South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde
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On 26 March 2020, the South African (SA) government initiated a 21-day national level 5 lockdown which was subsequently eased off and downgraded to level 4 on 1 May and to level 3 on 1 June. The effect of lockdown measures on SARS-CoV-2 infectivity is currently uncertain. In this article, we analyse the effects of the lockdown measures on the SARS-CoV-2 epidemic in one of the epicentres in SA. ⋯ The findings of this study testify to the rapid increase in ARs resulting from easing of the lockdown regulations, especially to level 3 in June. Of concern is the upward trend in the AR across all age groups, especially <20 years (15.9%), which was not reported in other parts of the world. Population age dynamics should therefore be considered when taking future decisions about lockdown regulations.
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Postoperative residual curarisation (PORC) is a potentially life-threatening complication of non-depolarising muscle relaxant use in anaesthesia. Quantitative neuromuscular monitoring has the potential to reduce the risk of PORC, but many anaesthetists rely on clinical assessment of neuromuscular function alone. ⋯ PORC is more common in practice than currently recognised. This deduction is supported by the low rate of intraoperative neuromuscular monitoring conducted and the high pass rate on clinical assessment. Routine use of quantitative monitoring of neuromuscular function should be encouraged to minimise the risk of this serious yet preventable condition.
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Although women are informed about the dangers of drinking and smoking during pregnancy when they book for antenatal care, it is uncertain whether this advice is accepted, or whether attempts are made to apply it in subsequent pregnancies. ⋯ Detailed information on the adverse effects of smoking and drinking during pregnancy was not effective in the population studied. Other methods to reduce or stop these toxic exposures should therefore be investigated. A short inter-pregnancy interval, as demonstrated by three enrolments in 7.5 years, is associated with preterm labour and fetal growth restriction, and is probably indicative of the role played by confounders such as poor socioeconomic conditions and drug exposure during pregnancy.
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The positive impact of physical activity and exercise on health is well known. Individuals who walk at least 10 000 steps per day are likely to meet recommended physical activity guidelines. Very little is known about the physical activity levels of doctors at work, in particular those working in emergency departments (EDs). ⋯ Doctors working in an SA ED are not achieving the daily recommended number of steps while at work. The increased risk of ill health and burnout in an already high-risk specialty heightens the importance of exercise and physical activity that needs to be achieved outside the workplace.