Publisher: SciELO   (Total: 887 journals)

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Showing 601 - 800 of 887 Journals sorted alphabetically
Revista Colombiana de Anestesiología     Open Access   (Followers: 1, SJR: 0.154, CiteScore: 0)
Revista Colombiana de Antropologia     Open Access   (Followers: 2, SJR: 0.232, CiteScore: 0)
Revista Colombiana de Biotecnología     Open Access   (Followers: 1)
Revista Colombiana de Cancerología     Open Access   (SJR: 0.106, CiteScore: 0)
Revista Colombiana de Cardiologia     Open Access   (SJR: 0.113, CiteScore: 0)
Revista Colombiana de Ciencias Químico-Farmacéuticas     Open Access  
Revista Colombiana de Educación     Open Access  
Revista Colombiana de Entomología     Open Access   (Followers: 1, SJR: 0.184, CiteScore: 0)
Revista Colombiana de Estadística     Open Access   (SJR: 0.361, CiteScore: 1)
Revista Colombiana de Matemáticas     Open Access   (Followers: 1, SJR: 0.136, CiteScore: 0)
Revista Colombiana de Psicología     Open Access   (SJR: 0.151, CiteScore: 0)
Revista Colombiana de Química     Open Access   (Followers: 1, SJR: 0.115, CiteScore: 0)
Revista Contabilidade & Finanças     Open Access   (SJR: 0.145, CiteScore: 0)
Revista Costarricense de Cardiología     Open Access  
Revista Costarricense de Psicología     Open Access  
Revista Cubana de Anestesiología y Reanimación     Open Access   (Followers: 1)
Revista Cubana de Angiología y Cirugía Vascular     Open Access  
Revista Cubana de Cirugía     Open Access  
Revista Cubana de Endocrinología     Open Access  
Revista Cubana de Enfermería     Open Access   (Followers: 2, SJR: 0.102, CiteScore: 0)
Revista Cubana de Estomatologí­a     Open Access   (SJR: 0.128, CiteScore: 0)
Revista Cubana de Hematología, Inmunología y Hemoterapia     Open Access   (SJR: 0.196, CiteScore: 0)
Revista Cubana de Información en Ciencias de la Salud     Open Access   (SJR: 0.229, CiteScore: 0)
Revista Cubana de Informática Médica     Open Access  
Revista Cubana de Investigaciones Biomédicas     Open Access   (Followers: 1, SJR: 0.13, CiteScore: 0)
Revista Cubana de Medicina     Open Access   (Followers: 2)
Revista Cubana de Medicina General Integral     Open Access   (Followers: 1, SJR: 0.263, CiteScore: 0)
Revista Cubana de Medicina Militar     Open Access   (Followers: 1, SJR: 0.202, CiteScore: 0)
Revista Cubana de Medicina Tropical     Open Access   (SJR: 0.143, CiteScore: 0)
Revista Cubana de Obstetricia y Ginecología     Open Access   (SJR: 0.191, CiteScore: 0)
Revista Cubana de Oftalmología     Open Access   (Followers: 1)
Revista Cubana de Ortopedia y Traumatologí­a     Open Access   (SJR: 0.101, CiteScore: 0)
Revista Cubana de Plantas Medicinales     Open Access   (Followers: 1, SJR: 0.127, CiteScore: 0)
Revista Cubana de Salud Pública     Open Access   (SJR: 0.262, CiteScore: 0)
Revista da Educação Física : UEM     Open Access   (Followers: 1)
Revista da Escola de Enfermagem da USP     Open Access   (Followers: 2, SJR: 0.279, CiteScore: 1)
Revista da Faculdade de Educação     Open Access  
Revista da Sociedade Brasileira de Fonoaudiologia     Open Access  
Revista da Sociedade Brasileira de Medicina Tropical     Open Access   (SJR: 0.658, CiteScore: 1)
Revista de Administração Contemporânea     Open Access  
Revista de Administração de Empresas     Open Access   (Followers: 1, SJR: 0.16, CiteScore: 0)
Revista de Administração Pública     Open Access   (SJR: 0.294, CiteScore: 0)
Revista de Análisis Económico     Open Access   (SJR: 0.112, CiteScore: 0)
Revista de Antropologia     Open Access   (Followers: 4, SJR: 0.102, CiteScore: 0)
