HITES: infection control’s weak link

High-touch environmental surfaces (HITES) are increasingly being recognised as vehicles for healthcare-associated infections. Consequently, there is a corresponding upsurge of interest in technologies for decontaminating HITES.

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CPD POINTS: 0

Using dressings to manage pain in diabetic foot ulcers

Proper management of diabetic foot ulcers is an essential but often overlooked component of diabetic wound care. Wound dressing technology is constantly advancing and there is no reason why diabetics should suffer complications resulting from ulceration or even amputation as a result of their condition.

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CPD POINTS: 1

Specialist Forum July CPD

Are methods based solely on cytology the most efficient strategy for cervical cancer screening? HPV testing with separate HPV16 and HPV18 detection provides a good alternative, but how effective is it really?

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CPD POINTS: 3

Cervical cancer: HPV and screening

MEDICAL CHRONICLE JULY 2018: CPD 5 of 5

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CPD POINTS: 0

Supplementing diabetic patients

MEDICAL CHRONICLE JULY 2018: CPD 4 of 5

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CPD POINTS: 0

What is new about SGLT-2 inhibitors?

MEDICAL CHRONICLE JULY 2018: CPD 3 of 5

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CPD POINTS: 0

Pathogenesis and origin of acne

MEDICAL CHRONICLE JULY 2018: CPD 2 of 4

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CPD POINTS: 0

Allergic rhinitis: what you need to know

MEDICAL CHRONICLE JULY 2018: CPD 1 of 4

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CPD POINTS: 0

Medical Chronicle July CPDs

These are the Medical Chronicle’s July CPDs. Click on the questionnaire below to start the CPD quiz.

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CPD POINTS: 3

Hepatitis C permanently damages NK cell diversity

The diversity of natural killer (NK) cells is irreversibly affected by exposure to hepatitis C, Swedish researchers claim.

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CPD POINTS: 0

Mind over sphincter: brain-training GORD away

PPIs are not the only way to address reflux, as multiple studies into the gastrointestinal effects of relaxation training and CBT prove.

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CPD POINTS: 0

Tapentadol knocks out pain

The word ‘pain’ is derived from the Latin word ‘Poena’, roughly translated as ‘punishment from God’.

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CPD POINTS: 0

Sprains and strains: An overview

Musculoskeletal injuries are synonymous with symptoms of pain.

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CPD POINTS: 0

Catching the red eye

Conjunctivitis in children is predominantly bacterial.

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CPD POINTS: 0

Does GDPR apply to your patients?

General Data Protection Regulation is an international regulation.

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CPD POINTS: 0

Cough treatment

The central organisation of cough reflex loop is poorly understood.

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CPD POINTS: 0

What is the link between ADHD and emotional dysregulation?

A population study found mood lability in 38% of children with ADHD.

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CPD POINTS: 0

Medical Chronicle June CPDs

Click on the links below to read each of the articles online.

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CPD POINTS: 3

Protein requirements & oral nutritional supplementation

The effect of disease related malnutrition can be detrimental on physical & clinical health.

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CPD POINTS: 0

Probiotics impact on infantile FGIDs

Many studies target probiotic therapy for conditions like colic & constipation.

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CPD POINTS: 0

Nutrition in pregnancy

A healthy, balanced diet is strongly recommended before, during, and after pregnancy.

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CPD POINTS: 0

More to a healthy lifestyle than just healthy eating

WHO estimate NCDs linked to lifestyle choices kill about 16 million people prematurely worldwide annually.

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CPD POINTS: 0

Herbs: Nature’s medicine

Herbalism is probably the oldest, most tried and tested form of medicine in the world.

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CPD POINTS: 0

Gastroenteritis 101

Gastroenteritis is marked by inflammation of the gastrointestinal tract involving the stomach & small

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CPD POINTS: 0

Active ageing

Ageing is the accumulation of physical, psychological and social changes in a human being over time.

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CPD POINTS: 0

A metronomic approach to NSCLC

About 14% of all new cancers are lung cancers. Metronomic chemotherapy offers hope for elderly patients with lung cancer.

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CPD POINTS: 3

Metabolic surgery can have many health benefits

Many South Africans have the misconception that metabolic surgery is done purely to achieve weight loss for cosmetic reasons.

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CPD POINTS: 0

The 3 stages of HIV

Without treatment, people with AIDS typically survive about 3 years.

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CPD POINTS: 0

iNova launches Pholtex Plus

An effective double action formulation to relieve both dry cough and nasal symptoms1,2

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CPD POINTS: 0

Nutrition for optimal digestive health

Digestive health changes depending how healthy overall habits are, your age, and your genetic make-up.

