Authorship: practices and experiences in the Faculty of Health Sciences of the University of the Free State

Background: The allocation of authorship of papers can lead to controversy. In medical journals, papers tend to be multiauthored and the contribution of each author is not always apparent. The International Committee for Medical Journal Editors provides clear guidelines regarding rights to authorship, and these guidelines are used by some journals. We wished to propose guidelines for the Faculty of Health Sciences of the University of the Free State (UFS) and, in order to do so, first determined the practices and experiences regarding authorship in the Faculty.Methods: Personal confidential interviews were conducted by the researcher in the Faculty of Health Sciences with first authors of papers published in accredited journals in 2000.Results: Eighteen of the 19 first authors interviewed in relation to 28 papers were in favour of a guideline for the Faculty. The issue of authorship was discussed beforehand among the authors for just under half of the papers with more than one author (48%). No problems were experienced regarding authorship in relation to 64% of the papers. In only 9% of the papers with more than one author did all the authors fulfil all three criteria of the international guidelines.Conclusion: On the basis of the positive feedback from the respondents, and their suggestions and experiences, a guideline was drafted for the Faculty. This should assist researchers in problematic cases and ensure that all, and only those, authors who deserve authorship are in fact listed as authors. SA Fam Pract 2005;47(4): 57-6

Hierarchically designed hybrid nanoparticles for combinational photochemotherapy against a pancreatic cancer cell line

© The Royal Society of Chemistry 2018. Here, we report the formulation of hybrid nanoparticles consisting of aggregated gold nanoparticles (GNPs) impregnated into a gemcitabine-polymer conjugate matrix that exhibit synergistic photo-chemo-therapeutic activity against pancreatic cancer. Well-defined, sub-100 nm hybrid NPs were successfully formulated and their photothermal conversion efficiency was evaluated, which was found to be as high as 63% in the red-visible spectrum. By varying the GNP and GEM-polymer feed, it was possible to control the red-shifting of the surface plasmon resonance at therapeutically relevant wavelengths. The hybrid NPs exhibited significant cytotoxicity against MiaPaCa-2 cells with a half-maximal inhibitory concentration (IC 50 ) of 0.0012 mg mL -1 ; however the IC 50 decreased by a factor of 2 after the cells were irradiated with a continuous wave red laser for 1 min (1.4 W cm -2 ). Although the irradiation of the aggregated GNPs loaded in the hybrid NPs produced a higher thermal effect for the same amount of non-loaded GNPs, the IC 50 of the hybrid NPs was significantly lower than that of the free GNPs, hence indicating a synergistic effect of the polymer bound GEM and the GNPs

Profile of Research Methodology and Statistics Training of Undergraduate Medical Students at South African Universities

Background: Medical practitioners need to have knowledge of statistics and research principles, especially with the increasing emphasis onevidence-based medicine. The aim of this study was to determine the profile of research methodology and statistics training of undergraduatemedical students at South African universities in terms of which topics are taught, by whom teaching is done, when these topics are taught and howthey are taught.Method: Respondents for this descriptive study were persons responsible for the teaching of statistics and research methodology at the eightmedical schools in South Africa. They were identified by the head of each school who also gave permission for the school to participate. Therespondents completed a questionnaire and checklist after giving informed consent. No response was obtained from one university. Responses werecompared to international guidelines.Results: At five universities the material is taught in the first year, at one in the second year and one in the third or fourth year, depending on whenit is selected as an elective. The material is reinforced in other modules in the medical programme at three universities. The persons responsible forteaching are mainly statisticians (six universities). Class sizes vary from 40 to 320 students with four universities having 200 or more students perclass. At two universities the current course has been in place since 2003, at two since 2000, and at two since the 1970/80s. The following topicsare taught at the majority of universities: study designs in medical research, exploring and presenting data, summarising data, probability, sampling, statistical inference, analysis of cross tabulation and critical reading. At four universities there are practical classes, three of these mainly for computer work. At three universities tutors are used, at two of these the tutors are postgraduate students in statistics whereas at one university registrars, doctors and researchers are used as tutors. Students at three of the universities complete a research project, at two of these the students complete the full research process from planning up to reporting, whereas the project at the other university focuses mainly on the analysis of data.Conclusion: Recommendations have been made regarding topics which should be covered and teaching methods which should be used at alluniversities. Doctors should be involved in the training to ensure clinically appropriate material and examples

Intravenous paracetamol — waste not, want not: a retrospective audit on the appropriate use of intravenous paracetamol at Universitas Academic Hospital Complex—Bloemfontein

Background: Paracetamol can be given both orally and intravenously (IV) with similar clinical efficacy, but the IV formulation is 360 times more expensive. IV paracetamol is therefore only recommended when the oral route is not available. This study investigated whether IV paracetamol was being used appropriately and whether there had been a change in prescribing patterns between 2008 and 2015 after the introduction and update of a prescribing protocol at an academic hospital complex in Bloemfontein, South Africa.Methods: A retrospective comparative audit of patient files was undertaken. The prescribing and administration habits of IV paracetamol were compared for two consecutive months, seven years apart, including 88 and 83 patients, respectively, who had received IV paracetamol.Results: IV paracetamol was administered appropriately in 37.5% of patients in 2008 and in 43.4% of patients in 2015 (p = 0.43). There was an improvement in the duration that IV paracetamol was prescribed for, which decreased from a median two days in 2008 to one day (p < 0.01) in 2015. In total, 55 (32.4%) patients had a concomitant oral and IV paracetamol prescription, of which 37 (21.6%) patients also received concomitant paracetamol administration. Twenty patients exceeded the 24-hour maximum dose. Seventeen patients weighed less than 40 kg; six of these patients (three paediatric and three adult) did not receive the correct weight adjusted dose of paracetamol, 15 mg/kg, resulting in excessive doses of paracetamol being administered (21– 32.3 mg/kg).Conclusions: Patients are receiving IV paracetamol when the oral route is available; this is an unnecessary waste of money. Excessive doses of paracetamol were administered due to concomitant oral and IV paracetamol prescription and administration, and a failure to calculate dose of paracetamol according to body weight in low body weight patients. Further remedial interventions are therefore required.Keywords: acetaminophen, analgesia, appropriate, audit, intravenous, pain, paracetamol, pyrexi