Revista de Bioética y Derecho     Open Access  
Revista de Biología Marina y Oceanografía     Open Access   (SJR: 0.23, CiteScore: 0)
Revista de Biología Tropical     Open Access   (Followers: 1, SJR: 0.326, CiteScore: 1)
Revista de Ciencia Politica     Open Access   (Followers: 2, SJR: 0.368, CiteScore: 1)
Revista de Ciencia y Tecnología     Open Access  
Revista de Ciências Agrárias     Open Access  
Revista de Ciencias Médicas de Pinar del Río     Open Access  
Revista de Ciencias Sociales     Open Access   (Followers: 1)
Revista de Cirugía     Open Access   (SJR: 0.121, CiteScore: 0)
Revista de Derecho     Open Access   (SJR: 0.364, CiteScore: 0)
Revista de Derecho (Concepción)     Open Access  
Revista de Derecho (Coquimbo)     Open Access  
Revista de Economía     Open Access  
Revista de Economia Contemporânea     Open Access   (SJR: 0.121, CiteScore: 0)
Revista de Economía del Caribe     Open Access  
Revista de Economia e Sociologia Rural     Open Access   (Followers: 2, SJR: 0.265, CiteScore: 0)
Revista de Economía Institucional     Open Access   (SJR: 0.141, CiteScore: 0)
Revista de Economia Poli­tíca     Open Access   (Followers: 1, SJR: 0.282, CiteScore: 0)
Revista de Enfermagem Referência     Open Access   (Followers: 2)
Revista de Estudios Historico-Juridicos     Open Access   (Followers: 1, SJR: 0.123, CiteScore: 0)
Revista de Estudios Sociales     Open Access   (Followers: 2, SJR: 0.166, CiteScore: 0)
Revista de Filosofia     Open Access   (SJR: 0.102, CiteScore: 0)
Revista de Geografía Norte Grande     Open Access   (Followers: 1, SJR: 0.296, CiteScore: 1)
Revista de Gestão Costeira Integrada     Open Access   (SJR: 0.251, CiteScore: 1)
Revista de Historia (Concepción)     Open Access  
Revista de Historia Americana y Argentina     Open Access  
Revista de Historia del Derecho     Open Access   (Followers: 1)
Revista de Ingeniería     Open Access  
Revista de Investigacion Psicologica     Open Access  
Revista de la Academia Colombiana de Ciencias Exactas, Físicas y Naturales     Open Access  
Revista de la Asociación Española de Neuropsiquiatría     Open Access  
Revista de la Ciencia del Suelo y Nutricion Vegetal     Open Access   (SJR: 0.224, CiteScore: 0)
Revista de la Construcción     Open Access   (SJR: 0.234, CiteScore: 1)
Revista de la Facultad de Agronomía     Open Access  
Revista de la Facultad de Ciencias Veterinarias, UCV     Open Access  
Revista de la Facultad de Derecho     Open Access  
Revista de la Facultad de Derecho y Ciencias Políticas     Open Access  
Revista de la Facultad de Medicina (México)     Open Access  
Revista de la Sociedad Boliviana de Pediatría     Open Access  
Revista de la Sociedad Española de Enfermería Nefrológica     Open Access  
Revista de la Sociedad Química del Perú     Open Access  
Revista de la Universidad Industrial de Santander. Salud     Open Access  
Revista de Medicina Veterinaria     Open Access  
Revista de Microbiologia     Open Access   (Followers: 1)
Revista de Nutrição     Open Access   (SJR: 0.282, CiteScore: 0)
Revista de Odontologia da UNESP     Open Access  
Revista de Odontologia da Universidade de São Paulo     Open Access  
Revista de Osteoporosis y Metabolismo Mineral     Open Access   (Followers: 2, SJR: 0.121, CiteScore: 0)
Revista de Otorrinolaringología y Cirugía de Cabeza y Cuello     Open Access  
Revista de Protección Vegetal     Open Access  
Revista de Psicología del Trabajo y de las Organizaciones     Open Access   (SJR: 0.418, CiteScore: 1)
Revista de Psiquiatria Clínica     Open Access   (Followers: 1, SJR: 0.271, CiteScore: 1)
Revista de Psiquiatria do Rio Grande do Sul     Open Access   (Followers: 1)