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CPD POINTS: 0

How to identify patients at imminent fracture risk

Recent fragility fracture is a powerful predictor of imminent risk of fracture.

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CPD POINTS: 0

How well do you know your eyes?

A good understanding of the six most commonly diagnosed eye conditions will ensure you’re better able to assist patients.

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CPD POINTS: 0

Odyssey Outcome trial: cure for atherosclerosis?

The Odyssey Outcomes trial looked at reduction of LDL-cholesterol with a PCSK9-inhibitor.

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CPD POINTS: 0

When food is an addiction

Food addiction not only contributes to the rapidly growing obesity epidemic but further also has significant psychosocial impact on individuals.

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CPD POINTS: 3

Why elderly people fall and how to prevent it

At the recent National Osteoporosis Foundation of South Africa (NOFSA) Congress, held from 16 – 18 March in Cape Town, Prof Brent Tipping of the University of the Witwatersrand and Dr Zane Stevens of Stellenbosch University shared their valuable real-world experiences.

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CPD POINTS: 2

Bridging the ‘silver tsunami’ gap

Only 20% of patients who present with an index fracture receive basic therapy or are offered screening for future fracture risk.

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CPD POINTS: 2

New insulin reduces nocturnal hypoglycaemia

Sanofi is the first company in South African medical history to introduce a newly launched product available at the cost of a clone.

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CPD POINTS: 3

Building a palliative care curriculum for oncologists

Palliative care improves patients facing life threatening illness quality of life through the prevention and the relief of suffering by means of biopsychosocial and spiritual care.

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CPD POINTS: 3

Foam dressings a MUST in the wound care toolkit

Globally millions of people develop pressure injuries. Foam dressings have been shown to reduce the risk of pressure injuries.

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CPD POINTS: 3

How to limit antibiotic use in acute sore throat

In January 2018, NICE released a guideline for antimicrobial prescribing in acute sore throat.

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CPD POINTS: 3

Superficial basal cell carcinoma: A focus on Imiquimod

Basal-cell carcinomas constitute approximately 80% of all nonmelanoma skin cancers.

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CPD POINTS: 3

BP control with current therapy

Initial combination treatment strategy may improve long-term BP control in a shorter time.

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CPD POINTS: 0

TB in SA: Are you protected?

Despite international attention to the importance of strengthening the global healthcare workforce, TB transmission in healthcare settings remains a serious concern.

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CPD POINTS: 3

The obese patient: health risks and medical options

Obesity is a global health problem. The obesity epidemic has been growing in developed nations, and has spread to developing nations.

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CPD POINTS: 3

A practical approach to oral and dermatological toxicities caused by anticancer therapies

Advances in the treatment of potentially life-threatening diseases such as cancer, are often accompanied by side effects, which can severely affect patients’ quality of life (QOL). As a result, some patients discontinue treatment.

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CPD POINTS: 3

Trazodone: a multifunctional drug

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V) defines depression as a heterogeneous disorder characterised by sadness, loss of interest or irritability. Depression ranges from mild to severe. Major depressive disorder (MDD) is the more severe form.

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CPD POINTS: 3

Treating depression: the drugs that work

A team of researchers, who collected data of 116 477 men and women, found that every type of antidepressant they studied was more effective at lessening symptoms of depression over time than placebo. They considered a drug ‘effective’ if it reduced depression symptoms by 50% or more.

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CPD POINTS: 0

How to manage an HIV-positive patient

In SA, many citizens are affected by HIV/Acquired Immunodeficiency Syndrome and access to treatment, fairness in the workplace and the right to privacy are issues which have been debated for many years.

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CPD POINTS: 3

Why bacterial vaginosis is all about balance

Bacterial vaginosis, an imbalance in vaginal flora characterised by low levels of lactobacilli and an increased frequency of facultatively anaerobic bacteria, is one of the most common reproductive tract infections in women globally.

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CPD POINTS: 3

Don’t leave actinic keratosis alone

Patients can reduce the risk of actinic keratoses by protecting their skin from the harmful effects of UV rays either from the sun or other sources like tanning beds.

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CPD POINTS: 3

Discovery welcomes sugar tax

n response to the proposed sugar tax, Dr Craig Nossel, Head of Vitality Wellness said: “We believe that action is required to reduce the intake of sugary drinks, and support the proposed sugar tax.

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CPD POINTS: 0

Exploring anaemia

Iron deficiency is the most common cause of anaemia.

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CPD POINTS: 0

Vitamin D deficiency “epidemic” can be reversed

Ascencao was responding to a recent international study which found Cape Town residents, in particular, were at risk of vitamin D deficiency in winter when UVB exposure from sunlight was extremely low, making it harder to fight disease and infection. The study said vitamin D supplementation may reverse deficiency and even slow down HIV infection.

