South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde
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Fractures of the occipital condyle are rare and occur when the head is severely injured; they may be associated with fractures of the skull and the cervical spine. Conservative management appears to give satisfactory results.
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Two-thirds of all occupational permanent disabilities among black workers in South Africa occur in the mining industry. Comparison of compensated permanent disability cases shows that the incidence of permanent disability among black mineworkers is several times higher than that in any other South African industry. Most permanent disabilities sustained in mining fall into the category of 1-5% disability. ⋯ Most disabled black miners receive compensation payments that are lower than poverty datum levels and high rates of inflation rapidly erode their real value. Since many black workers are repatriated after a disabling accident, the issue of employment becomes crucial. The problems highlighted suggest that compensation legislation requires reform to ameliorate the difficulties faced by disabled black miners and recommendations are made.
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The prevalence of sexually transmitted pathogens in two groups of women was studied: 50 women with clinical diagnoses of acute pelvic inflammatory disease (PID) and 50 asymptomatic women attending a family planning clinic (FPC). Genital specimens, collected by non-invasive procedures, were examined. Endocervical Neisseria gonorrhoeae was present in 62% of the PID group and 10% of the FPC group (P less than 0.0001). ⋯ Antibody to the human immunodeficiency virus was not detected in any of the 100 women. The high prevalence of recognised sexually transmitted pathogens underlines the need for appropriate antimicrobial agent(s) active against N. gonorrhoeae, C. trachomatis and M. hominis in patients with PID. In view of the high prevalence of penicillinase-producing strains of N. gonorrhoeae, routine use of an antibiotic active against such strains is desirable.
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In a study of 200 patients with chest wounds in whom the need for referral to a centre with radiographic facilities was not obvious, careful clinical examination (pulse, blood pressure, respiratory rate, haemoglobin value and chest auscultation) was found to be a reliable triage tool. The sensitivity of one or more positive signs was 99.2% with a false-positive rate of 16% and a false-negative rate of 2%. The positive predictive value of two or more positive signs was found to be 99.1%.
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Results of rehabilitation of physically disabled people for employment on the open labour market over the period 1975-1985 are presented. Out of 680 eligible clients, 53% were successfully placed. When corrected for uncontrollable withdrawals and uncontrollable dismissals the success rate rises to 77% (363 of 471 clients). ⋯ The problem of adequate evaluation and screening to predict outcome reliably is discussed and the use of a modified version of the International Classification of Impairments, Disabilities and Handicaps of the World Health Organisation is advocated. Of those clients who were successfully placed, 75-80% remained in employment for more than 1 year and 55-60% for more than 2 years. On the whole, the rehabilitation process appears to lead to successful re-integration into the working community for most of the physically disabled persons admitted to the Centre.