The development of passive health surveillance by a sentinel network of family practitioners in South Africa

Objective. For the South African Sentinel Practitioner Research Network (SASPREN), a volunteer network of family practitioners in South Africa, to develop a health surveillance system through the surveillance of important health events.Motivation. The incidence of important preventable diseases and the burden of disease are not reliably known in South Africa, both in the public and private sector. Incidence rates determined at primary care level could help with planning and delivery of appropriate health services and monitoring of the impact of intervention programmes.Methods. Altogether 183 sentinel practitioners were recruited in nine provinces, from 2 478 doctors invited to participate. Of these 120 were active in reporting all their new cases of 13 selected health events to the study centre on mailed postcards. After data-capturing, incidence rates were calculated for defined periods. Feedback was given to the sentinels through a newsletter and personalised reports.Results. A network of sentinel family practitioners has been established in South Africa, and can provide incidence rates for both diseases and interventions through a simple and cheap surveillance system. The calculated rates demonstrated periodic trends for certain events, as well as inter-provincial, -gender and -population group differences.Conclusions. As the validity of the dataset and its generalisation to the whole population is uncertain, its usefulness as point estimates of incidence rates isunknown. This information serves as an important pointer for further research. The trends of these rates may provide a valuable tool for monitoring the impact of public health policies

Thick domain walls around a black hole

We discuss the gravitationally interacting system of a thick domain wall and a black hole. We numerically solve the scalar field equation in the Schwarzschild spacetime and obtain a sequence of static axi-symmetric solutions representing thick domain walls. We find that, for the walls near the horizon, the Nambu--Goto approximation is no longer valid.Comment: 18 pages, 11 figures, one reference adde

Sacroiliac tuberculosis masquerading as mechanical lower back pain in a collegiate basketball athlete: a case presentation

Background: Sacroiliac tuberculosis is a rare condition for which early diagnosis and effective management frequently proves challenging. This report describes a case that was initially overlooked due to its presentation and unreported constitutional symptoms.Aim: To alert clinicians about skeletal tuberculosis, an often neglected diagnostic differential, which requires a high index of clinical suspicion, especially for patients from endemic areas.Findings: This patient’s presentation (sports injury) and unreported constitutional symptoms resulted in a delay in the diagnosis and initial institution of treatment.Implications: This report illustrates the importance of specifically asking about constitutional symptoms, even in sports injury settings and being mindful of infectious diseases or other chronic medical conditions, which may masquerade as common sports injuries.Keywords: skeletal tuberculosis, sacroiliitis, hip pai

Strings in gravity with torsion

A theory of gravitation in 4D is presented with strings used in the material action in $U_4$ spacetime. It is shown that the string naturally gives rise to torsion. It is also shown that the equation of motion a string follows from the Bianchi identity, gives the identical result as the Noether conservation laws, and follows a geodesic only in the lowest order approximation. In addition, the conservation laws show that strings naturally have spin, which arises not from their motion but from their one dimensional structure.Comment: 16 page

Effect of ospemifene on moderate or severe symptoms of vulvar and vaginal atrophy.

Objectives To determine whether assessment of all moderate-to-severe symptoms at baseline gives a more accurate evaluation of the treatment effect of ospemifene in vulvovaginal atrophy (VVA) than the most bothersome symptom (MBS) approach. Methods Data were pooled from two pivotal phase-III clinical trials evaluating the efficacy and safety of oral ospemifene 60 mg/day for the treatment of symptoms of VVA (n = 1463 subjects). Symptoms of vaginal dryness, dyspareunia, and vaginal and/or vulvar irritation/itching reported as moderate or severe at baseline were evaluated. Clinically relevant differences between ospemifene and placebo were analyzed using a four-point severity scoring system and presented as improvement, substantial improvement, or relief. Results Subjects in these studies reported statistically significant improvement, substantial improvement, and relief for vaginal dryness (p \u3c 0.00001), dyspareunia (p \u3c 0.001) and statistically significant improvement and relief for vaginal and/or vulvar irritation/itching (p \u3c 0.01) from baseline to week 12 with ospemifene compared with placebo. A similar trend was observed for women who reported substantial improvement of vaginal and/or vulvar irritation/itching. Conclusions For drug registration purposes, the use of the MBS model is appealing because of its simplicity and ease of scientific validation. However, the MBS model may underestimate the total magnitude of the clinical benefit of ospemifene treatment for symptomatic women suffering from VVA

Effect of ospemifene on moderate or severe symptoms of vulvar and vaginal atrophy.