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CPD POINTS: 0

Osteoporosis isn’t inevitable

Bone resorption is primarily due to an activation of osteoclastogenesis and an increase in receptor activator of nuclear factor kappa-B ligand (RANKL) expression, a cytokine involved in the final pathway of the osteoclast cycle.

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CPD POINTS: 0

STUDY: Probiotics and diarrhoea caused by antibiotics

A Rand Corporation study found that taking probiotics can reduce the risk of developing the diarrhoea that is a common side effect of taking antibiotics.

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CPD POINTS: 0

Iron deficiency 101

Broccoli is an excellent source of iron.

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CPD POINTS: 0

Magnesium’s role in bone health

Postmenopausal osteoporosis is closely associated with genetic factors and lifestyle. Minerals in the diet influence both the development and treatment of osteoporosis.

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CPD POINTS: 0

The benefits of bromelain

Enzyme Technologies is a South African-based biotechnology company that manufactures bromelain from waste pineapple stems.

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CPD POINTS: 0

A brave new world of genetic diagnosis and medicine

Just over sixty years ago James Watson, Francis Crick and Rosalind Franklin unravelled the mysteries of our genetic code through the discovery of DNA.

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CPD POINTS: 3

Spider bites in SA: Identification and treatment

Diagnosing spider bites can be very difficult, especially when you do not know what caused the bite. It could be a mosquito bite, flea bite, or even poison ivy.

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CPD POINTS: 0

PCOS: Perspectives from a South African infertility practice

A Polycystic ovary syndrome (PCOS) label might not be needed to effectively treat many symptoms of PCOS, as the label may not change the type or intensity of the intervention.

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CPD POINTS: 0

That sugar high

In January 2018 the American Diabetes Association (ADA) updated their Standards of Medical Care for the treatment of type 1 diabetes and diabetes mellitus type 2 (DMT2).

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CPD POINTS: 0

How to manage Dry Eye Syndrome with Hyaluronic Acid

Dry eye occurs when the eye does not produce tears properly, or when the tears are not of the correct consistency and evaporate too quickly.

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CPD POINTS: 3

How to combat Vitamin deficiencies in oral contraceptive use

Contraception is one of the most powerful public health tools for any country. However, there is an unmet treatment need.

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CPD POINTS: 3

Surgical site infections: What you need to know

SSIs create a significant burden on patients, health systems, and service payers through hospital readmissions, longer stays, additional surgeries, and lost work productivity.

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CPD POINTS: 3

How being overweight can affect fertility

A weight loss of as little as 5%-10% can improve a woman’s chance of falling pregnant. In fact, in the world’s first comprehensive study on weight and its effect on fertility, researchers found that losing even 5% can have a significant effect on a woman’s chances of conceiving.

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CPD POINTS: 0

Weighing in on metabolic syndrome

Metabolic syndrome is the name for a group of risk factors that raises the risk for heart disease and other health problems such as diabetes and stroke.

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CPD POINTS: 0

Bacterial Vaginosis – why this common condition needs to be treated correctly

Bacterial Vaginosis, defined as an imbalance in vaginal flora characterised by low levels of lactobacilli and an increased frequency of facultatively anaerobic bacteria, is one of the most common reproductive tract infections in women globally.

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CPD POINTS: 0

Enter Entresto: A new era in the treatment of heart failure

Globally the prevalence of heart failure is about one in 25 of the general population with increasing prevalence with increasing age.

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CPD POINTS: 3

Combat winter ailments naturally with buchu

The common cold, including chest and head cold, as well as seasonal flu are caused by viruses. While flu symptoms are similar to that of cold symptoms, they include fever, headache, and muscle soreness.

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CPD POINTS: 0

What’s causing your cough?

Coughs can make breathing difficult and irritating. Being aware of the cause of your cough will help you treat it quickly and effectively, and help restore health. The first step? Knowing whether the culprit’s a bacteria or a virus.

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CPD POINTS: 0

The plague that is cold sores

Affecting such a large segment of the population, cold sores is one of the most common complaints you’ll face from frustrated customers over the winter season.

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CPD POINTS: 0

Coughs give vital clues to pneumonia

Annually, pneumonia kills over 1.8 million children throughout the world.

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CPD POINTS: 0

Mouth ulcers 101

Mouth ulcers can occur in any age group or population.

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CPD POINTS: 0

New product launch: Dynaval

Pharma Dynamics announces the addition of Dynaval (valsartan) to its range of cardiovascular medicines.

