Impact of 20-day strike in Polokwane Hospital (18 August - 6 September 2010)

Background. Doctors’ strikes have a negative effect on hospital performance indicators. Hospital mortality during such strikes is the most important indicator.Objective. To determine the effects of the 2010 strike on Polokwane Hospital.Methods. Information was collected from the Hospital Information System, Polokwane Hospital Casualty Department, wards and theatres.Results. During the 20-day strike, a total of 262 patients were  admitted to Polokwane Hospital, with 40 patients to the surgical department; 96 operations were performed in the hospital and 40 in the surgical department; and 50 deaths were reported in the hospital (8 deaths in the surgical department). During 20 days of a non-striking period in May 2010, there were 975 admissions to the hospital, with 125 to the surgical department. In the entire hospita l, 340 operations were performed, and 79 in the surgical department. For this period, 61 deaths were reported in the hospital and 12 in the surgical department.Conclusions. The total number of patients admitted to the hospital and the surgical department during the strike was significantly lower than during a non-striking situation. Total mortality during the strike in Polokwane Hospital decreased, compared with the normal situation, but it increased when judged against emergency cases. However, when mortality was qualified by the number of admissions, it showed a significant increase. Strikes seriously and significantly affect service delivery

Nodular thyroid disease and thyroid malignancy: Experience at Polokwane Mankweng Hospital Complex, Limpopo Province, South Africa

Background. Nodular thyroid disease is common throughout the world. Numbers of patients with goitre are increasing worldwide, as also noted in Limpopo Province, South Africa (SA). Globally, thyroid nodules have been reported in 4 - 7% of the population on neck palpation and in 30 - 50% by ultrasonography.Objectives. To review the profile of thyroid disease in patients with goitre presenting to the Department of Surgery at Polokwane Mankweng Hospital Complex (PMHC), Limpopo, SA, to characterise the pattern of malignancy in patients with goitre, and to determine the most common thyroid cancer.Method. A 6-year retrospective study (2003 - 2008) of all patients with thyroid nodules who underwent thyroid surgery at PMHC.Results. The study group included 90 patients (mean age 45 years, range 4 - 80). The male-to-female ratio was 1:17 (5 men, 85 women). Of these patients, 80 (89.9%) had benign lesions, of which 52 (57.8% of the total) were adenomas, 25 (27.8%) multinodular goitres (MNGs), 2 (2.2%) hyperplastic nodules and 1 (1.1%) Hashimoto’s thyroiditis. Ten patients (11.1%) had malignant lesions (7 follicular carcinomas and 3 papillary carcinomas), of which 2 were found in MNGs.Conclusions. Adenoma and MNG were the predominant non-malignant conditions (85.6%). The prevalence of thyroid cancer in our study was 11.1%, and of all 90 patients, 7.8% had follicular carcinoma. The risk of malignancy in MNG was 8.9%. Rates of thyroid nodules and carcinoma were highest in women aged 41 - 60 years. We advocate that total thyroidectomy be considered for MNG, because MNG can harbour incidental carcinoma

Using Images to create a Hierarchical Grid Spatial Index

This paper presents a hybrid approach to spatial indexing of two dimensional data. It sheds new light on the age old problem by thinking of the traditional algorithms as working with images. Inspiration is drawn from an analogous situation that is found in machine and human vision. Image processing techniques are used to assist in the spatial indexing of the data. A fixed grid approach is used and bins with too many records are sub-divided hierarchically. Search queries are pre-computed for bins that do not contain any data records. This has the effect of dividing the search space up into non rectangular regions which are based on the spatial properties of the data. The bucketing quad tree can be considered as an image with a resolution of two by two for each layer. The results show that this method performs better than the quad tree if there are more divisions per layer. This confirms our suspicions that the algorithm works better if it gets to look at the data with higher resolution images. An elegant class structure is developed where the implementation of concrete spatial indexes for a particular data type merely relies on rendering the data onto an image.Comment: In Proceedings of the IEEE International Conference on Systems, Man and Cybernetics, Taiwan, 2006, pp. 1974-197

Provision of an emergency theatre in tertiary hospitals is cost-effective: Audit and cost of cancelled planned elective general surgical operations at Pietersburg Hospital, Limpopo Province, South Africa

Background. Cancellations of planned elective surgical operations increase financial cost to the patient and the hospital.Objectives. To determine the rate and reasons for cancellations, estimate the cost incurred by such cancellations and recommend possible solutions.Methods. We did a prospective descriptive study of cancellations of elective general surgical operations over the 1-year period January -December 2014 in the main theatre at Pietersburg (PTB) Hospital, Limpopo Province, South Africa. All patients listed on the theatrebooking slate for elective general surgical operations before the cut-off time of 13h00 on the day before the anticipated operation were included. Epi Info version 7 was used to analyse the data and derive the descriptive statistics.Results. There were 537 booked patients (median age 47 years, range 1 - 94); a total of 298 operations were performed, and 239 were cancelled (cancellation rate 44.5%). Reasons for cancellation were as follows: theatre needed for an emergency n=154 (64.4%), theatre equipment failure and lack of consumables n=17 (7.1%), non-theatre equipment failure n=10 (4.2%), prolonged time of operations n=13 (5.4%), abnormal blood results n=8 (3.3%), patient comorbidity and poor general condition n=9 (3.8%), patients absent from the ward n=8 (3.3%), patients not starved n=2 (0.8%), patients’ condition improved significantly n=3 (1.3%), nurses’ strike n=5 (2.1%), rebooking of cases for senior surgeons or other specialty n=2 (0.8%), and other reasons n=8 (3.3%). The cost per inpatient per day was estimated at ZAR4 890 at PTB Hospital and ZAR2 100 at district hospitals, and the total cost per cancelled operation was ZAR25 860.Conclusions. Over the 1-year period 44.5% of elective operations at PTB Hospital were cancelled, 64.4% because the theatre was needed for an emergency operation. We recommend that a theatre dedicated to emergencies be opened at PTB Hospital. The cost incurred due to cancellations was about ZAR6 million for the hospital, with additional cost and emotional trauma for the patients

