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)

Smart cities in South Africa! a case of misplaced priorities?

Abstract: The ‘smart cities concept’ has emerged as a defining and dominant discourse in urban planning. This discourse has permeated through to most South African metropolitan cities such as Johannesburg and Cape Town. Nevertheless, the question remains, do we really need smart cities in South African and other cities in Africa mired in poverty and inequality juxtaposed with wealth and un-paralleled information and communications infrastructure? This study argues that although the smart cities concept is a noble and viable approach, it often leads to undesired outcomes in South Africa because urban managers have hastily applied the smart futures approach. Moreover, what the people really want is not smart cities but an end to poverty, inequality and poor living conditions. If this drive towards smart cities continues unabated it will further entrench spatial segregation and inequality which where the hallmarks of apartheid planning in South Africa. Perhaps what is needed is a rethink of the smart cities concept, one that has been readapted and redefined to suit South Africa and developing countries in general, rather than imitating the developed world. A smart city strategy that meets citizen’s needs is also needed

An analysis to investigate spatial cognitive factors which influence cycling patterns in Johannesburg

Abstract: Cycling in most African cities is done as either a mode of commuting or for recreational purposes. Apart from Smart cities encouraging a shift from cars to public transport by providing efficient last-mile connections, commuter cycling can take a significant share of end-to-end short distance trips. The ultimate realization of cycling merits by urban dwellers, (such as in Johannesburg, South Africa) is hindered by a lack of appropriate data to aid in understanding the dynamics of cycling behaviour. This paper seeks to be the first step in building a multi-model to govern the use of multi-modes of mobility in the city by initial focusing on promoting NMT usage as a mode of commuting in the city. Identification of these factors would go a long way in improving cycling uptake as well as inform policy strategies for non-motorized transportation in the city. Using an analytical approach, the authors conducted a survey along pre-known locations were cyclist choose to cycle. One route with newly developed cycling infrastructure and another without cycling infrastructure. A self-reported travel behaviour form, was used for the collection of spatial cognitive and attitudinal data on participants’ travel environment, attitude, behaviour, norm, intention, and habit was utilized to gather data to understand cyclist cognitive reasoning for choosing one path over another. The data collected from the survey was then overlaid with Strava Metro cycling data showing locations were cyclist prefer to cycle in the city. Findings from the analysis suggest perceived safe routes and routes that maximize health benefits are preferred. Based on the findings it is recommended that planners need to use crowd sourced data before developing infrastructure for cycling the city

Changing pattern of incidence, aetiology and mortality from acute pancreatitis at Kalafong Hospital, Pretoria, South Africa, 1988-2007: A retrospective evaluation

Background: Literature reports from Western countries suggest an increasing incidence of acute pancreatitis (AP) and changing pattern over the past two decades. The aim of this study was to document the incidence, aetiology and mortality from AP over two decades and to examine any emerging trends.Methods: A retrospective study of all confirmed cases of AP admitted over a 20-year period to the surgical department was performed. Patients’ demographics, year of admission, number of attacks, aetiology, management and outcome were entered on a special study proforma.Results: Altogether 707 attacks of AP (M: F, 5.7: 1) were recorded. The proportion of gallstone AP increased (3.1% to 12.7%) and that of alcohol-related AP decreased (84% to 67.6%). Alcohol was the main aetiological factor for AP. Drugs, hyperlipidaemia, human immunodeficiency virus (HIV) and endoscopic pancreatography-related AP increased in the second decade. The in-hospital mortality rate during the respective periods was 6.5% and 3.1%.Conclusion: Gallstone AP increased during second decade from more Caucasian admissions and increased gallstones among Blacks. The reduced mortality was attributed to changing trends in the nature and aetiology of AP recorded, heightened awareness of the condition and improved management

Effect of glyphosate application time on yield parameters of South African glyphosate-resistant maize cultivars

Glyphosate is the most used herbicide in South Africa. Due to observations by some South African maize producers that the application of glyphosate to glyphosate-resistant (GR) maize cultivars resulted in reduced yield, we conducted an in-depth study under local conditions. Through field trials, over two seasons (2017/2018 and 2018/2019), we investigated whether the application time of glyphosate would impact maize yields negatively. Various yield parameters were measured subsequent to glyphosate application to the local GR maize cultivars DKC74-74BR, DKC78-79BR, KKS4581, KKS8408, BG5785BR, PAN6R-710BR, P1814R and P2880WBR. Four glyphosate products were included (Roundup PowerMax®; Slash Plus 540 SL; TouchdownForte® and MambaTM DMA 480 SL), resulting in 32 cultivar x glyphosate product combinations. Each product was applied at V4, V4+V6, V6 and V8 growth stages together with an untreated control. Yield parameters measured (ears per plant, rows per ear, kernels per row, thousand kernel mass and yield) were expressed as a percentage of the control. The trials were planted as randomised complete block designs with three replicates. Limited response was observed with all the parameters investigated, with a significant negative yield response, greater than the untreated control, observed in only 3.1% of the cultivar x glyphosate product combinations evaluated. No clear trends or discernible and consistent impacts on yield and yield parameters could be established based on the application time of glyphosate (within label recommendations) across seasons. The findings contribute significantly to the knowledge base and current understanding of the international community and local producers alike regarding the effective use of glyphosate and generic variations thereof in crops of diverse genetic backgrounds. Significance: Limited response in the yield parameters evaluated were obtained in response to the application time (V4, V4+V6, V6 and V8) of the four glyphosate products on eight GR maize cultivars tested (p=0.1). Inconsistent patterns or trends were detected in cases where significance was obtained, implying that it would not be possible to draw accurate conclusions or formulate recommendations. Application time of glyphosate did not result in a significant reduction in yield compared to the untreated control, in the majority of the cultivar x glyphosate product combinations investigated, confirming that glyphosate application conducted within label specifications would not reduce yield, irrespective of the glyphosate product or genetic background of maize