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CPD POINTS: 0

The answer to periconceptional folate intake?

Large global and European surveys show that there are challenges in ensuring sufficient periconceptional folate levels in women, being timely counselling, unplanned pregnancies, and compliance.

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CPD POINTS: 0

SAD: Facing the winter blues

We’ve all had a day or so when we’ve felt down, despondent and blue. But how can you tell when it’s more than just a bad day and is in fact SAD?

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CPD POINTS: 0

Winter ailments

As the cold fingers of Autumn tighten their grip into Winter, it’s time again to face the spectre of winter ailments: colds, coughs, sore throats and influenza.

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CPD POINTS: 0

Human rhinovirus infection

Costing billions annually in medical visits and missed days of work, the human rhinoviruses (HRVs) occur worldwide and are responsible for more than half of cold-like illnesses.

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CPD POINTS: 0

General management of colds and flu in children

The common cold is an acute, self-limiting viral infection of the upper respiratory tract. Pre-school children are at greatest risk of developing frequent colds and tend to experience more prolonged symptoms than adults.

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CPD POINTS: 0

Don’t let your wheeze turn into a sneeze

Every time we think that spring’s about to arrive we seem to have another cold snap and out come all the jackets again. Unfortunately it seems the flu is equally determined to plague us for as long as possible this year.

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CPD POINTS: 0

Don’t let hand rashes ruin winter

Hand rashes can be frustrating, especially when the cause of the rash is unknown. Was it a new brand of hand soap? Eczema?  Or just really dry skin?

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CPD POINTS: 0

Diabetics at greater risk of contracting flu

Research shows that people living with diabetes are at greater risk of contracting flu than non-diabetics.

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CPD POINTS: 0

Baby killer, ‘old man’s friend’

Pneumonia is still one of the few infectious diseases to rank consistently among the top five causes of death in both developed and underdeveloped communities.

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CPD POINTS: 0

What to do about flu?

Although generally harmless, complications can arise from influenza, especially in the very young, elderly or immune-compromised. 

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CPD POINTS: 0

Summer cold strikes back

Summer colds tend to be more intense than their winter counterparts. The symptoms can also last for several days at a time, mimicking hay fever.

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CPD POINTS: 0

General management of colds and flu in children

The common cold is an acute, self-limiting viral infection of the upper respiratory tract. Pre-school children are at greatest risk of developing frequent colds and tend to experience more prolonged symptoms than adults.

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CPD POINTS: 0

Hospital in the cloud

Modern ‘Hospital-as-a-Service’ Cloud solutions present significant advantages over outdated systems.

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CPD POINTS:

Cold & flu questions answered

There are many myths surrounding colds and flu.

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CPD POINTS: 0

Cold, flu or allergy?

Know the difference for best treatment

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CPD POINTS: 0

Cold when it’s hot

Colds can go on to involve the sinuses, ears, larynx, trachea and bronchi directly or through secondary effects.They are viral infections of the nose and throat.

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CPD POINTS:

Cold vs flu

Antibiotics will not improve cold symptoms and will not prevent a bacterial infection from developing after a cold.

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CPD POINTS: 0

Antibiotic use in treating URTIs

Influenza is an acute upper respiratory tract infection caused by influenza virus A or B. It affects patients of all ages, but the highest incidence is in children.

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CPD POINTS: 0

Knowledge leads to better outcomes

During the last 10 years there has been a dramatic increase in the number and types of burn wound dressings available on the market.

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CPD POINTS: 0

A brief history about efficacy of NPWT

Most guidelines recommend negative pressure wound therapy (NPWT) for acute and chronic wounds.

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CPD POINTS: 0

Burns Awareness Month

Approximately 300 000 people annually die worldwide as a result of burn injuries, according to the World Health Organization (WHO).

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CPD POINTS: 0

Wound assessment crucial to effective treatment

Proper wound assessment can significantly influence patient outcome. Remember that accurate descriptions are essential for guiding ongoing wound care.

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CPD POINTS: 0

The superficial partial thickness burn and Sorbact

Thermal damage to the skin that just breaches the dermis but leaves many islands of basal epithelial cells intact is named a partial thickness burn. Due to the multitude of these islands, re-epithelialisation occurs within 7-14 days and the largely intact dermis means the scar is of good quality. This is the natural history of a truly superficial partial thickness burn.

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CPD POINTS: 0

First aid for minor burns

Burns are a global public health problem, accounting for an estimated 265 000 deaths annually. A burn is an injury to the skin or other organic tissue primarily caused by heat or due to radiation, radioactivity, electricity, friction, or contact with chemicals.

