Scielo RSS <![CDATA[SAMJ: South African Medical Journal]]> http://www.scielo.org.za/rss.php?pid=0256-957420120003&lang=en vol. 102 num. 3 lang. en <![CDATA[SciELO Logo]]> http://www.scielo.org.za/img/en/fbpelogp.gif http://www.scielo.org.za <![CDATA[<b>Traditional healers formalised?</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0256-95742012000300001&lng=en&nrm=iso&tlng=en http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0256-95742012000300002&lng=en&nrm=iso&tlng=en <![CDATA[<b>Consent for children participating in research</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0256-95742012000300003&lng=en&nrm=iso&tlng=en <![CDATA[<b>Mini-slings - concern regarding marketing of these devices in South Africa</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0256-95742012000300004&lng=en&nrm=iso&tlng=en <![CDATA[<b>Management guidelines for common kidney disorders relevant to South Africa</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0256-95742012000300005&lng=en&nrm=iso&tlng=en <![CDATA[<b>Health professionals should be speaking out about the victimisation of doctors in Bahrain</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0256-95742012000300006&lng=en&nrm=iso&tlng=en <![CDATA[<b>Side-effect of acetazolamide in prevention of acute mountain sickness</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0256-95742012000300007&lng=en&nrm=iso&tlng=en <![CDATA[<b>Bogus neurosurgeon beats system hands down</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0256-95742012000300008&lng=en&nrm=iso&tlng=en <![CDATA[<b>Medical aid system</b>: <b>change way overdue</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0256-95742012000300009&lng=en&nrm=iso&tlng=en <![CDATA[<b>Answering when opportunity knocks - SATS goes global</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0256-95742012000300010&lng=en&nrm=iso&tlng=en <![CDATA[<b>Voluntary male medical circumcision</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0256-95742012000300011&lng=en&nrm=iso&tlng=en <![CDATA[<b>The medical proof doesn't get much better than VMMC</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0256-95742012000300012&lng=en&nrm=iso&tlng=en <![CDATA[<b>Voluntary male medical circumcision - Dan Ncayiyana responds</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0256-95742012000300013&lng=en&nrm=iso&tlng=en <![CDATA[<b>Circumcision - what's wrong with plastic rings?</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0256-95742012000300014&lng=en&nrm=iso&tlng=en A key issue facing countries that are scaling up circumcision services its use in adults. Cyanoacrylate tissue adhesive, widely used in all is the technical difficulty, resources used, complications, and time areas of medicine, has been shown to be superior to sutures in to healing using open surgical techniques, the only methods circumcision in terms of safety, ease of use, operative time, and approved by the major external funding agency, PEPFAR. The cosmetic results. Our experience in Mozambique suggests that WHO has developed a framework for evaluating new circumcision Gomco clamp circumcision plus tissue adhesive closure meets all devices, and two promising disposable plastic devices that have the WHO criteria for the ideal circumcision technique, and we been partially evaluated are the Shang Ring and the Prepex system. strongly recommend that African researchers conduct clinical trials However, given South Africa's disastrous experience with the Tara to compare it with open surgical circumcision. KLamp, healthy scepticism about plastic ring devices is justified. The Gomco clamp has been used in children and adults since 1935 in the USA, but there are no published studies demonstrating its use in adults. Cyanoacrylate tissue adhesive, widely used in all areas of medicine, has been shown to be superior to sutures in circumcision in terms of safety, ease of use, operative time, and cosmetic results. Our experience in Mozambique suggests that Gomco clamp circumcision plus tissue adhesive closure meets all the WHO criteria for the ideal circumcision technique, and we strongly recommend that African researchers conduct clinical trials to compare it with open surgical circumcision. <![CDATA[<b>Sick certificates issued by South African traditional health practitioners</b>: <b>current legislation, challenges and the way forward</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0256-95742012000300015&lng=en&nrm=iso&tlng=en Traditional health practitioners (THPs) play a significant role the delayed establishment of the Interim THP Council, does not in South African healthcare. However, the Basic Conditions of relieve the employer's burden of 'illegitimate' medical certificates Employment Act (BCEA) does not consider sick notes issued by issued by THPs. While seen as a dilemma for some employers, THPs to be valid. This creates a dilemma for employees, whose others have accommodated African cultural beliefs and accept right to consult a practitioner of their choice is protected by the THP-issued sick notes. Finalising the Interim THP Council will Constitution. We assessed the current legislation and highlight the allow THP registration and oblige employers to honour sick notes challenges that employees face in selecting a healthcare system of issued by THPs. The empowerment of THPs to play a meaningful their choice. The services of THPs represent