Journal of the colleges of medicine of South Africa最新文献

{"title":"Palliative care needs at a South African district hospital: A descriptive study using supportive and palliative care indicators tool South Africa.","authors":"Louis D K Roodt, Cornel F van Rooyen, Hanneke Brits","doi":"10.4102/jcmsa.v4i1.465","DOIUrl":"https://doi.org/10.4102/jcmsa.v4i1.465","url":null,"abstract":"<p><strong>Background: </strong>Patients with advanced life-limiting diseases (ALLDs) are often admitted to district hospitals for acute curative care, resulting in delayed or omitted palliative care. Early identification by clinicians ensured better care, efficient resource use and prevented avoidable hospitalisations. This study aimed to determine the prevalence and profile of admitted adult patients with palliative care needs at National District Hospital (NDH).</p><p><strong>Methods: </strong>This was a retrospective descriptive study. Investigators identified palliative care needs based on the Supportive and Palliative Care Indicators Tool South Africa (Supportive and Palliative Care Indicators Tool [SPICT]™-SA) criteria.</p><p><strong>Results: </strong>Out of 297 patient records reviewed, 127 (42.8%) met the criteria for palliative care based on SPICT™-SA. The most common qualifying disease-specific diagnoses included infectious diseases (21.8%), neurological conditions (15.6%), dementia or frailty (13.6%), and kidney disease (15.0%), while cancer (including haematological malignancies) accounted for 10.9%. The general indicators qualifying for palliative care included frequent unplanned visits (39.3%), poor functional status (26.2%) and dependence on others for care (24.3%).</p><p><strong>Conclusion: </strong>The findings pointed to a gap in recognising palliative care needs among hospitalised patients, especially those with non-malignant conditions. Introducing routine screening using the SPICT™-SA tool at the district level supported earlier identification and enabled planning of care. This led to improved patient outcomes and effective use of health system resources.</p><p><strong>Contribution: </strong>The study demonstrated how routine screening with the SPICT™-SA tool during admission could help identify palliative care needs in a district hospital.</p>","PeriodicalId":521047,"journal":{"name":"Journal of the colleges of medicine of South Africa","volume":"4 1","pages":"465"},"PeriodicalIF":0.0,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13636360/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149123910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hydronephrosis and its causes identified on correlative fluoroscopy in a paediatric population at a resource-constrained tertiary hospital in Southern Africa.","authors":"Faatimah Khan, Tanusha Sewchuran","doi":"10.4102/jcmsa.v4i1.351","DOIUrl":"https://doi.org/10.4102/jcmsa.v4i1.351","url":null,"abstract":"<p><strong>Background: </strong>Paediatric hydronephrosis has a high global prevalence. Identifying aetiologies is critical for planning investigations, management and preventing chronic renal impairment. This study reviewed the underlying causes of unilateral and bilateral hydronephrosis, specifically on voiding cystourethrogram (VCUG) examinations.</p><p><strong>Methods: </strong>A retrospective descriptive study (Jan 2021-June 2024) included children < 13 years who underwent VCUG following a sonographic diagnosis of hydronephrosis. Ultrasound and VCUG studies were retrieved from the institutional Radiology Information System. Data collected included demographics, hydronephrosis laterality and severity, VCUG and mercaptoacetyltriglycine-3 (MAG-3) results. Hydronephrosis was graded according to a dual grading system combining Radiology grading system and Onen's criteria. Statistical significance was set at <i>p</i> < 0.05.</p><p><strong>Results: </strong>Of sixty-five patients included, 67.7% were male. Bilateral hydronephrosis occurred more frequently in males, while unilateral disease was more common in females. Grade III hydronephrosis was most prevalent. A cause was identified in 85.7% of bilateral vs. 43.2% of unilateral cases (<i>p</i> < 0.001). Posterior urethral valves (PUV) were the leading aetiology (36% bilateral; 14% unilateral; <i>p</i> = 0.035) followed by vesicoureteric reflux and bladder diverticula. Of 22 MAG-3 studies, 59% showed delayed excretion or reduced cortical function consistent with obstructive VCUG findings.