SSMJ February 2021
Editorials
While South Sudan awaits the arrival of the vaccines, whenever that will be, the focus should be on the prevention strategies, implemented in tandem with restrictions that should minimally affect daily lives. A mask mandate throughout the country will go a long way in preventing new cases of the virus.
News, Reports and Policy
Nyaduoth Jock was a 5-year-old girl living in the village of Pare in the Western part of Yomding Payam, 20 kilometres from Ulang County, Upper Nile State. Pare village has a population of about 1500 and most earn a living mainly by farming and cattle rearing. Pare community accesses its health services at Rupboard Primary Health Care Centre (PHCC) seven kilometres away.
The world renowned South Sudanese academician, cardiologist and HIV researcher Professor James Gita Hakim died on January 26th, 2021 in Harare, Zimbabwe, from COVID-19 related complications.
Professor Hakim was a member of the South Sudan Medical Journal’s Editorial Board and a long-standing supporter of the journal.
Dr. Elsa was a mother, a colleague, and partner in eye care; she held a lot of promise to our effort to advance eye care in South Sudan. Her death has robbed South Sudan of a brilliant, focused, and forward-looking medical professional who would have contributed immensely to the improvement of health care in the country.
Clinical Guidance
Elbow injuries are common in the paediatric population. Diagnosing these injuries relies on X-rays taken on initial presentation in the emergency department. Interpreting these radiographs can occasionally be challenging, partly because of the sequential appearance of secondary ossification centres in the paediatric elbow. We propose a methodical approach that would help a clinician identify these injuries, especially the radiographically subtle ones.
Antimicrobial drugs are the basis of modern medicine, saving lives and allowing surgery and chemotherapy to be possible. Inappropriate use of antimicrobials has led to resistance, meaning we can no longer rely on them being effective. This is further complicated by a lack of new drugs coming to market. Antimicrobial resistance is a well-documented global problem and threatens low and middle-income countries (LMIC) disproportionately.
WHO has produced an update to the living guideline on drugs for COVID-19 in the article published by by BMJ. It replaces earlier versions (4 September and 20 November 2020) and supersedes the BMJ Rapid Recommendations on remdesivir published on 2 July 2020. The previous versions can be found as data supplements. New recommendations will be published as updates to this guideline.
ebrain is a large online elearning environment that can be used by both trainees and trainers to support continuing professional development. It is owned jointly by all the major UK and European Clinical Neuroscience Organisations.
Corona Scanner is a free online dashboard solution which offers real-time coronavirus statistics like the amount of infections, deaths, still sick and recovered people per country.
A living WHO guideline on drugs treatment of COVID-19
Research
The coronavirus pandemic (COVID-19) has placed enormous challenges on the health sector. Diagnosis is one of these challenges, where a clinical presentation may suggest a disease other than COVID-19. In this review we describe many presentations unrelated to the respiratory system. The ACE2 receptor is present in a wide variety of body tissues and it appears that this may be a link with the clinical pathology. To find these data we searched the major academic research engines, Google Scholar, and Pubmed, as well as the most recent case reports and original research published in specialized journals.
Case Reports
The purpose of this case report is to describe our experience of the anaesthetic management of a patient with morbid obesity undergoing general surgery. The obese patient is at great risk of problems with endotracheal intubation and developing peri-operative respiratory and cardiovascular complications. The difficulties in moving and positioning the patient and gaining venous access add to the problems.
Subtarsal foreign bodies (FB) are a significant cause of ocular discomfort and are often missed on slit lamp examination of the everted upper eye lid. We report a patient with a needle-like subtarsal FB which was missed on repeated examinations over a three-month period. Staining with fluorescein and observation of scratch marks on epithelial surface of the cornea can give a clue to the presence of such a FB.
Summaries
he MRCP UK examination is one of the most difficult for UK graduates. International Medical Graduates (IMGs) will find it even harder for a variety of reasons.
I moved to the UK in 2010 after leaving an international public health career. Travelling from one country to another with a family had become difficult. After GMC registration in 2011, I worked for three years as a foundation doctor followed by being a locum.