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CPD POINTS: 0

Burns: basic first aid

Burns destroy skin, which controls the amount of heat our bodies retain or release, holds in fluids and protects us from infection. While minor burns on fingers and hands are usually not dangerous, burns injuring even relatively small areas of skin can cause serious complications.

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CPD POINTS: 0

Fast burn treatment decreases mortality

Data shows that on average, nine children die every day from of burn injuries. Research shows that men, children and old people are more at risk of sustaining burn injuries.

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CPD POINTS: 0

Burns: The long term

Hypertrophic scars are variations of typical wound healing when there is an imbalance between the anabolic and catabolic phases and more collagen is produced than is degraded. This is a difficult problem for burn patients.

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CPD POINTS: 0

Burns: The first 24 hours

Burns remain undertreated

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CPD POINTS: 0

Burns: The first 24 hours

It is imperative to understand the depth of the burn wound. A partial thickness wound will heal spontaneously. The most appropriate dressing choice is one that can be applied as a single application and is only removed once epithelialisation is complete.

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CPD POINTS: 0

Think Again

A study by Emma Gee Kee et al, Randomised controlled trial of three burns dressings for partial thickness burns in children published in Burns (2015), compared the effects of three silver dressing combinations on small to medium size acute partial thickness burns in children, focusing on reepithelialisation time, pain and distress during dressing changes.

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CPD POINTS: 3

Pharmacological treatment of osteoporosis

The National Osteoporosis Guideline Group (NOGG) in the UK has updated the clinical guidelines for the prevention and treatment of osteoporosis in 2017.

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CPD POINTS: 3

MM in SA: New treatment guidelines

Although the SA guidelines for malignant melanoma (MM) was last updated in 2004, this is by no means due to the fact that nothing new has happened and we all treat melanomas the same way we used to more than a decade ago.

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CPD POINTS: 3

PPIs and vitamin, mineral deficiencies

The prevalence of gastro-oesophageal reflux symptoms (GORS) is on the rise. Ness-Jensen et al (2011) showed an increase in the prevalence of GORS measured over a decade. Any GORD symptoms increased by 30%, severe GORD symptoms increased by 24% and weekly GORD symptoms increased by 47%.

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CPD POINTS: 3

AOMT and its treatment

Acute otitis media (AOM) is a common childhood illness – 75% of children have at least one episode by 3 years of age. However, AOM is often misdiagnosed.

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CPD POINTS: 3

SA’s first Methylphenidate ER generic

Mylan South Africa has launched Contramyl XR, SA’s first Methylphenidate ER generic

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CPD POINTS: 0

The fight against HIV

The Southern African HIV Clinicians Society (SAHCS) recently published their new antiretroviral therapy (ART) guidelines for adults with HIV/AIDS.

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CPD POINTS: 3

Real world outcomes: treat and extend studies

Two recent studies reported on the outcomes of a treat and extend (TREX) therapy, using aflibercept in eyes with neovascular age-related macular degeneration.

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CPD POINTS: 3

Clinical relevance of small airway disease

The bronchial tree continuously divides down to the 23rd generation (division). One consequence of this division is that the mucosal surface area of the airways is relative larger in the distal lung than in the proximal lung. This may be important when dealing with an airway disease.

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CPD POINTS: 3

MSD announces local regulatory approval of new oncology drug

In recognising the impact that Pembrolizumab would have in oncology treatment, MSD received regulatory approval by the Medicines Control Council (now South African Health Products Regulatory Authority) in South Africa.

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CPD POINTS: 0

Why do antibiotics fail in Strep A infections?

The failure of penicillin to eradicate Streptococci from the throat occurs in up to 35% of patients with pharyngo-tonsillitis.

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CPD POINTS: 0

Pharyngitis vs laryngitis

GPs are often faced with patients experiencing sore throats, especially during the winter months. Many of these can be handled with over-the-counter medications, while others will require prescription medication.

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CPD POINTS: 0

Sore throats: Are antibiotics always the answer?

The sore throat is one of the most common conditions that GPs encounter and overtreatment is widespread.

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CPD POINTS: 0

A first for southern Africa: HSRC MSM study

HIV risk and transmission among male-male partnerships continues to be inadequately studied in many countries and under-represented in national HIV surveillance systems and in targeted prevention programmes.

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CPD POINTS: 0

Personalise diet, fertility and medication with genetic testing

Understanding your DNA means better healthcare, minimising risk and knowing what the future holds.

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CPD POINTS: 0

Same same, but different

Genetic profiling approach will enable medical professionals to quickly find the best combination of ARVs for the patient and avoid costly trial and error. It will reduce the risk of unnecessary adverse drug reactions as result of incompatibility with the patient’s genetic profile.