</p><p><strong>Conclusion: </strong>Bilateral hydronephrosis correlated with higher severity grades, mostly due to posterior urethral valves. Severity grading highlights the importance of early detection and intervention to prevent renal failure. Resource constraints challenge SASPI treatment algorithm implementation, necessitating institution-specific imaging pathways.</p><p><strong>Contribution: </strong>This study highlights PUV as the primary aetiology of severe bilateral hydronephrosis and advocates for institution-specific, multidisciplinary imaging pathways.</p>","PeriodicalId":521047,"journal":{"name":"Journal of the colleges of medicine of South Africa","volume":"4 1","pages":"351"},"PeriodicalIF":0.0,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13636397/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149123868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of suture-assisted gonioscopy-assisted transluminal trabeculotomy in a cohort of South African patients with primary open-angle glaucoma.","authors":"Walid Huwaidi, Mansour Wasl, Christopher Tinley, David Steven","doi":"10.4102/jcmsa.v4i1.418","DOIUrl":"https://doi.org/10.4102/jcmsa.v4i1.418","url":null,"abstract":"<p><strong>Background: </strong>Gonioscopy-assisted transluminal trabeculotomy (GATT) is a minimally invasive glaucoma surgery that enhances trabecular outflow by circumferentially incising Schlemm's canal. Internationally, studies have reported favourable outcomes, but evidence from South African patients remains limited. This study evaluated the effectiveness and safety of GATT in South African patients with primary open-angle glaucoma (POAG).</p><p><strong>Methods: </strong>A retrospective cohort study was conducted at Eerste River Hospital. Patients with POAG who underwent GATT between August 2020 and November 2022 were followed for 24 months. They were divided into two groups: combined phacoemulsification and GATT (Group I) and standalone GATT (Group II). Demographic characteristics, intraocular pressure (IOP), glaucoma medication use, and postoperative complications were collected.</p><p><strong>Results: </strong>Fifty-two patients (<i>n</i> = 52) were included. Mean preoperative IOP for the entire cohort was 23.4 ± 6.4 mmHg and decreased significantly to 13.8 ± 4.2 mmHg at 24 months (<i>p</i> = 0.006). Mean glaucoma medication use also decreased, from 3.5 ± 0.6 preoperatively to 2.5 ± 1.1 at 24 months (<i>p</i> < 0.001). The cumulative success rate at 24 months was 94.23%. Complications were mostly transient, with hyphema being the most frequent. No serious adverse events were reported.</p><p><strong>Conclusion: </strong>Gonioscopy-assisted transluminal trabeculotomy, performed alone or combined with phacoemulsification, was an effective and safe option for lowering IOP in South African patients with POAG. The sustained IOP reduction, decreased medication burden and favourable safety profile support its use, particularly in resource-limited settings.</p><p><strong>Contribution: </strong>This study provides region-specific evidence on the outcomes and safety of GATT in a South African POAG cohort.</p>","PeriodicalId":521047,"journal":{"name":"Journal of the colleges of medicine of South Africa","volume":"4 1","pages":"418"},"PeriodicalIF":0.0,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13636947/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149123899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Public versus private trauma intensive care unit outcomes: A retrospective cohort study.","authors":"Mariska Els, Naadiyah Laher, Megan Lubout, Maeyane S Moeng","doi":"10.4102/jcmsa.v4i1.411","DOIUrl":"https://doi.org/10.4102/jcmsa.v4i1.411","url":null,"abstract":"<p><strong>Background: </strong>Trauma remains a leading cause of morbidity and mortality in low- and middle-income countries (LMICs), with South Africa experiencing a high burden of intentional and high-energy injuries. Disparities in critical care resources between the public and private healthcare sectors have been reported, but comparative trauma intensive care unit (ICU) outcomes remain incompletely described.</p><p><strong>Methods: </strong>This retrospective cohort study compared adult trauma patients admitted to public and private healthcare sector ICUs in Johannesburg between July 2022 and June 2023. The primary outcome was 30-day in-hospital mortality. Secondary outcomes included injury characteristics, severity of illness and factors associated with mortality. Descriptive statistics and multivariate logistic regression were used for data analysis.