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E-Doc on Tuesday, May 18 @ 19:38:05 SAST
The South African Academy of Family Practice’s Rural
Health Initiative (RHI) is proud to be able to bring you the following section of the
journal, that will concentrate on issues pertaining to rural health in South Africa. We
hope to provoke discussion on these issues and would encourage anyone interested in rural
health to offer contributions to future issues.
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The South African Academy of Family Practice’s Rural
Health Initiative (RHI) is proud to be able to bring you the following section of the
journal, that will concentrate on issues pertaining to rural health in South Africa. We
hope to provoke discussion on these issues and would encourage anyone interested in rural
health to offer contributions to future issues.
E-Doc on Tuesday, May 18 @ 19:21:42 SAST
Ensuring Quality Use of Medicines – Engaging with PBMs and PMBs
This postscript to the Quality Use of Medicines series of reviews will look back at the principles put forward in the first article, while considering how these should be deployed by the family practitioner in the current practice milieu.1 The articles in the series have tried to convey how the application of evidence can promote the “therapeutically sound and cost-effective use of drugs” – what the World Health Organization (WHO) calls the “rational use of medicines”.2 The approach suggested in that first paper was the WHO “P-drug” process – a systematic way to select and apply medicines, taking into account the efficacy, safety, suitability and cost of different options.3 Can this process help the individual practitioner to ensure the quality use of medicines in the face of changing circumstances?
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Ensuring Quality Use of Medicines – Engaging with PBMs and PMBsThis postscript to the Quality Use of Medicines series of reviews will look back at the principles put forward in the first article, while considering how these should be deployed by the family practitioner in the current practice milieu.1 The articles in the series have tried to convey how the application of evidence can promote the “therapeutically sound and cost-effective use of drugs” – what the World Health Organization (WHO) calls the “rational use of medicines”.2 The approach suggested in that first paper was the WHO “P-drug” process – a systematic way to select and apply medicines, taking into account the efficacy, safety, suitability and cost of different options.3 Can this process help the individual practitioner to ensure the quality use of medicines in the face of changing circumstances?
E-Doc on Tuesday, May 18 @ 19:19:49 SAST
MP-Joint Dislocation of the Thumb
Dear Colleague, RE: Your patient with a painful dislocated MP-joint of the right thumb Thank you for the referral of Mrs. R J J a thirty-three year old right hand dominant housewife, who slipped and fell on a wet floor injuring her right thumb. She noticed that her right thumb was deformed at the metacarpophalangeal (MP) joint level. The thumb was very tender. She also noticed a swelling on the volar aspect of her thumb.
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MP-Joint Dislocation of the ThumbDear Colleague, RE: Your patient with a painful dislocated MP-joint of the right thumb Thank you for the referral of Mrs. R J J a thirty-three year old right hand dominant housewife, who slipped and fell on a wet floor injuring her right thumb. She noticed that her right thumb was deformed at the metacarpophalangeal (MP) joint level. The thumb was very tender. She also noticed a swelling on the volar aspect of her thumb.
E-Doc on Tuesday, May 18 @ 19:15:52 SAST
HYPERCALCAEMIA: A finding not to be taken too lightly
Many conditions are associated with hypercalcaemia: primary hyperparathyroidism, advanced secondary hyperparathyroidism, milk alkali syndrome, vitamin D intoxication, thiazide diuretic treatment, malignancy with or without bone metastases, and immobilisation. Primary hyperparathyroidism (pHPT) is the most common cause in ambulatory adult patients, but malignancy in hospitalised patients.1
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HYPERCALCAEMIA: A finding not to be taken too lightlyMany conditions are associated with hypercalcaemia: primary hyperparathyroidism, advanced secondary hyperparathyroidism, milk alkali syndrome, vitamin D intoxication, thiazide diuretic treatment, malignancy with or without bone metastases, and immobilisation. Primary hyperparathyroidism (pHPT) is the most common cause in ambulatory adult patients, but malignancy in hospitalised patients.1
E-Doc on Tuesday, May 18 @ 19:13:51 SAST
Avian Flu - What is the risk to humans?
