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The use of statistics to derive insights from the data has provided researchers with empirical tools to describe, diagnose, predict, and prescribe actions, interventions and generate knowledge from varied data sets. Depending on the types of data (structured, semi-structured, and unstructured), different statistical models and tests can be performed to generate the said insights and new knowledge. Correctly identifying the data types (whether the data is discrete or continuous) aids researchers in identifying the applicable statistical tests. The distribution of the data also has an implication for determining the relevant statistical test. When continuous data are said to be normally distributed, the types of tests that can be used to compare groups differ to when the data are found to be not normally distributed. The same is true for discrete data, in that there are certain assumptions that need to be satisfied to identify the correct statistical tests to use in comparing the data groups. In this paper, the discussion will be focused on nine commonly used statistical tests. These common tests include the t-test, paired t-test, analysis of variance (ANOVA) test, Wilcoxon rank-sum test (WRST), Wilcoxon signed-rank test (WSRT), nonparametric ANOVA, chi-square (X2) test, Fisher's exact test, and McNemar's test. The conditions for the use of these tests will be described, and the applications thereof will be discussed. Therefore, the purpose of this paper is not to describe the mathematical theories behind different statistical tests but to introduce the tests and their applications. [ABSTRACT FROM AUTHOR]

Data-driven clinical practice and evidence-based medicine present themselves as critical tenets of medical practice the world over. The use of data to achieve these tenets often involves using known clinical patient presentations and biological data to predict disease outcomes and other post-care events (i.e. major adverse effects of treatment or mortality). These predictions are achieved using statistical techniques, such as hypothesis testing and forecasting or prediction analysis, also accepted as regression analysis. In its simplicity, regression analysis represents the statistical technique of applying certain mathematical computational equations to determine the relationship between variables. Therefore, in the use of such mathematical equations, a change in a unit of one variable (the independent variable) can lead to a predictable corresponding change in the dependent variable. This corresponding change can be a unit change, in the independent variable, or it can be a quantifiable factor of the unit of change observed in the independent variable. The current paper takes an introductory and non-technical approach to discuss processes involved in regression analysis. The focus is the understanding and application of linear and logistic regression to clinical data. Other types of regression methods such as lasso, ridge, and polynomial regression analysis are mentioned but not fully discussed. [ABSTRACT FROM AUTHOR]

This paper reviews the history of the College of Anaesthetists of South Africa (CASA), starting with the establishment of the College of Physicians and Surgeons of South Africa (CPSSA), the subsequent formation of the Faculty of Anaesthetists as part of the College of Surgeons of South Africa (FFACSSA), to its present form as the CASA. This review includes major milestones achieved over the years, including international recognition, key role players involved, development of examinations, medals and awards given as well as individuals honoured by the CASA. [ABSTRACT FROM AUTHOR]

Introduction: Understanding the complex link between our gut health and general well-being has drawn more attention in recent years. Prebiotics can promote mineral absorption, influence metabolism, improve immune system regulation, and fight infections. Aim: This article focuses into the evolving paradigms in prebiotics research, highlighting their regulation, diverse applications, impact on diseases, and their growth on the global market. Discussion: Prebiotics are Generally Recognized as Safe (GRAS), novel foods and food additives by the Food and Drug Administration (FDA), EU and Japan, respectively. The multifaceted applications of prebiotics go across various sectors, ranging from functional foods and dietary supplements to cosmetics. A comprehensive review of prebiotics' effects on human health and illness prevention is a significant strength of the paper. Prebiotics support a healthy microbiome by feeding helpful gut flora, which may reduce the risk of a variety of illnesses and improve general health. In parallel, it covers an overview of the prebiotics industry in the world, considering aspects including consumer knowledge of gut health and growing prebiotic demand. Conclusion: Prebiotics are anticipated to have a significant role in determining the direction of nutrition and preventive healthcare as research advances and consumer demand for natural health solutions rises. [ABSTRACT FROM AUTHOR]

Statistical issues in clinical research arise in many situations and at different stages of the research process. The purpose of this paper/opinion is to highlight the connections between different stages of a clinical research process with the statistical issues and how the challenges that may arise due to these issues may be mitigated. The paper also reflects on the ASA statement on misconceptions about p-values and how these can be addressed. The paper concludes by recommending that clinical researchers need some knowledge and understanding of basic statistical techniques. In addition, they would also benefit immensely from consulting with domain experts such as biostatisticians or statistical experts before embarking on their clinical research endeavours. [ABSTRACT FROM AUTHOR]