</p><p><strong>Results: </strong>A total of 453 trauma patients were included (private ICU <i>n</i> = 209; public ICU <i>n</i> = 244), with male predominance in both cohorts. Private ICU patients were older, more frequently sustained blunt trauma, and had longer ICU stays. Public ICU patients were younger and more likely to sustain penetrating trauma (68.4% vs 14.4%; <i>p</i> < 0.001). Thirty-day mortality did not differ significantly (private 8.6% vs public 11.9%; <i>p</i> = 0.255), despite greater illness and injury severity among private ICU patients. Greater severity of illness and injury independently predicted mortality, while public ICU admission was associated with increased adjusted odds of mortality.</p><p><strong>Conclusion: </strong>Despite differences in injury profiles, patient mortality was similar in both healthcare sectors. Illness severity remains the prevailing determinant of outcome, underscoring the importance of severity scoring systems and potential system-level factors in LMICs' trauma care. Level of evidence: Level III; prognostic and epidemiological study.</p><p><strong>Contribution: </strong>This study provides comparative trauma ICU outcomes data from the public and private healthcare sectors in Johannesburg, highlighting the role of illness severity and healthcare sector infrastructure on patient mortality and informing trauma critical care in LMICs.</p>","PeriodicalId":521047,"journal":{"name":"Journal of the colleges of medicine of South Africa","volume":"4 1","pages":"411"},"PeriodicalIF":0.0,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13636414/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149123873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of a structured tracheostomy educational programme on healthcare professionals' knowledge and confidence: A quasi-experimental pre-test-post-test study at Nelson Mandela Academic Hospital.","authors":"Zanele Tuswa, Banele Kokose, Mirabel K K Nanjoh, Charles Myataza","doi":"10.4102/jcmsa.v4i1.236","DOIUrl":"https://doi.org/10.4102/jcmsa.v4i1.236","url":null,"abstract":"<p><strong>Background: </strong>Tracheostomy care requires healthcare professionals to recognise and manage routine and emergency complications promptly. Knowledge and preparedness gaps may compromise patient safety, particularly in resource-limited settings. This study assessed baseline knowledge and self-reported confidence in tracheostomy care and evaluated the immediate effect of a structured educational programme at Nelson Mandela Academic Hospital.</p><p><strong>Methods: </strong>A quantitative quasi-experimental one-group pre-test-post-test study was conducted among healthcare professionals involved in tracheostomy care. Participants completed structured questionnaires before and immediately after a tracheostomy educational programme. Changes in knowledge and confidence were analysed using McNemar's test, Friedman's test and generalised estimating equations (GEE).</p><p><strong>Results: </strong>Seventy-seven healthcare professionals participated. High overall knowledge increased from 14.3% pre-intervention to 67.5% post-intervention (<i>p</i> < 0.001). Participants had significantly higher odds of adequate knowledge after the intervention (adjusted OR 11.71, 95% CI 4.30-31.88; <i>p</i> < 0.001), while > 11 years of clinical experience was also associated with adequate knowledge (adjusted OR 4.74, 95% CI 1.77-12.69; <i>p</i> = 0.002). Confidence in tracheostomy tube insertion improved significantly (<i>p</i> = 0.003), with participants aged ≤ 40 years more likely to report high confidence (adjusted OR 2.27, 95% CI 1.06-4.88; <i>p</i> = 0.035).</p><p><strong>Conclusion: </strong>A structured tracheostomy educational programme significantly improved healthcare professionals' knowledge and self-reported confidence. Regular education incorporating simulation may improve preparedness and promote safer tracheostomy care, particularly in resource-limited settings.</p><p><strong>Contribution: </strong>This study contributes to the limited South African literature on healthcare professionals' knowledge of tracheostomy care by identifying important knowledge gaps and demonstrating that a structured educational intervention can significantly improve both knowledge and confidence. The findings provide locally relevant evidence to support the development of standardised tracheostomy-care training, regular refresher programmes and institutional protocols aimed at improving the safety and quality of tracheostomy care.