Revista de Salud Animal     Open Access  
Revista de Salud Pública     Open Access   (Followers: 1, SJR: 0.171, CiteScore: 0)
Revista de Saúde Pública     Open Access   (Followers: 1, SJR: 0.807, CiteScore: 2)
Revista de Sociologia e Polí­tica     Open Access   (Followers: 2, SJR: 0.482, CiteScore: 0)
Revista del Instituto de Medicina Tropical     Open Access  
Revista del Nacional     Open Access  
Revista Dental Press de Ortodontia e Ortopedia Facial     Open Access   (Followers: 1)
Revista Diacrítica     Open Access  
Revista Direito GV     Open Access   (Followers: 1)
Revista do Colégio Brasileiro de Cirurgiões     Open Access   (SJR: 0.221, CiteScore: 1)
Revista do Departamento de Psicologia. UFF     Open Access  
Revista do Hospital das Clinicas     Open Access  
Revista do Instituto de Estudos Brasileiros     Open Access   (Followers: 1)
Revista do Instituto de Medicina Tropical de São Paulo     Open Access   (SJR: 0.669, CiteScore: 1)
Revista Dor     Open Access  
Revista Ecuatoriana de Neurología     Open Access  
Revista EIA     Open Access   (Followers: 1)
Revista electrónica de investigación educativa     Open Access   (Followers: 1, SJR: 0.187, CiteScore: 0)
Revista Electronica Educare     Open Access   (Followers: 2)
Revista Española de Cirugía Oral y Maxilofacial     Open Access   (Followers: 1, SJR: 0.117, CiteScore: 0)
Revista Española de Enfermedades Digestivas     Open Access   (SJR: 0.417, CiteScore: 1)
Revista Española de Salud Pública     Open Access   (SJR: 0.249, CiteScore: 1)
Revista Española de Sanidad Penitenciaria     Open Access   (SJR: 0.135, CiteScore: 0)
Revista Estudos Feministas     Open Access   (SJR: 0.208, CiteScore: 0)
Revista Facultad de Ciencias Económicas: Investigación y Reflexión     Open Access  
Revista Facultad de Ingenieria - Universidad de Tarapaca     Open Access   (Followers: 1)
Revista Facultad de Ingeniería Universidad de Antioquia     Open Access   (Followers: 1, SJR: 0.172, CiteScore: 0)
Revista Facultad de Medicina de la Universidad Nacional de Colombia     Open Access   (SJR: 0.125, CiteScore: 0)
Revista Facultad Nacional de Agronomía, Medellín     Open Access   (SJR: 0.138, CiteScore: 0)
Revista Facultad Nacional de Salud Pública     Open Access  
Revista Gaúcha de Enfermagem     Open Access   (SJR: 0.225, CiteScore: 1)
Revista Geológica de América Central     Open Access  
Revista Geológica de Chile     Open Access   (Followers: 1)
Revista Gerencia y Políticas de Salud     Open Access   (SJR: 0.136, CiteScore: 0)
Revista Habanera de Ciencias Médicas     Open Access   (SJR: 0.211, CiteScore: 0)
Revista Historia y Sociedad     Open Access  
Revista IBRACON de Estruturas e Materiais     Open Access   (Followers: 1)
Revista Ingeniería Biomédica     Open Access  
Revista Ingenieria de Construcción     Open Access   (Followers: 1, SJR: 0.204, CiteScore: 0)
Revista Ingenierías Universidad de Medellín     Open Access  
Revista Integra Educativa     Open Access  
Revista Interamericana de Bibliotecología     Open Access   (Followers: 7)
Revista Internacional de Contaminación Ambiental     Open Access   (SJR: 0.152, CiteScore: 0)
Revista ION     Open Access  
Revista IUS     Open Access  
Revista Katálysis     Open Access  
Revista Lasallista de Investigación     Open Access   (SJR: 0.146, CiteScore: 0)
Revista Latino-Americana de Enfermagem     Open Access   (SJR: 0.339, CiteScore: 1)
Revista Latinoamericana de Bioética     Open Access  
Revista Latinoamericana de Derecho Social     Open Access   (Followers: 1, SJR: 0.101, CiteScore: 0)
Revista Latinoamericana de Desarrollo Económico     Open Access  
