With 23.5 suicide-related deaths per 100 000 population, South Africa (SA) has the eighth-highest age-standardised suicide rate in the world. Intentional self-poisoning is associated with significant ...morbidity, mortality and cost. In SA, self-poisoning is the leading method of suicide in females and the second leading method in males. To determine the profile of patients presenting with intentional self-poisoning to the Charlotte Maxeke Johannesburg Academic Hospital emergency department. The study was a cross-sectional, retrospective audit of the medical records of patients who presented over a 12-month period with intentional self-poisoning.Of the 288 patients included, 62.8% were female, 62.1% were aged 18 - 30 years, 22.2% were foreign nationals, 88.9% were single, 62.8% were unemployed, 82.3% reported that the episode was precipitated by an acute stressful event, 5.6% required intensive care unit (ICU) admission, and 4.5% died prior to hospital discharge. Organophosphate/carbamate pesticide ingestion was the most common method of self-poisoning (25.3%) and was responsible for the majority of ICU admissions (81.3%), cases requiring hospitalisation for >6 days (56.5%) and deaths (69.2%).A large proportion of patients were female, 18 - 30 years of age, single, unemployed, and reported an acute stressful event as a precipitant. Organophosphate/carbamate pesticide ingestion was the most common method of self-poisoning and accounted for the majority of deaths and ICU admissions. Nationwide efforts should be aimed at enhancing awareness and implementing strategies to identify those at increased risk of suicidal behaviour.
Stroke is a leading cause of morbidity and mortality. Most deaths occur in low- and middle-income countries, with the incidence predicted to increase as populations undergo socioeconomic and ...epidemiological changes. Knowledge of contributing factors in a South African (SA) population can be used to drive healthcare initiatives to modify this burden of disease. To analyse epidemiological data on patients with stroke presenting to an emergency department in Johannesburg, SA. The study was a 12-month descriptive, retrospective review of medical records, undertaken at a tertiary-level hospital. Patients’ records were selected based on the presumptive diagnosis of stroke. Data collected included ethnicity, age, gender, risk factors, signs and symptoms at presentation, and computed tomography (CT) brain scan findings.Of 312 records reviewed, 160 were eligible for inclusion. The mean age of the patients included was 57.7 years, and 64 patients (40%) had CT-confirmed haemorrhagic strokes. Hypertension was the most common comorbidity/risk factor identified, in the sample as a whole (n=93; 58%) and in both patients with haemorrhagic (n=33; 52%) and ischaemic strokes (n=56; 61%). Diabetes was the second most common comorbidity/risk factor (n=23; 14%), and was three times more likely in patients with ischaemic strokes (n=19; 20%) compared with haemorrhagic strokes (n=4; 6%).Stroke is an important healthcare concern for SA. Our study demonstrated a lower mean age of patients presenting with stroke compared with high- and upper middle-income countries, and a higher proportion of haemorrhagic strokes. Several modifiable risk factors such as hypertension and diabetes were identified. Data collection on a regional and national level is important to drive targeted healthcare initiatives.
SARS-CoV-2 has resulted in a global pandemic within months following its initial detection. South Africa (SA), like many other countries, was not prepared for the impact this novel infection would ...have on the healthcare system. In this paper, the authors discuss the challenges experienced while facing COVID-19 at a tertiary-level institution in Gauteng province, SA, and the dynamic strategies implemented to deal with the epidemic.
Early online T Hardcastle; A Engelbrecht; V Lalloo ...
South African medical journal,
06/2023, Letnik:
113, Številka:
6
Journal Article
Recenzirano
Odprti dostop
This article explores the management of snakebite to vulnerable patient groups, namely children and pregnant women as well as providing detail on the current best practice when caring for venom ...ophthalmia and surgical wounds resulting from snakebite. Finally, the optimal free-to-use medical record for accurate documentation of snakebite incidents is provided for use by South African practitioners.
Coronary artery fistulas (CAF) are unusual coronary artery connections with low pressure cardiac chambers or vessels. The majority are congenital, but can also be acquired. Complications include ...heart failure, myocardial infarction and arrhythmias. Symptomatic and large CAF require treatment and options include surgical ligation or percutaneous device embolisation of the fistula which has emerged as a less invasive and equally efficacious management modality. Careful interrogation of the CAF is required prior to occlusion in order not to compromise normal coronary artery vasculature that may arise from the fistula which can lead to myocardial ischaemia and infarction. Several reported cases highlight thrombus formation within large CAF after surgical ligation with propagation of the thrombus into coronary vessels arising proximally, resulting in myocardial compromise. We present a series of 6 children with CAF, 2 were treated by per-cutaneous embolisation (one developed a myocardial infarction post procedure) and 3 were treated surgically.
Medical records may be considered to be any information and documents kept in a systematic, scientific and easy way that help clinicians retrieve the required data on a patient at the time it is ...needed. They can cover a wide range of material including handwritten notes, computerised records, correspondence between health professionals, laboratory reports, imaging reports, videos and printouts from monitoring equipment.
Background. Acute mountain sickness (AMS) is an ever-increasing burden on the health sector. With reported incidences of greater than 50%, coupled with the fact that recreational activities at high ...altitude are gaining increasing popularity, more persons are developing AMS. Physicians are therefore increasingly faced with the task of managing and preventing AMS. Objectives. The pathophysiology of AMS is poorly understood, with little understanding of risk factors for the development of AMS. This research aimed to identify epidemiological and physiological risk factors for development of AMS. Methods. This study is a questionnaire-based study conducted in London and at Everest Base Camp, in which 116 lowlanders were invited to participate and fill in a questionnaire to identify potential risk factors in their history that may have contributed to development of or protection against AMS. Results. A total of 89 lowlanders enrolled in the study. Thirty-seven of the participants had AMS at Everest Base Camp, giving a prevalence of 42%. Of the demographic variables, only weight and body mass index (BMI) were statistically significantly associated with AMS, with those who weighed less or had a lower BMI more likely to get AMS. Previous high-altitude experience was also associated with AMS, with those who had such experience less likely to get AMS. Conclusion. Predicting AMS and furthering our understanding of the pathophysiology of AMS will be of tremendous benefit. Further research is needed in this regard. S Afr J Sports Med 2015;27(3):82-86. DOI: 10.7196/SAJSM.8112
PDF
