Idiopathic hypoparathyroidism

Idiopathic hypoparathyroidism is a rare disease. Drake, Albright, Baur and Castleman 3 fully described it in 1939. Only 50 or 60 proven cases (de Mowbray,2 1953) have been reported in the literature. As far as we know the following is the first reported case in an African

Variant (prinzmetal's) form of angina pectoris manifesting in complicating ventricular extrasystoles

A case of the variant (Prinzmetal's) atypical form of angina pectoris is presented. Secondary and primary changes affecting the S-T segment and T wave are discussed. The features were also present, and indeed more marked, in complicating ventricular extrasystoles, one of which reflected the infarction pattern.S. Afr. Med. J., 48. 1146 (1974)

A coding system for the arrhythmias

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Right bundle-branch block associated with transient left posterior hemiblock in a case of acute myocardial infarction

The intraventricular conduction defect of left posterior hemiblock is very uncommon. Its occurrence as a transient phenomenon during the course of acute myocardial infarction, as described in this report, is exceptionally rare. The presentation revealed a planar reorientation of QRS forces, and demonstrated the masking effect of left posterior hemiblock on the parameters of anterolateral myocardial ischaemia.S. Afr. Med. J., 48, 1237 (1974)

Relative communicators: evaluation of an innovative hospital role emerging from the Covid-19 pandemic

Background: During the COVID-19 pandemic, hospital visiting policies made communication challenging. Effective communication is known to reduce anxiety for patients and relatives, and improve trust in healthcare services. We describe an innovative project in which students and staff were deployed to the role of ‘Relative Communicators’, enabling routine updates and facilitating video calls between patients and their next of kin (NOK). The aim of our project was to explore NOK's perceptions of communication about their inpatient relatives and the Relative Communicators. // Method: Participants were asked to complete a structured interview over a telephone call but could use the online form if this was not possible. Hence, we obtained data using a combination of interviews and online surveys. NOK, who utilized the relative communicator service (n = 30), were surveyed. Quantitative data and free-text responses were analysed to understand their perceptions. // Results: 85.7% of respondents (24/28) were satisfied with information they received from Relative Communicators. 43.3% (13/30) of NOK felt they could communicate with their relative ‘the right amount’, and 56.7% (17/30) felt they were sufficiently involved in care decisions. Qualitative data provided further insights around the demand for proactive updates, frustration with existing communication models, and praise of telecommunication methods. // Conclusions: We suggest proactive updates and telecommunication could improve the experience for patients and NOK. Relative Communicators provided a bridge for inpatients and NOK to connect. The pandemic has exacerbated systemic communication issues and innovations, such as the Relative Communicators, may help to address these challenges

Noise Effects on the Complex Patterns of Abnormal Heartbeats

Patients at high risk for sudden death often exhibit complex heart rhythms in which abnormal heartbeats are interspersed with normal heartbeats. We analyze such a complex rhythm in a single patient over a 12-hour period and show that the rhythm can be described by a theoretical model consisting of two interacting oscillators with stochastic elements. By varying the magnitude of the noise, we show that for an intermediate level of noise, the model gives best agreement with key statistical features of the dynamics.Comment: 4 pages, 4 figures, RevTe

Digital clubbing in tuberculosis – relationship to HIV infection, extent of disease and hypoalbuminemia

BACKGROUND: Digital clubbing is a sign of chest disease known since the time of Hippocrates. Its association with tuberculosis (TB) has not been well studied, particularly in Africa where TB is common. The prevalence of clubbing in patients with pulmonary TB and its association with Human Immunodeficiency Virus (HIV), severity of disease, and nutritional status was assessed. METHODS: A cross-sectional study was carried out among patients with smear-positive TB recruited consecutively from the medical and TB wards and outpatient clinics at a public hospital in Uganda. The presence of clubbing was assessed by clinical signs and measurement of the ratio of the distal and inter-phalangeal diameters (DPD/IPD) of both index fingers. Clubbing was defined as a ratio > 1.0. Chest radiograph, serum albumin and HIV testing were done. RESULTS: Two hundred patients (82% HIV-infected) participated; 34% had clubbing by clinical criteria whilst 30% had clubbing based on DPD/IPD ratio. Smear grade, extensive or cavitary disease, early versus late HIV disease, and hypoalbuminemia were not associated with clubbing. Clubbing was more common among patients with a lower Karnofsky performance scale score or with prior TB. CONCLUSION: Clubbing occurs in up to one-third of Ugandan patients with pulmonary TB. Clubbing was not associated with stage of HIV infection, extensive disease or hypoalbuminemia

An appraisal of the electrocardiographic exercise test

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