bluuebunny/crossref_metadata_2025 huggingface dataset:
Accointance, intentionnalité et conscience phénoménale
Authors: Roy Jean-Michel
Published: September 2019

L’article s’attache à poser et définir le problème de la pertinence de la théorie de l’accointance de Russell pour le débat contemporain sur la conscience phénoménale, ainsi qu’à en entreprendre l’examen. Il avance deux hypothèses principales. La première est que, d’un point de vue théorique, ce problème recouvre principalement la question de savoir s’il convient de défendre une conception intentionnaliste de la nature de la conscience phénoménale. La seconde est qu’une partie importante du débat contemporain, correspondant au camp de ceux qui se réclament d’une approche non représentationaliste de la conscience phénoménale et qui est illustré de façon centrale par le travail du philosophe Ned Block, répondent négativement à une telle question et reconnaissent donc du même coup, quoique de manière principalement implicite, que ce qui est en fait pertinent dans la théorie de l’accointance russellienne c’est que son auteur en soit venu à la rejeter en 1919.
Le coup du paquet de cigarettes
Authors: Renucci France , Kouchner Camille
Published: September 2019

On peut mourir socialement et délibérément pour ressusciter ailleurs ou sous une autre identité. La littérature connaît de telles aventures, mais le droit a dû s’y intéresser aussi. Disparaître, une liberté publique, un droit de l’homme ?
Notre part d’éternité
Authors: Melot Michel
Published: September 2019

Désincarnée, la personne morale du défunt se matérialise dans les objets qu’il lègue. Mais c’est le tri opéré par les héritiers, séparant mémoire et déchet, qui décide in fine de sa part d’éternité.
Masques mortuaires
Authors: Douplitzky Karine
Published: September 2019

Inter-face entre le mort et le vivant, le masque mortuaire a cédé la place aux images technologiques du défunt : quels changements anthropologiques et médiologiques révèle cette substitution ? Quel effroi nous sommes-nous ainsi épargné ?
Restons-en là
Authors: Gaillard Françoise
Published: September 2019

En dépit d’un habillage scientifique et technologique, le transhumanisme est nourri de fantasmes qui l’inscrivent dans une longue tradition.
Violences sexuelles & ripostes partisanes
Authors: Jérome Vanessa
Published: September 2019

Depuis l’automne 2017, le mouvement #MeToo a provoqué un véritable séisme sociétal. Initié comme une double invitation, à la dénonciation du caractère systémique des violences sexuelles et à la sororité, il a relativement épargné les politiques. Non parce qu’il n’y aurait rien à en dire. Mais parce qu’ici se combinent, de manière paroxystique, les logiques classiques de l’omerta et les spécificités d’un champ qui échappe encore largement aux tentatives de régulation.
« Au-delà du « non », faire du consentement une éthique de vie »
Authors: Oxymore  , Delage Pauline
Published: September 2019

Si la question des violences et de la sexualité est souvent posée du point de vue hétérosexuel, elle est traitée différemment au sein des groupes queers radicaux. C’est ce qu’illustre cet entretien avec Oxymore, membre du Wely Wely Want et de Cambouis, deux collectifs développant des savoirs et des savoir-faire émancipateurs, destinés à améliorer les conditions de vie et les relations de personnes minorisées.
Faire réagir les témoins face au harcèlement de rue. Enquête sociologique sur la politisation des rapports de genre dans l’espace public
Authors: Dekker Mischa
Published: September 2019

Dans les récentes campagnes de sensibilisation contre le harcèlement de rue, la critique des témoins, qualifiés de passifs, est constante. On retrouve souvent l’image d’un.e passant.e apathique, qui serait indifférent.e à l’agression, et on présente souvent la non-intervention des témoins comme une forme d’égoïsme, ou liée à la peur de subir soi-même des violences. En France, le problème public du harcèlement de rue a été défini principalement à partir du vécu de la victime et comme une violence faite aux femmes, orientant les débats vers une explication de la non-intervention des témoins comme une forme d’indifférence au sexisme. En mettant l’accent sur le caractère violent et envahissant de ces comportements vis-à-vis des victimes, ce cadrage s’est moins intéressé aux difficultés qu’ont souvent les témoins de ces situations pour les qualifier comme relevant du harcèlement. Nous nous intéressons à des interventions en milieu scolaire, organisées par des associations afin de sensibiliser des lycéens à la question du harcèlement de rue et les encourager à intervenir s’ils en sont témoins. Si les intervenant.e.s expliquent initialement la non-intervention comme une forme d’indifférence au sexisme et de résistance à leur politique qui vise à protéger l’autonomie des femmes et des personnes LGBTQI+, les réactions des élèves montrent que celle-ci vient plutôt de la peur qu’une intervention soit perçue comme une atteinte illégitime à l’autonomie d’autrui. Cet article interroge ainsi la réduction de toutes les résistances à des politiques progressistes et anti-sexistes à l’expression d’idées conservatrices et misogynes, en montrant qu’elles peuvent être le fruit de tensions internes aux politiques visant à protéger l’autonomie des individus. La réflexivité des militant.e.s et la façon dont ils vont adapter leur démarche en fonction de ces résistances pratiques illustrent les difficultés mais également les manières de promouvoir des comportements solidaires dans une société qui valorise les libertés individuelles.
À tous les Pierrots
Authors: Sanguet Marcel
Published: September 2019

