Mthatha General Hospital

Pulmonary tuberculosis (TB) is predominantly caused by Mycobacterium tuberculosis complex (MTBC) and can also involve nontuberculous mycobacteria (NTM). These pathogens pose significant global health challenges, particularly in developing countries. Differentiating between MTBC and NTM in clinical specimens is often difficult using conventional acid-fast staining methods, leading to an underestimation of NTM prevalence in TB-endemic regions. This study aims to identify mycobacterial species in sputum samples from patients suspected of having TB, utilizing polymerase chain reaction (PCR) assays and gene sequencing techniques. We collected 111 sputum samples from patients at Dr. Wahidin Sudirohusodo Central General Hospital, Hasanuddin University Hospital, and Makassar Community Lung Health Center. The samples were analyzed at the Clinical Microbiology Laboratory of Hasanuddin University using standard microscopy and molecular detection techniques. Descriptive statistics were employed to summarize patient demographics, infection characteristics, and outcomes. We collected sputum from suspected TB patients with an average age of 50.86 years. We found 16.2% (n = 18) acid-fast bacteria in 111 patients with suspected pulmonary TB, and molecularly, we identified 17.1% (n = 19) Mycobacterium species by multiplex PCR. Three sputum samples tested positive for NTM. Phylogenetic analysis, based on 16S rRNA gene sequencing, revealed similarities between the samples and known mycobacterial species. The study underscores the challenges in differentiating between MTBC and NTM, highlighting the necessity for molecular diagnostic approaches. Notably, we found NTM in sputum samples from patients previously treated for TB. These findings can serve as a reference for improving diagnostic accuracy and preventing misdiagnosis of mycobacterial infections.

Background: Preeclampsia is an idiopathic multisystem disorder specific to pregnancy and the puerperium in which multiorgan abnormalities occur in at-risk pregnancies resulting in hypertension and multiorgan dysfunction in the form of an increase in left ventricular mass index which leads to diastolic heart failure.
 Aim: Determine the relationship the effect of factors causes preeclampsia towards left ventricle mass index on preeclampsia patient in Undata Regional Hospital of Palu
 Methods: This study used a cross sectional research approach. These variables are measured by research instruments where data can be analyzed according to statistical procedures.
 Results: From total sample, there were pregnant women of abnormal age 37.67 years (27.3%) and normal age 28.12 years (72.7%) with a mean age of 30.73 ± 5.89 years with history preeclampsia. There were 21 patients (95.5%) with previous obesity and 1 patient (4.5%) had no history of obesity, 14 patients (63.6%) with a history of primigravida and 8 patients with multigravida (36.4%). One patient with multiple pregnancies (4.5%) and 21 patients (95.5% with no history of multiple pregnancies, 3 patients (13.64%) with chronic disease and 19 patients (86 .36%) no history of chronic disease, There are 16 patients (72.7%) patients who use contraception and while 6 patients (27,3%) did not use contraception. Statistical tests risk factors for preeclampsia associated with cardiovascular disease events, hypertension which causes an increase in the Left Ventricle Mass Index (LVMI) it can be seen that in all preeclampsia patients causes uncontrolled hypertension and increase in LVMI above normal values ​​(description according to table), the incidence of preeclampsia with a previous history of preeclampsia 1 (25%) showed a significant relationship with a value of p = 0.001.
 Conclusion: Factors that cause significant preeclampsia, pregnant women who have a history of preeclampsia and who have a history of multiple pregnancies affect the occurrence of hypertension and an increase in left ventricular mass index.

Emergency medicine accounts for a large proportion of medical care in many low- and middle-income countries. A better understanding of the burden of disease will guide training and resource allocation priorities, but lack of electronic medical records and standardised data collection systems makes it difficult to obtain this information. To draw attention to the proportionally large burden of trauma in emergency centres (ECs) throughout Eastern Cape Province, South Africa (SA), in the hope of influencing resource allocation and medical provider training protocols accordingly. A secondary data analysis was performed from information gathered in HIV testing studies in two large tertiary care centres and one regional hospital in the Eastern Cape region of SA. All patients presenting to the ECs during the 6-week study period who met the inclusion criteria were approached and requested to provide consent for point-of-care HIV testing and collection of demographic information. Information collected included patient demographics, presenting complaints and final diagnoses. Simple descriptive statistics were used to analyse the data. Data were collected from 4 271 patients across three study sites: Frere Hospital (n=2391), Nelson Mandela Academic Hospital (n=622) and Mthatha Regional Hospital (n=1258). At the two tertiary care centres, most patients were between the ages of 18 and 30 years (41.2% and 32.6%, respectively) and male (57.8% and 60.2%), and 70.4% and 41.5% had traumatic injuries. The most common complaints were stab/gunshot wounds (18.3% and 20.2%). At the district hospital, the majority of patients were female (57.2%), 40.1% were between 18 and 30 years old, and 27.3% presented with traumatic injuries. Stab/gunshot wounds were the second most common complaint (7.2%) after lower respiratory tract infections (8.7%). From the proportion of presenting individuals sampled, we can conclude that a large proportion of care delivered in ECs in the Eastern Cape is for trauma. Local clinical capacitation efforts must focus on trauma training.

The management of carcinoma of the oesophagus poses formidable logistic problems in countries such as Transkei where the condition is common and resources are limited. Most patients present late, often with complications, and are reluctant to undergo major surgery. Two hundred and fifty consecutive patients who presented over nine months in Transkei were studied. The incidence increased with age until 70 years and the disease occurred equally in men and women. The neoplasm was predominantly squamous cell (243 patients, 97%) and was found most often in the middle third of the oesophagus (118, 47%). On admission only eight of the 250 patients could take a semi-solid diet and only 21 a fluid diet. The policy where feasible was to introduce a Proctor Livingstone tube endoscopically through the dilated oesophageal stricture by a pulsion technique under light general anaesthesia. When abdominal perforation of the oesophagus seemed likely, retrograde intubation via a gastrotomy was performed. Sixty patients were not intubated, because the stricture was too proximal (47) or could not be dilated adequately (6), the lesion was suitable for resection (6), or the patient refused (1). Fifty one (27%) patients died in hospital, 29 deaths being due to oesophageal perforation (including six of the 10 who were intubated retrogradely). The mean hospital stay was 4.7 days. On discharge 64% of the intubated patients were able to take semi-solid food and a further 6% a fluid diet. Palliation by intubation was performed rapidly and the tube was well tolerated by patients. The overall mortality was high, but this can be reduced by experience. Intubation is an acceptable, cost effective solution where large numbers of patients present with advanced oesophageal carcinoma in circumstances where resources are severely limited.