardised questionnaire, which included a section investigating household pesticide use, was administered by four trained fieldworkers to the parents/guardians of the 740 children (25%) aged between 3 and 11 years identified as having atopic dermatitis either by clinical examination or according to the UK criteria (rural N=387, urban N=292, informal N=61). RESULTS: Of the children with atopic dermatitis, 539 (73%) had been exposed to household pesticides. Most childhood exposure (89%) occurred in the informal settlements, followed by 78% in the urban area and 63% in the rural area. CONCLUSIONS: This research highlighted considerable home environment pesticide exposure of South African children in lower socio-economic groups in rural, urban and informal areas. As children are particularly vulnerable to the short- and long-term health effects of pesticide exposure, further indepth investigation is needed to ascertain and document the health effects associated with such exposure in the home. <![CDATA[<b>Guideline for using growth hormone in paediatric patients in South Africa</b>: <b>treatment of growth hormone deficiency and other growth disorders</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0256-95742009000300023&lng=en&nrm=iso&tlng=en The Paediatric and Adolescent Endocrine and Diabetes Society of South Africa (PAEDS-SA) recommends, in line with other international groups, that growth hormone (GH) therapy be considered for children and adolescents with significantly short stature and poor growth velocity in the following instances: GH deficiency; Turner syndrome; Prader-Willi syndrome; small-for-gestational-age children with failure of catch-up growth; idiopathic short stature; and chronic renal insufficiency. We have produced treatment guidelines for the use of GH, designed to allow flexibility to determine coverage on a case-by-case basis. We further recommend that when used for growth promotion, GH therapy should be initiated and monitored by, or in consultation with, a paediatric endocrinologist. <![CDATA[<b>Erratum</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0256-95742009000300024&lng=en&nrm=iso&tlng=en The Paediatric and Adolescent Endocrine and Diabetes Society of South Africa (PAEDS-SA) recommends, in line with other international groups, that growth hormone (GH) therapy be considered for children and adolescents with significantly short stature and poor growth velocity in the following instances: GH deficiency; Turner syndrome; Prader-Willi syndrome; small-for-gestational-age children with failure of catch-up growth; idiopathic short stature; and chronic renal insufficiency. We have produced treatment guidelines for the use of GH, designed to allow flexibility to determine coverage on a case-by-case basis. We further recommend that when used for growth promotion, GH therapy should be initiated and monitored by, or in consultation with, a paediatric endocrinologist.