Browsing by Author "Bezuidenhout, J"

Now showing 1 - 3 of 3
  • Thumbnail Image
    Item
    Incidence, trends of prevalence and pathological spectrum of head and neck lymphomas at national health laboratory services- Tygerberg
    (University of the Western Cape, 2007) Chetty, Manogari; Hille, JJ; Bezuidenhout, J
    MChD (Oral Pathology) minithesis, Department of Oral and Maxillofacial Pathology, Faculty of Dentistry, University of Western Cape Among malignant lesions, lymphoma ranks second only to squamous cell carcinoma in frequency of occurrence in the head and neck. Lymphomas in HIV patients' are second in frequency to Kaposi's sarcoma as AIDS-defining tumours. About 50% of lymphomas in HIV patients are extranodal and more than half of these occur in the head and neck area. The number, variety and diagnostic complexity of lymphoma cases that have primarily arisen in the head and neck region has steadily increased in the surgical pathology service of the National Health Laboratory Services (NHLS) - Tygerberg. This observation is particularly relevant in the context of increasing HIV infection rates in the population of South Africa as demonstrated by a study in 2006 conducted by the Medical Research Council of South Africa. This is a retrospective study using the records of cases of head and neck lymphomas diagnosed at NHLS-Tygerberg over the last five years. The aim of this study is to investigate the prevalence of head and neck lymphomas (HNL) at NHLS-Tygerberg from January 2002 to December 2006. The objective of this study is to determine the frequency and types of HNL and to determine, if possible, an association between the incidence of HNL and the HIV status of the patients. Trends of prevalence in terms of gender, referral centres, HIV status, age of patients and site of presentation are also examined. The results of this study show an increase in the number of patients with HNL from January 2002 to December 2006. A significant increase is noted in the number of HIV positive patients documented each year, from 17% in 2002 to 33% in 2006. Western Cape- urban (WC-U) remains the largest referral center. A notable increase is seen, each year, in the number of patients referred to Tygerberg-NHLS from the Eastern Cape (EC) and Western Cape- rural (WC-R) areas. A significant number of HIV positive patients are referred from the Eastern Cape and Western Cape rural areas. The average age of disease presentation in the HIV positive group of patients is 35 years with the unknown group being 46 years and the HIV negative group being 54 years. The main categories of lymphoma that presented in HIV positive patients are plasmablastic lymphoma (PBL) and diffuse large B-celllymphoma (DLBCL), which together form 56% of cases. 26% of cases are Hodgkin's lymphoma (HL); the second largest group of HNL cases. Burkitt's lymphoma (BL) consists of 8% of cases. 7% of cases are T-cell lymphomas. 3% of cases are Mantle zone lymphomas. No cases of SLL and Follicular lymphomas (FL) are described in this group of patients. DLBCL and HL form 27% each of the cases in patients with a negative HIV status. A significant number of Follicular lymphomas (15%), small lymphocytic lymphoma (SLL) (9%), MALT (7%), and T-cell lymphomas (8%) are identified. No PBL are seen in this group of patients. The incidence of HNL at NHLS-Tygerberg has increased over the last five years. This trend parallels that seen in other developing countries such as Tanzania, Nigeria, Thailand and India. This increase is possibly due to an increase in the number of referrals to our center, an increase in the overall population of the Western Cape, an increase in the number of HIV positive patients and the high incidence of EBV infection in the general population of the Western Cape. Social issues, such as poverty, lack of adequate education, female dependence on partners, rural communities and the non-availability of anti-retroviral drugs (ARV) and highly active anti-retroviral therapy (HAART) to most of the population that require these drugs, are considered major contributing factors. A trend is noted in the increased number of female patients diagnosed each year with HNL. A predominance of DLBCL was identified in our series. This is consistent with previous reports and studies on HNL. The number of biologically aggressive lymphomas, such as DLBCL, Plasmablastic and Burkitt's lymphomas diagnosed each year, has also significantly increased. These were prevalent mainly in the HIV positive group of patients who were also younger compared to the HIV negative patients. The documented findings of this study will serve as a guideline for the estimation of head & neck lymphoma burden and risk assessment at NHLS- Tygerberg.
  • Thumbnail Image
    Item
    Medical education units: A necessity for quality assurance in health professions education in Nigeria
    (Health & Medical Publishing Group, 2018) Adeola, Henry Ademola; Adefuye, AO; Bezuidenhout, J
    In recent years, curricula and pedagogical methods in medical education have undergone rapid and unprecedented changes globally. The emphasis has shifted from traditional, teacher-centred learning, characterised by the accumulation of non-integrated volumes of knowledge, to active, student-centred learning. The Medical and Dental Council of Nigeria (MDCN) reports that there are 31 fully accredited and 6 partially accredited medical schools in Nigeria. The majority of these medical schools still offer undergraduate medical training based on a curriculum characterised by a distinct separation of preclinical and clinical training, with minimal or no integration. This approach is coupled with low-quality teaching by medical educators, as many medical colleges in Nigeria presently use specialists as lecturers who have little or no training in higher education practices; their only exposure to teaching is that obtained during their postgraduate specialty training. Similarly, very few medical schools in Nigeria have established medical education units (MEUs), as recommended by the World Health Organization and the World Federation for Medical Education. We discuss the shortcomings of the present medical education system in Nigeria and suggest ways to improve the quality of pedagogy among Nigerian medical educators, such as the establishment of clinical-skills centres and MEUs at Nigerian medical schools. In addition, this review highlights the role and importance of MEUs in facilitating quality assurance in health professions education, and the urgent need for more medical schools in Nigeria to establish MEUs to promote, co-ordinate and evaluate medical education reforms based on needs assessments and within the confines of MDCN standards.
  • Thumbnail Image
    Item
    Trace elements risk assessment for consumption of wild mussels along South Africa coastline
    (Elsevier, 2021) Petrik, L; Nekhoroshkov, P.S; Bezuidenhout, J
    The study aimed to contribute to the scarce data on concentrations in the soft tissue of wild mussels growing in coastal cities of South Africa. The intake of 26 micro and macroelements was estimated. The mass fractions of sample sets from 8 sites along the South African coast from the West (Port Nolloth) to the East (Durban) were studied by neutron activation analysis at the Joint Institute for Nuclear Research (Russia). The following elements were identified as potentially hazardous due to high consumption risks: Al, Cr, Co, Zn, As, and I at stations in the Cape Town area (Waterfront, Hout Bay) and Durban. The mean concentrations of these elements among all individuals were 208, 0.8, 0.46, 60, 2.6, and 11 ppm of wet weight, respectively. In the studied mussels, the concentrations of Cr, Zn, As, and Se (ranging between 0.2−2.8, 14–290, 1.6−4.6, and 0.31−2.4 ppm of wet weight, respectively) exceeded maximum permissible levels for fish products. The weekly consumption of more than 250 g of fresh mussels per person could increase the risk for human health by potential intake of such elements as Al, As, and I