An investigation into the prescribing of analgesics

CITATION: Truter, I. & Kotze, T. J. v. W. 1996. An investigation into the prescribing of analgesics. South African Medical Journal, 86(11):1394-1397.The original publication is available at http://www.samj.org.zaTo investigate the prescribing of analgesic agents in a defined South African patient population. Design: Retrospective drug utilisation study. Setting: Prescribing behaviour of a sample of 50 dispensing doctors in Port Elizabeth. Data were obtained from a medical aid which used a formulary system. Percentage of central nervous system drugs that analgesics comprised; proportion of patients using combination analgesics; cost of analgesics. On average, 83.3% of all central nervous system drugs dispensed were analgesic agents. These agents represented 70.9% of the total cost of central nervous system drugs. A high percentage (82.2%) of the analgesic agents dispensed were combination or polycomponent analgesics. The combination analgesic tablet, consisting of paracetamol, meprobamate, caffeine and codeine phosphate, was the most frequently prescribed central nervous system drug. This product accounted on average for 40.4% of all analgesics dispensed. Nearly half (46.0%) of all the analgesics dispensed by the sample of doctors were available without a prescription. The high prescribing rate of combination analgesic prescription was a cause for concern, given the dependence-producing potential of some of the ingredients, e.g. meprobamate. The prescribing and use of analgesics should be carefully monitored by further drug utilisation studies in light of the serious adverse effects, such as analgesic nephropathy, associated with the long-term use of these agents.Publisher’s versio

Revival of the magnetar PSR J1622-4950: observations with MeerKAT, Parkes, XMM-Newton, Swift, Chandra, and NuSTAR

New radio (MeerKAT and Parkes) and X-ray (XMM-Newton, Swift, Chandra, and NuSTAR) observations of PSR J1622-4950 indicate that the magnetar, in a quiescent state since at least early 2015, reactivated between 2017 March 19 and April 5. The radio flux density, while variable, is approximately 100x larger than during its dormant state. The X-ray flux one month after reactivation was at least 800x larger than during quiescence, and has been decaying exponentially on a 111+/-19 day timescale. This high-flux state, together with a radio-derived rotational ephemeris, enabled for the first time the detection of X-ray pulsations for this magnetar. At 5%, the 0.3-6 keV pulsed fraction is comparable to the smallest observed for magnetars. The overall pulsar geometry inferred from polarized radio emission appears to be broadly consistent with that determined 6-8 years earlier. However, rotating vector model fits suggest that we are now seeing radio emission from a different location in the magnetosphere than previously. This indicates a novel way in which radio emission from magnetars can differ from that of ordinary pulsars. The torque on the neutron star is varying rapidly and unsteadily, as is common for magnetars following outburst, having changed by a factor of 7 within six months of reactivation.Comment: Published in ApJ (2018 April 5); 13 pages, 4 figure

An investigation into the prescribing of analgesics

CITATION: Truter, I. & Kotze, T. J. v. W. 1996. An investigation into the prescribing of analgesics. South African Medical Journal, 86(11):1394-1397.The original publication is available at http://www.samj.org.zaTo investigate the prescribing of analgesic agents in a defined South African patient population. Design: Retrospective drug utilisation study. Setting: Prescribing behaviour of a sample of 50 dispensing doctors in Port Elizabeth. Data were obtained from a medical aid which used a formulary system. Percentage of central nervous system drugs that analgesics comprised; proportion of patients using combination analgesics; cost of analgesics. On average, 83.3% of all central nervous system drugs dispensed were analgesic agents. These agents represented 70.9% of the total cost of central nervous system drugs. A high percentage (82.2%) of the analgesic agents dispensed were combination or polycomponent analgesics. The combination analgesic tablet, consisting of paracetamol, meprobamate, caffeine and codeine phosphate, was the most frequently prescribed central nervous system drug. This product accounted on average for 40.4% of all analgesics dispensed. Nearly half (46.0%) of all the analgesics dispensed by the sample of doctors were available without a prescription. The high prescribing rate of combination analgesic prescription was a cause for concern, given the dependence-producing potential of some of the ingredients, e.g. meprobamate. The prescribing and use of analgesics should be carefully monitored by further drug utilisation studies in light of the serious adverse effects, such as analgesic nephropathy, associated with the long-term use of these agents.Publisher’s versio

