The South African guidelines on enuresis-2017

Introduction: Enuresis (or Nocturnal Enuresis) is defined as discreet episodes of urinary incontinence during sleep in children over 5 years of age in the absence of congenital or acquired neurological disorders. Recommendations: Suggestions and recommendations are made on the various therapeutic options available within a South African context. These therapeutic options include; behavioural modification, pharmaceutical therapy [Desmospressin (DDAVP), Anticholinergic (ACh) Agents, Mirabegron (beta 3-adrenoreceptor agonists), and Tricyclic Antidepressants (TCA)], alternative treatments, complementary therapies, urotherapy, alarm therapy, psychological therapy and biofeedback. The role of the Bladder Diary, additional investigations and Mobile Phone Applications (Apps) in enuresis is also explored. Standardised definitions are also outlined within this document. Conclusion: An independent, unbiased, national evaluation and treatment guideline based on the pathophysiological subcategory is proposed using an updated, evidence based approach. This Guideline has received endorsement from the South African Urological Association, Enuresis Academy of South Africa and further input from international experts within the field

Exploring Grade 3 teachers’ strategies in the teaching of writing literacy

A full dissertation submitted in fulfillment of the requirements for the degree of Masters in Education Presented to the Faculty of Education and Social Sciences at the Cape Peninsula University of Technology 2013In this qualitative exploratory study the primary purpose was to examine the nature of teaching strategies employed by two Grade 3 teachers to teach writing literacy. The following research questions underpinned the study: i) What strategies are being implemented by Grade 3 teachers to develop literacy skills in their classes ii) How appropriate, relevant and potentially effective are these strategies in terms of the aspects of literacy they address and support? Interviews and video-observations of the teaching-learning process were the two methods of data collection. Through a constant interplay between what teachers do as they teach writing literacy and literature accounts of what constitutes good teaching of writing literacy, the study aimed to arrive at conclusions regarding the question on whether the teaching strategies were appropriate, relevant and have potential for effectiveness. Both the interview and observation data were analysed using the constant comparative method in order to arrive at conclusions regarding the two research questions. The study has revealed that though teaching happened in a piecemeal fashion, the teachers use a variety of good teaching strategies to develop literacy among their learners

Risk factors for invasive Group B <i>Streptococcal</i> (GBS) disease in early-onset and late-onset disease cases and matched controls.

<p>¹Univariate-OR(95%CI)-calculated odds ratio with 95% confidence using Fischer exact test comparing cases and controls.</p><p>² Multivariate-OR(95%CI)-calculated odds ratio with 95% confidence of disease using conditional logistic regression (For early-onset disease: adjusted for HIV-status, maternal age at delivery, gestational age, maternal GBS colonization, prolonged ROM, offensive liquor, maternal temperature>38, GBS bacteriuria and any intra-partum antibiotics. For late-onset disease: adjusted for HIV-status, maternal age at delivery, gestational age, maternal GBS colonization and GBS bacteriuria).</p><p>³ Prolonged ROM (>18 hours)-prolonged rupture of membranes.</p><p>⁴Maternal fever during labor.</p><p>⁵IAP-Intrapartum antibiotic prophylaxis to pregnant women that met risk-based criteria (gestation <37 weeks, PROM and maternal intra-partum fever).</p><p>Risk factors for invasive Group B <i>Streptococcal</i> (GBS) disease in early-onset and late-onset disease cases and matched controls.</p

Demographic characteristics of infants with invasive Group B <i>Streptococcal</i> (GBS) disease.