En balade le long de l’œuvre de Renaud, l’auteur montre comment l’artiste s’est saisi des désordres de l’enfance pour les mettre en chansons. Les enfants de Renaud sont toujours prêts à renverser le monde établi par la génération précédente pour se construire en tant que sujets de leur propre désir. Ils restent pourtant toujours imprégnés des premières projections idéales de leurs parents. L’enfant ne peut alors se construire que dans le conflit. Conflit qu’il s’agit de supporter et d’accompagner.
An Update on the Other Cause of Excess Death in Bipolar Disorder: Cardiovascular Disease
Authors: Fiedorowicz Jess G.
Published: September 2019

Although much attention has appropriately been paid to suicide risk in bipolar disorder, cardiovascular disease has not received commensurate attention. People with bipolar disorder bear approximately twice the expected risk of cardiovascular disease and mortality. Several potential explanations for this alarming finding are reviewed with a focus on potential targets for clinical intervention. Many medications used to treat bipolar disorder may adversely impact risk factors for cardiovascular disease. People with bipolar disorder are additionally more likely to smoke, less likely to exercise regularly, and less likely to have healthy eating habits. Sleep problems are also nearly ubiquitous in bipolar disorder. Unacceptably, patients with bipolar disorder receive inadequate screening for and management of risk factors for cardiovascular disease, even in countries with universal access to health care. As providers with the most contact with many of these patients, psychiatrists are challenged to come to the fore in addressing this public health disparity.

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Psychiatr Ann.
2019;49(9):380–385.]
Beyond Pharmacotherapy for Bipolar Disorder: The Role of Adjunctive Psychological Treatments
Authors: Fletcher Kathryn , Murray Greg
Published: September 2019

Recent years have seen increased research attention to psychological interventions as adjuncts to medication treatment of bipolar disorder (BD). Adjunctive psychological treatments are recommended in all major clinical guidelines for BD, and we now know that evidence-based treatment involves both pharmacotherapy and psychological therapy. We provide an overview of what is known about psychological interventions for BD, including the existing evidence base, core content elements of therapy, and emerging innovations. An overarching theme is the patient as a motivated agent in his or her own well-being; we emphasize recovery-oriented treatment goals, self-management approaches, and digital platforms to improve access to these empowering activities. Mental health professionals are encouraged to support their patients' participation in evidence-based psychological therapies as part of a holistic approach to managing BD.

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Psychiatr Ann.
2019;49(9):399–404.]
Colistin: our last line of defence
Authors: Coetzee Jennifer
Published: September 2019

No abstract available.
A reply to the response to the article entitled, Health policy implications of blood transfusion-related HTLV-1 infection and disease
Authors: Paruk Hoosain , Bhigjee Ahmed
Published: September 2019

No abstract available.
Liver dysfunction as the presenting feature of disseminated cryptococcosis
Authors: Shukla Shailaja , Garg Jyoti , Mahajan Gunjan , Sharma Sunita
Published: September 2019

Disseminated cryptococcosis is rare in immunocompetent individuals with central nervous and respiratory systems being the most common initial sites of involvement. Liver dysfunction as a presenting feature of disseminated cryptococcosis has been reported rarely, with the majority of patients being HIV negative and immunocompetent. We report a case of disseminated cryptococcosis in a three-year-old HIV seronegative, immunocompetent male child presenting with obstructive jaundice and lymphadenopathy. Initial diagnosis was made on liver and lymph node biopsy. Lung, skin, central nervous system (CNS) and urinary tract involvement occurred later in the course of disease. Diagnosis was confirmed by serology and culture.
High level of initial default among smear positive pulmonary tuberculosis in eThekwini health district, KwaZulu-Natal
Authors: Cele Lindiwe P. , Knight Stephen , Webb Elize , Tint Khin , Dlungwane Thembelihle
Published: September 2019

In this study, initial tuberculosis (TB) default was measured in clinics in a district with a high incidence of TB. A retrospective review of TB case identification registers in 2007 found 4049 (9.0%) new smear positive pulmonary tuberculosis (PTB) cases from 44 987 suspects. There were 725 (17.9%) initial defaulters. Fifty-three percent of those traced had already died. TB is the leading cause of death in South Africa due to an infectious disease, and the high level of initial defaults in PTB is one of the “unresolved issues” in TB control programmes that needs to be addressed.
Syphilis sero-positivity among pregnant women attending public antenatal clinics: A five-year analysis from 15 public clinics in Gaborone, Botswana
Authors: Ganiyu A. B. , Mason L. , Mabuza L. H.
Published: September 2019

Background: The prevalence of syphilis in pregnancy varies across the globe and among different age groups within the same country. In sub-Saharan Africa, syphilis prevalence among pregnant women has been found to range from 2.5 to 18% among antenatal clinic attendees, with the highest prevalence in the age group 35–49 years. Also, it is higher in the rural than urban clinics.Objectives: To determine trends in syphilis prevalence using the Venereal Disease Research Laboratory (VDRL) and the Rapid Plasma Reagin (RPR) test among pregnant women attending the public antenatal clinics in Gaborone, Botswana (2004–2008).Study design: Cross-sectional study using routinely collected antenatal data.Results: The overall syphilis prevalence amongst pregnant women in Gaborone, Botswana decreased from 2.96% (95% CI, 2.55– 3.37) in 2004 to 1.15% (95% CI, 0.89–1.41) in 2008 (p 0.001). The age specific prevalence per total number of reactive VDRL/RPR was highest amongst pregnant women aged 26 to 30 years (p 0.001) and lowest for those aged 16 to 20 years (p 0.025) during the period 2004–2008. However, there were variations in syphilis prevalence rates within and between the clinics.Conclusion: Syphilis sero-positivity in pregnancy in Gaborone, Botswana has been declining for the last five years, but was more prevalent amongst pregnant women aged 26 to 30 years with the lowest prevalence among those aged 16 to 20 years during the period 2004 to 2008. This decline may be attributed to a number of factors and, in particular, the adoption of the syndromic approach for management of sexually transmitted infections in the country.
Knowledge, attitudes and practices in the control and prevention of malaria in four endemic provinces of Zambia
Authors: Shimaponda-Mataa Nzooma M. , Tembo-Mwase Enala , Gebreslasie Michael , Mukaratirwa Samson
Published: September 2019

