The burden of hypertension in KwaZulu-Natal Province, South Africa: A 6-year perspective

Background. Hypertension (HPT) and its complications continue to pose a global threat and contribute to premature mortality worldwide. The adverse interactions between HPT, obesity and COVID-19 are currently being witnessed globally and represent a collision of pandemics. Understanding the burden that this non-communicable disease (NCD) poses in KwaZulu-Natal (KZN) Province, South Africa (SA), would help in developing improved public healthcare strategies.Objectives. To describe the burden of HPT in all the districts of KZN over a 6-year period.Methods. HPT data are routinely collected from all KZN public health facilities (both clinics and hospitals) as part of the District Health Information System (DHIS). In this retrospective study, we accessed HPT records from the DHIS over a period of 6 years (2014 - 2019, inclusive). Data collected included the number of patients screened, diagnosed and initiated on therapy for HPT, together with the number of obese patients.Results. The slopes for HPT screening were positive at both clinics and hospitals in KZN (considerably more at clinics than hospitals, with a difference in elevations of slopes of p<0.001), with a significantly greater percentage of the population having been screened at rural clinics than at hospitals (difference in elevation of slopes p<0.001). A significantly greater number of patients aged <40 years (p<0.001) were being screened for HPT at clinics than at hospitals (2017/18, 2018/19, 2019/20), while hospitals screened considerably more patients aged ≥40 years in 2017 - 2018 (p<0.001). The numbers of new hypertensives diagnosed and having treatment initiated were on an upward slope at both clinics and hospitals, with clinics having a greater elevation of slope than hospitals (p<0.001), irrespective of patient age. A significantly greater number of patients aged ≥40 years (p<0.05) were diagnosed with HPT at both clinics and hospitals in KZN (2017/18, 2018/19, 2019/20). KZN clinics remained the first port of call for known hypertensives throughout the study period. Obesity was prevalent at both clinic and hospital level, although figures were significantly higher at clinics. Over 80% of the obesity burden was carried by the rural clinics and hospitals.Conclusions. Screening, diagnosis, treatment initiation and chronic management of HPT occur mainly at rural clinic level. The SA government needs to heed these findings and redirect resources (staffing and equipment) to this level. The prevalence of obesity was highest at rural healthcare facilities (clinics more than hospitals). More needs to be done to combat the obesity pandemic if we are to win the battle against NCDs (HPT and diabetes mellitus). A significant number of patients aged <40 years are being screened for HPT, which bodes well for the province, as early diagnosis and treatment of HPT are vital to prevent complications

The prospects for mathematical logic in the twenty-first century

The four authors present their speculations about the future developments of mathematical logic in the twenty-first century. The areas of recursion theory, proof theory and logic for computer science, model theory, and set theory are discussed independently.Comment: Association for Symbolic Logi

Local magnetism of isolated Mo atoms at substitutional and interstitial sites in Yb metal : Experiment and Theory

Using TDPAD experiment and local spin density calculations, we have observed large 4d moments on isolated Mo atoms at substitutional and octahedral interstitial lattice sites in Yb metal, showing Curie-Weiss local susceptibility and Korringa like spin relaxation rate. As a surprising feature, despite strong hybridization with the Yb neighbours, interstitial Mo atoms show high moment stability with small Kondo temperature. While, magnetism of Mo, at substitutional site is consistent with Kondo type antiferromagnetic d-sp exchange interaction, we suggest that moment stability at the interstitial site is strongly influenced by ferromagnetic polarization of Yb-4f5d band electrons.Comment: 4 pages, 4 figure

Morphometric analysis of the mandible in the Durban Metropolitan population of South Africa

Background: The identification of an individual from skeletal remains plays a vital role in forensic investigation as it is essential for the identification of the individual’s age, sex, and/or race and further analysis. Skeletal characteristics differ from one population group to another since population-specific osteometric standards exist for sex determination. Since the mandible is the largest, strongest and most durable compact facial bone, it is the best preserved after death. While sexual dimorphism of the mandible is indicated by its shape and size, morphometric analysis is more accurate in the determination of sex from the skull. The aim of this study was to evaluate the morphometric parameters of the mandible in the Durban Metropolitan population. Materials and methods: Various morphometric parameters of the mandible were measured and assessed in 265 digital panoramic radiographs aged between 16 and 30 years (n = 530). Each parameter recorded was statistically analysed using SPSS to determine if a relationship existed between the parameter, and sex and age. Results: In this study the morphometric parameters of the male mandibles were greater than that of the females. This concurred with the findings of previous studies. The length of the mandibular ramus on the right and left sides was statistically significant with sex. Conclusions: This correlated with previous studies, indicating that the length of the mandibular ramus generally has higher sexual dimorphism than any other morphometric mandibular parameter (p = 0.000). However, only the length of the right mandibular body was statistically significant when compared with sex (p = 0.040). The findings of this study may assist forensic investigators, anatomists, anthropologists and maxillo-facial surgeons.