Medical Futility and End-Of-Life Care (Original Articles)

Acceptance of the concept of medical futility facilitates a paradigm shift from curative to palliative medicine, accommodating a more humane approach and avoiding unnecessary suffering in the course of the dying process. This should not be looked upon as...

Acupuncture for Treating Common Side Effects Associated with Breast Cancer Treatment: A Systematic Review (Original Articles) (Report)

INTRODUCTION BREAST CANCER IS A LIFE-THREATENING disease that affects approximately 22,460 individuals in Canada each year. (1) Breast cancer is defined as cancer that has a site of origin in tissues of the breast, usually occurring in the ducts...

Assessing Menopausal Status in Women Aged 40-49 Using Depot-Medroxyprogesterone Acetate, Norethisterone Enanthate Or Combined Oral Contraception (Original Articles) (Report)

Determining the onset of menopause in older users of hormonal injectable contraceptives depot medroxyprogesterone acetate (DMPA) and norethisterone enanthate (NET-EN) can be challenging. These contraceptive methods may mask menopausal symptoms such as amenorrhoea, which is a common side-effect of...

The South African Stress and Health (SASH) Study: 12-Month and Lifetime Prevalence of Common Mental Disorders (Original Articles) (Clinical Report)

At the end of the apartheid era, the African National Congress (ANC) formulated a broad policy framework that forms the basis for the current enabling health care legislation in South Africa. The ANC government developed a health care delivery...

Vasectomy Under Local Anaesthesia Performed Free of Charge As a Family Planning Service: Complications and Results (Original Articles)

The link between global warming and unbridled population growth emphasises the urgent necessity for political action to promote effective forms of contraception. (1) Vasectomy is one of the most reliable family planning methods but is underutilised worldwide, accounting for...

Monitoring the South African National Antiretroviral Treatment Programme, 2003-2007: the Iedea Southern Africa Collaboration (Original Articles) (Report)

The World Health Organization (WHO) estimated that in 2007, 9.7 million people in low–and middle-income countries needed antiretroviral treatment (ART), (1) 9% of whom were living in South Africa. (2) By the end of 2007, the South African National...

Abdominal and Pericardial Ultrasound in Suspected Extrapulmonary Or Disseminated Tuberculosis (Original Articles) (Report)

Extrapulmonary tuberculosis (EPTB) is defined as tuberculosis (TB) of organs other than the lungs and usually results from lympho-haematogenous dissemination of the organism. The term disseminated TB refers to TB that involves multiple body systems, including the lungs. Target...

Risks for Preterm Delivery and Low Birth Weight are Independently Increased by Severity of Maternal Anaemia (Original Articles) (Report)

Anaemia is the most widespread nutritional disorder in the world, affecting 30% of the global population, and is even more prevalent among pregnant women. Massawe et al. showed that 65% of pregnant women attending antenatal clinics in Dar es...

A Pivotal Role for Pneumolysin in the Immunopathogenesis, Treatment and Prevention of Pneumococcal Disease (Original Articles)

The pneumococcus remains an extremely important cause of morbidity and mortality worldwide. While the microorganism has a number of significant virulence mechanisms, many recent studies have focused on pneumolysin, which is recognised to be one of the most important...

Critically III Surgical Patients Followed in a Medical Intensive Care Unit/Bir Dahili Yogun Bakim Unitesi’nde Izlenen Kritik Cerrahi Hastalar (Original Investigation/Ozgun Arastirma) (Report)

Introduction Postoperative patients, especially when elderly and with co-morbidities, may have high hospital mortality rates (1). These patients may require intensive care unit (ICU) admission during their follow-up. Additionally, patients in the medical intensive care unit (MICU) can develop...

Mental Health Service Use Among South Africans for Mood, Anxiety and Substance Use Disorders (Original Articles) (Survey)

Of the national burden of disease, neuropsychiatric disorders are third only to HIV/AIDS and infectious disease, according to revised DALY (disability-adjusted life-years) estimates for the year 2000. (1,2) Yet mental health services are grossly under-resourced and there are many...

Perpetration of Gross Human Rights Violations in South Africa: Association with Psychiatric Disorders (Original Articles) (Report)

South Africa provides a unique laboratory for studying the perpetration of different forms of violence. During apartheid a range of acts of racial violence were perpetrated, including gross human rights violations (HRVs). However, both before and after apartheid there...

Newborn Hearing Screening in the Private Health Care Sector–a National Survey (Original Articles) (Survey)

Approximately 180 000 babies are born with or acquire permanent bilateral hearing loss (40 dB hearing level (HL)) within the first few weeks of life across sub-Saharan Africa every year. (1) In South Africa an estimated 17 babies are...

Dosage Adjustment in Medical Patients with Renal Impairment at Groote Schuur Hospital (Original Articles)

Failure to adjust dosing of renally excreted drugs in patients with renal impairment may lead to adverse effects, including nephrotoxicity. The incidence of in-hospital acute kidney injury attributed to drug nephrotoxicity is estimated at 19%.1 Drug-induced nephrotoxicity and adverse...

Mite and Cockroach Sensitisation in Patients with Allergic Rhinitis in the Free State (Original Articles)

Allergen sensitivities of patients with allergic rhinitis in the Free State have been described, (1,2) with sensitisation patterns being similar in asthmatic patients. (3) These studies showed a high prevalence of grass pollen sensitisation and a lower level of...

Hyperglycemic Crisis in the Eastern Cape Province of South Africa: High Mortality and Association of Hyperosmolar Ketoacidosis with a New Diagnosis of Diabetes (Original Articles) (Clinical Report)

Diabetic hyperglycaemic crisis is a major reason for high-care unit admissions, (1) with mortality rates of up to 30%. (2-9) It is characteristically classified as ketoacidotic or hyperosmolar.10 Presentations with the combination of ketoacidosis and hyperosmolality are recognised, (6,7,11-16)...

Allergenicity of Latex Rubber Products Used in South African Dental Schools (Original Articles) (Clinical Report)

Latex allergy is an occupational health problem among health care workers (HCWs), including dental health care professionals. Our aim was to quantify individual latex allergens to assess the allergenicity of latex products used in health care settings, to minimise...

Educational Factors That Influence the Urban-Rural Distribution of Health Professionals in South Africa: A Case-Control Study (Original Articles) (Report)

Among factors that influence health professionals’ career choices in favour of rural and under-served communities, the role of undergraduate and postgraduate training is assumed to be significant. (1-3) Selection criteria for entry to training, timing, duration, site and type...

HIV Prevention Responsibilities in HIV Vaccine Trials: Complexities Facing South African Researchers (Original Articles)

Background, aims and methodology Preventing new HIV infections is critical. However, less than one in five people has access to proven prevention methods, (1) and ‘for every person placed on antiretroviral treatment in 2006, another six people became newly...

Microbes, Molecules, Maladies and Man (Original Articles)

Dedication: To Professor Hendrik J Koornhof, mentor, friend and man with immense knowledge, insight, wisdom and compassion, who has been a true inspiration to all those who have had the privilege to know him. The planet Earth was formed,...