This study sought to determine malaria knowledge levels, attitudes and practices of the communities in four malaria endemic provinces of Zambia. A cross-sectional survey on knowledge, attitude and practices (KAP) on malaria transmission, prevention and control was conducted among 584 household heads of randomly selected communities in Luapula, Lusaka, north-western and western provinces in Zambia. Data analysis was performed by both descriptive and inferential statistics. Knowledge levels in malaria with regards to the mosquito being the vector and the capacity of malaria to kill were high in all the provinces and did not vary statistically. The two main sources of malaria information by weighted analysis were health facility and community health workers (CHWs). From the regression analysis, pain killer use was associated with high incomes, employment, secondary education, or higher, and the knowledge of fever as a sign for malaria. Additionally, the source of malaria information was related to education levels. There is a need to enhance information through available channels such as health facilities and CHWs and tailor them according to general education levels of a community.
Endo-parasites of public-health importance recovered from rodents in the Durban metropolitan area, South Africa
Authors: Archer Colleen E. , Appleton Christopher C. , Mukaratirwa Samson , Lamb Jennifer , Schoeman M. Corrie
Published: September 2019

Background: Parasite infections of public health importance carried by Rattus spp. on the African continent (excluding toxoplasmosis) have not been adequately researched. The aim of this study was to investigate endoparasites of public health importance, particularly those associated with R. norvegicus, at different locations and seasons within the port-city, Durban.Methods: Four hundred rodents (379 R. norvegicus, 10 R. rattus and 11 Mastomys natalensis) were live-trapped at 60 sites in four locations, during wet and dry seasons in 2009. Rats were humanely euthanased, cardiac blood drawn (for blood smears and serology), ectoparasites removed and dissected. Each organ was separately processed to collect parasites. Binary logistic regression and four-way ANOVAs were used to test for the effects of location, season, rodent age and gender on parasite prevalence, richness and abundance.Results: Eight parasites of public health importance were detected: Gongylonema sp. (25.3%), Trypanosoma lewisi (22.8%), Hymenolepis diminuta (17.2%), Angiostrongylus cantonensis (15.3%), Toxoplasma gondii (11.2%), Moniliformis moniliformis (9.5%), Calodium hepaticum (2.6%) and H. nana (0.8%). Ascaris spp. (probably A. lumbricoides) ova, assumed to have been acquired from consuming infected human faeces were found in rat faeces (4.8%). Parasite species richness was positively associated with location, season and rodent age. Location, season, rat age and gender differentially affected prevalence and worm abundance of parasite species.Conclusions: These occurrence data of parasites of public health importance provide valuable information to local and provincial organisations and medical practitioners for diagnoses of possible zoonoses, and a reference point for further studies in metropolitan areas of Africa.
Schistosomiasis risk factors based on the infection status among school-going children in the Ndumo area, uMkhanyakude district, South Africa
Authors: Kabuyaya Muhubiri , Chimbari Moses J. , Manyangadze Tawanda , Mukaratirwa Samson
Published: September 2019

Background:Schistosomiasis remains a public health burden in South Africa, particularly in KwaZulu-Natal. The study aimed to identify the risk factors for transmission of Schistosoma haematobium among school-going children in the Ndumo area of uMkhanyakude district, KwaZulu-Natal.Methods: A cross-sectional study involving 320 school-going children, aged 10–15 years, was conducted in 10 local primary schools in the Ndumo area, from May to June 2015. Data were collected using a structured questionnaire based on sociodemographic information, sanitation and water access, recreational, occupational activities, and knowledge about bilharzia. A filtration technique was used to detect S. haematobium eggs in 10 ml of urine. A Chi square test, bivariate and logistic regressions were performed to assess the association between variables. Odds ratios were used to determine the strength between significant predictors with 95% confidence interval and p value 0.05.Results: From the 320 participants, 120 (37.5%) were positive for Schistosoma haematobium infection. The risk factors associated with schistosomiasis were age, household head, poor sanitation, access to water source and knowledge about schistosomiasis.Conclusion: The Ndumo area is considered a moderate zone for schistosomiasis endemicity according to the World Health Organisation (WHO) classification. The significant factors identified should be considered in designing an effective schistosomiasis control program.
SASCM guideline for daptomycin use in South Africa – 2017 update
Authors: Lowman Warren , Coetzee Jennifer , Perovic Olga
Published: September 2019

Daptomycin is currently registered for use in treatment of complicated skin and skin structure infections (cSSSI) and Staphylococcus aureus bacteraemia. The role of daptomycin in treatment of severe Gram-positive infections needs to be considered outside of these specific and rigid indications. Based on surveillance data, supporting literature and within the context of antimicrobial stewardship, the South African Society for Clinical Microbiology (SASCM) provides recommendations for appropriate use of daptomycin. These recommendations were formulated by members of the National Antimicrobial Committee (NAC), a sub-committee of SASCM, following consultation and review of the relevant literature.
Recommendations for the use of meningococcal vaccines in South Africa
Authors: Meiring Susan , Hussey Gregory , Jeena Prakash , Parker Salim , Von Gottberg Anne
Published: September 2019