</p>","PeriodicalId":521047,"journal":{"name":"Journal of the colleges of medicine of South Africa","volume":"4 1","pages":"236"},"PeriodicalIF":0.0,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13636373/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149123896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quality-controlled newborn hearing screening in Ghana: Outcomes and challenges from a pilot project.","authors":"Estella Bilson-Amoah, Jemima Fynn, Emmanuel D Kitcher, Latifa Seidu, Eric Manu","doi":"10.4102/jcmsa.v4i1.396","DOIUrl":"https://doi.org/10.4102/jcmsa.v4i1.396","url":null,"abstract":"<p><strong>Background: </strong>Neonatal hearing impairment affects 1-2 per 1000 live births in high-income countries, making early detection and habilitation critical before 6 months of age to ensure optimal language and communication development. Ghana currently lacks national legislation supporting universal newborn hearing screening (UNHS).</p><p><strong>Methods: </strong>This multicentre, hospital-based pilot study analysed newborn hearing screening data from four facilities between July 2023 and January 2025. Screening was conducted by trained staff using transient-evoked otoacoustic emissions and automated auditory brainstem response. Infants requiring follow-up were referred to the diagnostic centre at Korle-Bu Teaching Hospital. Results were documented, communicated to caregivers, and securely transferred to a centralised tracking system (pathTrack). Data analysis was performed using Microsoft Excel and SPSS version 20.0.</p><p><strong>Results: </strong>Of 29 075 live births, 11 107 (38.2%) were registered in the screening database, and 11 058 (99.6%) underwent screening at a median age of 13 days. Of these, 9007 (81.5%) passed the initial screening. Among 10 019 infants completing the process, three were diagnosed with permanent congenital hearing loss. Challenges included low coverage due to limited personnel, restricted diagnostic access, financial hardship, stigma, and barriers to follow-up. Caregivers demonstrated high acceptance of the screening process.</p><p><strong>Conclusion: </strong>This pilot demonstrates that newborn hearing screening in Ghana is feasible but constrained by systemic challenges. Strengthening infrastructure, expanding the trained workforce, ensuring sustainable funding, and increasing public awareness are essential to scaling up and sustaining a national UNHS programme.</p><p><strong>Contribution: </strong>This study provides the first quality-controlled evidence of newborn hearing screening feasibility in Ghana, demonstrating high parental acceptance while revealing systemic barriers such as limited personnel, restricted diagnostic access, financial hardship, and high loss to follow-up. By documenting outcomes and challenges across multiple hospitals, the research highlights critical pathways for scaling up UNHS in resource-limited settings. These insights align with JCMSA's mission to strengthen clinical practice, public health systems, and medical education across Africa by providing context-specific evidence to guide policy integration, workforce development, and sustainable programme implementation.</p>","PeriodicalId":521047,"journal":{"name":"Journal of the colleges of medicine of South Africa","volume":"4 1","pages":"396"},"PeriodicalIF":0.0,"publicationDate":"2026-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13636402/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149123884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence, types, maternal and perinatal outcomes of cardiac disease in pregnancy at a tertiary Hospital in the Eastern Cape, South Africa.","authors":"Sibusiso B Mbili, Vulikhaya Mpumlwana, Charles B Businge","doi":"10.4102/jcmsa.v4i1.274","DOIUrl":"https://doi.org/10.4102/jcmsa.v4i1.274","url":null,"abstract":"<p><strong>Background: </strong>Cardiac disease is a leading non-obstetric cause of maternal morbidity and mortality, particularly in low- and middle-income countries.</p><p><strong>Methods: </strong>Retrospective cross-sectional review of all deliveries from 01 January 2020 to 31 December 2022. Echocardiography-confirmed cardiac disease cases were identified. Data included demographics, lesion type and/or severity (New York Heart Association [NYHA]), timing of diagnosis, delivery characteristics and outcomes. Associations were examined using χ² and <i>t</i>-tests (<i>p</i> < 0.05).