an untapped capacity role in healthcare delivery is of national importance. that can complement and strengthen healthcare services, especially in the workforce. The BCEA legislative technicality, coupled with the delayed establishment of the Interim THP Council, does not relieve the employer's burden of 'illegitimate' medical certificates issued by THPs. While seen as a dilemma for some employers, others have accommodated African cultural beliefs and accept THP-issued sick notes. Finalising the Interim THP Council will allow THP registration and oblige employers to honour sick notes issued by THPs. The empowerment of THPs to play a meaningful role in healthcare delivery is of national importance. <![CDATA[<b>Developing anatomical terms in an african language</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0256-95742012000300016&lng=en&nrm=iso&tlng=en Clinical and technical information imparted in most African The ChiShona language is used to explore the ability of an languages involves inexact terminology and code switching, so it African language to develop new terminology, to name the vertebral lacks the explanatory power characterised by the English language. skeleton and describe it scientifically. It uses word compounding to African languages are absent in the tertiary science education demonstrate terminology development. ChiShona has similarities environment and forums where African scientists could present with several hundred other Bantu languages in East, Central and scientific material in the medium of African languages. This limits Southern Africa. Advancing this language can promote similar the development of African languages in the scientific domain. developments in others, making them more explanatory for the lay There has recently been a trend in several African languages to public and health professionals. develop and intellectualise them, especially in the field of medical sciences. The ChiShona language is used to explore the ability of an African language to develop new terminology, to name the vertebral skeleton and describe it scientifically. It uses word compounding to demonstrate terminology development. ChiShona has similarities with several hundred other Bantu languages in East, Central and Southern Africa. Advancing this language can promote similar developments in others, making them more explanatory for the lay public and health professionals. <![CDATA[<b>Nazier Khan</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0256-95742012000300017&lng=en&nrm=iso&tlng=en Clinical and technical information imparted in most African The ChiShona language is used to explore the ability of an languages involves inexact terminology and code switching, so it African language to develop new terminology, to name the vertebral lacks the explanatory power characterised by the English language. skeleton and describe it scientifically. It uses word compounding to African languages are absent in the tertiary science education demonstrate terminology development. ChiShona has similarities environment and forums where African scientists could present with several hundred other Bantu languages in East, Central and scientific material in the medium of African languages. This limits Southern Africa. Advancing this language can promote similar the development of African languages in the scientific domain. developments in others, making them more explanatory for the lay There has recently been a trend in several African languages to public and health professionals. develop and intellectualise them, especially in the field of medical sciences. The ChiShona language is used to explore the ability of an African language to develop new terminology, to name the vertebral skeleton and describe it scientifically. It uses word compounding to demonstrate terminology development. ChiShona has similarities with several hundred other Bantu languages in East, Central and Southern Africa. Advancing this language can promote similar developments in others, making them more explanatory for the lay public and health professionals. <![CDATA[<b>Hans de V Heese</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0256-95742012000300018&lng=en&nrm=iso&tlng=en Clinical and technical information imparted in most African The ChiShona language is used to explore the ability of an languages involves inexact terminology and code switching, so it African language to develop new terminology, to name the vertebral lacks the explanatory power characterised by the English language. skeleton and describe it scientifically. It uses word compounding to African languages are absent in the tertiary science education demonstrate terminology development. ChiShona has similarities environment and forums where African scientists could present with several hundred other Bantu languages in East, Central and scientific material in the medium of African languages. This limits Southern Africa. Advancing this language can promote similar the development of African languages in the scientific domain. developments in others, making them more explanatory for the lay There has recently been a trend in several African languages to public and health professionals. develop and intellectualise them, especially in the field of medical sciences. The ChiShona language is used to explore the ability of an African language to develop new terminology, to name the vertebral skeleton and describe it scientifically. It uses word compounding to demonstrate terminology development. ChiShona has similarities with several hundred other Bantu languages in East, Central and Southern Africa. Advancing this language can promote similar developments in others, making them more explanatory for the lay public and health professionals. <![CDATA[<b>Missing & Murdered.