Background: Although meningococcal disease (MD) incidence in South Africa is low, Neisseria meningitidis (NM) causes severe disease that is often life-threatening and can cause long-term disabilities. A quadrivalent protein-conjugated meningococcal vaccine (MCV4) is available, and provides protection against 75% of disease causing serogroups in South Africa. Recommendations: We advise vaccination of persons at high risk of meningococcal disease including those with complement deficiency and asplenia; laboratory personnel from reference laboratories who work with NM; and travellers to Saudi Arabia. The need for routine vaccine against meningococcal disease in South Africa is controversial given the current burden of disease. However, due to the high morbidity/mortality of MD we recommend that clinicians consider vaccination of healthy infants and children; HIV-infected persons with a CD4 count 25%; students attending college /university /military academies; and miners.Conclusion: Protein-conjugated meningococcal vaccine is preferable to the polysaccharide vaccine given the ability of the protein-conjugated meningococcal vaccine to induce immune memory, allow for booster responses and eliminate carriage of the organism in the person vaccinated.
Effectiveness of early initiation of antiretroviral therapy in adults with HIV associated tuberculosis in Lesotho in 2012
Authors: Lenela Maletsatsi , Knight Stephen
Published: September 2019

Background:Lesotho has a huge burden of human immunodeficiency virus associated tuberculosis (HIV-TB). In this study we compared the effectiveness of early versus late commencement of antiretroviral therapy (ART) in adults living with HIV-TB in Lesotho.Methods: Three out of 17 hospitals were randomly selected and data extracted from the hospitals’ tuberculosis (TB) treatment registers for 247 adults living with HIV-TB who completed TB therapy during the first quarter of 2012.Results: Eighty (32%) commenced ART early (4 weeks), 100 (41%) were started late (≥4 weeks) and 67 (27%) received no ART. Both early and late ART initiators were more likely to have a successful TB outcome (Adjusted Odds Ratio (AOR) 10.1, 95% CI: 3.7 - 27.5 and AOR 8.4, 95% CI: 3.4 - 20.6, respectively) relative to the group who had no ART (p 0.001).Conclusions: Effective treatment exists for managing HIV-TB simultaneously. The guidelines for initiation of ART in adult HIV-TB in Lesotho have not been fully implemented, but those who commenced ART had significant clinical benefits. Health departments must address the challenges encountered in treating HIV-TB simultaneously to ensure those co-infected receive optimal care.
Horizontal transfer of OXA-23-carbapenemase-producing Acinetobacter species in intensive care units at an academic complex hospital, Durban, KwaZulu-Natal, South Africa
Authors: Swe Swe-Han Khine , Pillay Melendhran , Schnugh Desmond , Mlisana Koleka P. , Baba Kamaldeen , Pillay Manormoney
Published: September 2019

Introduction: Carbapenemase production is an important mechanism of carbapenem resistance in Acinetobacter species. This study investigated the presence of the carbapenem-hydrolysing class D β–lactamase- encoding genes, blaOXA-23 and blaOXA-58, and their association with the spread of multidrug-resistant (MDR) Acinetobacter species in intensive care units at an academic hospital. Method: Forty-four MDR Acinetobacter species were confirmed using VITEK®2 and Epsilometer tests. The blaOXA-23 and blaOXA-58 genes were detected by polymerase chain reaction (PCR) in twenty-four selected isolates. The blaOXA-23 amplicons were sequenced and compared to the GenBank database. Genotypic relatedness of isolates was determined by pulsed field gel electrophoresis (PFGE). Clinical and laboratory data were analysed. Results: Among the twenty-four isolates, eighteen were carbapenem resistant and six were sensitive. The blaOXA-23 gene, but not blaOXA-58, was detected in the eighteen resistant strains. The blaOXA-23 amplicons showed 100% identity with the GenBank database of blaOXA-23. The MICs of carbapenems against Acinetobacter species carrying the blaOXA-23 gene were 8 to 16 μg/ml. Genetic relatedness was evident among isolates of seven pairs from fourteen patients. Of these patients, twelve were in the same ICUs and two were adjacent to another ICU during the same hospitalisation period. Conclusion: The selected MDR Acinetobacter species carried the blaOXA-23 gene responsible for resistance to carbapenems, while molecular and clinical data analysis suggested horizontal transmission in ICUs. In addition, the PFGE typing of a diverse collection of MDR Acinetobacter species clones showed that isolates were related to no more than two patients, suggesting that no outbreak had occurred.
Plague and listeriosis: current outbreaks, and an historical South African connection
Authors: Frean John , Blumberg Lucille , McCarthy Kerrigan , Thomas Juno
Published: September 2019

No abdtract available.
Factors associated with delivering premature and/or low birth weight infants among pregnant HIV-positive women on antiretroviral treatment at Dr George Mukhari Hospital, South Africa
Authors: Gibango N. N. , Mda S. , Ntuli T. S.
Published: September 2019