</p><p><strong>Results: </strong>Among 11 728 deliveries, 182 had cardiac disease (prevalence 1.6%, 95% CI: 1.34-1.80). Median age was 26 years (IQR 22-31); 50.6% presented with NYHA III-IV. Rheumatic heart disease (RHD) predominated (61.5%), mainly mitral stenosis (43.8%) and mitral regurgitation (38.3%). Cardiomyopathy accounted for 31.3%; peripartum cardiomyopathy (PPCM) comprised 78.9% of cardiomyopathies, most diagnosed postpartum (64.9%) and frequently with Left Ventricular Ejection Fraction (LVEF) < 45%. Preterm birth occurred in 46.9% of pregnancies, particularly with RHD-MS (mean gestational age (GA) 33.0 ± 6.0 weeks; <i>p</i> = 0.005). Caesarean delivery occurred in 72.0% (131/182), mainly for obstetric (41.8%) rather than cardiac indications. Maternal complications were common (67.6%), including pulmonary oedema (28.6%, 95% CI: 22.1-35.7), pulmonary hypertension (13.2%, 95% CI: 8.6-19.0) and ICU admission (12.1%, 95% CI: 7.8-17.6). Maternal case fatality was 4.9% (9/182; 95% CI: 2.3-9.2). Most neonates had favourable short-term outcomes (5-min Apgar ≥ 7 in 83.5%) and were discharged (87.7%).</p><p><strong>Conclusion: </strong>Rheumatic heart disease and PPCM were the dominant lesions and major drivers of severe morbidity and mortality.</p><p><strong>Contribution: </strong>The high burden of late presentation and severe functional limitation underscores the need for earlier detection, systematised cardio-obstetric care and strengthened primary prevention of RHD.</p>","PeriodicalId":521047,"journal":{"name":"Journal of the colleges of medicine of South Africa","volume":"4 1","pages":"274"},"PeriodicalIF":0.0,"publicationDate":"2026-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13636372/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149123916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors associated with loss to follow-up in retinopathy of prematurity screening referrals at a South African tertiary hospital: A retrospective cohort study.","authors":"Masego Madibane, Carl-Heinz Kruse, Jerusha S John","doi":"10.4102/jcmsa.v4i1.430","DOIUrl":"https://doi.org/10.4102/jcmsa.v4i1.430","url":null,"abstract":"<p><strong>Background: </strong>Continuity of retinopathy of prematurity (ROP) screening follow-up is essential, as the disease progression can occur after the initial examination. Evidence on factors associated with loss to follow-up (LTFU) in South African ROP services is limited.</p><p><strong>Methods: </strong>This retrospective cohort study reviewed 1698 infants referred for ROP screening at Inkosi Albert Luthuli Central Hospital from 2016 to 2021. Demographic and clinical data were extracted from referral records and the electronic medical records. Loss to follow-up was defined as failure to attend any scheduled follow-up after the initial visit. Baseline (first-visit) characteristics were analysed separately from post-baseline follow-up descriptors. Univariable and multivariable logistic regression identified factors associated with LTFU.</p><p><strong>Results: </strong>Among the infants, 457 (26.9%) were LTFU. LTFU was more common among infants with lower birth weight, lower gestational age, anaemia, transfusion history, maternal HIV exposure and documented ROP. In multivariable analysis, documented ROP remained strongly associated with LTFU (adjusted odds ratio [aOR] 2.06; 95% confidence interval [CI] 1.60-2.67; <i>p</i> < 0.001). Maternal HIV exposure was also independently associated with LTFU in a sensitivity model (aOR 1.58; 95% CI 1.13-2.22; <i>p</i> = 0.008).</p><p><strong>Conclusion: </strong>More than one in four referred infants did not complete scheduled ROP screening follow-up, with those most in need of surveillance being most vulnerable to interrupted care. Strengthened counselling, clearer inter-facility handover and active reminder or tracing systems may improve continuity of care.</p><p><strong>Contribution: </strong>This study provides local evidence on factors associated with incomplete ROP follow-up in a South African tertiary referral pathway and identifies practical targets for service improvement.</p>","PeriodicalId":521047,"journal":{"name":"Journal of the colleges of medicine of South Africa","volume":"4 1","pages":"430"},"PeriodicalIF":0.0,"publicationDate":"2026-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13636398/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149123920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Candidates' perceptions of the revised Diploma in HIV Management curriculum and study programme: A cross-sectional survey.","authors":"Madeleine Muller, Oladele V Adeniyi, Eric Buch","doi":"10.4102/jcmsa.v4i1.453","DOIUrl":"https://doi.org/10.4102/jcmsa.v4i1.453","url":null,"abstract":"<p><strong>Background: </strong>The College of Family Physicians (CFP) revised the Diploma in HIV Management (Dip HIV Man) curriculum and, in 2021, introduced a 9-week structured-learning programme with linked resources to assist candidates in preparing for the assessment. This study determines the perceived contributions of the revised curriculum and the structured-learning programme to candidates' preparation and performance in the Dip HIV Man examination.