Publishing an article can be an arduous task, even for seasoned authors. But to a novice, publishing an interesting case report or research can appear to be an insurmountable task. This paper aims to assist by providing simplified advice on how to write a paper and get it published. [ABSTRACT FROM AUTHOR]

Collaboration has increased in nearly all scientific fields over the past century, with a marked acceleration in recent decades. Reasons for this increase include the information explosion and the strain it puts on individual researchers to assimilate knowledge, the complexity of research questions, which requires more diverse expertise, and the increasing importance of interdisciplinary research. The current study investigates the co-authorship network in one of the few Afrikaans language journals in the natural sciences, Suid-Afrikaanse Tydskrif vir Natuurwetenskap en Tegnologie (South African Journal of Science and Technology). Taking into account research articles published over the past four decades, it is shown that the average number of authors per paper has increased by 79% from the average of the 1980s to the average of the 2020s. The network, however, is shown to be highly fragmented, consisting of 226 unconnected components and a gigantic component that only comprises 10% of authors. These small, unconnected components are densely connected with an average path length of 2,47 and transitivity of 0,89, resulting in a small-worldness of 487. As found in other co-authorship networks, this network is also shown to be right-skewed with a skewness of 1,49, meaning that a small number of authors are highly productive collaborators, while the majority only collaborate on a few papers. Using degree centrality and PageRank, key authors are also identified. [ABSTRACT FROM AUTHOR]

The informal poultry and pig sector in the Eastern Cape Province (ECP) of South Africa is of significant socio-economic importance as it sustains livelihoods and ensures food security; yet little is known about the distribution and prevalence of infectious and zoonotic diseases in this region. This paper reviews data published for pig and poultry diseases in the province during the last 20 years (2000–2020). The review included relevant published papers identified by a computerised literature search from Web of Science; provincial animal health reports; the national database from the Department of Agriculture, Land Reform and Rural Development (DALRRD); animal health reports submitted by DALRRD to the World Organisation for Animal Health (OIE) via the World Animal Health Information Database (WAHID) interface and laboratory records. A publication was considered eligible if it included qualitative or quantitative information on any disease affecting pigs and poultry including zoonosis. The search retrieved 174 publications, of which 26 were relevant. The review found that Newcastle disease (ND), coccidiosis and fowl pox (FP) were the most reported avian diseases in the national database, whereas avian infectious bronchitis (AIB), ND and highly pathogenic avian influenza (HPAI) were the most reported diseases in the OIE database. Classical swine fever (CSF) was the most reported pig disease in both databases. The retrieved literature on pig and poultry diseases was scarce and no longer up to date, providing decision makers with little information. The review identified important zoonotic diseases that require further studies yet failed to find information on important neglected diseases like leptospirosis. [ABSTRACT FROM AUTHOR]

Health production faces two forever growing challenges, the increasing demands on limited resources on one side and the increasing cost of healthcare on the other side. Effective and efficient health resources allocation is required for a safe and distributive health. Health economic analysis facilitates decision-making by offering a decision-making framework assessing which health intervention provides the maximum clinical benefits at an economic cost. [ABSTRACT FROM AUTHOR]

Probiotics are living microbial adjuncts that improve health and prevent disease by restoring the balance of intestinal flora. Their use holds many advantages due to the fact that they do not induce microbial resistance, are non-toxic, and stimulate the immune system. Probiotic products can contain one or more microbe, of which the most commonly used are Lactobacillus and Bifidobacterium species, while others contain Saccharomyces boulardii (S. boulardii). Probiotics have many clinical uses, one being the treatment of Candida infections. When suggesting a probiotic to a patient, the pharmacist's assistant (PA) can play an important role, providing that he/she has the necessary background knowledge regarding probiotics. This paper attempts to provide the PA with such knowledge. [ABSTRACT FROM AUTHOR]

Emerging infectious diseases have affected every aspect of medical practice and the advent of COVID-19 in 2019 created many challenges for basic science research methods. Face-to-face data collection was extremely problematic to undertake in any healthcare environment. The emergency department (ED) in low-resource environments, specifically, was severely impacted by the research restrictions, the psychological state of the ED staff, and the lack of perceived importance of research in the emergency departments. This paper aims to reflect on the challenges in collecting research data in the ED during the COVID-19 pandemic and provides some suggestions and lessons learnt for other researchers embarking on such a path. Notwithstanding challenges inherent to virtual platforms, video-calling may be an option rather than in-person interviewing and can allow for data collection over a large geographical area, even when social distancing measures are not in place. New opportunities were acquired through which the self- reflexive practice characteristics of action research were strengthened. [ABSTRACT FROM AUTHOR]

