In vitro activity of a new 'higher-lactam' antibacterial agent LY 193239

In vitro activity ofthe new bicyclic pyrazolidinone LY 193239 (Eli Lilly) was evaluated against 52 clinical isolates of Haemophilus influenzae (4 were β-lactamase producers), 32 Enterococcus faecalis, 14 Neisseria gonorrhoeae (1 β-lactamasepositive) and 19 Neisseria meningitidis. Activity was best against Neisseria spp. and H. influenzae, including penicillinase- producing strains. Results of the time-kill study against a non-enzyme-mediated penicillin resistant strain of N. meningitidis indicate that exposure to an antibacterial concentration four times the minimal inhibitory concentration was bactericidal. E. faecalis was insensitive

Risk factors for teenage pregnancy among sexually active black adolescents in Cape Town. A case control study.

MOTIVATION: Teenage pregnancy is an important health and social problem in South Africa. So far research on adolescent sexual activity has been almost exclusively descriptive; as a result there is considerable knowledge about practices of adolescents in general and outcomes of their pregnancies, but very limited understanding of factors that place particular adolescents at increased risk of teenage pregnancy. Without this understanding, our ability to intervene effectively to reduce teenage pregnancy rates is limited. OBJECTIVE: To undertake an exploratory study to investigate risk factors for teenage pregnancy among sexually active adolescents in an urban and peri-urban context. METHODS: The study used a matched case-control design, with 191 cases and 353 age-matched controls from the same school or neighbourhood. Subjects were under 19 years of age and were recruited from township areas of Cape Town. A structured questionnaire was used to obtain information on socio-economic factors, contraceptive knowledge and use, and sexual behaviour. Conditional logistical regression was used to analyse the relationship between teenage pregnancy and the factors investigated. RESULTS: Teenage pregnancy was found to be most strongly associated with having frequent sex (risk ratio (RR) 30.81) without reliable contraceptive protection (RR 24.35), forced sexual initiation (RR 14.42), not owning a television set (RR 10.33), larger household size (RR 2.44), not living in a brick house (RR 5.09), not living with the biological father (RR 3.26), talking openly about sex with a boyfriend (RR 4.72), and perceiving most friends to be pregnant (RR 4.38). CONCLUSIONS: The findings suggest associations between the promotion of sexual health among adolescents and broader social development and promotion of gender equality. Although further research is needed, it is likely that important foci for short-term strategies should include developing assertiveness, enhancing decision-making competence, and promoting contraception and condoms as part of comprehensive sexual and reproductive health educational interventions

Safety issues relating to paraffin usage in Eshane, Kwazulu-Natal

This study describes results of a household survey conducted in Eshane in the rural Kwazulu-Natal Midlands in April 2002, including baseline sociodemographic, energy usage, paraffin-related injury and safety knowledge information. A total of 404 interviews were conducted in five villages that fell within a 10-kilometre radius of the proposed Eshane integrated Energy Centre. Paraffin usage was high (86.6%) and there were no significant differences between electrified and non-electrified villages. Paraffin ingestion by children and paraffin-related fires were reported in 3.6% and 6.3% of households respectively. The majority of respondents had heard safety messages, but message retention was only demonstrated for messages relating to fires, and not ingestion. It seems that safety education may have a role to play in the prevention and response to paraffin-related fires, but that child-resistant packaging may be the only viable intervention for the reduction of ingestion among children

Safety issues relating to paraffin usage in Eshane, Kwazulu-Natal

This study describes results of a household survey conducted in Eshane in the rural Kwazulu-Natal Midlands in April 2002, including baseline sociodemographic, energy usage, paraffin-related injury and safety knowledge information. A total of 404 interviews were conducted in five villages that fell within a 10-kilometre radius of the proposed Eshane integrated Energy Centre. Paraffin usage was high (86.6%) and there were no significant differences between electrified and non-electrified villages. Paraffin ingestion by children and paraffin-related fires were reported in 3.6% and 6.3% of households respectively. The majority of respondents had heard safety messages, but message retention was only demonstrated for messages relating to fires, and not ingestion. It seems that safety education may have a role to play in the prevention and response to paraffin-related fires, but that child-resistant packaging may be the only viable intervention for the reduction of ingestion among children

Unexpected survival of sharptooth catfish Clarias gariepinus (Burchell 1822) during acute rotenone toxicity trials will complicate management of invasions

The sharptooth catfish Clarias gariepinus is an emerging global invader for which control strategies might include the use of piscicides such as rotenone. Experimental exposure demonstrated that C. gariepinus was less susceptible to rotenone than most other fish species, with unexpected survival observed at rotenone concentrations of 87.5 and 100 lg L-1. C. gariepinus were also observed exhibiting avoidance behaviour to rotenone treated water and were found to be capable of recovering from rotenone exposure. As such, effective eradication might not be attainable even at a dose exceeding 100 lg L-1 with exposures of longer than 24 h. This exposure scenario may pose an unacceptable risk to non-target fauna and highlights the difficulty associated with managing current and future invasions