Fit-For-Purpose laboratory assessment of lightly stabilised fly ash material for road construction

The increased use of alternative materials, particularly streams of industrial by-products in transportation construction is motivated by the need to optimize construction of sustainable pavements. Fly ash has mostly been used as an additive in various applications in transportation construction. This paper presents a study on the use of a fly ash product as the primary constituent, rather than an additive. A fly ash product was lightly treated with cement in one test series, with lime and an enzyme based liquid stabilizer in the second and third test series respectively producing lightly stabilised fly ash (LSFA) material. Testing was aimed at fit-for-purpose assessment of the LSFA material in terms of mechanical properties. This is work in progress. The results have shown that the LSFA can achieve shear strength and modulus values highly appropriate and fit for design application in low volume roads.Paper presented at the 34th Annual Southern African Transport Conference 6-9 July 2015 "Working Together to Deliver - Sakha Sonke", CSIR International Convention Centre, Pretoria, South Africa.The Minister of Transport, South AfricaTransportation Research Board of the US

An overview of allergic conjunctivitis

Allergic diseases affect many people across the globe. They significantly impact on the quality of life of the people who are affected, creating personal and economic predicaments. Some of the most commonly diagnosed allergic diseases include atopic dermatitis, rhinitis, allergic conjunctivitis and sinusitis. Allergic conjunctivitis is an allergic disease characterised by the inflammation of the conjunctiva caused by airborne allergens; it presents as itching, excessive lacrimation, discharge and pink eye. Usually it is associated with other allergic conditions such as allergic rhinitis and bronchial asthma. Allergic conjunctivitis is further divided into acute, seasonal allergic conjunctivitis (SAC), and perennial allergic conjunctivitis (PAC). Other conditions, such as eosinophilic oesophagitis, are on the rise and are being diagnosed across all continents except Africa. The diagnosis is primarily clinical. Antihistamines have been the mainstay of therapy for most allergic conditions, except for other conditions that require corticosteroids, or in severe allergic conditions such as anaphylaxis where antihistamines are ineffective as main therapy. It is important to consider first- versus secondgeneration options when treating allergic diseases, also bearing in mind the duration of therapy and any comorbid conditions that a patient might have. This article provides an overview of these conditions and their current management options.http://www.sapj.co.za/index.php/SAPJdm2022Pharmacolog

The adjunctive use of carbimazole during radioactive iodine treatment reduces the cure rate of Graves’ disease

BACKGROUND : Radioactive iodine (RAI) is widely used in the treatment of hyperthyroidism. Adjunctive antithyroid drugs (ATDs) are commonly prescribed to treat the hyperthyroid state before the RAI has taken effect. However, there is no consensus on the use of or timing of adjunctive ATD treatment with RAI. OBJECTIVES : To determine the influence of the ATD carbimazole on the cure rate of RAI treatment for Graves’ disease. METHODS: A retrospective chart review was conducted in the Department of Nuclear Medicine of the Steve Biko Academic Hospital in Pretoria. The cure rate of patients treated with RAI for Graves’ disease was analysed. The effect of adjunctive carbimazole treatment with regard to its use and timing with RAI dosing was analysed. The cure rate was determined in patients treated with carbimazole either before RAI or before and after RAI administration. Cure rate was defined by the biochemical thyroid function status (thyroxine (T4), thyroidstimulating hormone (TSH)) as euthyroid or hypothyroid from 3 months and sustained at 12 months. The need for a second dose of RAI was recorded. RESULTS : RAI treatment was administered to 171 patients with Graves’ disease. The cure rate was higher in patients receiving a higher dose of RAI. The overall cure rate increased progressively from 3 months and was 91% at 12 months. The cure rate in 97 patients not receiving carbimazole was 98%. The cure rate of the 27 patients on carbimazole treatment given before RAI administration was 81%, and 73% in the 37 patients in whom it was resumed after RAI administration. The overall cure rate was lower in patients who received carbimazole (p<0.001), but especially in patients in whom carbimazole was continued after RAI administration (p<0.001). CONCLUSIONS : Adjunctive carbimazole treatment decreased the RAI cure rate of Graves’ disease significantly.http://www.samj.org.zadm2022Nuclear MedicineSurger

Perceptions of women diagnosed with gestational diabetes mellitus on the management of gestational diabetes mellitus in Limpopo province: a qualitative study

Summary. Objectives. Gestational diabetes mellitus remains a major public health challenge. This disease has serious adverse effects on the mother and pregnancy outcome. The objective of the study was to explore the perceptions of women diagnosed with gestational diabetes mellitus on how healthcare providers in the rural province of South Africa manage it. Methods. This qualitative study is part of a larger mixed-method study conducted in the public healthcare facilities of the Mopani district, Limpopo Province, South Africa. Purposive sampling was used to recruit 17 eligible women diagnosed with gestational diabetes mellitus, and all of them agreed to participate. Data was analysed using a thematic analysis approach. Results. Three main themes emerged from the findings: challenges in self-management of gestational diabetes mellitus; health systems support for gestational diabetes; and referral to a dietician. Conclusion. In conclusion, dietary habits adjustment, self-management of prescribed medicines, and referral to a dietician for nutrition therapy remain a concern. It is recommended that counselling and educational programs be developed and urgently improve the dietician referral rate