Changing pattern of incidence, aetiology and mortality from acute pancreatitis at Kalafong Hospital, Pretoria, South Africa, 1988-2007: A retrospective evaluation

Background: Literature reports from Western countries suggest an increasing incidence of acute pancreatitis (AP) and changing pattern over the past two decades. The aim of this study was to document the incidence, aetiology and mortality from AP over two decades and to examine any emerging trends.Methods: A retrospective study of all confirmed cases of AP admitted over a 20-year period to the surgical department was performed. Patients’ demographics, year of admission, number of attacks, aetiology, management and outcome were entered on a special study proforma.Results: Altogether 707 attacks of AP (M: F, 5.7: 1) were recorded. The proportion of gallstone AP increased (3.1% to 12.7%) and that of alcohol-related AP decreased (84% to 67.6%). Alcohol was the main aetiological factor for AP. Drugs, hyperlipidaemia, human immunodeficiency virus (HIV) and endoscopic pancreatography-related AP increased in the second decade. The in-hospital mortality rate during the respective periods was 6.5% and 3.1%.Conclusion: Gallstone AP increased during second decade from more Caucasian admissions and increased gallstones among Blacks. The reduced mortality was attributed to changing trends in the nature and aetiology of AP recorded, heightened awareness of the condition and improved management

A hybrid human machine system for the detection and management of potholes on asphalt road surfaces

Road distresses such as potholes can have a negative economic and social impact. The timeous detection and identification of potholes could expedite the maintenance and repair of potholes. The research team previously investigated and reported on the Visual Surveying Platform, which is a system that automatically detects and geo-tags potholes, with a detection accuracy of approximately 82%. At this level of accuracy, errors consisting largely of false positives could result in repair teams responding to non-existent potholes. In order to incorporate the detection system into the existing workflow of one of the municipalities in the Gauteng area, the detection accuracy needed to be improved. The research team modified the system to include a ?human-in-the-loop? mode of operation, where the detection system performs a more suggestive function. The mobile detection system automatically detects potholes in real-time and presents the detections to an operator for validation. The validated detections are then introduced into the operational workflow of the maintenance and repair teams. The ?human-in-the-loop? system and the operational workflow are described in detail in this paper.Paper presented at the 34th Annual Southern African Transport Conference 6-9 July 2015 "Working Together to Deliver - Sakha Sonke", CSIR International Convention Centre, Pretoria, South Africa.The Minister of Transport, South AfricaTransportation Research Board of the US

Gastro-intestinal stromal tumours (GISTs) – the Pretoria experience and a literature review

AIM: To analyse the presentation and management of patients with gastro-intestinal stromal tumours (GISTs) at Pretoria hospitals. DESIGN: A retrospective study was done in which all available clinical records of primary c-KIT positive GISTs were analysed. SETTING: Secondary and tertiary care institutions in Pretoria, including both private and public hospitals. SUBJECTS: The population studied included all individuals treated at Pretoria hospitals from 17 July 2000 to 1 April 2009 who had a GIST confirmed with immunohistochemical c‑KIT staining. Patients with incomplete or inaccessible clinical records were excluded. OUTCOME MEASURES. Patient demographics including gender, age and race; presenting symptoms and signs; results of special investigations; and treatment. RESULTS: Fifty-four cases were identified for inclusion in the study. The age of the subjects ranged from 15 to 83 years. The male-to-female ratio was 1.5:1. The organ most commonly affected was the stomach, and abdominal pain and weight loss were the most common presenting symptoms. Seventy-six per cent of the patients were treated surgically, and 24% received imatinib. CONCLUSION: GISTs often present late with nonspecific symptoms, and are frequently discovered incidentally. Large tumours tend to be malignant.http://www.hmpg.co.za/journaldetail.php?journalno=

A 10-year audit of burns at Kalafong Hospital

Kalafong Hospital is a secondary hospital situated to the west of Pretoria. It serves as the regional burns centre for Gauteng province north of the Jukskei river. It mainly serves a poor population. This is a retrospective review of a 10-year period, looking at both numbers and the aetiology of burns treated by this unit. Only adult cases – patients over the age of 12 – were assessed. Over this period, a total number of 1046 patients were admitted and treated by this unit, consisting of 634 males and 406 females. The period covered, includes a period when the government has been expending massive amounts of funds to electrify townships and rural areas. Despite this, however, the majority of burn wounds are still caused by open flames and paraffin stoves

Changing Pattern of Incidence, Aetiology and Mortality from Acute Pancreatitis at Kalafong Hospital, Pretoria, South Africa, 1988-2007: A Retrospective Evaluation

