Changing pattern of incidence, aetiology and mortality from acute pancreatitis at Kalafong Hospital, Pretoria, South Africa, 1988-2007: A retrospective evaluation

Background: Literature reports from Western countries suggest an increasing incidence of acute pancreatitis (AP) and changing pattern over the past two decades. The aim of this study was to document the incidence, aetiology and mortality from AP over two decades and to examine any emerging trends.Methods: A retrospective study of all confirmed cases of AP admitted over a 20-year period to the surgical department was performed. Patients’ demographics, year of admission, number of attacks, aetiology, management and outcome were entered on a special study proforma.Results: Altogether 707 attacks of AP (M: F, 5.7: 1) were recorded. The proportion of gallstone AP increased (3.1% to 12.7%) and that of alcohol-related AP decreased (84% to 67.6%). Alcohol was the main aetiological factor for AP. Drugs, hyperlipidaemia, human immunodeficiency virus (HIV) and endoscopic pancreatography-related AP increased in the second decade. The in-hospital mortality rate during the respective periods was 6.5% and 3.1%.Conclusion: Gallstone AP increased during second decade from more Caucasian admissions and increased gallstones among Blacks. The reduced mortality was attributed to changing trends in the nature and aetiology of AP recorded, heightened awareness of the condition and improved management

Pyrethroid treatment of cattle for tsetse control: Reducing its impact on dung fauna

Background: African trypansomiases of humans and animals can be controlled by attacking the vectors,various species of tsetse fly. Treatment of cattle with pyrethroids to kill tsetse as they feed is the most cost-effective method. However, such treatments can contaminate cattle dung, thereby killing the fauna which disperse the dung and so play an important role in soil fertility. Hence there is a need to identify cost-effective methods of treating cattle with minimal impact on dung fauna. Methodology/Principal Findings: We used dung beetles to field bioassay the levels of dung contamination following the use of spray and pour-on formulations of deltamethrin, applied to various parts of the body of cattle in Zimbabwe. Results suggested that dung was contaminated by contact with insecticide on the body surface as the cattle defecated, and by ingestion of insecticide as the cattle licked themselves. Death of dung beetles was reduced to negligible levels by using only the spray and applying it to the legs and belly or legs alone, i.e., places where most tsetse feed. Conclusion/Significance: The restricted applications suitable for minimising the impact on dung fauna have the collateral benefits of improving the economy and convenience of cattle treatments for tsetse control. The demonstration of collateral benefits is one of the surest ways of promoting environmentally friendly procedures

Primary gastric Kaposi's sarcoma presenting first with upper gastrointestinal bleeding and abdominal pain: A case report

Kaposi's sarcoma (KS) is the most common tumour among human immunodeficiency syndrome (HIV) infected individuals, but its involvement of the gastrointestinal tract was reported long before the acquired immunodeficiency syndrome (AIDS) epidemic. Although most cases of gastrointestinal KS are asymptomatic, advanced lesions may occasionally result in a severe life-threatening haemorrhage that requires immediate treatment. Endoscopy, with biopsy of suspicious lesions is necessary to make the diagnosis and is recommended in all HIV antibody positive patients with persistent upper gastrointestinal symptoms.We describe a patient with primary gastrointestinal involvement by KS who presented first with upper gastrointestinal bleeding and abdominal pain and no other stigmata. Afterwards, the diagnosis of an HIV infection was made.South African Gastroenterology Review Vol. 6 (1) 2008: pp. 5-

Pseudomyxoma extraperitonei of ovarian origin mimicking a psoas abscess

Pseudomyxoma peritonei (PMP) is a rare condition consisting of mucinous ascites, most commonly arising from mucinous tumours of the appendix and occasionally from the ovary. Very rarely, mucinous deposits arise in the retroperitoneum without intraperitoneal involvement. This has been termed pseudomyxoma extraperitonei (PME). Our 48-year-old female patient presented with PME mimicking a psoas abscess for which retroperitoneal exploration and biopsy was done with accidental breach of the peritoneum. She declined further surgery and re-presented 4 years later with disseminated PMP. She underwent debulking surgery including right oophorectomy which was confirmed as the primary tumour source

Changing Pattern of Incidence, Aetiology and Mortality from Acute Pancreatitis at Kalafong Hospital, Pretoria, South Africa, 1988-2007: A Retrospective Evaluation

Background: Literature reports from Western countries suggest an increasing incidence of acute pancreatitis (AP) and changing pattern over the past two decades. The aim of this study was to document the incidence, aetiology and mortality from AP over two decades and to examine any emerging trends. Methods: A retrospective study of all confirmed cases of AP admitted over a 20-year period to the surgical department was performed. Patients’ demographics, year of admission, number of attacks, aetiology, management and outcome were entered on a special study proforma. Results: Altogether 707 attacks of AP (M: F, 5.7: 1) were recorded. The proportion of gallstone AP increased (3.1% to 12.7%) and that of alcohol-related AP decreased (84% to 67.6%). Alcohol was the main aetiological factor for AP. Drugs, hyperlipidaemia, human immunodeficiency virus (HIV) and endoscopic pancreatography-related AP increased in the second decade. The in-hospital mortality rate during the respective periods was 6.5% and 3.1%. Conclusion: Gallstone AP increased during second decade from more Caucasian admissions and increased gallstones among Blacks. The reduced mortality was attributed to changing trends in the nature and aetiology of AP recorded, heightened awareness of the condition and improved management