Historically, feline infectious peritonitis (FIP) has been considered almost invariably fatal. The recent COVID-19 pandemic has fuelled research in coronavirus pathophysiology and treatment. An unintended consequence is that we now have an effective treatment accessible for FIP. This paper reports on the successful resolution of immunohistochemistry-confirmed effusive FIP in an adolescent cat in South Africa following monotherapy with remdesivir at 4.9–5.6 mg/kg daily for 80 days. [ABSTRACT FROM AUTHOR]

Bacterial vaginosis (BV) is a commonly-occurring and well-studied cause of vaginal discharge. It is characterised by typical and unsettling symptoms, with an array of risk factors and complications associated with the condition. Treatment is aimed at reducing symptoms and preventing any further complications or infections. This paper is intended to provide a review of recent information on the pathophysiology, an overview of the clinical presentation, complications and treatment of bacterial vaginosis. [ABSTRACT FROM AUTHOR]

We present a fifteen-step process to assist in taking an idea to a research publication. This process ensures that evidence-based medicine practice is followed to prevent redundant research questions. The steps are the following: Step 1 -- Identify broad research ideas with a potentially 'weak' evidence base, rather than starting with a specific research question. Step 2 -- Identify the knowledge gap within the intended field of research by examining the background literature. Step 3 -- Focus on the 'foreground knowledge' to frame a potential research question. Step 4 -- Conduct a comprehensive literature search, to determine whether the question has been asked before, and if so, if the research was robust. Step 5 -- Write a study one-page summary which provides a succinct summary of what you intend to do. Step 6 -- Learn how to pitch your research idea. Step 7 -- Write the protocol. The rigid process of protocol writing will ensure that a number of important practical study issues are dealt with timeously. Step 8 -- Discuss the protocol with experts. Their input will make your protocol more robust. Step 9 -- Consider the data points, statistical analysis plan and a potential process evaluation. This will ensure no data redundancy which often compromises research projects in resource-limited environments. Step 10 -- Make a 'social contract' committing oneself publicly to the project. Step 11 -- Write a grant application. This allows identification of funding priorities of potential grant funding agencies, thereby allowing the researcher to frame their research in such a manner to hopefully ensure the financial support necessary for the success of the project. Step 12 -- Ensure that the research protocol is publicly visible, which increases the integrity of the project. Step 13 -- Conduct the research, which requires education, communication and steering committee meetings to ensure early identification of study conduct problems. Step 14 -- Analyse the data according to the statistical analysis plan. Step 15 -- Write a good manuscript. [ABSTRACT FROM AUTHOR]

The South African Pharmaceutical Journal (SAPJ) is preparing for an eventful year in 2024. The journal plans to introduce new features, including articles on the impact of unprofessional behavior on patient safety, the identity of pharmacists, and the perspectives of young pharmacists. To enhance diversity, an editorial board will be appointed, and every review paper will include three questions for Continuous Professional Development (CPD). In addition, South Africa will host the 82nd International Pharmaceutical Federation's World Congress on Pharmacy and Pharmaceutical Sciences in Cape Town. The journal bids farewell to Mr. Ivan Kotze, the Executive Director of the Pharmaceutical Society of South Africa, who is retiring after 30 years of service. The journal looks ahead with optimism and invites readers to join in shaping the future of pharmacy in South Africa and beyond. [Extracted from the article]