Applicability and fairness of the oral examination in undergraduate psychiatry training in South Africa

Objective: There are several methods of evaluating medical students’ performance, such as written examination, oral examination and objective structured clinical examination (OSCE). Many studies have focused on the reliability and validity of these methods but few studies have explored comparison between these methods. Psychiatry is the only subject at the University of Stellenbosch where the final assessment consists of solely an oral component. The aim of the study was to compare students’ final overall and discipline specific examination marks (i.e. in the other subjects) with the examination marks in psychiatry, and to determine if content or structure (e,g. oral, written or OSCE format) of examination impacts more on the student performance in the examination. Method: 343 final year medical students were included. All undertook their psychiatry rotation at the University of Stellenbosch, South Africa during 2008 and 2009. Data of marks obtained in all the disciplines during 2008 and 2009 were collected and class marks were compared with their final examination marks across all disciplines. Bland-Altman plots were used to assess the level of agreement between the class and examination marks. Cases below the lower threshold were compared to all other cases across all disciplines. The odds ratio for group status was calculated for gender distribution of examiners. Results: The psychiatry class mark and final oral examination mark provided similar measures within a width of 31.5. Cases below the threshold had poorer performance in two other disciplines. The gender distribution of the examiners (female-female) significantly increased the odds ratio for poorer performance in the oral examination.Conclusion: The results suggest that a group of students underperform in their final examination independent of method of evaluation and that the gender of examiners impacts on examination marks. Therefore future research should focus on identifying and modifying factors (including choice of examiner combinations) that contribute to the poor performance of medical students in their final examination, in order to help students perform better. Gender distribution of examiners should also be considered when examinations are structured and designed.Keywords: Oral; Medical; Student; Gender; Examiner; Performance; OSC

Neurological soft signs as an endophenotype in an African schizophrenia population – a pilot study

Objective: The use of endophenotypes, such as neurological soft signs (NSS), is advocated as one possible method to elucidate the heterogeneity of schizophrenia. Exploring the associations between NSS and specific illness symptoms has revealed some trends, although results have been conflicting. To date, such studies have been conducted largely on Caucasian populations and our pilot study represents the first attempt to gather such data in a homogenous African population. Method: Fifty-one patients, all of Xhosa ethnicity and participating in a larger schizophrenia genetic study were recruited. NSS were evaluated using a modified Neurological Evaluation Scale. Data were analysed using SPSS with the strength of the overall relationships between NES groups and SANS and SAPS components analyzed by means of canonical correlation analysis. Results: The canonical correlation of SANS domains (excluding asociality) with the NES conceptual groups was 0.53 (SE=0.11, p=0.024) and of the SAPS domains 0.38 (SE=0.13, p=0.943). Conclusion: Our results suggest a correlation between negative symptoms of schizophrenia and the presence of NSS, supporting the recruitment of a larger sample to more comprehensively evaluate a possible role for NSS as an endophenotype in the Xhosa schizophrenia population. Taking into account that NSS evaluations allow for inexpensive, relatively easy-to-do objective evaluations, this method presents us with a valuable research tool that can be used effectively within our under-resourced environment to help inform on the neurobiological substrate of schizophrenia.Keywords: Schizophrenia; Endophenotype; Neurological Soft Sign

Undiagnosed metabolic syndrome and other adverse effects among clozapine users of Xhosa descent

Background. Clozapine use is known to be associated with significant side-effects, including prolongation of the QT-interval, agranulocytosis and metabolic syndrome. However, few data exist on the prevalence of clozapine side-effects in patients of Xhosa descent.  Objective. To gather data from Xhosa patients with schizophrenia to establish the prevalence of clozapine side-effects in this population.  Methods. Twenty-nine Xhosa patients with schizophrenia (as per the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR)) who had been receiving clozapine treatment for >1 year on an outpatient basis were selected for inclusion. All patients were participating in a genetics study in the Cape Metropolitan area. The participants were evaluated for the presence of side-effects (tests including an electrocardiogram, white blood cell count (WCC) and fasting blood glucose).  Results. The prevalence of metabolic syndrome was 44.8% (95% confidence interval (CI) 26.7 - 62.9) and of undiagnosed diabetes mellitus 13.8% (95% CI 1.24 - 26.34). There was a significant association between metabolic syndrome and body mass index (BMI) (p<0.01). The mean (SD) WCC was 7.8 × 109/L (2.8), with 3.4% of the subjects having a WCC <3.5 × 109/L. Sedation (82.8%; 95% CI 69.0 - 96.5), hypersalivation (79.3%; 95% CI 64.6 - 94.1) and constipation (44.8%; 95% CI 26.7 - 62.9) were common. The mean QT-interval was 373.8 (35.9) ms and 10% had a corrected QT-interval >440 ms. There was an association between the duration of clozapine treatment and QT-interval (with Bazett’s correction).   Conclusion. The high prevalence of metabolic syndrome and undiagnosed diabetes mellitus in this sample points to a need to monitor glucose levels and BMI on a regular basis. A larger study should be done to accurately quantify the differences in prevalence of side-effects between population groups