<p>¹EOD-Early-onset disease.</p><p>²LOD-Late-onset disease.</p><p>³OR(95%CI)-calculated odds ratio with 95% confidence comparing EOD to LOD.</p><p>⁴p-value-using Chi-squared, Fischer exact or Wilcoxon rank-sum (Mann-Whitney) test.</p><p>⁵CSF-Cerebrospinal fluid.</p><p>Demographic characteristics of infants with invasive Group B <i>Streptococcal</i> (GBS) disease.</p

Burden of Invasive Group B <i>Streptococcus</i> Disease and Early Neurological Sequelae in South African Infants

<div><p>Introduction</p><p>Group B <i>Streptococcus</i> (GBS) is a leading cause of neonatal sepsis and meningitis. We aimed to evaluate the burden of invasive early-onset (0–6 days of life, EOD) and late-onset (7–89 days, LOD) GBS disease and subsequent neurological sequelae in infants from a setting with a high prevalence (29.5%) of HIV among pregnant women.</p><p>Methods</p><p>A case-control study was undertaken at three secondary-tertiary care public hospitals in Johannesburg. Invasive cases in infants <3 months age were identified by surveillance of laboratories from November 2012 to February 2014. Neurodevelopmental screening was done in surviving cases and controls at 3 and 6 months of age.</p><p>Results</p><p>We identified 122 cases of invasive GBS disease over a 12 month period. Although the incidence (per 1,000 live births) of EOD was similar between HIV-exposed and HIV-unexposed infants (1.13 vs. 1.46; p = 0.487), there was a 4.67-fold (95%CI: 2.24–9.74) greater risk for LOD in HIV-exposed infants (2.27 vs. 0.49; p<0.001). Overall, serotypes Ia, Ib and III constituted 75.8% and 92.5% of EOD and LOD, respectively. Risk factors for EOD included offensive draining liquor (adjusted Odds Ratio: 27.37; 95%CI: 1.94–386.50) and maternal GBS bacteriuria (aOR: 8.41; 95%CI: 1.44–49.15), which was also a risk-factor for LOD (aOR: 3.49; 95%CI: 1.17–10.40). The overall case fatality rate among cases was 18.0%. The adjusted odds for neurological sequelae at 6 months age was 13.18-fold (95%CI: 1.44–120.95) greater in cases (13.2%) than controls (0.4%).</p><p>Discussion</p><p>The high burden of invasive GBS disease in South Africa, which is also associated with high case fatality rates and significant neurological sequelae among survivors, is partly due to the heightened risk for LOD in infants born to HIV-infected women. An effective trivalent GBS conjugate vaccine targeted at pregnant women could prevent invasive GBS disease in this setting.</p></div

Predictors of mortality from invasive Group B streptococcus (GBS) disease.

<p>¹OR(95%CI)-calculated odds ratio with 95% confidence comparing infants that demised versus survivors of GBS disease using Chi-squared or Fischer exact test.</p><p>² Multivariate-OR(95%CI)-calculated odds ratio with 95% confidence using logistic regression (adjusted for timing of disease, HIV-exposure, prematurity (<34 weeks), ventilation, inotropic support, apnea, seizures).</p><p>³WCC-White cell count.</p><p>⁴CRP-C-reactive protein.</p><p>Predictors of mortality from invasive Group B streptococcus (GBS) disease.</p

Needle electromyographic findings in 98 patients with myositis.

Item does not contain fulltextBACKGROUND/AIMS: Little is known about the distribution of electromyographic (EMG) abnormalities in myositis even though this is relevant in daily practice. METHODS: A retrospective semiquantitative analysis of needle EMG findings was performed in a group of 98 patients with myositis. The frequency, type, and distribution of abnormalities were studied. The influence of the use of corticosteroids and the stage of the disease were evaluated. RESULTS: In most patients, a myopathic pattern with spontaneous activity was found, although several clinically relevant exceptions were noted. Long-duration motor unit potentials were found in all three diagnostic groups and were not associated with disease duration. In the lower extremity a distal to proximal gradient was present, adding to the diagnostic confusion with neurogenic diseases, and spontaneous activity was absent in a relatively large group although none of the patients in the acute stage of the disease had a normal EMG. The use of corticosteroids reduced the number of abnormal findings in dermatomyositis and polymyositis, but not in inclusion body myositis. CONCLUSION: A myopathic pattern with spontaneous activity was most frequently found, although several clinically relevant exceptions were noted. These results illustrate the spectrum of EMG findings in myositis, and may aid the clinician in the interpretation of the EMG in these patients