Background: In South Africa, the doctrine of informed consent (introduced by the South African courts, Cape Provincial Division) dictates that all reasonable patients be told of material risks and alternative options before consenting to medical treatment or procedural interventions. The reasonable patient standard requires that a patient be told of all material risks that would influence a reasonable person in determining whether or not to consent to the treatment. Regional anaesthesia, including peripheral nerve blocks (PNBs), provides a plethora of benefits to patients undergoing surgery but, due to potential risks involved, also requires informed consent. Studies have shown that South African anaesthetists do not regularly obtain adequate informed consent for these procedures. We implemented a quality improvement project to facilitate and enhance documented informed consent in our setting. Methods: A prospective quality improvement project was established at Groote Schuur Hospital, Cape Town, including all PNBs performed in two-week blocks before and after the introduction of a standardised regional anaesthesia informed consent form. The primary outcome, comparing the incidence of documented informed consent between the two groups, was assessed with the McNemar's test for differences in proportions. Regression analysis was used to explore the effect of prespecified confounders (such as documented consent taken, benefits discussed, alternatives discussed, complications discussed and whether autonomy was documented). Results: In total, 39 and 43 patients were included in the pre- and post-intervention groups, respectively. In our setting, anaesthetists were 4.16 times (95% confidence interval (CI) -6.67 to -2.98, p < 0.001) more likely to take documented informed consent when provided with a standardised form. The incidence of documented informed consent improved from 7.7% to 60.5%. Regression analysis showed that these confounders influenced the recall of the PNB consent and discussed benefits and complications. Overall, recall was mostly influenced when benefits were discussed with patients (95%CI -20.023 to -14.64, p < 0.001). Conclusion: Documentation of informed consent for PNBs in our setting is poor. A standardised consent form can facilitate the documentation of consent significantly. Patient recollection of the consent process also improved, specifically when benefits were discussed. [ABSTRACT FROM AUTHOR]

Background: After surgery, patients are at risk of developing postoperative pulmonary complications (PPCs). Our current understanding of PPCs is based on data from high-income countries (HICs). Methods: A systematic review and meta-analysis was conducted to evaluate the incidence of PPCs in adult postsurgical patients from low- to middle-income countries (LMICs). The protocol was registered on the PROSPERO database (CRD42020212932). The search strategy was performed in 2021 on several electronic databases. Studies were assessed for risk of bias with the modified Newcastle-Ottawa Scale. Forest plots of the event rate for the incidence of PPCs and factors associated with PPCs were created. Results: The search strategy identified 1 052 records. Fifteen studies were included in the final review (total of 4 873 participants). Five studies were of high methodological quality. The overall pooled event rate for the incidence of PPCs was 22.4% (95% confidence interval (CI), 15.76-30.78%). In-hospital mortality in patients who developed PPCs was 33.1%. PPCs were identified as a risk factor for in-hospital mortality (odds ratio (OR) 18.2, CI 11.01-30.09). Insufficient outcome data were available to determine the association of PPCs between elective versus emergency surgery, and cardiothoracic versus non-cardiothoracic surgery. Advanced age was associated with the development of PPCs (MD 4.7, 95% CI 0.63-8.7). Male sex was associated with the development of PPCs (OR 1.5, 95% CI 1.17-2.02). PPCs were associated with increased length of hospital stay (mean difference (MD) 6.5, 95% CI 4.04-8.96). Conclusion: The incidence of PPCs was 22.4% following surgery in adult patients in LMICs and was influenced by differences in the definitions of PPCs used. PPCs were identified as a risk factor for in-hospital mortality. Data on the type of surgery and patient characteristics were poorly reported. Further research on PPCs in LMICs is needed to provide granular data for future use. [ABSTRACT FROM AUTHOR]

Background: Clinical registries are pivotal for advancing patient care and clinical research. The prospective Point of Care Ultrasound Registry (PURE) is a unique, pioneering initiative that aims to accumulate essential ultrasound data through a dedicated collection tool. This study investigates user satisfaction with the implementation of PURE, a first-of-its-kind registry, focusing on a spectrum of implementation outcomes. Methods: Using a cross-sectional survey approach, this study evaluated diverse implementation metrics such as acceptability, appropriateness, adoption, accessibility, feasibility, efficacy and efficiency. Statistical analyses were conducted to determine the overall user satisfaction with the implementation of this novel registry. Results: The study yielded a mean implementation score (IS) of 3.83 (95% CI 3.59-4.07). Effectiveness (E) had a mean score of 1.93 (95% CI 1.80-2.05) and Cumulative Implementation Factor (A) averaged 1.90 (95% CI 1.78-2.03). Notably, 11 of the 30 participants achieved an IS above 4, with a predominant 21 of 30 surpassing an IS of 3.8. Nevertheless, the scores for efficiency and feasibility, registered at 0.392/0.625 and 0.165/0.250, respectively, indicate areas for improvement. Conclusion: While PURE represents an innovative step forward in point-of-care ultrasound (POCUS) data collection, its initial implementation did not fully resonate with user satisfaction expectations. Significant possibilities for enhancement lie particularly within the efficiency and feasibility sectors. To improve its utility, measures such as optimising the data collection tool, bolstering training programmes, merging with existing systems, and implementing thorough evaluation and feedback processes are recommended. A nuanced understanding of the time pressure faced by anaesthetists during data input can provide valuable insights into further areas of potential refinement. [ABSTRACT FROM AUTHOR]