</b>: <b>A Personal Adventure in Forensic Anthropology.</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0256-95742012000300019&lng=en&nrm=iso&tlng=en Clinical and technical information imparted in most African The ChiShona language is used to explore the ability of an languages involves inexact terminology and code switching, so it African language to develop new terminology, to name the vertebral lacks the explanatory power characterised by the English language. skeleton and describe it scientifically. It uses word compounding to African languages are absent in the tertiary science education demonstrate terminology development. ChiShona has similarities environment and forums where African scientists could present with several hundred other Bantu languages in East, Central and scientific material in the medium of African languages. This limits Southern Africa. Advancing this language can promote similar the development of African languages in the scientific domain. developments in others, making them more explanatory for the lay There has recently been a trend in several African languages to public and health professionals. develop and intellectualise them, especially in the field of medical sciences. The ChiShona language is used to explore the ability of an African language to develop new terminology, to name the vertebral skeleton and describe it scientifically. It uses word compounding to demonstrate terminology development. ChiShona has similarities with several hundred other Bantu languages in East, Central and Southern Africa. Advancing this language can promote similar developments in others, making them more explanatory for the lay public and health professionals. <![CDATA[<b>Handling Truth</b>: <b>Navigating the Riptides of Rhetoric, Religion, Reason, and Research.</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0256-95742012000300020&lng=en&nrm=iso&tlng=en Clinical and technical information imparted in most African The ChiShona language is used to explore the ability of an languages involves inexact terminology and code switching, so it African language to develop new terminology, to name the vertebral lacks the explanatory power characterised by the English language. skeleton and describe it scientifically. It uses word compounding to African languages are absent in the tertiary science education demonstrate terminology development. ChiShona has similarities environment and forums where African scientists could present with several hundred other Bantu languages in East, Central and scientific material in the medium of African languages. This limits Southern Africa. Advancing this language can promote similar the development of African languages in the scientific domain. developments in others, making them more explanatory for the lay There has recently been a trend in several African languages to public and health professionals. develop and intellectualise them, especially in the field of medical sciences. The ChiShona language is used to explore the ability of an African language to develop new terminology, to name the vertebral skeleton and describe it scientifically. It uses word compounding to demonstrate terminology development. ChiShona has similarities with several hundred other Bantu languages in East, Central and Southern Africa. Advancing this language can promote similar developments in others, making them more explanatory for the lay public and health professionals. <![CDATA[<b>Healthcare information and the rural primary care doctor</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0256-95742012000300021&lng=en&nrm=iso&tlng=en Clinical and technical information imparted in most African The ChiShona language is used to explore the ability of an languages involves inexact terminology and code switching, so it African language to develop new terminology, to name the vertebral lacks the explanatory power characterised by the English language. skeleton and describe it scientifically. It uses word compounding to African languages are absent in the tertiary science education demonstrate terminology development. ChiShona has similarities environment and forums where African scientists could present with several hundred other Bantu languages in East, Central and scientific material in the medium of African languages. This limits Southern Africa. Advancing this language can promote similar the development of African languages in the scientific domain. developments in others, making them more explanatory for the lay There has recently been a trend in several African languages to public and health professionals. develop and intellectualise them, especially in the field of medical sciences. The ChiShona language is used to explore the ability of an African language to develop new terminology, to name the vertebral skeleton and describe it scientifically. It uses word compounding to demonstrate terminology development. ChiShona has similarities with several hundred other Bantu languages in East, Central and Southern