South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde
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Randomized Controlled Trial Comparative Study
Comparison of ultraviolet C light and isopropyl alcohol for the disinfection of cellular phones in a paediatric intensive care unit setting.
A considerable proportion of cellular phones (cell phones) used by healthcare workers (HCWs) have been shown to be contaminated with pathogenic micro-organisms, making these devices reservoirs to infect susceptible patients. Although many units have well-defined infection control protocols, methods for the decontamination of cell phones are scarce. ⋯ Although both 70% isopropyl alcohol and UVC light disinfection effectively reduced CFUs following decontamination, 70% isopropyl alcohol was determined to be much more effective.
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Observational Study
Analysis of emergency centre recidivism for interpersonal violence in a district-level hospital in Cape Town, South Africa.
Interpersonal violence is a major cause of morbidity and mortality in low- and upper-middle-income countries. It is postulated that a significant portion of these patients have repeated presentations to an already overburdened healthcare system. Data describing the burden of interpersonal violence recidivism are poor. ⋯ Recidivist presentations represent a significant proportion of interpersonally violently injured patients, and are likely to be under-documented. Recidivism poses a measurable burden, and further research is needed to facilitate the identification of at-risk individuals, and specific secondary prevention strategies should be developed to prevent or reduce escalating patterns of injury associated with interpersonal violence.
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Case Reports
Case report: First reported case of spondylodiscitis caused by Gemella morbillorum in South Africa.
Pyogenic spondylodiscitis is an uncommon but important clinical condition that often requires medical and/or surgical management. We report a case of spondylodiscitis caused by a rare pathogen, Gemella morbillorum. To date, worldwide, only six such cases of confirmed spondylodiscitis infection with this rare pathogen have been documented, and this is the first reported case in South Africa. ⋯ Tissue cultures from a biopsy identified G. morbillorum species infection, and she was treated successfully with antibiotics for 6 weeks. It is important to have a high index of suspicion when a patient has a history of dental work, and to rule out associated infection such as endocarditis. Treatment with culture-driven antibiotics yields good results.
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South Africa (SA) has the highest prevalence of people with tuberculosis (TB) and HIV coinfection globally. People living with HIV have an increased risk of TB infection, and are more likely to develop extrapulmonary TB. Approximately 10 - 20% of extrapulmonary TB accounts for skeletal TB, with spinal involvement in 50 - 60% of instances. Previous studies have shown highly heterogenic results regarding the effect of HIV status on clinical and laboratory characteristics in patients with spinal TB (STB). ⋯ In our cohort, HIV-infected patients with STB were more likely to present with vertebral collapse, and more vertebrae on average were diseased compared with HIV-uninfected patients with STB. CD4 cell count may affect granuloma formation, and it seems that HIV infection has a negative effect on cellular immunoresponse in STB, which emphasises the need for early antiretroviral therapy initiation.
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Golf club-related traumatic brain injuries are an uncommon occurrence in adults, and the use of golf clubs as a weapon of interpersonal assault resulting in compound skull fractures is rare. ⋯ This study highlights the potential dangers of golf clubs as a weapon of interpersonal assault, and the need for prompt and appropriate management of compound skull fractures to reduce the risk of complications.