Background: In many hospitals, theatre slates are booked according to potentially inaccurate estimations of procedural times. Furthermore, inaccurate time predictions can contribute towards suboptimal utilisation of theatre time. This study was conducted to evaluate theatre procedural time parameters and predictions. The objectives were to determine the average duration of common elective surgical procedures at Tygerberg Hospital (TBH) and to determine whether there are discrepancies between the estimated procedural times and the actual procedural times for selected common surgical procedures. Methods: We performed a single-centre retrospective observational study, analysing data from January to December in 2019, obtained from electronic theatre records. A total of 32 elective procedures were examined for total procedural, surgical, and nonsurgical times. Additionally, we prospectively compared the durations of the five most frequent procedures with their estimated times to assess discrepancies. Results: The time parameters of the 32 common elective surgical procedures performed at this institution were recorded. The cohort was further divided into minor and major surgery groups. The average mean non-surgical time for minor and major surgery was 36 and 44 minutes, respectively. Prospective data analysis showed a statistically significant underestimation of procedural time when compared to the actual duration of total abdominal hysterectomy (p = 0.011), total hip replacement (p < 0.001), transurethral resection of the prostate (p < 0.001), and above knee amputation (p = 0.013). The average procedural time underestimation for the four procedures ranged between 33% and 61%. Conclusion: Our study showed that procedural times of selected common elective procedures are frequently underestimated at our institution. This study also collected data that can assist with improving the accuracy of procedural time estimations at TBH, potentially improving theatre efficiency. [ABSTRACT FROM AUTHOR]

Background: The World Health Organization Surgical Safety Checklist (WHO Checklist) fosters communication and teamwork among the perioperative team; however, perceptions influence its acceptance and use. This study explores the perceptions of the perioperative team regarding the WHO Checklist in operating theatres at the University of the Witwatersrand (Wits) affiliated hospitals. Methods: A qualitative, contextual, and exploratory research design was employed. Purposive sampling was used to invite theatre nurses, anaesthetists, and surgeons to participate. Focus group interviews were held for each group, which were audio-recorded and transcribed verbatim. Thematic analysis was used to analyse the data. Results: Ten nurses, six anaesthetists, and four surgeons participated in the focus group interviews. Four themes relating to patient safety were identified: the prevalence of power struggles in theatre, a breakdown in communication, a culture of silence, and inadequate and siloed training. The metaphor of a daily flight plagued by turbulence describes the perceptions of the interviewed perioperative teams, which may result in serious adverse events. Conclusion: In a complex system, such as a hospital theatre environment, introducing a simple tool, such as the WHO Checklist, is perceived to have a limited impact on patient safety if the underlying supportive network is not intact. This study demonstrates the importance of interpersonal relationships, changing teams, lack of integration of teams, processes, and training on the use of the WHO Checklist as a safety tool in a South African hospital setting. A prevailing culture of safety is a prerequisite for the successful implementation and use of the WHO Checklist. [ABSTRACT FROM AUTHOR]

Background: Core temperature changes during obstetric spinal anaesthesia are likely underestimated because monitoring is challenging and often not performed. This study aimed to describe the incidence and severity of perioperative hypothermia in patients undergoing caesarean delivery under spinal anaesthesia in a resource-limited setting. Methods: We performed a prospective observational study of parturients undergoing either elective or emergency caesarean delivery under spinal anaesthesia in a South African regional hospital. We used dual-sensor heat flux technology to monitor their core temperature during the perioperative period. The primary outcome was the incidence of clinically relevant hypothermia (defined as core temperature decrease from baseline of > 1 °C) following spinal anaesthesia. Smoothing splines were used to estimate maximum changes in core temperature. Results: We included 166 patients in our analysis. A decrease of > 1 °C occurred in 49% of participants (95% CI 40-63%) while hypothermia (temperature < 36 °C) occurred in 67% (49-78%). Discharge from recovery room with core temperature < 35 °C occurred in 26% (20-34%) of the participants. There was a higher incidence of vomiting in those participants who experienced temperature decreases of > 1 °C (18% vs 6%, p = 0.03). Conclusion: In this resource-constrained environment, clinically relevant hypothermia during obstetric spinal anaesthesia occurred in half of participants. Hypothermia was often severe and participants did not recover by the time of discharge from anaesthesia care. Monitoring of a patient's core temperature should be a standard of care, and further research into the clinical impact of perioperative hypothermia and warming strategies in these settings is warranted. [ABSTRACT FROM AUTHOR]