The current Asian avian flu outbreaks in Thailand, Vietnam, Cambodia, South Korea and Japan has brought to the fore the risk posed by zoonotic diseases to humans. Zoonotic diseases are primarily diseases of vertebrate animals that are naturally transmitted to humans. As at 27 January 2004, the number of confirmed deaths related to avian flu in humans rose to eight cases, mostly in children, who were in close contact with live poultry in Thailand and Vietnam. What is worrying is the similarity of the present outbreaks of avian flu with the SARS outbreaks of November 2002. More than 10 pandemics of influenza-like illness have occurred since the end of the 16th century with disastrous consequences.
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Avian Flu - What is the risk to humans?The current Asian avian flu outbreaks in Thailand, Vietnam, Cambodia, South Korea and Japan has brought to the fore the risk posed by zoonotic diseases to humans. Zoonotic diseases are primarily diseases of vertebrate animals that are naturally transmitted to humans. As at 27 January 2004, the number of confirmed deaths related to avian flu in humans rose to eight cases, mostly in children, who were in close contact with live poultry in Thailand and Vietnam. What is worrying is the similarity of the present outbreaks of avian flu with the SARS outbreaks of November 2002. More than 10 pandemics of influenza-like illness have occurred since the end of the 16th century with disastrous consequences.
E-Doc on Tuesday, May 18 @ 19:12:15 SAST
Selected skin diseases located on the feet
Tinea pedis (ringworm of the feet, athlete’s foot) is the most common dermatophyte infection in the developed world. Three main factors constitute the basis of any tinea pedis infection; warmth, moisture and friction. Tinea pedis does not affect barefoot people. Shoes, in particular plastic and occluded, create a milieu for dermatophytes to prosper. Tinea pedis is most often caused by anthropophilic subspecies of Trichophyton; T. rubrum and T. mentagrophytes (interdigital). These agents can be transmitted directly from person to person as well as by the scales harbouring the fungus shed on a carpeted floor or in shared shoes. Tinea pedis may present in several clinical forms:
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Selected skin diseases located on the feetTinea pedis (ringworm of the feet, athlete’s foot) is the most common dermatophyte infection in the developed world. Three main factors constitute the basis of any tinea pedis infection; warmth, moisture and friction. Tinea pedis does not affect barefoot people. Shoes, in particular plastic and occluded, create a milieu for dermatophytes to prosper. Tinea pedis is most often caused by anthropophilic subspecies of Trichophyton; T. rubrum and T. mentagrophytes (interdigital). These agents can be transmitted directly from person to person as well as by the scales harbouring the fungus shed on a carpeted floor or in shared shoes. Tinea pedis may present in several clinical forms:
E-Doc on Tuesday, May 18 @ 19:06:00 SAST
Ethical Issues in Family Practice: Medical Futility – The debate
Like most ethical and bioethical dilemmas, the ‘futility debate’ has a long history. Both Hippocrates and Plato mentioned the problem. The Corpus Hippocraticum states: “Whenever a man suffers from an ill which is too strong for the means at the disposal of medicine, he surely must not even expect that it be overcome by medicine”. In The Republic, Plato writes: “For those whose bodies were always in a state of inner sickness Asclepios did not attempt to prescribe a regimen to make their life a prolonged misery”. In fact, it was not until the early 1990s that the concept of medical futility became widely discussed
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Ethical Issues in Family Practice: Medical Futility – The debateLike most ethical and bioethical dilemmas, the ‘futility debate’ has a long history. Both Hippocrates and Plato mentioned the problem. The Corpus Hippocraticum states: “Whenever a man suffers from an ill which is too strong for the means at the disposal of medicine, he surely must not even expect that it be overcome by medicine”. In The Republic, Plato writes: “For those whose bodies were always in a state of inner sickness Asclepios did not attempt to prescribe a regimen to make their life a prolonged misery”. In fact, it was not until the early 1990s that the concept of medical futility became widely discussed
E-Doc on Tuesday, May 18 @ 19:04:12 SAST
Allergic rhinitis: Not a trivial disease
Over the past 30 years there has been an exponential increase in the prevalence of allergic rhinitis, now present in between 17% and 28% of the South African population. In view of the close association between allergic rhinitis and asthma (over 70% of asthmatics have associated allergic rhinitis), an international initiative endorsed by the World Health Organization (WHO) has developed the Allergic Rhinitis and its Impact on Asthma (ARIA) document which provides international guidelines for evidence-based treatment of allergic rhinitis1.