Anthropogenic enrichment of the chemical composition of bottom sediments of water bodies in the neighborhood of a non-ferrous metal smelter (Silesian Upland, Southern Poland)

An assessment was carried out of the anthropogenic enrichment of the chemical composition of the bottom sediments of water bodies situated in an area with an urban and industrial character (63.7% of the total area). The endorheic catchments of the water bodies studied are lithologically uniform with sandy formations accounting for more than 90% of the surface area. On the basis of geoaccumulation index values, it was found that the bottom sediments of the water bodies studied were contaminated with the following elements: Cd, Zn, S, As, Pb, Sr, Co, Cr, Cu, Ba, Ni, V, Be, in degrees ranging from moderate to extreme, with lower contamination (or absence of contamination) with the same elements being found in the formations present in the vicinity and in the substrate of the basins of water bodies. It was found that one consequence of the fact that these water bodies are located in urban and industrial areas is that there is anthropogenic enrichment of the chemical composition of bottom sediments with certain basic components (organic matter, Mn, Ca and P compounds) and trace elements: Cd, Zn, Pb, Sb, As, Cu and Co, Br, Ni, S, Be, Cs, Sr, V, Cr, Sc, Ba, U, Ce, Eu and Th, with virtually no enrichment of sediments with the other basic and trace components analysed (La, Rb, K2O, Nd, Sm, Na2O, Hf, SiO2, Zr)

The development of freshwater deltas and their environmental and economic significance

The article presents the results of studies concerning the delta forms that arise as a result of the sedimentation of the debris fed to water bodies by watercourses. The study covered several dozen anthropogenic water bodies in the Upper Silesia region, which is well known for its high degree of urbanisation and industrialisation. Basic research work included morphometric measurements of deltas, analyses of the mechanical and chemical composition of delta sediments and analyses of the chemical composition of the common reed growing on the deltas. The research has demonstrated that the deltas exhibit certain characteristics typical of anthropogenic forms that result from the pollutants found in watercourses. In delta sediments, grains of sand usually dominate, but in many cases the share of the < 0.02 mm fraction is as high as ca. 30%. Sediments often contain fine coal and other organic pollutants, which is reflected by high weight loss on ignition. The content of trace elements in delta sediments is usually many times higher than the geochemical background for all types of sedimentary rocks. Deltas are an environment where pollutants accumulate and some of them are assimilated by plants. The content of macro elements in common reed tissues from different deltas does not vary widely while the content of trace elements often results from their content in the sediments. The material that forms deltas can be extracted and in some cases even used as fuel

Zbiornik Dzierżno Duże

"Zbiornik Dzierżno Duże znajduje się na pograniczu wschodniej części Kotliny Raciborskiej (318.59), która jest mezoregionem Niziny Śląskiej (318.5) i zachodniej części Wyżyny Katowickiej (314.13) zaliczanej do Wyżyny Śląskiej (341.1). Zlewnia zbiornika Dzierżno Duże o powierzchni 530 km2 prawie w całości jest położona także na Wyżynie Katowickiej, a tylko niewielkie skrawki północnego i południowego obrzeżenia zlewni zalicza się do sąsiednich mezoregionów. Pod względem administracyjnym zbiornik znajduje się w zachodniej części województwa śląskiego" [...] (fragm.

Impact of 20-day strike in Polokwane Hospital (18 August - 6 September 2010)

Background. Doctors’ strikes have a negative effect on hospital performance indicators. Hospital mortality during such strikes is the most important indicator. Objective. To determine the effects of the 2010 strike on Polokwane Hospital. Methods. Information was collected from the Hospital Information System, Polokwane Hospital Casualty Department, wards and theatres. Results. During the 20-day strike, a total of 262 patients were admitted to Polokwane Hospital, with 40 patients to the surgical department; 96 operations were performed in the hospital and 40 in the surgical department; and 50 deaths were reported in the hospital (8 deaths in the surgical department). During 20 days of a non-striking period in May 2010, there were 975 admissions to the hospital, with 125 to the surgical department. In the entire hospital, 340 operations were performed, and 79 in the surgical department. For this period, 61 deaths were reported in the hospital and 12 in the surgical department. Conclusions. The total number of patients admitted to the hospital and the surgical department during the strike was significantly lower than during a non-striking situation. Total mortality during the strike in Polokwane Hospital decreased, compared with the normal situation, but it increased when judged against emergency cases. However, when mortality was qualified by the number of admissions, it showed a significant increase. Strikes seriously and significantly affect service delivery