The article focuses on the physics behind neuromuscular monitors in anesthesia, exploring single-twitch, double-burst, and post-tetanic count techniques. Topics include the underlying physiology of neuromuscular blockade, determinants of neural stimulation, and clinical endpoints of neuromuscular blocking agents.

Background: Preoperative anxiety potentially results in perioperative anaesthetic complications. This study aimed to determine the prevalence of preoperative anxiety in adult patients scheduled to undergo elective orthopaedic surgery at an academic hospital in South Africa and identify contributory factors. Methods: This cross-sectional study included all patients scheduled for elective orthopaedic surgery the following day from 25 July to 3 November 2021. An adapted version of the Amsterdam Preoperative Anxiety and Information Scale (APAIS) was used. Four questions determined the patients' anxiety and two questions their desire for more information about their forthcoming anaesthesia and surgery. A 5-point Likert scale was used to capture the patients' responses to the APAIS questions. Data on other possible contributory factors to preoperative anxiety were collected using a questionnaire. Results: Of the 88 patients, 82 (93.2%) were included in the study. A total of 40 (48.8%) patients had an APAIS score of = 11, indicating anxiety. A high need-for-information score (= 8) was found in 31 (37.8%) patients. A significant association between patients with a higher anxiety score and a higher need-for-information score (p = 0.0063) was identified. Other non-significant factors associated with a higher anxiety score included a lower level of education and no postoperative home support. Conclusion: Patients with a high need for information tended to be more anxious on the day before surgery. The APAIS could be introduced in preoperative ward admissions to identify these patients and provide an appropriate level of counselling about their planned procedure. Counselling might reduce their preoperative anxiety, but further research needs to confirm this assertion. Larger studies are recommended to determine the influence of other factors contributing to preoperative anxiety. [ABSTRACT FROM AUTHOR]

Background: The post-anaesthesia high-care unit (PAHCU) at Tygerberg Hospital is a short-stay high-care unit that provides continuous monitored care to patients identified preoperatively as having an elevated risk for postoperative complications. This study aims to describe the patient population, utilisation, and functionality of this unit and to investigate the correlation between patient comorbidities, surgery type, and risk of exceeding a 24-hour stay. Methods: This is a retrospective, single-centre descriptive study of 1 020 patients' data admitted to the PAHCU from 1 January 2019 to 31 December 2020. All patients admitted were included. The primary outcome was the utilisation and functionality of the unit. Secondary outcomes were the indication for admission, modes of analgesia used, and length of stay. Results: Of the 1 020 patients, 69 (6.76%) patients exceeded the 24-hour stay. In total, 889 (87.2%) were pre-planned admissions and 130 (12.8%) unplanned, one (0.09%) patient demised, and 11 (1.07%) patients were transferred to the ICU for further management. Bed occupancy during weekdays was 86.8% in 2019 and 58.13% in 2020. Patients with aortic stenosis had 4.36 (95% CI 1.23-15.41, p = 0.022) times the odds of exceeding a 24-hour PAHCU stay. Additional significant factors included ages < 40 (p = 0.01) and > 61 (p = 0.006), admission for epidural care (p = 0.015), haemodynamic monitoring (p < 0.001), and patients who were admitted from the general surgery department (p = 0.014). Conclusion: PAHCU admissions are considered appropriate due to the low mortality rate, ICU transfer rate, and the number of patients exceeding a 24-hour stay. With a bed occupancy of 86.80% in 2019, the management of the unit can be considered effective. [ABSTRACT FROM AUTHOR]