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Allergic rhinitis: Not a trivial diseaseOver the past 30 years there has been an exponential increase in the prevalence of allergic rhinitis, now present in between 17% and 28% of the South African population. In view of the close association between allergic rhinitis and asthma (over 70% of asthmatics have associated allergic rhinitis), an international initiative endorsed by the World Health Organization (WHO) has developed the Allergic Rhinitis and its Impact on Asthma (ARIA) document which provides international guidelines for evidence-based treatment of allergic rhinitis1.
E-Doc on Tuesday, May 18 @ 19:01:41 SAST
The views of Medical Students on professionalism in South Africa
An article on medical professionalism was published in the Annals of Internal Medicine in February 2002 outlining a charter, and the fifth-year medical students of the Medical School of the University of Pretoria were asked to comment on the charter. The question was asked whether the principles and responsibilities as set out in the charter could also be applied to the South African context.
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The views of Medical Students on professionalism in South AfricaAn article on medical professionalism was published in the Annals of Internal Medicine in February 2002 outlining a charter, and the fifth-year medical students of the Medical School of the University of Pretoria were asked to comment on the charter. The question was asked whether the principles and responsibilities as set out in the charter could also be applied to the South African context.
E-Doc on Tuesday, May 18 @ 18:59:51 SAST
What helps volunteers to continue with their work?
Aim
The aim of the study was to understand what volunteers perceived to be the factors helping them to continue working as volunteers, thereby assisting project leaders to improve the recruitment procedures, as well as quality of service, in the future.
Methodology
A focus group interview was held with the 14 most active volunteers in order to understand their perceptions about their work and their ability to continue their work as volunteers. The recorded interview was transcribed, translated and analysed
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What helps volunteers to continue with their work?Aim
The aim of the study was to understand what volunteers perceived to be the factors helping them to continue working as volunteers, thereby assisting project leaders to improve the recruitment procedures, as well as quality of service, in the future.
Methodology
A focus group interview was held with the 14 most active volunteers in order to understand their perceptions about their work and their ability to continue their work as volunteers. The recorded interview was transcribed, translated and analysed
E-Doc on Tuesday, May 18 @ 18:58:10 SAST
Improving the Use of Lipidlowering Drugs at Brits Hospital
When it was found by the Brits Hospital Pharmacy and Therapeutics Committee (PTC) in 2000 that simvastatin was responsible for extremely high costs in a district hospital, it was decided to undertake a quality improvement study to assess and, if appropriate, rectify the situation
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Improving the Use of Lipidlowering Drugs at Brits HospitalWhen it was found by the Brits Hospital Pharmacy and Therapeutics Committee (PTC) in 2000 that simvastatin was responsible for extremely high costs in a district hospital, it was decided to undertake a quality improvement study to assess and, if appropriate, rectify the situation
E-Doc on Tuesday, May 18 @ 18:55:53 SAST
Family Medicine as a New Speciality in South Africa
Every creature on earth, whether man, beast or insect, is constantly looking for a space in the sun. A new medical professional creature has evolved form the general practitioner, the doctor all medical students previously became if they opted not to specialise. The Health Professions Council of South Africa (HPCSA) late in 2003 approved a new speciality, namely “Family Medicine”, and the practitioner will be called a “family physician”. This move was received very positively 1, but what does the decision actually mean and what will this new specialist be doing different from the present general practitioner or medical officer?
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Family Medicine as a New Speciality in South AfricaEvery creature on earth, whether man, beast or insect, is constantly looking for a space in the sun. A new medical professional creature has evolved form the general practitioner, the doctor all medical students previously became if they opted not to specialise. The Health Professions Council of South Africa (HPCSA) late in 2003 approved a new speciality, namely “Family Medicine”, and the practitioner will be called a “family physician”. This move was received very positively 1, but what does the decision actually mean and what will this new specialist be doing different from the present general practitioner or medical officer?
