Antibacterial activity of the five South African Erythroxylaceae species

Until recently, no medicinal uses were recorded for the South African Erythroxylaceae species, although, this family is used world wide in traditional medicine. This study reveals for the first time that Erythroxylum delagoense and Erythroxylum pictum roots were used to treat dysentery and diarrhoea and that Erythroxylum emarginatum leaves decoction was used to treat asthma, kidney problems, arthritis, child bearing problems and influenza in South Africa. To validate some of the medicinal uses, antibacterial testing was done for the first time on all five South African species. Leaf and bark extracts of four of the five South African Erythroxylaceae species (E. delagoense, E. emarginatum, E. pictum and Nectaropetalum capense) showed some good antibacterial activities with MIC <1 mg/ml. E. delagoense showed good results against Bacillus subtilis, Klebsiella pneumoniae and Staphylococcus aureus; E. emarginatum against Klebsiella pneumoniae; E. pictum against Bacillus subtilis and Klebsiella pneumonia; N. capense against Klebsiella pneumonia.Key words: Antimicrobial activity, Erythroxylaceae, medicinal uses, South Africa

'N vergelykende studie van vismeel, sonneblomoliekoekmeel en formaldehiedbehandelde sonneblomoliekoekmeel as proteïen supplemente vir skape

No Abstrac

Prevalence of hearing loss at primary health care clinics in South Africa

Background: Hearing loss prevalence data in South Africa is scarce, especially within primary health care settings. Objectives: To determine; (i) the prevalence of hearing disorders in patients ≥3 years of age attending two primary health care clinics, and (ii) the nature and characteristics of hearing disorders at these primary health care clinics. Method: A cross-sectional design was used at two primary health care clinics. Non-probability purposive sampling was used to screen participants at clinics for hearing loss with pure tone audiometry. A total of 1236 participants were screened (mean age 37.8 ±17.9 years). Diagnostic testing was available for confirmation of hearing loss on participants who failed the screening. Results: Hearing loss prevalence was 17.5% across both clinics. Most hearing losses were bilateral (70.0%) and were of a sensorineural nature (84.2%). Conclusion: Hearing loss prevalence was comparable at both primary health care clinics. Participants 40 years and older were at significantly higher risk for hearing loss. The current study is the first attempt to establish hearing loss prevalence for primary health care clinics in South Africa.Keywords: Hearing loss, primary health care clinics, South Africa

International survey of audiologists' attitudes toward telehealth

PURPOSE : A better understanding of the attitudes of audiologists toward teleaudiology and their willingness to use teleaudiology is required to progress the application of teleaudiology technologies and services into clinical practice. Audiologists around the world were surveyed on their attitudes toward teleaudiology and their willingness to use it. METHOD : An online survey was sent to audiologists through professional associations' mailing lists. The survey included questions on the use of computer and video-conferencing technologies, awareness and previous use of teleaudiology, and willingness to use teleaudiology. RESULTS : Responses were provided by 269 people from 28 different countries, representing a wide cross-section of experience, qualification, and work settings; 77.8% of respondents were women. Almost all respondents had used PC-based video-conferencing; most had used related technologies and reported positive attitudes toward using these. However, less than 25% had used teleaudiology. CONCLUSIONS : Despite positive attitudes toward telehealth and associated technology, the low number of audiologists who have used teleaudiology for services indicates limited clinical adoption.Portions of this work were presented at the Second International Meeting on Internet & Audiology, Snekkersten, Denmark (September 2015).http://aja.pubs.asha.org/Speech-Language Pathology and Audiolog

Applying the trigger review method after a brief educational intervention: potential for teaching and improving safety in GP specialty training?

<p>Background: The Trigger Review Method (TRM) is a structured approach to screening clinical records for undetected patient safety incidents (PSIs) and identifying learning and improvement opportunities. In Scotland, TRM participation can inform GP appraisal and has been included as a core component of the national primary care patient safety programme that was launched in March 2013. However, the clinical workforce needs up-skilled and the potential of TRM in GP training has yet to be tested. Current TRM training utilizes a workplace face-to-face session by a GP expert, which is not feasible. A less costly, more sustainable educational intervention is necessary to build capability at scale. We aimed to determine the feasibility and impact of TRM and a related training intervention in GP training.</p> Methods We recruited 25 west of Scotland GP trainees to attend a 2-hour TRM workshop. Trainees then applied TRM to 25 clinical records and returned findings within 4-weeks. A follow-up feedback workshop was held. <p>Results: 21/25 trainees (84%) completed the task. 520 records yielded 80 undetected PSIs (15.4%). 36/80 were judged potentially preventable (45%) with 35/80 classified as causing moderate to severe harm (44%). Trainees described a range of potential learning and improvement plans. Training was positively received and appeared to be successful given these findings. TRM was valued as a safety improvement tool by most participants.</p> <p>Conclusion: This small study provides further evidence of TRM utility and how to teach it pragmatically. TRM is of potential value in GP patient safety curriculum delivery and preparing trainees for future safety improvement expectations.</p&gt