Background: Prematurity and low birthweight (LBW) deliveries amongst pregnant women infected with the human immunodeficiency virus (HIV) remain a challenge worldwide. The association between prematurity, LBW and antiretroviral therapy (ART) or prophylactic antiretroviral drug (ARV) exposure in pregnancy is unclear. This study evaluates the risk of delivering a premature and/or LBW infant among HIV-positive pregnant women on ART or prophylactic ARV.Methods: A cross-sectional study was conducted (April to October 2012). HIV-positive women on prophylactic ARV (dual therapy) or lifelong ART (triple therapy or HAART) were enrolled in the study. Women who did not have a documented HIV result during pregnancy, those tested before delivery and those found to be HIV-positive were considered as not exposed to ARV drugs during pregnancy. This group received a standard dose of nevirapine during labour. The control group was made up of HIV-negative women.Results: Of the 496 mothers enrolled in the study, 59% (288/496) were HIV-positive, of whom 72% (206/288) were on ART or prophylactic ARV. The mean age was 27.6 ± 6.5 years (15 to 47 years). The mean gestational age (GA) was 35.9 ± 3.6 weeks (24– 42 weeks). Infants’ birthweights ranged from 550 to 4 900 g (2.5 ± 0.9 kg). HIV-positive mothers not on ART or ARV prophylaxis were likely to deliver an infant at GA  28 weeks (p 0.05) or birthweight  1 000 g (p 0.05) compared with their counterparts. Conclusion: HIV-positive pregnant women not on ART or ARV prophylaxis were at a risk of delivering babies at GA  28 weeks or birthweight  1 000 g. There is a need to encourage early and regular attendance for antenatal care so that HIV-positive pregnant women can be identified and have access to treatment during pregnancy.
Fluoroquinolone-resistant Salmonella typhi infection: a report of two cases in South Africa
Authors: Schellack N. , Bronkhorst E. , Maluleka C. , Hunt L. , Srinivas P. , Grootboom W. , Goff D. , Naicker P. , Modau T. , Babarinde O.
Published: September 2019

Typhoid and paratyphoid fever are acute, life-threatening febrile illnesses caused by systemic infection with the bacterium Salmonella enterica. Nineteen cases were reported in South Africa in 2016. We report on two cases of bacteraemic invasive S. typhi with fluoroquinolone resistance.
Black widow spider bite in Johannesburg
Authors: Thomas Teressa S. , Kemp Alan , Roberg Kim P.
Published: September 2019

Black widow spider bites are uncommon in South Africa, but it is important for clinicians to be aware of the clinical presentation in order to initiate appropriate treatment. This case highlights the presentation and management of a middle-aged gentleman who presented to the Chris Hani Baragwanath hospital following a spider bite. The bite was later confirmed to be that of a black widow spider. The patient presented with the typical symptoms of latrodectism – autonomic dysfunction, muscle rigidity and cramps – and was managed symptomatically with a favourable outcome.
Seroprevalence of onchocerciasis in Ogun State, Nigeria after ten years of mass drug administration with ivermectin
Authors: Surakat O. A. , Sam-Wobo S. O. , De Los Santos T. , Faulx D. , Golden A. , Ademolu K. , Yokobe L. , Adeleke M. A. , Bankole S. O. , Adekunle O. N. , Abimbola W. A. , Mafiana C. F.
Published: September 2019

Background: This serological study conducted between March and July 2015 investigated the status of onchocerciasis in Ogun State, Nigeria after a decade of mass drug administration (MDA) with ivermectin. Baseline information from the rapid epidemiological mapping of onchocerciasis (REMO) prior to MDA had indicated that Ogun State was meso-endemic to onchocerciasis. Following years of treatment with ivermectin, it has become important to investigate the current status of the disease using more sensitive diagnostic methods.Methods: The study was conducted in 32 communities in eight onchocerciasis-endemic local government areas (LGAs). Using the Ov16 rapid diagnostic test (Ov16 RDT), finger-prick whole blood was obtained from 3 895 consented participants from age five and above. Skin snips were obtained from a subset of 481 corresponding participants as the majority of community members did not consent to skin snipping.Results: Study revealed a cumulative seroprevalence of 9.3% (CI 9.29–9.31%) by RDT and 17.3% (CI 16.73–18.34%) microfilaridermia prevalence by the skin snip subset. Seroprevalence among children between the ages of five and nine was 2.9% (CI 1.74–3.53%) across all LGAs. A community microfilaria load (CMFL) between 0 and 1.21 MF/skin snip was recorded in the different communities studied. Among the studied LGAs, children in Odeda LGA recorded the highest seroprevalence by RDT (14.9%) followed by Abeokuta North (5.1%), Abeokuta South (4.8%) and Imeko-Afon (0.6%), while Ewekoro, Ifo, Obafemi-Owode and Yewa North LGAs recorded zero prevalence.Conclusion: It appears that the elimination of onchocerciasis in some LGAs is possible considering the lack of new infection among children and the hypo-endemicity among the adult population. However, the microfilaria prevalence observed among adults is of concern as it may imply that mass treatment has not been effective. Increased therapeutic coverage is advised to fully maximise the potential of ivermectin treatment to achieve the disease elimination.
The impact of cerebrospinal fluid viral analysis on empiric antibiotic use in children admitted to Tygerberg Children’s hospital with suspected meningitis
Authors: Kruger Irma , Maritz Jean , Finlayson Heather
Published: September 2019

