Impact of 20-day strike in Polokwane Hospital (18 August - 6 September 2010)

Background. Doctors’ strikes have a negative effect on hospital performance indicators. Hospital mortality during such strikes is the most important indicator.Objective. To determine the effects of the 2010 strike on Polokwane Hospital.Methods. Information was collected from the Hospital Information System, Polokwane Hospital Casualty Department, wards and theatres.Results. During the 20-day strike, a total of 262 patients were  admitted to Polokwane Hospital, with 40 patients to the surgical department; 96 operations were performed in the hospital and 40 in the surgical department; and 50 deaths were reported in the hospital (8 deaths in the surgical department). During 20 days of a non-striking period in May 2010, there were 975 admissions to the hospital, with 125 to the surgical department. In the entire hospita l, 340 operations were performed, and 79 in the surgical department. For this period, 61 deaths were reported in the hospital and 12 in the surgical department.Conclusions. The total number of patients admitted to the hospital and the surgical department during the strike was significantly lower than during a non-striking situation. Total mortality during the strike in Polokwane Hospital decreased, compared with the normal situation, but it increased when judged against emergency cases. However, when mortality was qualified by the number of admissions, it showed a significant increase. Strikes seriously and significantly affect service delivery

Nodular thyroid disease and thyroid malignancy: Experience at Polokwane Mankweng Hospital Complex, Limpopo Province, South Africa

Background. Nodular thyroid disease is common throughout the world. Numbers of patients with goitre are increasing worldwide, as also noted in Limpopo Province, South Africa (SA). Globally, thyroid nodules have been reported in 4 - 7% of the population on neck palpation and in 30 - 50% by ultrasonography.Objectives. To review the profile of thyroid disease in patients with goitre presenting to the Department of Surgery at Polokwane Mankweng Hospital Complex (PMHC), Limpopo, SA, to characterise the pattern of malignancy in patients with goitre, and to determine the most common thyroid cancer.Method. A 6-year retrospective study (2003 - 2008) of all patients with thyroid nodules who underwent thyroid surgery at PMHC.Results. The study group included 90 patients (mean age 45 years, range 4 - 80). The male-to-female ratio was 1:17 (5 men, 85 women). Of these patients, 80 (89.9%) had benign lesions, of which 52 (57.8% of the total) were adenomas, 25 (27.8%) multinodular goitres (MNGs), 2 (2.2%) hyperplastic nodules and 1 (1.1%) Hashimoto’s thyroiditis. Ten patients (11.1%) had malignant lesions (7 follicular carcinomas and 3 papillary carcinomas), of which 2 were found in MNGs.Conclusions. Adenoma and MNG were the predominant non-malignant conditions (85.6%). The prevalence of thyroid cancer in our study was 11.1%, and of all 90 patients, 7.8% had follicular carcinoma. The risk of malignancy in MNG was 8.9%. Rates of thyroid nodules and carcinoma were highest in women aged 41 - 60 years. We advocate that total thyroidectomy be considered for MNG, because MNG can harbour incidental carcinoma

Micropapillary carcinoma of the breast: A case review at Mankweng Hospital breast oncology clinic in Limpopo Province, South Africa

Invasive micropapillary carcinoma (IMPC) of the breast is a clinically aggressive rare form of breast cancer. Patients with IMPC present with higher clinical stages, higher histological degrees, higher rate of lymph-vascular invasion and axillary lymph node extracapsular extension. In this case report, we seek to explore and share our experience of invasive micropapillary carcinoma of the breast and give a literature review of the standard of care

Primary thyroid cavernous haemangioma: Report of a case with review 3 years after operation

A 51-year-old man presented with progressive symptomatic anterior neck swelling. Thyroid scintigraphy showed a multinodular goitre predominantly on the left side, and left thyroid lobectomy was performed. Histological examination of the specimen showed cavernous haemangioma. Cavernous haemangiomas of the thyroid are seldom suspected preoperatively, as they are very rare. Only a few cases have been reported in the literature. Three years after the operation, the patient was reviewed and found to be clinically well with no thyroid-related symptoms. The prognosis after surgery is good. In this case report, we share our experience of primary thyroid cavernous haemangioma and provide a literature review

Evaluation of the performance of lecturers in general surgery by 4th- and 6th-year MB ChB students at the University of Limpopo, Polokwane, South Africa

Background. Students’ evaluation of teaching performance is one of the important means of measuring the quality of higher education worldwide. Students are valuable contributors to improvement of the teaching performance of lecturers. For any academic institution, it is very important to receive feedback on teaching quality from students. Objectives. To determine lecturers’ performance as evaluated by undergraduate students in general surgery, with the aim of identifying the lecturers’ strengths and planning tactics for any necessary improvement measures. Methods. This study followed a descriptive research design to evaluate seven lecturers in general surgery by 4th- and 6th-year MB ChB students at the University of Limpopo, Polokwane, South Africa. Results. Seven lecturers were evaluated by the students. From the study results, there is strong evidence that the majority of the participants were satisfied with 5/7 lecturers’ interpersonal skills and communication and presentation style, including an overall rating (p<0.0001). Two lecturers were considered by the students to require some level of improvement in performance (p<0.0001). Conclusion. General surgery students expressed satisfaction with the teaching performance of most members of the academic staff. However, some lecturers need to improve with regard to audibility and preparation for slide presentations

Profile of burn patients at Mankweng Hospital, Polokwane, Limpopo Province, South Africa

Background. Burn injuries are a common cause of preventable morbidity and mortality. In all societies, burns continue to constitute a medical, psychological and economic problem. Burn wounds are one of the most common surgical emergencies leading to hospitalisation. Objectives. To understand the profile of patients with burn injuries presenting to Mankweng Hospital in Polokwane, Limpopo Province, South Africa. Methods. This was a retrospective study using a descriptive quantitative design to analyse the profile of all patients admitted consecutively to the Mankweng Hospital burns unit from 1 January 2018 to 31 December 2020. Results. During the study period, a majority of males (n=412; 56.7%) were admitted, indicating a significant sex difference. Conclusion. Children aged <5 years were found to be more affected than any other age group. Males were more affected than their female counterparts. Scalds and flame burns were the most common burn injuries

Breast cancer: Factors influencing late-stage presentation at the Mankweng Hospital breast cancer clinic, Polokwane, Limpopo Province, South Africa

Background. Female breast cancer remains the most common cancer in many parts of the world. According to GLOBOCAN (2021), female breast cancer has become the most commonly diagnosed cancer, surpassing lung cancer. Women in low- and middle-income countries are reported to seek medical help at an advanced stage of the disease, which negatively affects the prognosis, irrespective of the care available. Objectives. To determine factors influencing late-stage diagnosis of breast cancer in women at the specialist breast cancer clinic at Mankweng Hospital in Polokwane, Limpopo Province, South Africa. Methods. The study was conducted at the Mankweng breast cancer clinic in the rural province of Limpopo over the 18-month period July 2020 - December 2021 and applied a quasi-experimental design to determine the stage of breast cancer at the time of presentation to the clinic, and factors influencing late-stage presentation. Results. Of the study sample, 269 patients were female (98%) and 5 male (2%). The majority of the females (n=203; 75%) had late-stage cancer at presentation, only 66 (25%) being in the early stages. Conclusion. Most of the patients (76%) presented with late-stage disease. The main reason for the delay was lack of knowledge about breast cancer and its symptoms (not painful, not considered serious). Of concern is the higher proportion of educated patients presenting with late-stage disease compared with the group with a lower level of education