Hepatitis B and HIV co-infection in South Africa: just treat it!

There are an estimated 350 million hepatitis B carriers worldwide. The prevalence of mono-infection with hepatitis B in South Africa has been estimated at approximately 10% for the rural population and 1% in urban areas.1,2 The transmission routes of hepatitis B and HIV are similar, but hepatitis B is more efficient. Co-infection with HIV and hepatitis B is therefore not unusual. Recent studies have shown that the prevalence of HIV/HBV co-infection (using HBV surface antigen (HBsAg) as a marker for HBV) in South Africa ranges from 4.8% to 17%, depending on the population studied.The guidelines for the South African HIV Comprehensive Care,  anagement and Treatment (CCMT) programme do not include viral hepatitis studies.6 Hepatitis B serology is usually done only if serum aminotransferases are evaluated in the absence of another known cause (e.g. tuberculosis and concomitant medications). The clinical sequelae of HIV/HBV co-infection are multiple and can cause an increase in morbidity and mortality. Awareness of HBV/HIV co-infection with appropriate diagnosis and management is imperative for improved care of our HIV patients.

Deep copycat networks for text-to-text generation.

Most text-to-text generation tasks, for example text summarisation and text simplification, require copying words from the input to the output. We introduce Copycat, a transformer-based pointer network for such tasks which obtains competitive results in abstractive text summarisation and generates more abstractive summaries. We propose a further extension of this architecture for automatic post-editing, where generation is conditioned over two inputs (source language and machine translation), and the model is capable of deciding where to copy information from. This approach achieves competitive performance when compared to state-of-the-art automated post-editing systems. More importantly, we show that it addresses a well-known limitation of automatic post-editing - overcorrecting translations - and that our novel mechanism for copying source language words improves the results

Decreased sexual risk behaviour after the diagnosis of HIV and initiation of antiretroviral treatment - a study of patients in Johannesburg

Objectives. An extended programme for free antiretroviral treatment (ART) of HIV was launched in South Africa in April 2004. It is essential to assess the effects on sexual risk behaviour. Design and setting. A questionnaire was distributed to patients on ART at Helen Joseph Hospital, Johannesburg, between 17 January and 22 February 2005. Results. The percentage of men who had sexual contacts outside their relationship decreased from 48% before HIV diagnosis to 11% after starting ART. Condom use with casual partners increased from 53% among the men and 46% among the women before the diagnosis of HIV to 87% and 81% respectively on ART. The majority of patients were tested for HIV because they presented with symptoms of illness. We noted no significant difference in disclosure rate after the start of ART. All participants were positive about the treatment and felt physically better. The majority of the patients experienced a better quality of life. Conclusions. The ART had an overall positive effect on health with no increase of sexual risk behaviour. Southern African Journal of HIV Medicine Vol. 7 (4) 2006: pp. 12-1

Fever, sore throat and myalgia

A 20-year-old man presented with a severely sore throat and myalgia, which were unresponsive to antibiotics. He was admitted to a regional hospital with an ongoing painful throat, generalised myalgia, fever and a transient, recurring, salmon-pink rash on his hands and trunk. He did not respond to ceftriaxone and had a continual significant fever daily. 

Pelatihan Percakapan Dalam Bahasa Inggris Untuk Para Perawat Di Rumah Sakit Lavalette Malang

Pentingnya bahasa Inggris sebagai bahasa Internasional sangat dibutuhkan untuk menunjang pekerjaan dan berkomunikasi sebagai perawat, mengingat pasien datang dari berbagai latarbelakang termasuk berbicara berbagai bahasa. Berdasarkan kondisi yakni kurang lebih terdapat lima pasien asing yang berobat di rumah sakit Lavallete setiap minggunya, beberapa perawatmengalami kendala berkomunikasi sehingga tidak dapat menangani pasien dengan cepat dantepat dan perawat yang mampu berkomunikasi dalam bahasa Inggris terbatas tiga orang danperawat tersebut tidak setiap saat mendapatkan giliran jaga sehingga perlu dicarikan solusi yaituberupa pelatihan percakapan bahasa Inggris khususnya bahasa Inggris untuk tujuan khusus.Dengan materi greeting for nurses, useful expression for admission, nursing instruction, givingprocedures dan handling patient complaints melalui teknik yang bervariasi mulai daribrainstorming, modeling, drilling, role play, maupun mini lesson, pelatihan percakapan bahasaInggris diadakan untuk perawat di RS Lavalette

To What Extent do Fiscal Regimes Equalize Opportunities for Income Acquisition Among Citizens?