Background: Literature reports from Western countries suggest an increasing incidence of acute pancreatitis (AP) and changing pattern over the past two decades. The aim of this study was to document the incidence, aetiology and mortality from AP over two decades and to examine any emerging trends. Methods: A retrospective study of all confirmed cases of AP admitted over a 20-year period to the surgical department was performed. Patients’ demographics, year of admission, number of attacks, aetiology, management and outcome were entered on a special study proforma. Results: Altogether 707 attacks of AP (M: F, 5.7: 1) were recorded. The proportion of gallstone AP increased (3.1% to 12.7%) and that of alcohol-related AP decreased (84% to 67.6%). Alcohol was the main aetiological factor for AP. Drugs, hyperlipidaemia, human immunodeficiency virus (HIV) and endoscopic pancreatography-related AP increased in the second decade. The in-hospital mortality rate during the respective periods was 6.5% and 3.1%. Conclusion: Gallstone AP increased during second decade from more Caucasian admissions and increased gallstones among Blacks. The reduced mortality was attributed to changing trends in the nature and aetiology of AP recorded, heightened awareness of the condition and improved management

Registrar perceptions on general surgical training in South Africa: A report by the South African Society of Surgeons in Training (SASSiT)

BACKGROUND : Surgical training varies significantly amongst universities within the same country. This trend is reflected in South Africa and provides an opportunity for innovation to improve the quality of general surgical training. OBJECTIVE : To assess the perceptions of South African general surgery registrars regarding surgical training. METHOD : A prospective descriptive study was performed by means of a confidential questionnaire distributed to general surgical registrars at all eight training centers in South Africa. Participants were asked to give comments regarding adequacy of formal academic teaching, level of supervision during surgical procedures, exposure to and training in minimally invasive surgery (MIS), and preparation for examinations. Descriptive statistics were generated with Microsoft Excel. Ethics clearance was obtained from the University of the Witwatersrand Human Research Ethics Committee. RESULTS : Of 200 questionnaires distributed 105 (52.5%) were returned. 44% (105/241) of all registrars from six training institutions participated. 89.5% (94/105) of respondents reported that they attended less than six hours of formal academic teaching per week and 71.4% (75/105) indicated that their institution offered less than six hours of formal academic teaching per week. 76.2% (80/105) of respondents regarded lack of protected academic time as the greatest obstacle to their surgical training and 95.2% (99/105) reported that clinical responsibilities prevented them from attending formal academic teaching regularly. Overall, only 31.4% (33/105), 41.9% (44/105) and 37.1% (39/105) were satisfied with the amount of formal academic teaching, level of supervision during theatre procedures and exposure to minimally invasive surgery respectively. Lack of resources and lack of appropriate skills were identified as a hindrance to MIS training by 47.6% (50/105) and 28.6% (30/105) of respondents respectively. CONCLUSION : Surgical registrars are dissatisfied with the amount of formal academic teaching and protected academic time, level of supervision in theatre and their exposure to MIS. These challenges compromise trainees’ ability to practice independently after qualification. Numerous interventions are necessary and possible to address these challenges.http://www.sajs.org.za/index.php/sajsam2018Surger

Registrar perceptions on general surgical training in South Africa : a report by the South African Society of Surgeons in Training (SASSiT)

BACKGROUND : Surgical training varies significantly amongst universities within the same country. This trend is reflected in South Africa and provides an opportunity for innovation to improve the quality of general surgical training. OBJECTIVE : To assess the perceptions of South African general surgery registrars regarding surgical training. METHOD : A prospective descriptive study was performed by means of a confidential questionnaire distributed to general surgical registrars at all eight training centers in South Africa. Participants were asked to give comments regarding adequacy of formal academic teaching, level of supervision during surgical procedures, exposure to and training in minimally invasive surgery (MIS), and preparation for examinations. Descriptive statistics were generated with Microsoft Excel. Ethics clearance was obtained from the University of the Witwatersrand Human Research Ethics Committee. RESULTS : Of 200 questionnaires distributed 105 (52.5%) were returned. 44% (105/241) of all registrars from six training institutions participated. 89.5% (94/105) of respondents reported that they attended less than six hours of formal academic teaching per week and 71.4% (75/105) indicated that their institution offered less than six hours of formal academic teaching per week. 76.2% (80/105) of respondents regarded lack of protected academic time as the greatest obstacle to their surgical training and 95.2% (99/105) reported that clinical responsibilities prevented them from attending formal academic teaching regularly. Overall, only 31.4% (33/105), 41.9% (44/105) and 37.1% (39/105) were satisfied with the amount of formal academic teaching, level of supervision during theatre procedures and exposure to minimally invasive surgery respectively. Lack of resources and lack of appropriate skills were identified as a hindrance to MIS training by 47.6% (50/105) and 28.6% (30/105) of respondents respectively. CONCLUSION : Surgical registrars are dissatisfied with the amount of formal academic teaching and protected academic time, level of supervision in theatre and their exposure to MIS. These challenges compromise trainees’ ability to practice independently after qualification. Numerous interventions are necessary and possible to address these challenges.http://www.sajs.org.za/index.php/sajsam2018Surger