BackgroundCurrent practice in the Western Cape region of South Africa is to discharge newborns born in-hospital within 24 h following uncomplicated vaginal delivery and two days after caesarean section. Mothers are instructed to bring their newborn to a clinic after discharge for a health assessment. We sought to determine the rate of newborn follow-up visits and the potential barriers to timely follow-up.MethodsMother-newborn dyads at Tygerberg Hospital in Cape Town, South Africa were enrolled from November 2014 to April 2015. Demographic data were obtained via questionnaire and medical records. Mothers were contacted one week after discharge to determine if they had brought their newborns for a follow-up visit, and if not, the barriers to follow-up. Factors associated with follow-up were analyzed using logistic regression.ResultsOf 972 newborns, 794 (82%) were seen at a clinic for a follow-up visit within one week of discharge. Mothers with a higher education level or whose newborns were less than 37 weeks were more likely to follow up. The follow-up rate did not differ based on hospital length of stay. Main reported barriers to follow-up included maternal illness, lack of money for transportation, and mother felt follow-up was unnecessary because newborn was healthy.ConclusionsNearly 4 in 5 newborns were seen at a clinic within one week after hospital discharge, in keeping with local practice guidelines. Further research on the outcomes of this population and those who fail to follow up is needed to determine the impact of postnatal healthcare policy.

Background: Medically Supervised Exercise (MSE) are advisable for the prevention and treatment related side effects among breast cancer survivors. Aerobic and resistance either exercise, separately or in combination, have been shown to improve physical functioning and manage some symptoms in breast cancer patients. However, the level of evidence on the effects of lifestyle interventions on therapy related adverse events and the required dose responses of exercises are not yet systematically reviewed. This review was conducted to assess the efficacy of medically supervised exercises(MSE) coupled with diet in preventing/managing aromatase inhibitors induced adverse events and improving range of motion(ROM) and heath related quality of life (HRQOL) in postmenopausal breast cancer patients following treatment. Methods: Two independent authors extracted data using PRISMA guidelines of published clinical trials. We searched the Cochrane Central Register of Controlled Trials, PubMed, MEDLINE, EMBASE, as well as clinical practice guidelines. We included only randomized controlled trials that examined exercise interventions coupled with diet interventions in postmenopausal breast cancer women. Health related quality of life (HRQOL) and range of motion were assessed as the main outcomes. Results: Random effects meta-analysis was conducted for pooling of the effect size. The age of patients varied from 50 to 60 years. The results illustrate that the mean difference (MD) in improving ROM in the MSE group versus no supervised exercises was 1.35% (95% CI: 0.63 to 2.07%, P = 0.0002; heterogeneity: Tau² = 0.71; Chi² = 112.14, df = 5 (P < 0.00001); I² = 96%). A summary of the data shows that supervised exercises significantly improved ROM and HRQOL in postmenopausal BCS on endocrine therapy compared to no supervised exercises 3.02 (95% CI: 2.59 to 3.45, P < 0.00001). These outcomes show that lifestyle interventions (MSE +diet) have positive effects on AI-associated adverse events and likely improve ROM and HRQOL in postmenopausal BC patients. Conclusion: The evidence was based on a body of research with moderate study quality. Moreover, further studies are recommended to assess the effect of lifestyle interventions on markers of inflammation as the predictors of treatment non-response and associated comorbidities.

Background: Chronic limb-threatening ischemia (CLTI) is a complex disease caused by peripheral artery disease. It is associated with ischemic foot pain (rest pain) and tissue loss in the form of chronic nonhealing foot ulcers or gangrene. CLTI has a high short-term risk of limb amputations, postoperative sepsis, and cardiovascular-related events. Aims: The present study was conducted to assess the demographic and anthropometric profile of patients with CLTI and their postoperative outcomes after 2-year follow-up at Groote Schuur Hospital, Cape Town, South Africa. Methods: This prospective descriptive pilot study, nested in a prospective cohort study, included adult patients with CLTI admitted to Groote Schuur Hospital from 1st January 2015 to 31st December 2016. Demographic data, anthropometric markers of CLTI, and the postoperative outcomes were documented using piloted and pretested vascular questionnaire. Descriptive statistics were used for baseline data, and postoperative outcomes were presented using actuarial life-table method (Kaplan–Meier analysis). Odds ratio, 95% confidence interval, and P value < 0.05 were used to test the hypothesis. Results: Thirty-seven (50.6%) patients had a BMI >25.0. The mean waist: hip ratio was 0.96. Prevalence of smoking was 86%. Limb salvage and ambulation at 1 year were 79% and 67%, respectively. Majority of the patients who were ambulant preoperatively remained ambulant postoperatively. Conclusion: Most patients had truncal obesity with a high prevalence of smoking. High postoperative ambulatory recovery among ambulant preoperative patients was a significant outcome observed in our study.

No abstract