Background: Perioperative bleeding contributes significantly to patient morbidity and mortality while the cost of blood products is substantial. Viscoelastic testing (VET) forms part of the armamentarium for perioperative patient blood management. To date, there is a lack of published literature on the knowledge, attitudes, and practices (KAP) of medical practitioners regarding VET. The objective of this study was to describe the KAP of South African anaesthesiology registrars concerning perioperative point-of-care (POC) VET. Methods: A descriptive, cross-sectional study design was performed using a novel, electronic self-administered questionnaire as the data collection instrument. The study population consisted of South African anaesthesiology registrars who were part of the South African Society of Anaesthesiologists' (SASA) electronic mailing list. Results: A total of 71 completed questionnaires were received (response rate = 16.67%). Based on this, 69% of registrars were found to have adequate knowledge. Senior registrars were more likely to have adequate knowledge than junior registrars (p = 0.043). Of the registrars, 64.7% had a positive attitude score towards perioperative VET. All registrars felt they would benefit from a formal education platform on VET. The overall median self-rated confidence score for interpreting VET results was 6/10. Senior registrars had a higher median self-rated confidence score (6 vs 5) compared to junior registrars (p = 0.005). Registrars stated that a lack of VET consumables and trained technologists to administer the test was the greatest barrier to requesting VET for patients at their respective institutions. Conclusion: Overall knowledge scores were encouraging, however, there is room for improvement, particularly at the junior registrar level. Targeted educational interventions should be implemented at both a local and national level. The lack of national guidelines should be addressed by a multidisciplinary team. Locally developed guidelines can serve as a tool for improving registrar knowledge on the subject of VET and can be used for improving uniformity in practices and standards across the various registrar training circuits in South Africa. [ABSTRACT FROM AUTHOR]

Bacteriophages are viruses that selectively kill specific bacterial species. There is extensive experience in Eastern Europe in using bacteriophages for infections that are difficult to treat. Globally increasing antimicrobial resistance renders many infections untreatable with limited or no antibiotic options. Bacteriophages are not currently used in South Africa, with limited research, laboratory and clinical experience. The authors introduce the use of bacteriophages and demonstrate its activity on laboratory strains of bacteria using a commercial bacteriophage cocktail. This study aims to promote knowledge and develop protocols for bacteriophage susceptibility testing in South African laboratories and thus, eventually, use in clinical settings. The authors used a commercial phage preparation against laboratory strains of bacteria to describe a laboratory protocol that can be used by routine diagnostic laboratories for phage-bacteria susceptibility testing. Routine diagnostic laboratories can easily develop the skills to provide phage-bacteria susceptibility testing. Although only the Pseudomonas aeruginosa ATCC strain was susceptible to the commercial phage cocktail, this study showed that testing is important due to phage specificity and that clinical isolates would need to be tested before therapy with a commercial cocktail is initiated. Phage therapy will become essential as antibiotic resistance is inevitable. Commercial phage cocktails are a possible solution to multidrug resistant pseudomonal infections in South Africa. The authors will test the commercial phage against clinical Pseudomonas aeruginosa strains in the next phase of the study and recommend that diagnostic laboratories become familiar with phage susceptibility testing should phage therapy become a reality. [ABSTRACT FROM AUTHOR]

Background: Smartphone use has increased exponentially, having formed an integral part of the COVID-19 pandemic era, especially in the academic arena. It has been established that fomites can harbour potentially pathogenic microorganisms, which pose health risks to humans, particularly to the immunocompromised. The purpose of this study was to determine which microorganisms were harboured on the surfaces of smartphones, document the device sanitisation and hand hygiene habits of students within a university cohort, and determine associations of these habits with microorganism colonisation on smartphones. Methodology: This study prospectively sampled 168 randomly selected students from different departments at the Durban University of Technology (DUT). After informed consent, a swab sample from each participant's smartphone was collected and transported to the microbiology laboratory for culture following standard microbiological guidelines. Participants were also asked about device sanitisation and their awareness of smartphones harbouring microorganisms. IBM Statistical Package for Social Sciences (SPSS) Statistics V.27 was used for data analysis with the use of descriptive statistics, Pearson chi-square and Pearson's correlation tests. Results: From the 168 participants, microorganisms were detected in 113 (67.3%) samples, from which 20 different microorganisms were isolated. The majority of microorganisms (n = 17; 73.7%) were opportunistic pathogens. Out of the 168 questionnaire responses, only 36 (21.4%) study participants sanitised their smartphones despite 97 (57.7%) stating that they were aware of smartphones harbouring microorganisms. Conclusion: This study reports a high prevalence of microorganisms harboured on smartphones. The isolation of opportunistic pathogens, as well as the low frequency of smartphone sanitisation, raises a need for awareness of the contamination of smartphones and the potential risk of infection. [ABSTRACT FROM AUTHOR]