Africa. Advancing this language can promote similar developments in others, making them more explanatory for the lay public and health professionals. <![CDATA[<b>The potential impact of a cataract surgery programme on the care of orphans and vulnerable children in Swaziland</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0256-95742012000300022&lng=en&nrm=iso&tlng=en We aimed to evaluate the potential impact of a cataract surgery weeks after surgery, there was a sizable increase in the proportions programme at the Good Shepherd Hospital, Siteki, Swaziland, of subjects who were able to undertake self-care activities, attend on the care of orphans and vulnerable children in Swaziland. We to activities of daily living, undertake income-generating activities studied consecutive patients aged 50 years and older undergoing and care for children. Cataract surgery on elderly visually impaired surgery for age-related cataract who reported having children living patients has the potential to impact positively on the care of in their household. Of 131 subjects recruited, 65 (49.6%) were the orphans and vulnerable children. primary caregivers for the child(ren) in their household. Visual acuities measured 2 weeks after surgery significantly improved. Four weeks after surgery, there was a sizable increase in the proportions of subjects who were able to undertake self-care activities, attend to activities of daily living, undertake income-generating activities and care for children. Cataract surgery on elderly visually impaired patients has the potential to impact positively on the care of orphans and vulnerable children. <![CDATA[<b>The changing trends of childhood poisoning at a tertiarychildren's hospital in South Africa</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0256-95742012000300023&lng=en&nrm=iso&tlng=en CONTEXT: Information on childhood poisoning in the developing world, including South Africa, is scarce, despite its contribution to morbidity and mortality. OBJECTIVE: We describe the profile of children with exposures and poisonings presenting to Red Cross War Memorial Children's Hospital (RCWMCH) in Cape Town, South Africa, from 2003 to 2008 and compare the trends of causative agents over the past two decades METHODS: Cases were identified by review of the RCWMCH case records. RESULTS: Of the total incidents (N=2 872), paraffin (kerosene) was the commonest agent (n=692, 24%) with 124 poisonings including two deaths. Drugs were the most common toxin group (n=988, 34%), including 139 single-drug poisonings with 5 deaths; 4 associated with traditional medicine use. Household cleaning product incidents (n=302, 10%) resulted in 29 singleproduct poisonings with no deaths. Pesticide incidents (n=311, 10%) included 6 deaths; 203 (65%) incidents were due to organophosphates or carbamates. The suburban distribution of the main toxin groups varied. Comparing 1987 and 2008, the number of incidents decreased from 1 116 to 447; drug and paraffin incidents decreased respectively (from 673 to 150 and from 332 to 87), household cleaning products and cosmetics increased (21 to 69) and pesticide incidents increased (7 to 69). CONCLUSION: Despite a decrease in the overall number of incidents over two decades at RCWMCH, paraffin and drugs remain the principal agents responsible for paediatric exposures and poisonings, with increasing incidents due to household cleaning products and pesticides. Identification of these toxin groups coming from specific suburbs allows for targeted prevention initiatives. <![CDATA[<b>Academic hospital accreditation strengthens postgraduate training programmes</b>: <b>Case study from Universitas Academic Hospital</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0256-95742012000300024&lng=en&nrm=iso&tlng=en Benefits derived from the Council for Health Services Accreditation South Africa (COHSASA) accreditation of the Universitas Academic Hospital (UAH) in Bloemfontein are illustrated. Accreditation assessments were performed between 2001 and 2007, and full compliance with the COHSASA standards for Academic Hospitals was achieved. An initiative to develop thoracic surgery in central South Africa (SA) was launched by the Department of Cardiothoracic Surgery at UAH. The synergistic effects of quality improvements in healthcare provision owing to the accreditation process, and the project to increase service provision in thoracic surgery in central SA, have led to a qualitative and quantitative increase in thoracic surgical service provision. The importance of academic hospital accreditation in strengthening postgraduate training programmes is shown, and the accreditation process is recommended for all South African academic teaching hospitals to support, improve and sustain our training platforms. <![CDATA[<b>False-positive HIV DNA PCR testing of infants</b>: <b>Implications in a changing epidemic</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0256-95742012000300025&lng=en&nrm=iso&tlng=en AIM: To examine false-positive HIV DNA polymerase chain reaction (PCR) test results in children, and the potential implications for the paediatric HIV epidemic in sub-Saharan Africa. METHODS: A review was done of records over a 6-year period of children less than 18 months old at an HIV treatment site in South Africa, to evaluate those with an initial 'false'-positive HIV DNA PCR result, but later proven to be