South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde
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The South African Health Products Regulatory Authority (SAHPRA) monitors the safety of health products by collecting and evaluating adverse drug reaction (ADR) reports submitted by healthcare professionals, patients and pharmaceutical companies. The reports are shared with the World Health Organization (WHO) Programme for International Drug Monitoring. A demographic and clinical profile of ADR reports will improve our understanding of ADR reporting in South Africa to enhance training of reporters at all levels. ⋯ This was the first study that described ADR reports received by SAHPRA and improves our understanding of reporting in the country. The core clinical elements that are important in signal detection were often not included in reports. The findings demonstrated that patients were more active contributors to the national pharmacovigilance database than pharmacists. Reporters should be trained in pharmacovigilance and ADR reporting processes to increase the quantity and completeness of reports.
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South African data on the bacteriology and sensitivity profile of periprosthetic joint infection is lacking. Current regimens for systemic and local antibiotic therapy are based on international literature. These regimens are different for the United States of America and Europe and might thus not be relevant to South Africa. ⋯ Our study identifies the bacteriology of periprosthetic joint infections and their sensitivities in a South African setting. We recommend that empiric antibiotic-loaded cement spacers and systemic antibiotic regimens should consist of Meropenem or Gentamycin; Vancomycin and Rifampicin to achieve the broadest spectrum of coverage and most likely success in eradicating infection.
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Alcohol is a significant contributor to injury-related morbidity and mortality in South Africa (SA). During the COVID-19 global pandemic, restrictions to movement and to the legal access of alcohol* were introduced in SA. This study aimed to investigate the effect of alcohol bans during the COVID-19 lockdown periods on injury-related mortality and the blood alcohol concentrations (BAC) in these deaths. ⋯ There was a clear decrease in injury-related deaths in the WC during the COVID-19-related lockdown periods that coincided with the alcohol ban and restriction of movement and an increase following relaxation of restrictions on alcohol sales and movement. The data illustrated that mean BACs were similar between all periods of alcohol restriction compared to 2019, apart from hard lockdown in April-May, 2020. This coincided with a smaller mortuary intake during the level 5 and 4 lockdown periods. Keywords: Alcohol; blood alcohol concentration; COVID-19; injury; lockdown; South Africa; violent death; Western Cape * Alcohol refers to ethanol.
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Ivermectin remains a popular, albeit unproven, therapy used in both the prevention and treatment of COVID-19. We discuss a patient who developed jaundice and a liver injury 3 weeks after initiating ivermectin for COVID prevention. Liver histology demonstrated a pattern of injury that was both portal and lobular, with a bile ductulitis as well with marked cholesasis. She was managed with low dose corticosteroids, later tapered and withdrawn. She remains well a year after presenting.
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Snake bite management is largely driven by expert opinion and consensus, however there are a few large retrospective studies and RCT's that have improved the quality of medical guidance currently available. South African snakes are different in the venomous potential and it behooves the hospital provider and the average medical practitioner to know the current best practice concepts concerning assessment, treatment and antivenom use. The recent SASS meeting in July 2022 provided an update and national consensus from which this Hospital Care document is derived.