Background: Viral meningitis is the most common form of aseptic meningitis and requires minimal investigation and treatment. Polymerase chain reaction (PCR) has become the ‘gold standard’ for identifying viruses in cerebrospinal fluid and can provide rapid results. The objective of the study was to describe the aetiology and epidemiology of viral meningitis at Tygerberg Children’s Hospital, as well as the impact of a positive cerebral spinal fluid (CSF) viral panel on the duration of empiric antibiotic treatment.Methods: This was a retrospective folder review of all children aged between 29 days and 13 years who had a CSF specimen on which a viral analysis was performed from January 1, 2010 to December 31, 2014.Results: A total of 288 specimens were identified from the laboratory database. Seventy-nine specimens were presented for data analysis. Thirty-seven specimens had a positive viral analysis. The median age was 11.3 months (IQR 3.7–49.16 months). The microscopy and chemistry results were similar for the two groups except for the CSF lymphocyte count, which was significantly higher in the group with a positive CSF viral analysis compared to those with a negative CSF viral analysis (median 52 vs. 12 × 106/l, p = 0.005). The most common identified virus was Epstein–Barr virus (EBV) (23%), followed by enterovirus (17%). Children with a positive viral analysis tended to receive antibiotics for longer than those who had negative results (p = 0.223).Conclusion: The addition of CSF viral analysis could be helpful in the management of children with meningitis, but at present appears to have little impact on the length of antibiotic use.
Usage of antibiotics in the intensive care units of an academic tertiary-level hospital
Authors: Johnston Deanne , Khan Razeeya , Miot Jacqui , Moch Shirra , Van Deventer Yolande , Richards Guy
Published: September 2019

Background: The post-antibiotic era is approaching fast as multidrug-resistant bacteria emerge and the antibiotic pipeline slows to a trickle. Antibiotic stewardship requires that antibiotics be used appropriately and as such this study reviewed the utilisation of antibiotics in five adult intensive care units (ICUs) at Charlotte Maxeke Johannesburg Academic Hospital.Methods: A retrospective, cross-sectional record review of admissions to the Coronary, Cardiothoracic, Multidisciplinary, Neurology and Trauma ICUs was conducted over one month. Information from the ICU chart was captured on a modified version of the South African Antibiotic Stewardship Programme, Antibiotic Prescription Chart.Results: A total of 204 files were reviewed with 55.2% of patients receiving antibiotics during admission. The three most frequently prescribed were amoxicillin clavulanate (n = 46), piperacillin/tazobactam (n = 32) and cefazolin (n = 28), while colistin was used on one occasion. The majority of antibiotics (84.9%) were given for five days or less. Of concern however, of 35 instances where concurrent administration of antibiotics occurred, 8 had a similar spectrum and on 7 occasions the duration of antibiotic treatment was longer than 7 days. Cultures were ordered on 228 occasions. In patients receiving antibiotics 61.6% had cultures ordered; however, only 56.3% of these were taken before or on the day that antibiotics were started.Conclusion: This study showed that generally the duration of antibiotic treatment was short, concurrent use of antibiotics was minimal and the use of a restricted formulary limited the use of specific antibiotics such as colistin. However, implementation of stewardship principles and ordering of appropriate cultures would assist in further improving appropriate use of antibiotics in the ICU setting.
Antimicrobial resistance surveillance in the South African public sector
Authors: Perovic Olga , Ismail Husna , Van Schalkwyk Erika
Published: September 2019

Electronic surveillance for antimicrobial resistance was established in 2013 for public sector laboratories and released annually. This article reports susceptibility data on ESKAPE pathogens for 2016.
Hepatitis A in Nelson Mandela Bay and Sarah Baartman districts, Eastern Cape, South Africa
Authors: Newman Howard , Tshabalala Donald , Estrada Guillermo A. Pulido , Nguetchueng Romuald Kom
Published: September 2019

Background: Hepatitis A is the most common cause of acute viral hepatitis, not only in South Africa, but in many other countries. In South Africa, there is a lack of data regarding the true incidence of hepatitis A, and even fewer data regarding hepatitis A cases requiring hospitalisation. In the Eastern Cape province of South Africa in particular, there is a paucity of published data that could be used to guide public health officials. An analysis of all the laboratory-confirmed cases in the area over a period of time may help to better describe the extent of the problem.Methods: This was a retrospective study analysing the laboratory-confirmed cases of hepatitis A in the Nelson Mandela Bay and Sarah Baartman districts of the Eastern Cape province in South Africa for the three-year period from 2015 to 2017.Results: A total of 194 laboratory-confirmed cases of hepatitis A were identified for the three-year period from 2015 to 2017. Of these, 138 (71%) cases were children 16 years old or younger, with adults accounting for 56 cases (29%). There was no overall seasonality associated with laboratory-confirmed cases of hepatitis A.Conclusions: Hepatitis A is a serious problem in the Eastern Cape region. More studies are needed to determine the exact cause of the continuing epidemic.
The Safety of Using Active Triage to Provide Advice Rather than a Face-To-Face Neurology Outpatient Appointment
Authors: Bennett Karina , de Boisanger Louis , Moreton Fiona , Davenport Richard , Stone Jon
Published: September 2019

Background

Neurology referrals from primary care are increasing. Actively triaging referrals is one way of providing a better patient-focussed service.

Methods

We reviewed the safety and cost-effectiveness of ‘advice only’ rather than face-to-face appointments for neurology patients via active triage. Referrals triaged as ‘advice only’ were identified over a 6-month period. Data were collected on reason for referral, opinion of triaging neurologist and whether the patient re-presented to neurology within 12 months.

Results

A total of 10% (236 out of 2,445) of referred patients were given advice only after active triage. A total of 71% (n = 167) had no further secondary care presentations in 12 months. The most common presentation was headache (n = 57; 13%). One patient had a major diagnostic change following delayed review.