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CPD POINTS: 0

Genetics… the future of healthcare and medicine

Essentially, genetic testing and screening is used as a tool to detect the gene variants associated with a specific disease or health condition.

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CPD POINTS: 0

Polygenic risk scores can identify patients who will benefit most from statin therapy

Atherosclerotic coronary artery disease is responsible for millions of deaths worldwide on a yearly basis. Statin therapy reduces the risk of a first myocardial infarction.

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CPD POINTS: 0

Vitamin B12 Deficiency Indicators

Vitamin B deficiency is common, affecting up to 10 % of adults.  As the symptoms can be variable, subtle and non-specific, the deficiency often goes unrecognised and if left untreated can have serious consequences.

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CPD POINTS: 3

Safety, efficacy of Biosimilar human insulins

Diabetes mellitus (diabetes) affects people worldwide and poses major public health and socio-economic challenges. The disorder was previously thought to be rare or undocumented in rural Africa, but over the past few decades it has emerged as an important non-communicable disease (NCD) in sub-Saharan Africa (SSA).

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CPD POINTS: 3

Take it till you make it

Research indicated that adherence to medication in patients with rheumatoid arthritis is low, varying from 30 to 80%.

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CPD POINTS: 3

Not so hot

An overview of the pharmacological treatment options for gastro-oesophageal reflux (GORD) has recently been published in the South African Family Practice Journal.

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CPD POINTS: 3

The Role of Vit D and Zinc in BP control

Hypertension was the number 1 risk for death in 2010, estimated to cause 500 000 deaths and 10 million years of life lost. There was a 67% increase in hypertension between 1990 and 2010.

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CPD POINTS: 3

Getting a grip on Gastroenteritis

Gastroenteritis is caused by common viruses and can be treated effectively with over-the-counter medication.

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CPD POINTS: 3

Achieving glycaemic control

Diabetes is South Africa’s second biggest killer but there is a critical lack of consensus among experts and policymakers about how this growing epidemic should be tackled.

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CPD POINTS: 3

Postoperative pain: a psychological assessement

An effective postoperative management is not a standardised regime and is rather tailored to the needs of the individual patient

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CPD POINTS: 3

The treatment of asthma

Asthma prevalence is increasing worldwide and surveys indicate that the majority of patients in developed and developing countries do not receive optimal care.

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CPD POINTS: 3

Management of conjunctivitis

Loteprednol etabonate can be considered for the long-term treatment of seasonal and perennial allergic conjunctivitis.

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CPD POINTS: 3

A new era in the management of type 2 Diabetes

Various studies have thrust the sodium glucose cotransporter 2 (SGLT2) inhibitors (‘gliflozin’) into the forefront of T2DM guidelines.

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CPD POINTS: 3

Hyluronans and Molecilar weight

Investigators in several preclinical studies evaluating joint-structure modification in osteoarthritis models have reported advantages to using low- to mid-MW hyaluronans.

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CPD POINTS: 3

Review of once-monthly oral ibandronate

Ibandronate 150mg oral once monthly is indicated for the treatment of osteoporosis in postmenopausal women, in order to reduce the risk of vertebral fractures.

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CPD POINTS: 3

Sanofi launches new once-daily oral treatment for RRMS

Multiple sclerosis (MS) affects about three in every 100 000 people in SA. The good news is that Aubagio (teriflumonide), an affordable, novel, immunomodulatory, disease-modifying oral drug with anti-inflammatory properties, is now available in the country.

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CPD POINTS: 3

Codeine Care Initiative

Roxann van Rugge, Professional Trainer and Legal Advisor to the Daly Morgan Group

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CPD POINTS: 3

PAIN: A sensory and emotional experience

Axial spondyloarthritis (axSpA) is a chronic inflammatory disease predominantly affecting the axial skeleton (sacroiliac joints and spine).

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CPD POINTS: 3

Antihistamine that tackles inflammation

Histamine is clearly not the only mediator involved in the inflammatory process. There is an emerging view that drugs that can inhibit a broader range of inflammatory agents may prove to be more effective in providing symptomatic relief in both allergic rhinitis and chronic urticaria.

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CPD POINTS: 3

Surviving the rollercoaster: adult ADHD

Guidelines outlining the requirements for adult attention-deficit/hyperactivity disorder that covers comprehensive diagnostic assessement and treatment, have been published for the first time in the South African Journal of Psychiatry.

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CPD POINTS: 3

OST reduces risk of HIV infection

According to the World Health Organization (WHO), injecting illicit drugs is a major risk factor for the acquisition and transmission of HIV, accounting for approximately 5% to 10% of all cases of new HIV infections worldwide.

