SSMJ February 2015
Editorials
In this issue of SSMJ there is an article entitled “The crucial role of medical doctors in reducing maternal deaths in South Sudan”. It is based on two circumstances. Firstly, South Sudan has the highest national maternal mortality ratio in the world, above 2000, which is roughly 1000 times higher than in Sweden. Secondly, leading cadres in the Ministry of Health in Juba have an open, evidence- based and scientifically updated attitude to the most fundamental underlying problem: the scarcity of human resources for health (HRH) to save maternal lives.
News, Reports and Policy
Clinical Guidance
Cassava is the third most important food source in the tropics and the staple food of tropical Africa. Cassava:
• is easy to grow,
• produces a good yield of starchy roots in 6-9 months even in poor soils without added fertilizer,
• is drought resistant; the roots are a reserve source of food in drought and famine conditions [1].
Millennium Development Goal (MDG) 5 is related to reducing maternal mortality. Against the background of the failure of this MDG, South Sudan has two features that make it interesting for the international donor community:
‘Cough’ is so common we sometimes do not realise just how important it can be. It is at best annoying to patients (and families) especially if nocturnal and, at worst, very distressing particularly if associated with dyspnoea, copious sputum and/or pain. It may be associated with many serious diseases including lung cancer and tuberculosis.
Neonatal scalp seborrhoeic dermatitis or psoriasis?
Research
Paediatric malnutrition is a significant problem in South Sudan, with rates of wasting up to 22% reported in some areas [1]. Severe acute malnutrition (SAM) is associated with a high mortality [2]. Affected patients require thorough assessment and holistic care including appropriate therapeutic feeding, treatment of associated complications and rehabilitation in order to achieve good outcomes.
Case Reports
‘Guillain-Barre syndrome’ (GBS) is a broad term used to describe a collection of clinical syndromes which manifest as acute immune-mediated demyelinating diseases or more rarely axonal diseases of the peripheral nervous system. The most commonly recognised form is ‘acute inflammatory demyelinating polyradiculoneuropathy’ (AIDP), which classically presents as a proximal and distal weakness with diminished reflexes, often involving the cranial nerves and muscles of respiration [1]. It is a neurological emergency as these patients are at risk of developing respiratory failure; one third will require admission to the Intensive Care Unit (ICU) for ventilatory support, and mortality rates of 3-10% have been reported [2].
Summaries