</p><p><strong>Methods: </strong>A cross-sectional online survey (Aug-Oct 2023) was sent to all 545 candidates who wrote the Dip HIV Man examination in 2022 and first semester 2023. Likert scale and open-ended data were collected via Google Forms. Descriptive and logistic regression analyses were performed using open statistical software jamovi.</p><p><strong>Results: </strong>Among 545 candidates, 199 responded (36.5%); most were medical officers working in district or tertiary hospitals with 1 year - 5 years of experience. Most used the revised curriculum and rated resources as relevant and high-quality. Half engaged in the study programme, with high perceived value. Frequent use of curriculum and especially resources seemed associated with passing, with resource use showing the most consistent independent effect. Study group engagement showed weaker, inconsistent associations. Clinical HIV exposure was not associated with success. Overall, 90.4% reported that completing the diploma helped their clinical decision-making.</p><p><strong>Conclusion: </strong>The candidates found the revised Dip HIV Man curriculum, linked resources and study programme valuable in their examination preparation and perceived it as helpful in their clinical work. However, increased awareness among doctors and tailored resources is needed for further improvements.</p><p><strong>Contribution: </strong>This study underscores the value of structured educational interventions in postgraduate medical education and provides insights into optimising future examination preparation.</p>","PeriodicalId":521047,"journal":{"name":"Journal of the colleges of medicine of South Africa","volume":"4 1","pages":"453"},"PeriodicalIF":0.0,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13636410/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149123867","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigating visual field measurements on perimetry and ganglion cell complex on optical coherence tomography in patients with suprasellar tumours.","authors":"Saajidah Gaibie, Susan Williams","doi":"10.4102/jcmsa.v4i1.380","DOIUrl":"10.4102/jcmsa.v4i1.380","url":null,"abstract":"<p><strong>Background: </strong>Suprasellar tumours can cause compressive optic neuropathy with preventable visual loss. Standard automated perimetry is central to assessment but is subjective; optical coherence tomography (OCT) provides ganglion cell complex (GCC) metrics, yet structure-function relationships in chiasmal compression remain unclear. This study evaluated the relationship between GCC thickness and visual field (VF) loss (10-2 and 30-2).</p><p><strong>Methods: </strong>Prospective observational study of patients with suprasellar tumours undergoing OCT GCC imaging and Humphrey VF testing (10-2 and 30-2). Ganglion cell complex abnormality was defined as a machine-flagged red value. Visual field abnormality was defined on the pattern deviation (PD) map as a scotoma (≥ 3 adjacent points with <i>p</i> < 5%). Associations between GCC thickness and VF PD were assessed, and agreement between binary classifications was evaluated.</p><p><strong>Results: </strong>Seventeen eyes were included (mean age 50.7 years; 70.0% female). Visual field abnormality was frequent (10-2: 82.4%; 30-2: 94.1%), while GCC was abnormal in 58.8%. Mean PD was -6.84 dB (10-2) and -8.66 dB (30-2). Ganglion cell complex thickness correlated with PD at 10-2 (<i>p</i> < 0.001) and 30-2 (<i>p</i> = 0.001). Agreement was moderate for GCC versus VF 10-2 (κ = 0.469) and slight for GCC versus VF 30-2 (κ = 0.164).</p><p><strong>Conclusion: </strong>Visual field abnormalities were common, with 30-2 classifying more eyes as abnormal despite normal GCC. Ganglion cell complex thickness showed a graded association with VF loss on both strategies, supporting OCT GCC as an adjunct for quantifying chiasmal compression-related dysfunction; however, binary OCT classification may miss milder functional deficits.</p><p><strong>Contribution: </strong>Supports combined OCT-perimetry interpretation and strategy-aware follow-up.</p>","PeriodicalId":521047,"journal":{"name":"Journal of the colleges of medicine of South Africa","volume":"4 1","pages":"380"},"PeriodicalIF":0.0,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13543280/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148898888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}