Revista Latinoamericana de Educación Inclusiva     Open Access  
Revista Latinoamericana de Filosofía     Open Access   (Followers: 1)
Revista Latinoamericana de Hipertension     Open Access   (SJR: 0.158, CiteScore: 0)
Revista Latinoamericana de Investigación en Matemática Educativa     Open Access   (SJR: 0.171, CiteScore: 0)
Revista Latinoamericana de Psicopatologia Fundamental     Open Access   (SJR: 0.201, CiteScore: 0)
Revista Medica de Chile     Open Access   (SJR: 0.259, CiteScore: 1)
Revista Médica del Hospital Nacional de Niños Dr. Carlos Sáenz Herrera     Open Access   (Followers: 1)
Revista Médica del Uruguay     Open Access  
Revista Médica Electrónica     Open Access  
Revista Médica La Paz     Open Access  
Revista Médico-Científica : Luz y Vida     Open Access  
Revista Mexicana de Análisis de la Conducta     Open Access   (SJR: 0.405, CiteScore: 1)
Revista Mexicana de Astronomía y Astrofísica     Open Access   (Followers: 2, SJR: 0.596, CiteScore: 1)
Revista Mexicana de Biodiversidad     Open Access   (SJR: 0.421, CiteScore: 1)
Revista Mexicana de Ciencias Agrícolas     Open Access   (Followers: 1)
Revista Mexicana de Ciencias Farmaceuticas     Open Access   (Followers: 1)
Revista Mexicana de Ciencias Geológicas     Open Access   (SJR: 0.308, CiteScore: 1)
Revista Mexicana de Ciencias Pecuarias     Open Access   (Followers: 1, SJR: 0.17, CiteScore: 0)
Revista Mexicana de Economía y Finanzas     Open Access  
Revista Mexicana de Física     Open Access   (SJR: 0.203, CiteScore: 0)
Revista mexicana de física E     Open Access  
Revista Mexicana de Fitopatología     Open Access  
Revista Mexicana de Ingeniería Biomédica     Open Access  
Revista Mexicana de Ingeniería Química     Open Access   (SJR: 0.328, CiteScore: 1)
Revista Mexicana de Investigación Educativa     Open Access   (Followers: 3, SJR: 0.291, CiteScore: 0)
Revista Mexicana de Micologí­a     Open Access  
Revista Mexicana de Sociologí­a     Open Access   (Followers: 9, SJR: 0.142, CiteScore: 0)
Revista Musical Chilena     Open Access   (SJR: 0.1, CiteScore: 0)
Revista MVZ Córdoba     Open Access   (SJR: 0.173, CiteScore: 0)
Revista Nutrícias     Open Access  
Revista Odonto Ciência     Open Access   (SJR: 0.101, CiteScore: 0)
Revista Opinión Jurídica     Open Access  
Revista Panamericana de Salud Pública     Open Access   (SJR: 0.452, CiteScore: 1)
Revista Paulista de Pediatria     Open Access   (SJR: 0.472, CiteScore: 1)
Revista Perspectivas     Open Access  
Revista Pilquen : Sección Ciencias Sociales     Open Access  
Revista Politécnica     Open Access  
Revista Portuguesa de Cirurgia     Open Access   (Followers: 1)
Revista Portuguesa de Enfermagem de Saúde Mental     Open Access  
Revista Portuguesa de Imunoalergologia     Open Access   (Followers: 2, SJR: 0.141, CiteScore: 0)
Revista Portuguesa de Ortopedia e Traumatologia     Open Access  
Revista Portuguesa de Saúde Pública     Open Access   (SJR: 0.155, CiteScore: 0)
Revista Portuguesa e Brasileira de Gestão     Open Access  
Revista Republicana     Open Access  
Revista Signos     Open Access   (SJR: 0.174, CiteScore: 0)
Revista Universitaria de Geografía     Open Access  
Revista Uruguaya de Cardiologia     Open Access  
Revista Vectores de Investigación     Open Access  
Revista Veterinaria     Open Access   (SJR: 0.105, CiteScore: 0)
RGO : Revista Gaúcha de Odontologia     Open Access   (SJR: 0.104, CiteScore: 0)
RIDE : Revista Iberoamericana para la Investigación y el Desarrollo Educativo     Open Access  
RIIIT : Internacional de Investigación e Innovación Tecnológica     Open Access  