Conclusions

Advice only’ allows patients to receive timely advice and management. It appears safe and is likely to be cost effective, although further data are required on whether it provides satisfactory outcomes for patients and general practitioners.
Radiographic Analysis of Resistant and Neglected Clubfoot treated by Fixator
Authors: Kumar Mithilesh , Khanna Manish
Published: September 2019

Sixteen resistant and neglected clubfoot deformities in patients of age group from 8 months to 11 years were treated with external fixator during December 2012 to November 2013. The radiological evaluation of feet was done to know the alignment of bones to decide the extent of correction required. Results were graded as good.

How to cite this article

Khanna M, Kumar M. Radiographic Analysis of Resistant and Neglected Clubfoot treated by Fixator. J Foot Ankle Surg (Asia-Pacific) 2015;2(2):71-73.
Ankle Reconstruction in Charcot's Neuroarthropathy: Challenges and Solutions
Authors: Panchbhavi Vinod K
Published: September 2019

Ankle injuries in the presence of neuropathy have potential to cause deformity in the ankle, which can in turn cause ulcerations and infections leading to significant morbidity including loss of limb or even life. These injuries although devastating can start off innocuously and may not be immediately apparent to the patient because of lack of pain. This can lead to a late presentation. Often, the main concern is swelling, for which the patient seeks attention. And even when medical attention is sought, unless the physician is vigilant, the condition can potentially be missed or misdiagnosed as deep vein thrombosis or cellulitis. A sprain or even a fracture in the ankle is not suspected as the patient retains the ability to walk. This condition and its true nature further escapes detection if, as often is the case, a nonweight-bearing radiograph is obtained. Radiographs obtained without the weight-bearing or other stress modality may not reveal the instability at the ankle joint due to ligament damage. A thorough clinical evaluation including assessment for neuropathy and weight-bearing radiographs are necessary for diagnosis. Stable fractures and ankle sprains can be managed conservatively in a cast or boot. Unstable ankle following ligamentous disruption and/or fractures in the vicinity of the ankle needs internal or external stabilization. The stabilization in the presence of neuropathy should be stronger and the protection from weight bearing last longer and twice that used for patients with similar condition but without neuropathy.

How to cite this article

Panchbhavi VK. Ankle Reconstruction in Charcot's Neuroarthropathy: Challenges and Solutions. J Foot Ankle Surg (Asia-Pacific) 2016;3(2):65-70.
Transposition of Tibialis Anterior to the Cuboid after Tarsometatarsal Amputation
Authors: Bal Arun , Moonot Pradeep , Qureshi Ammar
Published: September 2019

Forefoot and midfoot amputees are prone to develop nonhealing ulcers at the closure site. This mainly occurs due to the limited dorsiflexion ability of the ankle and associated loss of protective function as seen in diabetics. One of the proposed methods to prevent these postamputation ulcers includes tendoachilles lengthening during the procedure. We describe three cases with nonhealing ulcers on the lateral aspect after a midfoot amputation. All of the cases underwent a tibialis anterior transposition to the lateral aspect of the foot to correct the deformity and at the same time also achieved healing of the ulcers.

How to cite this article

Moonot P, Bal A, Qureshi A. Transposition of Tibialis Anterior to the Cuboid after Tarsometatarsal Amputation. J Foot Ankle Surg (Asia-Pacific) 2016;3(2): 107-110.
Ultrasonography-guided Platelet-rich Plasma Injection in Chronic Plantar Fasciitis
Authors: Gaur Tribhuwan NS , Rao Harish , Rai Garjesh S
Published: September 2019

Introduction

Heel pain is a very common problem. The most common cause of heel pain is plantar fasciitis, and this often refractory to conservative treatment leads to disability. Platelet-rich plasma (PRP) derived from autologous blood containing high concentration of growth factors helps in tissue healing, so it is postulated to promote native tissue regeneration. The purpose of this work was to study the effectiveness of PRP in the treatment of chronic plantar fasciitis.

Materials and methods

The study was conducted in Orthopedic Department in collaboration with Radiodiagnosis Department at People's College of Medical Sciences and Research Centre, Bhopal, Madhya Pradesh, India. In this study, there were 44 patients, with 48 feet affected by plantar fasciitis.

Results

All patients were evaluated preinjection and postinjection by visual analog score. There was significant improvement after injection and no adverse reaction was seen.

Conclusion

Platelet-rich plasma is considered as a safe therapeutic option. It also effectively decreases heel pain in chronic plantar fasciitis.

How to cite this article

Gaur TNS, Rao H, Rai GS. Ultrasonography-guided Platelet-rich Plasma Injection in Chronic Plantar Fasciitis. J Foot Ankle Surg (Asia-Pacific) 2017;4(1):1-4.
Surgical Management of Haglund's Syndrome in Nonathletes: A Retrospective Review
Authors: Agarwala Sanjay , Agrawal Pranshu , Sobti Anshul S
Published: September 2019

Aim

The present study was carried to retrospectively analyze the outcomes of patients with Haglund's syndrome treated with author's preferred technique and to compare and validate its results by comparing with the available literature.

Materials and methods

Twenty-four patients who had undergone surgery for Haglund's syndrome between 2008 and 2014 were identified retrospectively from records and included in the study cohort. Visual analog scale (VAS) score and American Orthopedic Foot and Ankle Score (AOFAS) were computed preoperatively and at each follow-up, the records of which were available through patient notes. The mean follow-up period was 32 months (12—55 months).

Results

The VAS score improved from a mean of 6.9 to 0.5 at 6 weeks follow-up and to 0.12 at 12 weeks follow-up. The mean AOFAS increased from 55.54 ± 7.26 to 91.20 ± 6.84 at 12 weeks follow-up. None of the patients had any significant complications. At 1 year follow-up, all the patients had returned to their predisease activity level.