A survey of nurses’ basic life support knowledge and training at a tertiary hospital

Objective: Survival after cardiac arrest is related to time taken for resuscitation, and defibrillation, to commence. At many hospitals, the healthcare worker most likely to be present when a patient suffers a cardiac arrest is a nurse. This study was performed to assess BLS knowledge and training of nurses, and thus to determine whether further action is required to improve their BLS competency. Method: The study was a cross-sectional survey. A questionnaire was distributed, on one day, to nurses in the wards, out-patient-departments and theatres. Completion of the form was voluntary and confidential. The forms were all returned that day. Results: Questionnaires were completed by 338 of the 405 nursing personnel on duty that day (83.4% response rate). Administrators and student nurses were excluded as well as incomplete questionnaires , leaving a final sample size of 286 nurses. A pass mark of 80% was achieved by 11% of responders. Training in BLS had been available for 77.5% of nurses and of these 93.1% had attended a course, 60.9% within the last year. Training in the use of a defibrillator had not been received by 32% of nurses and there was generally a poor understanding of the significance of defibrillation in resuscitation. Conclusion: Despite a relatively good rate of attendance at recent BLS courses, over a fifth of nurses remain without any BLS training. In addition few nurses have retained the BLS knowledge required for competency. Action is needed to ensure all nurses receive BLS training and practice this skill regularly

The prevalence of skin scars in patients previously given intramuscular diclofenac injections attending the Pain Clinic at Universitas Academic Hospital, Bloemfontein, South Africa

Intramuscular (IM) diclofenac rarely causes scarring (reported incidence <0.05%). Some patients attending the Pain Clinic at Universitas Academic Hospital, Bloemfontein, South Africa, presented with scars that had developed after IM diclofenac injections. We investigated the prevalence of scars in patients at the clinic and how the injections had been obtained. Patients attending the clinic over a period of 9 months who said they had received diclofenac (N=131) were included. Information was collected using a questionnaire and physical examination. Data obtained from 118 patients who were certain that they had received diclofenac were analysed. Ninety-three patients (78.8%) indicated they had not been warned about the possibility that a diclofenac injection could result in scarring. Scarring had occurred in 10 patients (8.5%). Two-thirds of the patients who had obtained diclofenac from a pharmacy had never had a prescription for it. Four patients had required medical treatment for an ulcer or abscess, of whom two had undergone surgery. The risk of skin lesions associated with IM diclofenac is higher than reported previously. Contrary to regulations, diclofenac injections were often dispensed to patients without a prescription

Die sesweke-ondersoek ná koronêre vatchirurgie: bevindinge by Bloemfontein Medi-Clinic Hospitaal

The six-week examination after coronary bypass surgery: findings at a Medi-Clinic Hospital in Bloemfontein. Background: Surgery provides symtomatic relief and improves the prognosis in patients with coronary artery disease. The general practitioner manages the postoperative patient. The aim of the study was to establish which symptoms and signs are present at the time of the six-week follow-up after coronary artery bypass graft surgery. Methods: A descriptive database search with a retrospective direction of enquiry was undertaken to establish the symptoms and signs experienced by patients six weeks after coronary artery bypass surgery (CABG). The patients were operated on by one surgeon in one hospital. The prevalence of readmissions, chest pain, angina, blood pressure, NYHA class, lung auscultation, wounds and medications were noted. Results: Records were available for 181 patients. However, only 158 patients were seen in the surgeon\'s rooms six weeks after surgery. Patients were also consulted before and after the six weeks, but usually in hospital. One patient died before her appointment and two patients did not return for follow-up. Fifteen (8.5%; 95% CI 4.9% to 13.7%) patients were readmitted to a hospital for a variety of reasons, Severe chest pain was present in 3.4% (95% CI 1.3% to 7.2%) patients. One patient had a myocardial infarction with patent grafts at cardiac catheterisation. Another two patients were investigated for possible angina, but it could not be proved. A total of 82.2% (95% CI 76.5% to 87.9%) of the patients were in NYHA I, whereas 3.5% (95% CI 1.3% to 7.4%) were class III, of whom two thirds were in class III before the operation. Hypertension was noticed in 70.1% of the patients (95% CI 62.9% to 77.2%). During auscultation of the lungs, abnormalities were picked up in 4.9% of the patients, while the sternum was not properly healed in 3.4% (95% VI 1.3% tot 7.2%). All the patients were on aspirin, but only 57% took an ACE inhibitor, 37% took a statin and 29% a beta-blocker.Conclusions:This study provides a picture of what to expect six weeks after a CABG.South African Family Practice Vol. 47(3) 2005: 61-6