Paediatric trauma care

Paediatric trauma care varies in different countries. In South Africa injury is the leading cause of death in the 5 - 14-yearold age group - 1,5 - 3,8 times higher than in the USA. In 1978 the Child Safety Centre was established and prospectively collected data on paediatric injuries. The various types of injuries are discussed. Trauma is responsible for the highest percentage of years of life lost but the least amount of money is being spent on research and prevention of injuries. The Child Accident Prevention Foundation of Southern Africa has been constituted to research, prevent and reduce the risk factors of the injuries and to improve facilities for the injured child

Self-reported hearing loss and pure tone audiometry for screening in primary health care clinics

OBJECTIVE : To evaluate the performance of self-reported hearing loss alone and in combination with pure tone audiometry screening in primary health care clinics in South Africa. DESIGN : Nonprobability purposive sampling was used at 2 primary health care clinics. A total of 1084 participants (mean age 41.2 years; SD 15.5 years; range 16-97 years, 74.0% female) were screened using self-report and audiometry screening. Those failing audiometric screening and a sample of those who passed audiometric screening were also assessed by diagnostic pure time audiometry, to confirm or negate the finding of a hearing loss. RESULTS : Four hundred and thirty-six participants (40.2%) self-reported a hearing loss with no significant association with gender or race. One hundred and thirty-six participant (12.5%) self-reported hearing loss and failed audiometry screening (35 dB HL at 1, 2, and 4 kHz). Combining self-report with a second stage audiometry screening revealed a high test accuracy (81.0%) for hearing loss, being most accurate (86.1%) to identify high-frequency hearing loss. CONCLUSION : While self-report of hearing loss is an easy and time-efficient screening method to use at primary health care clinics, its accuracy may be limited when used in isolation and it may not be sufficiently sensitive to detect hearing loss. Combining a simple audiometry screening as a second-stage screen can significantly improve overall performance and efficiency of the screening protocol.The financial assistance of the National Research Foundation (NRF) toward this research is hereby acknowledged (Grant No. 87757).https://journals.sagepub.com/home/jpcam2019Speech-Language Pathology and Audiolog

Accuracy of remote hearing assessment in a rural community

BACKGROUND : This study determined the accuracy of pure tone air conduction (AC) thresholds obtained using a synchronous telemedicine approach without a sound booth in a rural South African community. The global need for increased hearing healthcare currently far exceeds the capacity for delivering these services, especially in developing countries. A tele-audiology approach using a portable diagnostic audiometer could provide the solution, enabling hearing assessments to be conducted remotely and without a sound booth. MATERIALS AND METHODS : Hearing thresholds in a sound booth and natural environment were obtained froman initial sample of 20 adults (age range, 19– 63 years; mean age, 50 – 13 years; 55%female), recruited from a rural agricultural community. A subgroup of 10 adults (20 ears) volunteered for the telemedicine threshold testing. AC thresholds (250–8,000 Hz) were determined and subsequently compared in these environments. Typical threshold variability was determined using test–retest correspondence as a reference for the threshold correspondence using a telemedicine mode. RESULTS : Test–retest threshold correspondence in the booth and natural environmentswas within – 5 dB in 96.7%and 97.5%of comparisons, respectively. No significant differences were obtained in AC hearing thresholds determined in the telemedicine configuration comparedwith those recorded in the gold standard booth environment. Threshold correspondence between the telemedicine compared with booth and natural environments were within – 5 dB in 82% and 85% of comparisons, respectively. CONCLUSIONS : The current study demonstrates the validity of using synchronous telemedicine for conducting hearing assessments in a remote rural agricultural community without a sound booth.http://online.liebertpub.com/TMJhb201

Primary keratinocyte cell culture on EpiGen membranes for autologous skin grafts in paediatric burn patients

Cultured epithelial autografts have been shown to be an effective permanent skin replacement for major burn injuries and have proved life-saving when insufficient donor skin has been available. Several membrane systems have been developed that facilitate the transfer of cultured cells on to the recipient. The aim of the study reported here was to test the effectiveness of EpiGen, a synthetic polymer membrane, as a cell culture support matrix for the transplantation of cultured autografts. Skin biopsies were obtained from 22 paediatric burn patients with an affected total body surface area of between 7% and 80%. Basal keratinocytes were harvested from the dermal/epidermal junction and cultured in a collagen 1-coated flask in modified Green’s medium. After two passages, isolated keratinocytes were grown on EpiGen membranes until semiconfluent. Wound beds were excised and covered with widely (1:3) meshed split skin grafts. Membranes were grafted with the basal cell layer directed against the wound bed. Unseeded membranes were applied and served as controls. Wounds were dressed and closed appropriately. Grafts were regularly inspected for ‘take’ and the membranes were removed 10 days after application. Seven patients had to be excluded from the study. Cell culture results of the remaining 15 patients showed excellent cell growth and expansion on EpiGen membranes within a mean culture time of 2.6 days post membrane seeding. The membranes facilitated easy transfer of cultures onto the recipient. A mean keratinocyte graft ‘take’ of 95% and a mean control graft ‘take’ of 90% were recorded at the time of membrane removal. The mean level of clinically evident re-epithelialization on keratinocyte grafted areas in recipients was 87% as opposed to 60% in the unseeded control areas