Conclusion

Open surgical management with an individualized approach provides good to excellent outcomes with minimal complication rates.

How to cite this article

Agarwala S, Agrawal P, Sobti AS. Surgical Management of Haglund's Syndrome in Nonathletes: A Retrospective Review. J Foot Ankle Surg (Asia-Pacific) 2017;4(1):19-22.
The Lauge-Hansen Classification for Ankle Fractures: Is it Relevant in 2017?
Authors: Sharma Siddhartha , Mehta Nikhil , Dhillon, Mandeep S , Kumar, Lokesh
Published: September 2019

Despite being one of the commonest fractures, classifications of ankle injuries are still debated, with modern surgeons decrying the use of the so-called antiquated system based on injury mechanisms. Despite glaring lacunae, especially with lack of reproducibility using modern methods, and an understanding that many fractures which we now see routinely may not fit into this classification, the Lauge-Hansen classification is still worth preserving. It clarifies some, if not most deforming forces, allows us to understand the ankle injury in a three-dimensional concept, both on the medial and lateral sides, and allows an understanding of reduction methods. The limitations in its use are the lack of prognostication ability, the fact that most reductions are now done open, and the recognition of some transitional and posterior malleolar injuries unclassifiable by it. Not being alphanumeric is another disadvantage in the computer age. Nevertheless, it is an important landmark in the history of orthopedics, and in the development of our understanding of ankle fractures. Even in 2017, it is too important a piece of work to be discarded, and modern orthopedic students are encouraged to gain an understanding of this classification system, and to combine it with the newer ones to get an overall picture of the ankle injury.

How to cite this article

Dhillon MS, Kumar L, Sharma S, Mehta N. The Lauge-Hansen Classification for Ankle Fractures: Is it Relevant in 2017? J Foot Ankle Surg (Asia-Pacific) 2017;4(2):53-56.
Thalidomide in Axial Spondyloarthropathy: An Eastern Indian Experience
Authors: Paul Rudrajit , Sarkar Arijit , Bhattacharjee Urmimala , Baisya Ritasman , Biswas Pallab , Sarkar Rathindranath , Das Chandan K
Published: September 2019

Background

Axial spondyloarthropathy (SpA) is seronegative arthritis which mainly affects young adults and causes much morbidity. Tumor necrosis factor-alpha (TNF-α) is one of the main mediators of inflammation in joints and enthuses in SpA. Nonsteroidal anti-inflammatory drugs (NSAIDs), disease-modifying antirheumatic drugs (DMARDs), and biologics like TNF-α inhibitors are the mainstay of therapy in SpA. However, in India, the cost is one limiting factor in the use of biologics for the treatment of SpA in eligible patients. Thalidomide is an oral TNF-α inhibitor which has reported benefit in axial SpA, and it is a cheap option in the Indian setting. However, there is almost no Indian data on its efficacy.

Materials and methods

This is a retrospective analysis of patients receiving thalidomide for axial SpA in the rheumatology clinic of a tertiary care hospital of Kolkata. In this clinic, thalidomide was used at 100 mg/day. Patients receiving thalidomide, who had completed at least one year follow up were included in the analysis. Assessment of SpondyloArthritis International Society (ASAS)-20, ASAS-40, and ankylosing spondylitis disease activity score with C-reactive protein (ASDAS-CRP) were measured three monthly during the follow-up. Side effect profile of thalidomide was also recorded.

Results

The completed data of 66 patients were analyzed. All patients were human leukocyte antigen (HLA) B27 positive. Ninety-five point percent fulfilled ASAS-20 criteria at 12 months and 71.2% fulfilled the ASAS-40 criteria at 12 months. Three patients were nonresponders. The average ASDAS-CRP score also decreased from 2.9 to 1.5 over one year.

Conclusion

In our study, oral thalidomide resulted in significant improvements in axial SpA. Further randomized controlled trials are needed to find the relative efficacy of thalidomide with respect to other forms of treatment.
Qualitative Research: Data Analysis
Authors: Paul Uttam , Arup Bandyopadhyay
Published: September 2019

Qualitative research is a simple, inexpensive and effective tool in medical research. The data analysis in qualitative researches, though based on certain ground rules, do not follow a rigid process like the data analysis of quantitative researches. It is ongoing through and through method. One interesting feature of data collection and analysis in qualitative research is “constant comparison”. This is a highly unique method in this type of research as compared to the quantitative research. Qualitative researches usually involve inductive reasoning, but there is deductive reasoning also. The first step of analyzing qualitative data is to transcribe all data into English from vernacular language. This transcript is then subjected to selection of “codes” which are nothing but descriptive names applied to certain thoughts coming up repeatedly in a transcript. Several codes together make a broader “category”. Themes are emerged from categories which are broad categories of information. The process of transcript analysis is called “content analysis” and this is at the end converted into “thematic analysis” which gives the meaning of the whole research and the answers to the original research question(s). There is ‘consolidated criteria’ for reporting qualitative research (COREQ) which is a 32 item check list for interviews and focus group discussions.
Heart Transplant: A Brief History
Authors: Paul Rudrajit
Published: September 2019

Cardiac transplant is a life-saving procedure and with the advancement in technology, it is rapidly becoming available for patients in all corners of the world. As the heart transplant program is extended to Eastern India, this is an opportune moment to look back on the history of this medical miracle and how we reached the current level of excellence. this article is a brief recount of that illustrious history.