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South African Medical Journal
Journal Prestige (SJR): 0.45
Citation Impact (citeScore): 1
Number of Followers: 5  

  This is an Open Access Journal Open Access journal
ISSN (Print) 0256-9574 - ISSN (Online) 2078-5135
Published by SciELO Homepage  [887 journals]
  • Thank you from SAMA and the editors

    •  
  • Role of clinical informatics in the implementation of universal health
           coverage

    •  
  • 'Getting out of the dark': Implications of load shedding on healthcare in
           South Africa and strategies to enhance preparedness

    •  
  • Child health, infant formula funding and South African health
           professionals: Eliminating conflict of interest

    • Abstract: Despite clear evidence of the benefits of exclusive and continued breastfeeding for children, women and society, far too few children in South Africa (SA) are breastfed. One of the major impediments to improving this situation is the continued and aggressive marketing of breastmilk substitutes (BMSs) and infiltration of the BMS industry into contexts with exposure to health professionals. In this article we, as academics, practitioners and child health advocates, describe contraventions of the regulations that protect breastfeeding in SA and argue that bold, proactive leadership to eliminate conflict of interest in respect of the BMS industry is urgently required, together with far greater investments in proven interventions to promote and support breastfeeding.
       
  • Is it time for South Africa to end the routine high-dose vitamin A
           supplementation programme'

    • Abstract: In accordance with World Health Organization guidelines, South Africa (SA) introduced routine periodic high-dose vitamin A supplementation (VAS) in 2002. These guidelines were developed after research in the 1980s and 1990s showed the efficacy of VAS in reducing childhood mortality. However, two recent studies in low- to middle-income countries (2013 and 2014) have shown no effect of high-dose VAS on mortality. Additionally, there is no clear research evidence that 6-monthly doses of vitamin A result in a sustained shift in serum retinol levels or reduce subclinical vitamin A deficiency. These two points should encourage SA to re-examine the validity of these guidelines. A long-term view of what is in the best interests of the majority of the people is needed. The short-term intervention of administering vitamin A capsules not only fails to improve serum retinol levels but may create dependence on a 'technical fix' to address the fundamental problem of poor nutrition, which is ultimately underpinned by poverty. It may also cause harm. Although there are those, some with vested interests, who will argue for continuation of the routine high-dose VAS programmes, SA policymakers and scientists need to evaluate the facts and be prepared to rethink this policy. There is cause for optimism: SA's health policymakers have previously taken bold stands on the basis of evidence. The examples of regulation of tobacco products and taxation of sugar-sweetened beverages, ending the free distribution of formula milk for HIV-positive mothers and legislating against the marketing of breastmilk substitutes provide precedents. Here is a time yet again for decision-makers to make bold choices in the interests of the people of SA. While the cleanest choice would be national discontinuation of the routine VAS programme, there may be other possibilities, such as first stopping the programme in Northern Cape Province (where there is clear evidence of hypervitaminosis A), followed by the other provinces in time.
       
  • The ketamine crisis : Does South Africa have a plan
           B'

    • Abstract: South Africa (SA) has a high incidence of deaths from trauma and injuries. Trauma has been identified as one part of the quadruple burden of disease afflicting the country. This article is concerned with the management of burns, which 3% of the population suffer from annually. Ketamine, acknowledged for its versatility and safety profile, remains a critical component in the medical arsenal of anaesthesiologists and clinicians treating both acute and chronic pain. In the management of burn-injured patients in particular, ketamine is the cornerstone of many analgesia protocols. However, issues pertaining to shortages of this medicine in SA warrant concern and discussion, particularly in view of the high reliance of doctors on ketamine for first-line procedural analgesia in the management of burns in both adult and paediatric patients. This article attempts to highlight the issues related to ketamine shortages, which often have significant clinical, safety, operational and research implications.
       
  • Training South African clinician-scientists: Lessons from the University
           of Cape Town's intercalated programme

    • Abstract: In 2011, the Faculty of Health Sciences at the University of Cape Town, South Africa (SA), established the Clinician-Scientist Training Programme (UCTCSTP), consisting of intercalated BMedSci Hons/MB ChB and integrated MB ChB/MSc/PhD tracks. We report and reflect on the programme's performance and challenges. The UCTCSTP has so far enrolled 71 students: 51 have received BMedSci Hons degrees and 4 have received Master's degrees, while there are 14 BMedSci Hons, 4 MSc and 4 PhD candidates. Graduates have produced significant research outputs, and many remain actively engaged in research. The UCTCSTP has been successful in encouraging a cohort of future clinician-scientists, but should aim to broaden and improve its appeal to address the need to transform and grow the SA clinical academic workforce. As graduates progress with their postgraduate clinical training, they require institutional support and guidance, which may necessitate policy reform.
       