HIV-uninfected with HIV DNA PCR and/or quantitative HIV RNA PCR tests. We calculated the influence of changing HIV transmission rates on predictive values (PV) of HIV DNA PCR tests in a hypothetical population of all HIV-exposed infants over a 1-year period. (Positive PV: proportion of individuals with a positive test with disease; negative PV: proportion of individuals with negative test and no disease). RESULTS: Of 718 children, 40 with an initial positive HIV DNA PCR test were subsequently proven to be HIV-uninfected, resulting in a positive PV of 94.4%. Most (75%) uninfected children had PMTCT interventions and were asymptomatic or mildly symptomatic (77.5%). Calculations using a test specificity of 99.4%, as reported previously, show a decrease in positive PV using a single-test strategy from 98.6% at 30% HIV transmission rate, to 94.8% at 10% transmission, to 62.5% at 1% transmission. Reduction in test specificity further decreases positive PV at low transmission rates. CONCLUSION: Decreasing mother-to-child HIV transmission rates reduce the positive predictive value of a single HIV DNA PCR test result, necessitating adaptations to diagnostic algorithms to avoid misdiagnosis and inappropriate treatment, especially with early initiation of antiretroviral therapy in asymptomatic infants. <![CDATA[<b>Nurses at risk for occupationally acquired blood-borne virus infection at a South African academic hospital</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0256-95742012000300026&lng=en&nrm=iso&tlng=en AIM: We aimed to ascertain if there had been any improvement in the number of nurses being immunised against hepatitis B virus (HBV) infection in a large academic hospital in which, 10 years previously, only 30.6% of the nurses were immune to infection with the virus, and to ascertain the incidence of infection with hepatitis C virus (HCV) and human immunodeficiency virus (HIV) in these nurses. METHODS: We studied 170 predominantly black nurses. Their blood was tested for the presence of active or past HBV infection using appropriate immunoassays, HCV infection by chromatographic immunoassays confirmed by polymerase chain reaction assays, and HIV using a rapid test confirmed by enzymelinked immunosorbent assays. RESULTS: Serum of 89 (52.4%) nurses was positive for hepatitis B surface antibody (anti-HBs). Of these nurses 18 said that they had not received the vaccine; the serum of 9 of these was positive for anti-hepatitis B core antibody (anti-HBc) as well as anti-HBs, indicating natural infection with the virus. Of the nurses positive for anti-HBs, 89 were tested for anti-HBc; 28.2% tested positive for anti-HBc. Three nurses gave dates of immunisation that fell outside of their nursing careers; 3 (1.8%) were actively infected with the virus; 2 (1.8%) were infected with HCV; 10 nurses (5.9%) were positive for HIV. CONCLUSION: Nurses at this academic hospital remain at high risk of work-related HBV infection. <![CDATA[<b>HBV/HIV co-infection</b>: <b>The dynamics of HBV in South African patients with AIDS</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0256-95742012000300027&lng=en&nrm=iso&tlng=en OBJECTIVE: As sub-Saharan Africa is highly endemic for hepatitis B virus (HBV) and human immunodeficiency virus (HIV) infections, and their co-infection requires special management, we aimed to assess the serological and molecular characteristics of HBV in patients with AIDS. DESIGN: This was a cross-sectional, case control study, which enrolled 200 patients with AIDS and 200 HIV-negative controls. HBV serology was done in all participants and HCV serology in participants with a hepatitis B core antibody (anti-HBc) only serological pattern. Nested HBV polymerase chain reaction (PCR) and HBV viral load assays were used for HBV molecular detection. RESULTS: Hepatitis B surface antigen (HBsAg) prevalence was 3-fold higher while the "anti-HBc only" pattern was 6-fold higher in the AIDS group compared with the controls. Mean HBV viral load was significantly higher in HBsAg-positive patients with CD4+ cell counts <100 cells/μl than in patients with CD4+ cell counts of 100-200 cells/μl (p=0.019). There were markedly reduced hepatitis B surface antibody (anti-HBs) titres in the AIDS group compared with the controls (p=0.002). A significant proportion of AIDS patients with an "anti-HBc only" pattern had CD4+ cell counts <100 cells/μl (p=0.004). Occult HBV prevalence was 3.5% in the AIDS group compared with 1% in the controls (p=0.092). When occult HBV infection was taken into consideration, the overall HBV prevalence became 10% in the AIDS group and 3% in the control group. CONCLUSION: We showed an increased HBV prevalence in patients with AIDS and identified a CD4+ cell count <100 cells/μl as a major risk factor for the "anti-HBc only" pattern and increased HBV replication. These data have significant public health implications for HBV in developing countries, especially in areas where antiretroviral (ARV) guidelines do not cater for HBV/HIV co-infection. <![CDATA[<b>Sharps disposal practices among diabetic patients using insulin</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0256-95742012000300028&lng=en&nrm=iso&tlng=en Insulin-dependent diabetic patients are not educated on safe sharps disposal methods, so leading to unsafe disposal of needles. Appropriate education on the correct disposal of sharps should be an integral