Injuries in children and adolescents seen during 2006 at the emergency department of the National District Hospital, Bloemfontein

Background: Most children and adolescents recover fully from injuries. However, permanent disabilities may occur. The objective of the study was to investigate the prevalence and profile of injuries in children and adolescents five to 19 years of age seen at the emergency department of the National District Hospital in Bloemfontein.Methods: A retrospective descriptive study was conducted. Demographic and injury-specific information obtained from hospital records of 2006 was entered into a data-capturing form. Data were analysed by using descriptive statistics. Results: The prevalence of injuries in this age group was 20.3%. Two hundred and nine records were investigated. The majority of cases were male (68.3%). The median age was 15 years, and 43.5% of injuries occurred in the age group 15 to 19 years. Approximately half (51.7%) were Afrikaans-speaking and resided in suburban areas (50%). Most injuries occurred at home (40.2%) between 12h00 and 17h00 (38.7%). Falls (33.7%) were the most common cause of injury. Soft tissue injuries (35.9%) occurred most commonly, fol lowed by lacerations (33.0%) and fractures (16.7%). Upper limb injuries (42.1%) were seen more than lower limb injuries (27.8%). Facial injuries occurred in 12% of cases. X-rays were performed in 57.9% of cases. Most patients (93.3%) received medication, while 22% were referred for specialist treatment. All cases except one were discharged from the emergency department. Parents accompanied patients in 65.6% of cases.Conclusions: Optimal treatment should be given to the injured child or adolescent to avoid possible long-term injuryrelated sequelae. Preventive strategies should be formulated, enforced and evaluated.Keywords: injuries; children; adolescents; prevalence; preventio

The prevalence of the diagnosis of increased intra-ocular pressure in a general practice

Glaucoma is one of the main causes of blindness.1 The disease occurs in 3% to 4% of all people over the age of 70 years.1 As many as 50% of patients suffering from this disease are unaware of their condition until a comparatively late stage, due to the asymptomatic nature of the disease.2 Of the objective signs of primary open angle glaucoma, the loss of visual field and pathological cupping would generally have reached an advanced stage before they could be recognised by a general practitioner, and aqueous flow can only be measured with the use of specialised equipment. However, increased intra-ocular pressure can easily be detected by tonometry performed by a general practitioner.3For full text, click here:SA Fam Pract 2006;48(3):16-1

risk-factor profile for chronic lifestyle diseases in three rural Free State towns

Background: Chronic diseases of lifestyle account for millions of deaths each year globally. These diseases share similar modifiable risk factors, including hypertension, tobacco smoking, diabetes, obesity,  hyperlipidaemia and physical inactivity. In South Africa the burden of noncommunicable disease risk factors is high. To reduce or control as many lifestyle risk factors as possible in a population, the distinct risk-factor profile for that specific community must be identified. Therefore, the aim of this study was to assess the health status in three rural Free State communities and to identify a distinct risk-factor profile for chronic lifestyle diseases in these communities.Methods: This study forms part of the baseline phase of the Assuring Health for All in the Free State project, which is a prospective and longitudinal epidemiological study aimed at determining how living in a rural area can either protect or predispose one to developing chronic lifestyle diseases. The communities of three black and coloured, rural Free State areas, namely Trompsburg, Philippolis and Springfontein, were evaluated. The study population consisted of 499 households, and 658 individuals (including children) participated in the study. Only results of adult participants between 25 and 64 years will be reported in this article. The study group consisted of 29.4% male and 70.6% female participants, with a mean age of 49 years. During interviews with trained researchers, household socio-demographic questionnaires, as well as individual  questionnaires evaluating diet, risk factors (history of hypertension and/or diabetes) and habits (tobacco smoking and physical activity levels), were completed. All participants underwent anthropometric evaluation, medical examination and blood sampling to determine fasting blood glucose levels.Results: Multiple risk factors for noncommunicable diseases were identified in this study population, including high blood pressure, tobacco smoking,high body mass index (BMI), diabetes and physical inactivity. The reported risk-factor profile was ranked. Increased waist circumference was rankedhighest, high blood pressure second, tobacco smoking third, physical inactivity fourth and diabetes fifth. The cumulative risk-factor profile revealed that 35.6 and 21% of this study population had two and three risk factors, respectively.Conclusions: The study demonstrated a high prevalence of risk factors for noncommunicable diseases, e.g. large waist circumference, high BMI,raised blood pressure, tobacco smoking and raised blood glucose levels. Serious consideration should be given to this escalating burden of lifestylediseases in the study population. The development and implementation of relevant health promotion and intervention programmes that will improvethe general health and reduce the risk for noncommunicable diseases in this population are advised.Keywords: risk; lifestyle; chronic disease

The effects of applied water at various fractions of measured evapotranspiration on reproductive growth and water productivity of Thompson Seedless grapevines

The reproductive growth and water productivity (WPb) of Thompson Seedless grapevines were measured as a function of applied water amounts at various fractions of measured grapevine ETc for a total of eight irrigation treatments. Shoots were harvested numerous times during the growing season to calculate water productivity. Berry weight was maximized at the 0.6–0.8 applied water treatments across years. As applied water amounts increased soluble solids decreased. Berry weight measured at veraison and harvest was a linear function of the mean midday leaf water potential measured between anthesis and veraison and anthesis and harvest, respectively. As applied water amounts increased up to the 0.6–0.8 irrigation treatments there was a significant linear increase in yield. Yields at greater applied water amounts either leveled off or decreased. The reduction in yield on either side of the yearly maximum was due to fewer numbers of clusters per vine. Maximum yield occurred at an ETc ranging from 550 to 700 mm. Yield per unit applied water and WPb increased as applied water decreased. The results from this study demonstrated that Thompson Seedless grapevines can be deficit irrigated, increasing water use efficiency while maximizing yields