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CPD POINTS: 3

Burning Issue

For those who survive major burn injury recovery is characterised by considerable aesthetic, functional and psychosocial challenges. This paper overviews selected considerations when managing the patient with an extensive burn injury.

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CPD POINTS: 3

Vitamin B deficiencies and treatment

There are eight essential B vitamins that cannot be synthesised in the body and hence need to be ingested daily.

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CPD POINTS: 3

Sun protection

While sunlight has numerous benefits to human skin, the most important being vitamin D biosynthesis, excessive sun exposure may manifest with an array of skin conditions.  It is known to accelerate the signs of aging, cause sunburn and increase skin cancer risk.

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CPD POINTS: 3

Multiple MoA

When eyes are exposed to substances like pollen or mold spores, they may become red, itchy, and watery. These are symptoms of allergic conjunctivitis, an eye inflammation caused by an allergic reaction.

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CPD POINTS: 3

Hot and bothered

Guidelines to treating the menopausal patient.

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CPD POINTS: 3

Rare but there

Male breast cancer is an uncommon disease that has been the focus of limited research. Because this disease is rare, no randomised trials have been possible.

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CPD POINTS: 3

How effective is the LNG-IUS in relieving chronic pelvic pain caused by AM?

The definition of AM is characterised by the presence of heterotopic endometrial glands and stroma within the myometrium, >2.5mm in depth in the myometrium or more than one microscopic field at 10 times magnification from the endometrium–myometrium junction and a variable degree of adjacent myometrial hyperplasia.

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CPD POINTS: 0

Women’s hearts

Premature deaths caused by heart and blood vessel diseases (CVD) in people of working age (35-64 years) are expected to increase by 41% between 2000 and 2030.

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CPD POINTS: 0

Clinical Update: Erectile Dysfunction

While the numbers of men experiencing ED are increasing, so too is the understanding of the complex mechanisms involved in male erectile pathways and the various treatment options that are specifically targeted at these mechanisms.

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CPD POINTS: 0

Managing a monster

Diabetes is a life-long disease that affects the way the body handles glucose, a sugar in the blood. Most people with the condition have type 2. Type 2 diabetes has been increasing substantially over the last 20 years.

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CPD POINTS: 3

Risk of sudden death in heart failure

Current recommended treatment for heart failure: Angiotensin-converting enzyme inhibitor (ACE-Inhibitors) or Angiotensin-receptor blockers (ARB), beta-blockers (Carvedilol, Bisoprolol and Metoprolol) and mineralocorticoid receptor antagonists.

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CPD POINTS: 0

Issues in hypertension

Hypertension increases the risk for coronary heart disease by two-fold and the risk for heart failure and stroke by four-fold.

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CPD POINTS: 0

What is the impact on CVD outcome of non-adherence?

As measured over the last two decades, the mortality from cardiovascular disease (CVD) has declined by about 50% and at least half of this decline has been   attributed to the use of evidence-based medication.  

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CPD POINTS: 0

Heart failure with preserved ejection fraction

Heart failure with reduced ejection fraction has shown improved outcomes with evidence-based treatment but heart failure with preserved ejection fraction has not shown any improved outcomes with treatment demonstrating our lack of effective therapies for this condition.

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CPD POINTS: 0

A first for SA

Spec Etoricoxib is indicated for the acute use for short-term relief of acute gouty arthritis, acute pain, primary dysmenorrhea and moderate to severe acute post-operative dental surgery pain.

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CPD POINTS: 0

Stable angina pectoris

Ischaemic heart disease refers to a state in which there is inadequate blood supply (oxygen) to a portion of the myocardium due to an imbalance of myocardial oxygen supply and myocardial oxygen demand.

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CPD POINTS: 0

RTIs linked to asthma

An international study of 154 492 European children found that those who had had upper respiratory infections, such as colds, sinusitis, laryngitis, tonsillitis, pharyngitis and otitis, by the age of five years had a 1.5-fold increased risk of developing asthma in later life.

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CPD POINTS: 0

Advances in IBS

IBS also represents a major burden in terms of patient quality of life, work productivity, and healthcare costs.

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CPD POINTS: 0

Weight gain studied for second-generation antipsychotics

The Cincinnati Children’s Hospital Medical Center study found that patients treated with Zyprexa (olanzapine) have the highest risk of weight gain, while Geodon (ziprasidone) and Seroquel (quetiapine) were not associated with an increase in body mass index.

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CPD POINTS: 0

Cough treatment

These receptors generate information that reaches the central nervous system.