This project employs the theory of equality of opportunity, described in Roemer's book (Equality of Opportunity, Harvard University Press, 1998), to compute the extent to which tax-and-transfer regimes in ten countries equalize opportunities among citizens for income acquisition. Roughly speaking, equality of opportunity for incomes has been achieved in a country when it is the case that the distributions of post-fisc income are the same for different types of citizen, where a citizen's type is defined by the socioeconomic status of his parents. Intuitively, a country will have equalized opportunity if the chances of earning high (or low) income are equal for citizens from all family backgrounds. Of course, pre-fisc income distributions, by type, will not be identical, as long as the educational system does not entirely make up for the disadvantage that children, who come from poor families face, but the tax-and-transfer system can play a role in rectifying that inequality. We include, in our computation, two numbers that summarize the extent to which each country's current fiscal regime achieves equalization of opportunities for income, and the deadweight loss that would be incurred by moving to the regime that does.

To what extent do fiscal regimes equalize opportunities for income acquisition among citizens?.

This paper employs the theory of equality of opportunity, described in Roemer’s book (Equality of Opportunity, Harvard University Press, 1998), to compute the extent to which tax-and-transfer regimes in 11 countries equalize opportunities among citizens for income acquisition. Roughly speaking, equality of opportunity for incomes has been achieved in a country when it is the case that the distributions of post-fisc income are the same for different types of citizen, where a citizen’s type is defined by the socio-economic status of his parents. Intuitively, a country will have equalized opportunity if the chances of earning high (or low) income are equal for citizens from all family backgrounds. Of course, pre-fisc income distributions, by type, will not be identical, as long as the educational system does not entirely make up for the disadvantage that children, who come from poor families face, but the tax-and-transfer system can play a role in rectifying that inequality. We include, in our computation, two numbers that summarize the extent to which each country’s current fiscal regime achieves equalization of opportunities for income, and the deadweight loss that would be incurred by moving to the regime that does.Fiscal regimes; Equal opportunities; Income acquisition;

Outcomes of treatment of drug-susceptible tuberculosis at public sector primary healthcare clinics in Johannesburg, South Africa: A retrospective cohort study

Background. Despite the large number of tuberculosis (TB) patients treated in South Africa (SA), there are few descriptions in the published literature of drug-susceptible TB patient characteristics, mode of diagnosis or treatment outcomes in routine public sector treatment programmes.Objective. To enhance the evidence base for public sector TB treatment service delivery, we reported the characteristics of and outcomes for a retrospective cohort of adult TB patients at public sector clinics in the Johannesburg Metropolitan Municipality (JHB), SA.Methods. We collected medical record data for a retrospective cohort of adult (≥18 years) TB patients registered between 1 April 2011 and 31 March 2012 at three public sector clinics in JHB. Data were abstracted from National TB Programme clinic cards and the TB case registers routinely maintained at study sites. We report patient characteristics, mode of diagnosis, mode of treatment supervision, treatment characteristics, HIV status and treatment outcomes for this cohort.Results. A total of 544 patients were enrolled in the cohort. Most (86%) were new TB cases, 81% had pulmonary TB, 58% were smear-positive at treatment initiation and 71% were HIV co-infected. Among 495 patients with treatment outcomes reported, 80% (n=394) had successful outcomes, 11% (n=55) were lost to follow-up, 8% (n=40) died and 1% (n=6) failed treatment.Conclusions.Primary healthcare clinics in JHB are achieving relatively high rates of success in treating drug-susceptible TB. Missing laboratory results were common, including follow-up smears, cultures and drug susceptibility tests, making it difficult to assess adherence to guidelines and leaving scope for substantial improvements in record-keeping at the clinics involved.