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

Genetic sequences derived from suppression subtractive hybridization analysis provides insight into their possible roles in Xanthomonas albilineans

Leaf scald disease (LSD) is caused by the Gram-negative bacterium, Xanthomonas albilineans. Genomic DNA from X. albilineans and Xanthomonas hyacinthi were analyzed by suppression subtractive hybridization (SSH) using X. albilineans as the tester from which unique sequences were sought and X. hyacinthi as the driver. Following the SSH procedure, amplification products within the size range of 100 - 600 bp were generated, purified, directly cloned with the Promega pGEM-T vector cloning kit, and transformed into ultracompetent Escherichia coli X L2-blue MRF’ cells (Stratagene, La Jolla, CA). Clones selected were sequenced (using a Perkin Elmer ABI PRISM Dye terminator cycle sequencing kit and ABI Model 377 DNA sequencer) in one direction with SP6 and T7 primers (Promega). Clone Xa 6 revealed very close homology with a probable bacterioferritin from Pseudomonasaeruginosa. Clone X. albilineans 12 showed 92% homology to the acetate repressor proteins and clone X. albilineans 18 displayed 85% homology to the plasmid pTOM9 from Alcaligenes xylosoxidans.Sequencing data also revealed homology to various hypothetical proteins

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

Supply chain constraints in the South African construction industry – perspectives from supply chain practitioners

Abstract : In the face of slowing economies globally, the construction industry faces many challenges such as socio-economic stress, resource shortages, institutional weaknesses and a general inability to respond to key issues. These have intensified and become more severe in recent years. Empirical research in supply chain management points to barriers that limit construction industries in developing countries such as South Africa. This paper aims to explore supply chain constraints in the South African construction industry. Relevant literature was reviewed and insights from 15 experienced supply chain practitioners were elicited by means of semi-structured interviews. Content analysis was employed using the ATLAS.ti (version 7) software to analyse qualitative data. Six themes emerged from the interviews, which include lack of investment in supply chains, lack of supply chain innovation process constraints, supply chain change management, supply chain collaboration, supply chain leadership, and time management. It is recommended that construction companies adopt supply chain management systems, integrated solutions, and collaborative project management tools and technologies

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

Ameloblastic fibrosarcoma arising in the maxilla

Background: Ameloblastic fibrosarcoma (AFS) is a rare odontogenic neoplasm of the jaw that usually arises de novo or through a malignant change in the mesenchymal component of a preexisting or recurrent benign fibroma. The majority of AFS cases reported in the literature arise in the mandible. Case Report: A 35-year-old male presented with an asymptomatic left maxillary mass that on imaging was found to be effacing most of his maxillary sinus. He underwent a left maxillectomy with free-flap reconstruction and adjuvant radiotherapy to the tumor bed. Conclusion: Wide local excision remains the treatment of choice for AFS, given the poor survival rates of patients with recurrent disease. However, long-term studies and follow-up are needed to elucidate the role of adjuvant therapies in the primary treatment of AFS