  • Descriptive analysis of World Health Organization-recommended second-line
           antiretroviral treatment: A retrospective cohort data analysis

    • Abstract: BACKGROUND. World Health Organization guidelines recommend that HIV patients who do not achieve viral suppression on efavirenz-based first-line antiretroviral therapy (ART) should be changed to a protease inhibitor (Pl)-based regimen. In South Africa (SA), -200 000 people are on second-line treatment, but little is known about these patients.OBJECTIVES. To describe second-line black African patients in a large urban area.METHODS. A quantitative retrospective study of 825 second-line patients in central Johannesburg, SA (subdistrict F), was performed with data extracted from government databases. Demographic characteristics, treatment status and laboratory information were gathered, then analysed with CD4+ cell count, viral load (VL) and retention-in-care data as outcome variables.RESULTS. The average recorded time to VL measurement after the switch to a Pi-based ART regimen was 20 months, and 83.1% (570/686) of patients with a recent VL achieved viral suppression while on second-line treatment. The most recent median CD4+ cell count for the cohort was 286 cells/uL (interquartile range 160 - 478), which represented a 177 cells/uL increase from the baseline count at the start of first-line ART. Slightly less than three-quarters (72.4%) of the population remained active in care in the study clinics from initiation on first-line ART. Demographic characteristics such as being
       
  • Stillbirth risk across pregnancy by size for gestational age in Western
           Cape Province, South Africa: Application of the fetuses-at-risk approach
           using perinatal audit data

    • Abstract: BACKGROUND. There is little published work on the risk of stillbirth across pregnancy for small-for-gestational-age (SGA) and large-for-gestational (LGA) pregnancies in low-resource settings.OBJECTIVES. To compare stillbirth risk across pregnancy between SGA and appropriate-for-gestational-age (AGA) pregnancies in Western Cape Province, South Africa (SA).METHODS. A retrospective audit of perinatal mortality data using data from the SA Perinatal Problem Identification Program was conducted. All audited stillbirths with information on size for gestational age (N=677) in the Western Cape between October 2013 and August 2015 were included in the study. The Western Cape has antenatal care (ANC) appointments at booking and at 20, 26, 32, 34, 36, 38 and 41 (if required) weeks' gestation. A fetuses-at-risk approach was adopted to examine stillbirth risk (28 - 42 weeks' gestation, >1 000 g) across gestation by size for gestational age (SGA
       
  • Surveillance and comparison of antimicrobial susceptibility patterns of
           ESKAPE organisms isolated from patients with bacteraemia in South Africa,
           2016 - 2017

    • Abstract: BACKGROUND. In South Africa (SA), the National Department of Health has developed an Antimicrobial Resistance National Strategy Framework document to manage antimicrobial resistance (AMR). One of the strategic objectives is to optimise surveillance and early detection of AMR. At the National Institute for Communicable Diseases (NICD), an analysis of selected organisms and antimicrobial agents from both the public and the private sectors was conducted.OBJECTIVES. The relevance of surveillance for AMR is increasingly recognised in the light of global action plans to combat resistance. In this report, we present an overview of ESKAPE (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, Enterobacter spp.) organisms and Escherichia coli reported from public and private sector laboratories in SA for the period 2016-2017.METHODS. Antimicrobial susceptibility testing (AST) profiles on selected ESKAPE organisms and E. coli isolated from blood cultures from the public and private sectors in 2016 and 2017 were analysed. AST data were extracted from a web-based electronic platform created by the NICD. Drug-bug combinations following the World Health Organization's Global Antimicrobial Surveillance System guidelines were included in the analysis.RESULTS. A total of 28 920 ESKAPE organisms and E. coli were reported in 2016 and 32 293 in 2017 across the two health sectors. Proportions of some organisms differed between the two health sectors, such as E. coli (19% in the public sector and 36% in the private sector), A. baumannii (14% public and 4% private), P. aeruginosa (7% public and 11% private) and S. aureus (27% public and 17% private). Susceptibility data indicated changing patterns in both sectors towards an increase in non-susceptibility to carbapenems in K. pneumoniae (p
       
  • The pH of lye and no-lye hair relaxers, including those advertised for
           children, is at levels that are corrosive to the skin