Obesity is associated with anaemia and iron deficiency indicators among women in the rural Free State, South Africa

Objective: Obesity and anaemia remain global public health problems, holding major consequences for human health. The objective was to determine body composition, prevalence of anaemia and iron deficiency, contraception use and associations between variables in rural women in the Free State, South Africa. Design: A cross-sectional study design was applied. Setting: The study was undertaken in rural Trompsburg, Philippolis and Springfontein. Subjects: A total of 134 HIV-uninfected non-pregnant females, aged between 25 and 49 years participated. Exposure and outcome measures: Data were collected on anthropometry, contraception use and biochemical markers of anaemia, iron deficiency and inflammation. Results: Median body mass index (BMI) (28.7 [24.2, 34.7] kg/m2), waist circumference (90.8 [80.9, 103.0] cm) and body fat percentage (38.8 [34.3, 42.1] %) were classified as unhealthy. Only 2/134 had iron deficiency and 1/134 iron deficiency anaemia. Overall, 3.8% had low red cell folate levels. Almost half (45.0%) had elevated C-reactive protein (CRP) levels. More than half (54.1%) reported that they regularly menstruate and 71.6% currently or had previously used injectable contraceptives. Mean corpuscular volume (MCV), mean corpuscular haemoglobin (MCH) and transferrin saturation were significantly associated with BMI, waist circumference and body fat percentage. Conclusion: A predominant pattern of malnutrition, characterised by overweight and obesity, was prevalent. Risk for iron deficiency was associated with obesity. Prevalence of iron deficiency could be underestimated due to the large percentage with elevated CRP levels. Interventions should aim to improve the nutritional status of these women in order to reduce their risk for both chronic diseases and anaemia

Guidelines prescribed by general practitioners to patients with acute low back pain regarding “return to work”

Background: The traditional treatment protocol for acute low back pain (ALBP) primarily used by healthcare professionals has in the past decade been strict bed rest, corsets, traction and ‘back schools'. However, current research has led to dramatic changes in the traditional treatment protocol. The literature suggests that the protocol should be replaced by parsimonious imaging, early return to normal activities and greater emphasis on exercise to prevent recurrences of ALBP and to treat chronic pain. The aim of this study was to investigate the guidelines prescribed by general practitioners (GPs) to patients with acute low back pain (ALBP) regarding ‘return to work'. Methods: A systematic sample of 212 GPs, selected from a list supplied by the Health Professions Council of South Africa (HPCSA), was selected to complete questionnaires. The highest qualifications of the GPs were MBChB or MFamMed, and all of them practise in the Bloemfontein area. Results: Sixty-three respondents stated that 40% of ALBP patients returned for follow-up consultations. Of the 63 respondents, eight GPs had not consulted ALBP patients in the preceding two years, and thus were excluded from the final number of respondents. Bed rest is still prescribed by 67.27% of GPs and, although 47.27% of the GPs were aware of the change in protocol, only 9% prescribe ‘return to work'. A total of 18.18% are aware of evidence-based guidelines and 10% of the GPs prescribe these. Among the guidelines defined by the GPs are lifestyle changes, rest and stabilisation. Only 18.18% of ALBP patients are referred to occupational therapy for treatment. Conclusion: Only 47.27% of the GPs knew about the new ALBP protocol, and even fewer had any knowledge of the content of the new protocol. Also, the guidelines prescribed by the GPs concerning ‘return to work' were indefinite. The researchers hypothesised that the reasons for this were a lack of awareness of the change in the acute low back pain protocol suggested by the Agency for Healthcare Research and Quality, as well as a lack of knowledge of the evidence-based guidelines suggested for their profession. South African Family Practice Vol. 48 (10) 2006: pp. 15-15

A Sensing Role of the Glutamine Synthetase in the Nitrogen Regulation Network in Fusarium fujikuroi

Contains fulltext : 125173.pdf (publisher's version ) (Open Access)In the plant pathogenic ascomycete Fusarium fujikuroi the synthesis of several economically important secondary metabolites (SM) depends on the nitrogen status of the cells. Of these SMs, gibberellin and bikaverin synthesis is subject to nitrogen catabolite repression (NCR) and is therefore only executed under nitrogen starvation conditions. How the signal of available nitrogen quantity and quality is sensed and transmitted to transcription factors is largely unknown. Earlier work revealed an essential regulatory role of the glutamine synthetase (GS) in the nitrogen regulation network and secondary metabolism as its deletion resulted in total loss of SM gene expression. Here we present extensive gene regulation studies of the wild type, the Deltagln1 mutant and complementation strains of the gln1 deletion mutant expressing heterologous GS-encoding genes of prokaryotic and eukaryotic origin or 14 different F. fujikuroi gln1 copies with site-directed mutations. All strains were grown under different nitrogen conditions and characterized regarding growth, expression of NCR-responsive genes and biosynthesis of SM. We provide evidence for distinct roles of the GS in sensing and transducing the signals to NCR-responsive genes. Three site directed mutations partially restored secondary metabolism and GS-dependent gene expression, but not glutamine formation, demonstrating for the first time that the catalytic and regulatory roles of GS can be separated. The distinct mutant phenotypes show that the GS (1) participates in NH4 (+)-sensing and transducing the signal towards NCR-responsive transcription factors and their subsequent target genes; (2) affects carbon catabolism and (3) activates the expression of a distinct set of non-NCR GS-dependent genes. These novel insights into the regulatory role of the GS provide fascinating perspectives for elucidating regulatory roles of GS proteins of different organism in general