Objectives To determine whether assessment of all moderate-to-severe symptoms at baseline gives a more accurate evaluation of the treatment effect of ospemifene in vulvovaginal atrophy (VVA) than the most bothersome symptom (MBS) approach. Methods Data were pooled from two pivotal phase-III clinical trials evaluating the efficacy and safety of oral ospemifene 60 mg/day for the treatment of symptoms of VVA (n = 1463 subjects). Symptoms of vaginal dryness, dyspareunia, and vaginal and/or vulvar irritation/itching reported as moderate or severe at baseline were evaluated. Clinically relevant differences between ospemifene and placebo were analyzed using a four-point severity scoring system and presented as improvement, substantial improvement, or relief. Results Subjects in these studies reported statistically significant improvement, substantial improvement, and relief for vaginal dryness (p \u3c 0.00001), dyspareunia (p \u3c 0.001) and statistically significant improvement and relief for vaginal and/or vulvar irritation/itching (p \u3c 0.01) from baseline to week 12 with ospemifene compared with placebo. A similar trend was observed for women who reported substantial improvement of vaginal and/or vulvar irritation/itching. Conclusions For drug registration purposes, the use of the MBS model is appealing because of its simplicity and ease of scientific validation. However, the MBS model may underestimate the total magnitude of the clinical benefit of ospemifene treatment for symptomatic women suffering from VVA

Retrieval analysis of ceramic-coated metal-on-polyethylene total hip replacements

PURPOSE: Ceramic coatings have been used in metal-on-polyethylene (MOP) hips to reduce the risk of wear and also infection; the clinical efficacy of this remains unclear. This retrieval study sought to better understand the performance of coated bearing surfaces. METHODS: Forty-three coated MOP components were analysed post-retrieval for evidence of coating loss and gross polyethylene wear. Coating loss was graded using a visual semi-quantitative protocol. Evidence of gross polyethylene wear was determined by radiographic analysis and visual inspection of the retrieved implants. RESULTS: All components with gross polyethylene wear (n = 10) were revised due to a malfunctioning acetabular component; 35 % (n = 15) of implants exhibited visible coating loss and the incidence of polyethylene wear in samples with coating loss was 54 %, significantly (p = 0.02) elevated compared to samples with intact coatings (14 %). CONCLUSIONS: In this study we found evidence of coating loss on metal femoral heads which was associated with increased wear of the corresponding polyethylene acetabular cups

An experience with misoprostol for the introduction of first trimester abortions in a secondary hospital in South Africa

CITATION: Fuchs, J., De Klerk, H., De Villiers, P. J. T. & Atzl, C. 2000. An experience with misoprostol for the introduction of first trimester abortions in a secondary hospital in South Africa. South African Family Practice, 22(7):8-12.The original publication is available at http://www.safpj.co.zaBackground: Misoprostol is a prostaglandin analogue with uterotonic properties. Administered orally or vaginally, it is an effective agent for induction of first trimester abortions. Aim: To establish the effectivenes and complications arising within the first week following the administration of Misoprostol for termination of pregnancy (TOP) in the first trimester of pregnancy. Setting: A regional hospital in the Helderberg basin of the greater Cape Town area, serving both as district and secondary hospital. Methods: Prospective descriptive study of patients using Misoprostol as induction agent in the first trimester of pregnancy. Success rate, side effects and complications were monitored over three visits, up until one week after termination Results: 105 patients were enrolled into the study. Following the intake of Misoprostol, 70% reported a successful induction within 48 hours. The evacuation of the uterus was found to be uncomplicated in 64% of these patients. g% received a repeat dose of Misoprostol,3% required a third medical induction. In 1 patient with an unsuccessful induction, an ectopic pregnancy was diagnosed. In 4 women the uterus had been surgically perforated, without need for further surgery. Conclusion: The use of Misoprostol for the induction of termination of pregnancy in the first trimester proved to be effective and acceptably safe.http://www.safpj.co.za/index.php/safpj/article/view/2135Publisher's versio

Primary beam effects of radio astronomy antennas -- II. Modelling the MeerKAT L-band beam

After a decade of design and construction, South Africa's SKA-MID precursor MeerKAT has begun its science operations. To make full use of the widefield capability of the array, it is imperative that we have an accurate model of the primary beam of its antennas. We have taken available L-band full-polarization 'astro-holographic' observations of three antennas and a generic electromagnetic simulation and created sparse representations of the beams using principal components and Zernike polynomials. The spectral behaviour of the spatial coefficients has been modelled using discrete cosine transform. We have provided the Zernike-based model over a diameter of 10 deg averaged over the beams of three antennas in an associated software tool (EIDOS) that can be useful in direction-dependent calibration and imaging. The model is more accurate for the diagonal elements of the beam Jones matrix and at lower frequencies. As we get more accurate beam measurements and simulations in the future, especially for the cross-polarization patterns, our pipeline can be used to create more accurate sparse representations of MeerKAT beams.Comment: 16 pages, 18 figures. This is a pre-copyedited, author-produced PDF of an article accepted for publication in MNRAS following peer review. The version of record [K. M. B. Asad et al., 2021] is available online at: https://doi.org/10.1093/mnras/stab10