Endoscopic investigation for gastric cancer in a high-risk group

CITATION: Louwrens, H. D. et al. 1992. Endoscopic investigation for gastric cancer in a high-risk group. South African Medical Journal, 81:406-408.The original publication is available at http://www.samj.org.zaEarly gastric cancer (EGC) was diagnosed in only a small percentage (<1%) of gastric cancer cases seen at Tygerberg Hospital over a 10-year period (1976-1985). This study, aimed at increasing the yield of EGC, was conducted in some high-incidence areas for gastric cancer. Coloured men, who are at high risk for gastric cancer, were identified by their medical practitioners and investigated. A total of 272 coloured males with nonspecific foregut symptoms underwent upper gastro-intestinal endoscopy and multiple biopsy specimens were obtained from all localised mucosal lesions. Twelve gastric cancers were histologically verified, of which 11 were diagnosed in males over 40 years of age. Two EGCs were diagnosed in older males, resulting in a markedly higher proportion of EGC in this subgroup (18,2%) than the proportion of EGC in inpatients at our institution (0,9%). Twenty-two per cent of males over 40 years of age had gastric ulcers compared with 9,2%. of younger males. Chronic atrophic gastritis was present in 56,2% of older males but in only 24,6% of younger males. Those over 40 years of age emerged as a subgroup with a high prevalence of gastric cancer and EGC, and concomitant conditions.Publisher’s versio

Which tree orders in southern Africa have the highest antimicrobial activity and selectivity against bacterial and fungal pathogens of animals?

BACKGROUND: The study randomly screened leaf extracts of several hundred southern African tree species against important microbial pathogens to determine which taxa have the highest activity and may yield useful products to treat infections in the animal health market. METHODS: We determined the antibacterial and antifungal activity of 714 acetone leaf extracts of 537 different tree species against Enterococcus faecalis, Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa, Candida albicans and Cryptococcus neoformans. A sensitive serial dilution microplate method was used. RESULTS: Several extracts had MICs as low as 0.02 mg/ml. We analysed 14 out of the 38 tree orders where we determined the activity of more than 8 different tree species representing 89% of all species examined. There were statistically significant differences in some cases. Celastrales, Rosales and Myrtales had the highest activity against Gram-positive bacteria, the Myrtales and Fabales against the Gram-negative bacteria and the Malvales and Proteales against the fungi. Species present in the Asterales followed by the Gentiales and Lamiales had the lowest activities against all the microorganisms tested. Fabales species had the highest activities against all the microorganisms tested. There was substantial selectivity in some orders. Proteales species had very high activity against the fungi but very low activity against the bacteria. The species in the Celastrales and Rosales had very low antifungal activity, low activity against Gram-negative bacteria and very high activity against Gram-positive bacteria. CONCLUSION: Against all classes of microorganisms, the four orders containing species with the highest average antimicrobial activities also contained several species with low activities against different pathogens and vice versa. These results therefore should be used with circumspection in selecting tree orders that would yield the highest probability of finding species with promising activities. Nevertheless there was a twofold increase in probability of finding extracts with interesting antifungal activity from orders with high mean activity than from orders with low mean activity. The probability increased to threefold and fivefold for Gram-positive and Gram-negative bacteria respectively.The National Research Foundation (NRF)http://www.biomedcentral.com/bmccomplementalternmedam201

The MeerKAT Galaxy Cluster Legacy Survey. I. Survey Overview and Highlights

International audienceMeerKAT's large number (64) of 13.5 m diameter antennas, spanning 8 km with a densely packed 1 km core, create a powerful instrument for wide-area surveys, with high sensitivity over a wide range of angular scales. The MeerKAT Galaxy Cluster Legacy Survey (MGCLS) is a programme of long-track MeerKAT L-band (900−1670 MHz) observations of 115 galaxy clusters, observed for ∼6−10 h each in full polarisation. The first legacy product data release (DR1), made available with this paper, includes the MeerKAT visibilities, basic image cubes at ∼8″ resolution, and enhanced spectral and polarisation image cubes at ∼8″ and 15″ resolutions. Typical sensitivities for the full-resolution MGCLS image products range from ∼3−5 μJy beam−1. The basic cubes are full-field and span 2° × 2°. The enhanced products consist of the inner 1.2° × 1.2° field of view, corrected for the primary beam. The survey is fully sensitive to structures up to ∼10' scales, and the wide bandwidth allows spectral and Faraday rotation mapping. Relatively narrow frequency channels (209 kHz) are also used to provide H I mapping in windows of 0 200. We find no dependence of the star-formation rate on distance from the cluster centre, and we observe a small excess of the radio-to-100 μm flux ratio towards the centre of Abell 209 that may reflect a ram pressure enhancement in the denser environment. We detect diffuse cluster radio emission in 62 of the surveyed systems and present a catalogue of the 99 diffuse cluster emission structures, of which 56 are new. These include mini-halos, halos, relics, and other diffuse structures for which no suitable characterisation currently exists. We highlight some of the radio galaxies that challenge current paradigms, such as trident-shaped structures, jets that remain well collimated far beyond their bending radius, and filamentary features linked to radio galaxies that likely illuminate magnetic flux tubes in the intracluster medium. We also present early results from the H I analysis of four clusters, which show a wide variety of H I mass distributions that reflect both sensitivity and intrinsic cluster effects, and the serendipitous discovery of a group in the foreground of Abell 3365. Data are available at https://doi.org/10.48479/7epd-w356