Editorial

Coronary artery disease and insulin resistance in the South African India

Acute Renal Failure from Callilepsis laureola

This article describes the clinical course and management of a patient who developed hyperkalaemic acute renal failure due to a herbal medicine, Callilepsis laureola

The abridged South African hypertension guideline 2011

Extensive data from randomised controlled trials have shown the benefit of treating hypertension. The target blood pressure (BP) for antihypertensive management is < 140/90 mmHg, and < 130/80 mmHg in patients with end-organ damage, coexisting risk factors, and co-morbidity. Benefits of management include reduced risk of death, stroke, cardiac failure, chronic kidney disease, and coronary heart disease. The correct BP measurement procedure is described, and evaluation of cardiovascular risk factors and recommendations for antihypertensive therapy, are stipulated. Lifestyle modification and patient education are cornerstones in the management of every patient. Major indications, precautions, and contraindications to each recommended antihypertensive drug are listed. Combination therapy should be considered ab initio if the BP is ≥ 20/10 mmHg above goal. First-line drug therapy for uncomplicated essential hypertension includes low-dose thiazide-like diuretics, calcium-channel blockers, angiotensin-converting enzyme inhibitors, or angiotensin-receptor blockers. The guideline was developed by the Southern African Hypertension Society

Recurrent Respiratory Papillomatosis

Recurrent respiratory papillomatosis (RRP) is a condition caused by human papillomavirus (HPV) that occurs in both children and adults, characterized by recurrent growths of intraluminal papillomas in the airway, usually in the larynx. Patients present with dysphonia (both roughness and breathiness), coughing, and eventually airway obstruction. The most common causative HPV types are HPV6 and HPV11. RRP has a significant adverse effect on quality of life. In the absence of a curative treatment, patients have to undergo frequent surgical procedures. Some patients require more than a 100 procedures. Several adjuvant therapies have been proposed to reduce the severity of disease and the number of surgical interventions. The introduction of vaccines against HPV6 and HPV11 can reduce the incidence of RRP.</p

Recurrent Respiratory Papillomatosis

Recurrent respiratory papillomatosis (RRP) is a condition caused by human papillomavirus (HPV) that occurs in both children and adults, characterized by recurrent growths of intraluminal papillomas in the airway, usually in the larynx. Patients present with dysphonia (both roughness and breathiness), coughing, and eventually airway obstruction. The most common causative HPV types are HPV6 and HPV11. RRP has a significant adverse effect on quality of life. In the absence of a curative treatment, patients have to undergo frequent surgical procedures. Some patients require more than a 100 procedures. Several adjuvant therapies have been proposed to reduce the severity of disease and the number of surgical interventions. The introduction of vaccines against HPV6 and HPV11 can reduce the incidence of RRP.</p

Risk factors for coronary heart disease in the white community of Durban

Coronary heart disease (CHD) is the leading cause of death among the white and Indian populations of Durban. This was a community-based study of the white population of Durban, which is predominantly English-speaking. There were 396 subjects (194 men, 202 women) aged 15 - 69 years. A history of CHD was present in 9,3% of the subjects. The important risk factors were hypercholesterolaemia, hypertension and smoking. The minor risk factors were obesity, hypertriglyceridaemia, hypeuricaemia, a sedentary occupation and a history of CHD in the immediate family. Electrocardiograph abnormalities denoting CHD were present in 17% of subjects. A study of the major risk factors showed that 35,1% (age and sex adjusted) had at least one major risk factor at the higher level (level A) and 33,8% (age and sex adjusted) at the lower risk levels (level B). When the combination of risk factors was taken into account, 15,2% and 28% had two major risk factors, one each at levels A and B respectively. On average the percentage of men and women with one risk factor or more increased with age. A protective high-density lipoprotein/total cholesterol ratio≥20% was present in 53,5% of the respondents. Because of the severe nature of CHD, an intensive programme for the primary prevention of CHD risk factors should be instituted