    • Abstract: BACKGROUND. Hair relaxers are used by up to 70% of females of black African ancestry. Occupational safety regulations list a pH >10.5 as irritant and a pH >11.50 as corrosive to the skin.OBJECTIVES. To determine the pH of all relaxers sold on the South African market and whether it is lower in no-lye relaxers and those marketed for children.METHODS. Relaxers were purchased from retailers in Cape Town, but more than half (54%) of the 39 brands tested were international. The pH was determined using a benchtop pH meter with an electrode for emulsions. Three pH readings were done over 3 consecutive days for each sample, and the average was used for data analysis. Differences between relaxers were analysed using Kruskal-Wallis, Wilcoxon rank-sum (Mann-Whitney) and two-sample f-tests (p
       
  • Outcome determinants of urethroplasty in the management of inflammatory
           anterior urethral strictures

    • Abstract: BACKGROUND. Limited data are available on outcomes of the surgical management of inflammatory urethral strictures secondary to infection, a major cause of stricture. Several shortcomings that need to be addressed have been identified in the past.OBJECTIVE. To determine the impact of stricture length, position and degree of obliterative urethral lumen on the surgical outcomes of corrective procedures for inflammatory anterior urethral strictures.METHODS. This retrospective analysis used the records of patients who presented with proven infective anterior urethral strictures at an academic hospital from 2007 to 2010. All patients were followed up after 48 months. Urethroplasty outcomes were analysed according to stricture location and length and effect of urethral obliteration.RESULTS. The median age of the 174 patients in the study was 47 (range 21 - 86) years. Anastomotic urethroplasty was successful in 59/99 (59.6%) patients. Augmented anastomotic urethroplasty was successful in 11/15 (73.3%) patients. Dorsal onlay buccal mucosa graft urethroplasty was successful in 23/32 (71.9%) patients, significantly higher than in 2/9 (22.2%) patients who underwent ventral onlay buccal mucosa graft urethroplasty (p=0.017; hazard ratio 3.4; 95% confidence interval 1.29 - 9.40). The one-stage circular pedicled penile skin-flap urethroplasty was successful in 1/12 (8.3%) patients. Two-stage urethroplasty was successful in 5/7 (71.4%) patients. A primary component analysis of the 73 failed procedures showed that stricture length was the main contributor to failure (eigenvalue 1.79; 45%).CONCLUSIONS. Urethroplasty remains a challenge in inflammatory urethral strictures, where stricture length was the main reason for treatment failure.
       
  • The accuracy of a point-of-care test among different operators using the
           QBC Autoread Plus Analyzer for the measurement of a basic full blood count
           

    • Abstract: BACKGROUND. Major issues around the implementation of point-of-care testing (POCT) include: user type, regulatory control, ongoing quality monitoring and limited guideline adherence.OBJECTIVES. To determine if there are significant differences in the results of a POC full blood count test between different levels of healthcare and non-medical 'lay users compared with laboratory users (technologists/pathologists).METHODS. This article retrospectively reviews the technical evaluation database of the intensive care unit (ICU), Chris Hani Baragwanath Academic Hospital, Johannesburg, South Africa. We searched for samples analysed by doctors, clerks and laboratory personnel. A minimum number of 60 comparisons were required. Bland-Altman plots, Spearman's correlation and Passing-Bablok fit were used to analyse the dataset.RESULTS. There were 72 comparisons for haematocrit (Hct), 98 for white cell count (WCC) and 137 for platelets (Pit) between the clerk and laboratory personnel. The correlations were 0.91, 0.96 and 0.92, respectively. All were statistically significant. Using the Bland-Altman method, there was good agreement between results of the clerk and those of the laboratory staff, with a mean bias of 0.5% (Hct), 0.1 χ 10(9)/L (WCC) and 10 χ 10(9)/L (Pit). An insufficient number of tests were performed by medical doctors for statistical comparison.CONCLUSIONS. With appropriate training, non-medical, non-healthcare lay users are able to perform a moderately complex POCT with similar accuracy as trained laboratory professionals. The focus should shift to equipment and quality management processes rather than the medical/technical qualification of the user.
       