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CPD POINTS: 0

Antibiotics or watchful waiting?

More than 20% of antibiotics prescribed in adults are for sinusitis or rhinosinusitis, making it the fifth most common diagnosis responsible for antibiotic therapy.

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CPD POINTS: 0

Advances in the pharmacological treatment of Irritable Bowel Syndrome

Irritable bowel syndrome (IBS) is a common functional bowel problem that mostly affects younger individuals, mostly women (a 2:1 female predominance in the western world) and patients with other functional gastrointestinal problems.

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CPD POINTS: 0

Gut health

These are usually dealt with symptomatically with drugs that can reduce the discomfort for the patient despite the fact that this approach does not deal with the underlying problem.

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CPD POINTS: 0

Avoiding litigation: It’s not child’s play

There has been a dramatic increase in medical litigation in recent years. Those practicing in specialties considered high risk such as obstetrics and neurosurgery now pay very high premiums for malpractice insurance.

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CPD POINTS: 0

Brain-gut axis is real

IBS is defined as chronic abdominal symptoms of bloating, altered bowel habit and cramping pain arising from the colon but with no underlying organic pathology.

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CPD POINTS: 0

Adult rhinosinusitis

Rhinosinusitis is a common condition, which affects about 30% of the population at some point. Of this number, about 1% develop acute rhinosinusitis.

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CPD POINTS: 0

Battling bacterial conjunctivitis

Bacterial conjunctivitis is inflammation of the conjunctiva as a result of bacterial infection.

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CPD POINTS: 3

Be SMART about diabetes care

Achieving glycaemic control

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CPD POINTS: 3

Pause for thought

Study confirms that a higher body mass index is related to a higher prevalence of certain menopause symptoms.

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CPD POINTS: 3

A nauseating feeling

Treatment in the prevention and control of chemotherapy-induced nausea and vomiting.

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CPD POINTS: 3

Advances in Irritable bowel syndrome (IBS)

Irritable bowel syndrome (IBS) is characterised by chronic intermittent abdominal pain and associated diarrhoea (IBS-D), constipation (IBS-C), or both. IBS can significantly impact patient function and quality of life.

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CPD POINTS: 0

Manifestations of the metabolic syndrome: Part 1

This article deals with the definition, investigations, epidemiology and aetiology of metabolic syndrome.

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CPD POINTS: 0

Myofascial pain syndrome on the increase

MFTPs are categorised clinically dependent on their type. There are two types of MFTPs – active and latent (Travell and Simons, 1999).

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CPD POINTS: 0

SMART diabetes care

Diabetes has become a leading cause of death worldwide. Although there is no cure for diabetes, blood glucose monitoring combined with appropriate medication can enhance treatment efficiency, alleviate the symptoms, as well as diminish complications.

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CPD POINTS: 0

Burden of HIV-associated Cryptococcal meningitis

Cryptococcus is the most common cause of meningitis in adults living with HIV in sub-Saharan Africa. Estimates of national, regional, and global burden of cryptococcal meningitis are crucial to guide prevention strategies and identify needs for diagnostic tests, antifungal medicines, and medical supplies, such as lumbar puncture needles and manometers.

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CPD POINTS: 3

Superficial fungal infections of the nails

Superficial fungal infections tend to infect the stratum corneum layer of the skin, the hair or the nails, causing various types of clinical symptoms, which can be very distressful to the patient

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CPD POINTS: 0

Post-stroke pain

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CPD POINTS: 0

Manifestations of the metabolic syndrome: part 2

Continuing on from Manifestations of the Metabolic Syndrome: Part 1, which appeared in the February issue of Medical Chronicle, which was all about diagnostic numbers, we look further at pathophysiology, progression, clinical presentations, prevention and practical management of the metabolic syndrome (Met-S).

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CPD POINTS: 0

Enhancement of fluoxetine by folic acid

The World Health Organization ranks unipolar major depression as the fourth most important cause of premature mortality and disability (Murray and Lopez, 1997).

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CPD POINTS: 3

The right vitamins for osteoporosis

Osteoporosis, defined by porous bones, is a common problem in Western countries. It is especially common among elderly women and strongly raises the risk of fractures.

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CPD POINTS: 3

Bacterial conjunctivitis: Making every drop count

Article reviewed by Dr Mohamed Dawood Saloojee, Ophthalmologist, Gatesville Medical Centre, Cape Town.

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CPD POINTS: 0

New agent for a poorly controlled condition

Asthma is common. In SA, it is estimated that 20% of adolescent children have asthma. And, despite the fact that the mortality from asthma is falling, individuals with asthma still have a significantly impaired quality of life.

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CPD POINTS: 3

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