Browsing by Author "Nkgudi, Boitumelo"

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    An audit of emergency hernia operations: Surrogate of system failure or incidentalomas?
    (2020) Nkgudi, Boitumelo; Kloppers, Jacobus; Rayamajhi, Shreya
    Background: Hernia emergencies common surgery. Around 20 million groin hernia operations occur world-wide, and these form 70% of all hernia operations. Incisional hernias complicate 15- 30% of laparotomies and 20% of these present as emergencies. Watchful waiting is often applied for groin, ventral and incisional hernias in patients who are asymptomatic or those who are poor surgical candidates. The factors associated with poor outcomes include - elderly patients, multiple comorbidities, delays in presentation, those which are incarcerated or strangulated and delays in getting to theatre. Management of emergency hernias include resuscitative efforts to address life threatening problems, and thereafter performing the safest and most durable repairs. Aim: We aim to elucidate patient and health care systems factors that contribute to hernia emergency presentations and to document the mortality and morbidity of such presentations in our unit. Method: We aim to review case files of all patients above 18 years of age who had their emergency surgery for a complicated hernia. All elective cases will be excluded. Conclusion: This study will contribute to understanding emergency hernias in south Africa and will seek to improve patient care in our setting. A hernia registry has recently been established and thus we will be able to contribute to its foundation.
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    Open Access
    Notification of rheumatic fever in South Africa - evidence for underreporting by health care professionals and administrators
    (2006) Nkgudi, Boitumelo; Robertson, Kate A; Volmink, Jimmy; Mayosi, Bongani M
    Objective. To determine whether under-reporting of rheumatic fever occurs at hospital, municipal, provincial and national levels of the South African health system. Background. Information on the incidence of rheumatic fever (RF) and the prevalence of rheumatic heart disease (RHD) is required for the prevention of valvular heart disease in developing countries. In South Africa, RF was made a notifiable condition in 1989. It has recently been suggested that the reporting of RF cases may be incomplete, possibly because of underreporting by health care professionals and deficient administration of the disease notification system in South Africa. Method and results. We assessed whether underreporting of RF cases occurs by comparing the numbers of RF cases reported per year at hospital, municipal, provincial and national levels from 1990 to 2004. There was a fall in the number of RF cases reported per year at national and provincial level over the 15 years of observation. A detailed analysis of the number of RF cases reported at hospital, municipal and provincial level for a 5-year period showed that more cases were diagnosed in one hospital (serving a smaller population) than were captured at municipal and provincial level (serving a larger population), suggesting underreporting by health care professionals. There were discrepancies in the number of cases reported at municipal, provincial and national level, suggesting poor administration of the notification system. Conclusion. There appears to be underreporting of RF cases by health care professionals, and poor administration of the RF notification system. Health care professionals need to be educated about the statutory requirement to notify all RF cases in South Africa. An effective national disease notification system is required.