  • A diabetes profile of the eight districts in the public health sector,
           Eastern Cape Province, South Africa

    • Abstract: BACKGROUND. The International Diabetes Federation (IDF) recently reported that there are 1.8 million South Africans with diabetes, and estimates an additional undiagnosed population of 69% of the total number of diabetics. The African continent is expected to see the highest increase in diabetes globally by 2045. Healthcare measures to manage this surge in diabetes and its related complications should be tailored to Africa's unique challenges; however, the epidemiolocal data essential for policy development are lacking. Bridging the data gap will guide funding distribution and the creation of evidence-based initiatives for diabetes.OBJECTIVES. To investigate the frequency, age proportion and distribution of new patients diagnosed with diabetes in the public healthcare sector of Eastern Cape (EC) Province, South Africa (SA).METHODS. All data collected to date were obtained from the EC District Health Information System. According to the information collected from the Department of Health, diabetes-related data collection fields were implemented in 2013, which resulted in this 4-year study. Additional open-source data on population estimates, mortality and medical aid coverage were provided by Statistics SA.RESULTS. Of the eight districts in the province, O R Tambo was recorded as having the highest average proportion of new patients diagnosed with diabetes. A positive correlation was found between the calculated incidence of disease and the diabetes mortality rate.CONCLUSIONS. The study showed an annual growth in the incidence of diabetes in the EC since 2014, and highlights the issue of an increasing burden of diabetes in the rural population. This increase is consonant with predictions by authoritative bodies on the growing burden of diabetes in Africa. The pattern of distribution highlights the deprived district of O R Tambo contradicting the well-known link between diabetes and urbanisation.
       
  • Prevalence of low serum testosterone levels among men with type 2 diabetes
           mellitus attending two outpatient diabetes clinics in KwaZulu-Natal
           Province, South Africa

    • Abstract: BACKGROUND. The reported prevalence of low testosterone among men with type 2 diabetes mellitus (T2DM) is high. However, there is a dearth of information on the prevalence of androgen deficiency symptoms and low serum testosterone levels in men with T2DM from sub-Saharan Africa. Scanty data are available from Nigeria, Ghana and South Africa (SA).OBJECTIVES. To determine the prevalence of low serum testosterone and associated risk factors and the prevalence of androgen deficiency symptoms in men with T2DM.METHODS. In a cross-sectional observational study, androgen deficiency symptoms in men with T2DM attending two outpatient diabetes clinics in Durban, KwaZulu-Natal Province, SA, were assessed using the Ageing Males' Symptoms Scale (AMS) questionnaire and direct enquiry. Serum total testosterone (TT), sex hormone-binding globulin (SHBG), luteinising hormone (LH), fructosamine, serum lipids and glycated haemoglobin (HbAlc) were measured and free testosterone (FT) was calculated. TT, SHBG and FT levels were measured in control subjects with no history of diabetes.RESULTS. There were 148 men with T2DM in the study group and 50 control subjects in the control group. In the study group, the majority were black Africans (58.8%); Indians (39.2%) and whites (2.0%) constituted the remainder. The mean (standard deviation (SD)) age was 57.5 (11.2) years, the mean duration of diabetes 11.4 (8.9) years and the mean HbAlc 8.6% (1.9%). Of the study group, 85.8% had metabolic syndrome. Mean TT, SHBG and FT and median LH (interquartile range) in the study group were within normal ranges. However, mean (SD) serum TT and FT were lower in the study group than in the control subjects (14.5 (5.8) v. 18.8 (7.2) nmol/L;p
       
  • The prevalence and characteristics of moderate- to high-risk regulated and
           unregulated substance use among patients admitted to four public hospitals
           in Tshwane, South Africa

    • Abstract: BACKGROUND. Alcohol, tobacco and unregulated substance use contributes to the global burden of disease. Admission to hospital provides an opportunity to screen patients for substance use and offer interventions.OBJECTIVES. To determine the prevalence and nature of substance use and treatment as well as interest in harm reduction among inpatients from four hospitals in the City of Tshwane, South Africa.METHODS. In a cross-sectional study, sociodemographic and substance use data were collected from 401 patients using the World Health Organization's Alcohol, Smoking and Substance Involvement Screening Test. Demographic characteristics were analysed using descriptive statistics. Bivariate and multivariate analyses of moderate- to high-risk tobacco and unregulated substance use in relation to demographic characteristics were also done.RESULTS. Most patients were South African (88%) and black African (79%), over half were female (57%), and they were relatively young (median age 38 years). Most (82%) lived in formal housing. Over half (56%) had completed high school, and 33% were formally employed. Bivariate analysis found substance use-related admission to be higher where scores for tobacco and unregulated substance use were moderate to high (13% v. 0.3%, p
       
 
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