Some medical impressions of India, with particular reference to diabetes mellitus and cardiovascular disease

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Clinical trial of a new sulphonylurea in maturity-onset diabetes-hb419 (Glibenclamide)

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Diabetes mellitus in the urbanized Johannesburg African

Diabetes mellitu is a common and important clinical problem in the urbanized Johannesburg African. A survey of Africans aged 30 and over attending the Baragwanath Hospital Casualty Department showed an incidence of diabetes of about 1%.1 Yet, apart from Campbell's studies on the Zulu diabetic, a search of the literature yielded little of note on diabetes in the South African Bantu. We have therefore undertaken an analysis of the records of 250 new cases of diabetes mellitus in African subjects admitted to Baragwanath Hospital during the period 1951 - 1957. These cases were selected at random and constituted at least 75% of all the new African diabetics admitted during this period

Treatment of human tapeworm infections with Yomesan: Single dose treatment in non-fasting subjects

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Haemolytic anaemia, thrombocytopenia and uraemia in eclampsia

Haemolytic anaemia has long been known as a not infrequent complication of eclampsia. Thrombocytopenia may also be associated with eclampsia, while the simultaneous occurrence of both haematological complications has recently been reported by Pritchard et al As these haematological disturbances may have an important bearing on the patbogenesis and therapy of eclampsia, it is the purpose of this paper to draw attention to their occurrence and management, by presenting 2 cases in African patients in whom eclampsia was associated with acute intravascular haemolysis, thrombocytopenia, and uraemia

Asymptomatic bacteriuria in diabetes mellitus

A study was undertaken to determine the frequency of asymptomatic bacteriuria among 100 ambulant diabetic patients attending a diabetic outpatient clinic. At the same time, we assessed the reliability of the Uricult dip-slide method for detecting urinary bacterial growth. Significant bacteriuria occurred in 9% of the total diabetic group, largely attributable to the high prevalence in elderly diabetic women. Important characteristics of the affected diabetic patients included infection, commonly with Escherichia coli, frequently associated pyuria, good diabetic control with normal renal function and a high recurrence rate of bacteriuria after treatment. The dipslide method compared quite favourably with the laboratory culture method, but it failed to detect 2 out of 8 cases with significant bacteriuria.S. Afr. Med. J., 48, 1306 (1974)

Studies in Glycosuria and diabetes in non-white populations of the Transvaal part 2: Indians

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Hyperlipidaemia, obesity and drug misuse in a diabetic clinic

A study of middle-aged and elderly patients attending a diabetic clinic has revealed a disturbing state of affairs. Hyperlipidaemia and obesity were very common but little attention was paid to implementing appropriate dietary regimens. Management was largely confined to the control of hyperglycaemia by using oral hypoglycaemic agents, especially combinations of sulphonylureas and diguanides. This situation is deplored. Firstly, it ignores the correction of factors which are as important, if not more so, than hyperglycaemia, in regard to the development of the most lethal complication of maturity-onset diabetes, namely occlusive atherosclerosis. Secondly, it substitutes for dietary therapy, which is physiological, treatment by drugs which are potentially harmful. It is probable that a similar situation obtains in many other diabetic clinics.S. Afr. Med. J., 48, 277 (1974)

Relationship between pica and iron nutrition in Johannesburg black adults

On direct questioning by a Black staff nurse, 23% of 348 consecutive unselected adult outpatients attending the Johannesburg Non-European Hospital said that they regularly ate earth or ash. The prevalence was higher in the women (33%) than in the men (11 %), and in 50 women with minor gynaecological complaints who were interviewed by a Black psychologist, it was 72%. The quantity eaten varied from an occasional tablespoonful to several handfuls a day. In an attempt to define the reasons for the habit a thematic apperception test was used. A strong association with pregnancy was identified, but the explanation for this was not established. Some subjects claimed that the material was eaten for medicinal purposes, while others merely liked the taste. The effect on iron nutrition appeared to be variable, depending on the ironbinding capacity of the soluble iron content of the material consumed.S. Afr. Med. J., 48. 1655 (1974

Selected risk factors for coronary heart disease in male scholars from the major South African population groups

A num.ber of risk factors for coronary heart disease (CHD) in 7 groups of South African male scholars aged between 15 and 20 years were surveyed. Selection of the groups was based on socioeconomic status and comprised urban and rural blacks, Indians of higher and lower socio-economic status, coloureds of higher and lower socio-economic status, and middle-class whites. Both Indian groups, both coloured groups and the whites had a much greater prevalence and severity of CHD risk factors than the two black groups. This held for total cholesterol, low-density lipoprotein cholesterol (LDLC), high-density lipoprotein cholesterol (HDLC), the HDLC/LDLC ratio, apolipoprotein B, apolipoprotein A-I, insulin, fibrinogen and mass. One exception was lipoprotein a, levels of which were higher in both black groups. In general the CHD risk factor profile was worse in the higher socio-economic groups, and it also tended to be worse in urban than in rural blacks. These findings stress the need to reduce CHD risk factors in our developed populations and to prevent their emergence in our developing peoples