part of their diabetic counseling. Doctors, nurses and pharmacists should all take responsibility for educating and reinforcing information about correct sharps disposal methods. Patients should be advised to either discard sharps into punctureresistant containers placed into their household refuse, or return them in secure containers for disposal by the dispensing institutions. Patients should also be educated regarding health risks associated with used needles. The South African Metabolic and Endocrine (SEMDSA) Guidelines and the South African Standard Treatment Guidelines (STG) should also give clear guidance on the safe disposal of needles. <![CDATA[<b>Chromosome 22q11 in a Xhosa schizophrenia population</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0256-95742012000300029&lng=en&nrm=iso&tlng=en Chromosome 22q11 aberrations substantially increase the risk for developing schizophrenia. Although micro-deletions in this region have been extensively investigated in different populations across the world, little is known of their prevalence in African subjects with schizophrenia. We screened 110 African Xhosa-speaking participants with schizophrenia for the presence of micro-deletions. As further verification for the presence or absence of 22q11 microdeletions, we screened 238 Xhosa schizophrenia patients and 240 healthy Xhosa individuals from a larger schizophrenia candidate 22q11 gene study using molecular analyses. Data from molecular and cytogenetic analyses confirmed the absence of 22q11 microdeletions in the Xhosa schizophrenia samples. Although the absence of chromosome 22q11 micro-deletions in this group of patients does not exclude the possibility that it may occur in Xhosa schizophrenia patients, we concluded an extremely low prevalence. Our findings suggest that unique susceptibility loci may be present in this group. <![CDATA[<b>Assisted reproductive technology in South Africa</b>: <b>first results generated from the South African Register of Assisted Reproductive Techniques</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0256-95742012000300030&lng=en&nrm=iso&tlng=en OBJECTIVE: We present the first report from the South African Register of Assisted Reproductive Techniques. METHODS: All assisted reproductive technology (ART) centres in South Africa were invited to join the register. Participant centres voluntarily submitted information from 2009 on the number of ART cycles, embryo transfers, clinical pregnancies, age of female partners or egg donors, and use of fertilisation techniques. Data were anonymised, pooled and analysed. RESULTS: The 12 participating units conducted a total of 4 512 oocyte aspirations and 3 872 embryo transfers in 2009, resulting in 1 303 clinical pregnancies. The clinical pregnancy rate (CPR) per aspiration and per embryo transfer was 28.9% and 33.6%, respectively. Fertilisation was achieved by intracytoplasmic sperm injection in two-thirds of cycles. In most cycles, 1 - 2 embryos or blastocysts were transferred. Female age was inversely related to pregnancy rate. CONCLUSION: The register achieved a high rate of participation. The reported number of ART cycles covers approximately 6% of the estimated ART demand in South Africa. The achieved CPRs compare favourably with those reported for other countries. <![CDATA[<b>Paediatric anticoagulation guidelines</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0256-95742012000300031&lng=en&nrm=iso&tlng=en BACKGROUND: Recent progress has been made in the understanding of venous thrombo-embolism (VTE) in children and neonates; however, indications for laboratory investigations and therapeutic interventions are not well defined. METHOD: The Southern African Society of Thrombosis and Haemostasis reviewed available literature and comprehensive evidence-based guidelines for paediatric antithrombotic therapy. A draft document was produced and revised by consensus agreement. The guidelines were adjudicated by independent international experts to avoid local bias. RESULTS AND CONCLUSION: We present concise, practical guidelines for the clinical management and laboratory investigation of VTE in children and neonates. Recommendations reflect current best practice which will hopefully lead to improved anticoagulation practice in this age group. <![CDATA[<b>South African Dyslipidaemia Guideline Consensus Statement</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0256-95742012000300032&lng=en&nrm=iso&tlng=en The European Society of Cardiology together with the European Atherosclerosis Society published updated dyslipidaemia guidelines in 2011. SA Heart and the Lipid and Atherosclerosis Society of Southern Africa officially adopt these guidelines. This statement adapts aspects of the guidelines to the South African situation. Using the updated Framingham risk charts, interventional strategies are based according to the cardiovascular risk score and low-density lipoprotein cholesterol (LDL-C) levels. The Framingham risk score refers to the 10-year risk of any cardiovascular event, and includes four categories of risk. Treatment targets are those of the European guidelines. The LDL-C goal is 1.8 mmol/l for the very high-risk group (>30%), 2.5 mmol/l for the high-risk group (15 - 30%), and 3 mmol/l for those below 15% risk. Intensive management of dyslipidaemia in South Africa will significantly reduce the cardiovascular disease health burden.