Haemorrhage - the main presenting feature of diverticular disease of the colon in blacks

Haemqrrhage is one of the less common presentations of diverticular disease. This retrospective 5 year study of 23 patients has identified it as the main presentation (74%) among South African blacks in whom the disease is uncommon, but emerging as a clinical problem. Women constituted a statistically significant majority of patients with bleeding (76%); this was in excess of their overall proportion among patients with diverticular disease (61%) (P =0,018)

Problem based learning at the Nelson R Mandela School of Medicine

A problem-based learning curriculum was phased in to replace our traditional lecture-based curriculum in 2001. True integration, both vertically and horizontally of the basic sciences and clinical disciplines, is reflected in each unit of learning in the first three years. The teaching programme is centrally coordinated and students work in small groups while guided by clinical and non-clinical facilitators. In the last two years, teaching and learning becomes more clinical as students rotate through the clinical disciplines. Both formative and summative assessment (including OSCE and OSPE) is used. Students have to pass each independent, clinical assessment in their final year. This paper highlights the problems and solutions of our transition to PBL. We advocate that staff and students should collaborate in the review to allow resource poor countries to find a model suitable for their unique conditions. Our programme combines the advantages of both the PBL and the traditional pedagogies

Issues in medicine: Engaging surgeons among clinician-scientists

Since completion of the Human Genome Project at the turn of the century, there have been significant advances in genomic technologies together with genomics research. At the same time, the gap between biomedical discovery and clinical application has narrowed through translational medicine, so establishing the era of personalised medicine. In bridging these two disciplines, the clinician-scientist has become an integral part of modern practice. Surgeons and surgical diseases have been less represented than physicians and medical conditions among clinician-scientists and research. Here, we explore the possible reasons for this and propose strategies for moving forward. Discovery-driven personalised medicine is both the present and the future of clinical patient care worldwide, and South Africa is uniquely placed to build capacity for biomedical discovery in Africa. Diverse engagement across clinical disciplines, including surgery, is necessary in order to integrate modern medicine into a developing-world contextualised perspective

Engaging surgeons among clinician-scientists

Since completion of the Human Genome Project at the turn of the century, there have been significant advances in genomic technologies together with genomics research. At the same time, the gap between biomedical discovery and clinical application has narrowed through translational medicine, so establishing the era of personalised medicine. In bridging these two disciplines, the clinician-scientist has become an integral part of modern practice. Surgeons and surgical diseases have been less represented than physicians and medical conditions among clinician-scientists and research. Here, we explore the possible reasons for this and propose strategies for moving forward. Discovery-driven personalised medicine is both the present and the future of clinical patient care worldwide, and South Africa is uniquely placed to build capacity for biomedical discovery in Africa. Diverse engagement across clinical disciplines, including surgery, is necessary in order to integrate modern medicine into a developing-world contextualised perspective

Optimal Control System of Under Frequency Load Shedding in Microgrid System with Renewable Energy Resources

Book ChapterNowadays many of the power systems are facing serious problems because of the lack of know-how to utilize the available renewable energy resources (RER) so as to balance between the power supply and demand sides. As the consequence of the power unbalancing into their distribution networks, under frequency load shedding (UFLS) which leads to life span reduction of various expensive equipment and deteriorating production in general are of much concerns. Thus, proper control system for the load flow in a system like microgrids (MG) with RER in general is the first thing to carry out the assessment with the aim to solve the power balancing problem within the power system networks. Actually, the major problems which many utilities are facing all over the world are how to utilize the available and future energy resource reserves in order to balance between the supply and demand sides within their power distribution networks. Moreover, because of the quick, improvised and unforeseen increasing number of consumers’ power demands and lack of additional macro energy resources plants which can favorably respond to the instantaneous consumer requirements, optimal control strategy (OCS) is inevitable. The OCS is required to maintain the steady-state operations and ensure the reliability of the entire distribution system over a long period. For that case, the OCS is required to principally stabilize parameters such as voltage, frequency, and limit the injection of reactive power into the MG system under stress. Therefore, in this chapter, the OCS is proposed as an approach to be applied in an intelligent way to solve the UFLS and blackout problems (BP) in a typical MG with RER. The proposed control solution is analyzed using emergency power supply reserves integrated with RER. These typical energy resources can be wind and photovoltaic (solar PV) systems associated with the battery energy storage system (BESS), hydro pump storage, biomass power plant and fuel cell systems

Incisional Hernia: Experience in a single surgical unit

Background: Incisional hernias are a common problem in general surgery and they have a varied aetiology. The aim of this study was to document a single unit experience with the management of incisional hernias at King Edward VIII Hospital, Durban, South Arica.Patients and Methods: This was a prospective audit of incisional hernias in a single surgical unit from January 2001 to May 2004. All patients underwent open repair. Clinical data and intra-operative findings were documented.Results: A total number of 77 patients were seen of which 70 were female. Fifty three (68.8%) and 24 (31.2%) of patients underwent elective and emergency surgery respectively. A total of 56 patients had previously undergone gynaecological surgery compared to 21 who had undergone general surgery. There was a documented history of previous sepsis in 4 (7%) of patients. There was 1 sheath defect in 36 patients, 2 defects in 9 patients, 3 defects in 10 patients, 4 or more defects in 9 cases. In 55 patients the original suture could not be identified. Gangrenous bowel was present in 3 patients. Only 3 (3.9%) of the patients had a mesh repair. The rest (96.1%) underwent tissue repair. Morbidity rate was 17% and there were no deaths. Five patients needed management in the ICU. Hospital stay was 8 + 11 yearsConclusion: Most incisional hernias followed gynaecological surgery. There was no evidence of a nonabsorbable suture having been used at the original operation in over half of the patients. We recommend that meticulous technique is essential in closing the abdominal incision

Remarkable thermal conductivity enhancement in Ag—decorated graphene nanocomposites based nanofluid by laser liquid solid interaction in ethylene glycol

We report on the synthesis and enhanced thermal conductivity of stable Ag-decorated 2-D graphene nanocomposite in ethylene glycol based nanofluid by laser liquid solid interaction. A surfactant free nanofluid of Ag nanoparticles anchored onto the 2-D graphene sheets were synthesized using a two-step laser liquid solid interaction approach. In order to understand a pulsed Nd:YAG laser at the fundamental frequency (λ = 1,064 nm) to ablate Ag and graphite composite target submerged in ethylene glycol (EG) to form AgNPs decorated 2-D GNs-EG based nanofluid. From a heat transfer point of view, it was observed that the thermal conductivity of this stable Ag-graphene/EG is significantly enhanced by a factor of about 32.3%; this is highest reported value for a graphene based nanofluid