Masters Degrees (Anaesthesiology)
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Browsing Masters Degrees (Anaesthesiology) by Author "Lamacraft, G."
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Item Open Access Knowledge of relevant medical laws pertaining to informed consent, by doctors working at the Department of Anaesthesiology of the UFS in June 2015(University of the Free State, 2015) Lourens, T.; Lamacraft, G.Doctors follow an ethical code imprinted on them from the time of Hippocrates. Practicing medicine within these ethical codes, doctors also have to practice their craft within the legal boundaries of the country and institution they inhabit. The primary aim of this study was to investigate the current knowledge of relevant medical laws pertaining to informed consent, by doctors working at the Department of Anaesthesiology of the University of the Free State, UFS, in June 2015. The secondary aim of the study was to determine if doctors working at the Department of Anaesthesiology of the UFS complete their section of the standard surgical consent form available in the hospitals they practice in. The study was designed as a cross sectional observational study, using self-administered questionnaires after approval by the Ethics Committee of the Faculty of Health Sciences, UFS. Data analysis was performed by the Department of Biostatistics at the UFS. The results were summarised using frequencies and percentages. Results of the primary aim of the study indicated a poor level of understanding pertaining to the medical laws in which doctors' practice with various levels of confusion to details especially regarding the Children's Act of 2005 and the Choice on Termination of Pregnancy Act of 1996. This study demonstrated the poor understanding of biomedical ethical concepts and how they are incorporated in the various South African laws.This study indicated that the doctors that worked at the Department Anaesthesiology of the University of the Free State during June 2015 expose themselves to possible medical malpractice and future litigation due to lack of documentation on the informed consent form.Item Open Access The prevalence of patients with undiagnosed pulmonary tuberculosis, undergoing surgery at Pelonomi Tertiary Hospital(University of the Free State, 2021-06) Botha, Anna Margaretha; Steyn, D.; Lamacraft, G.Introduction: Tuberculosis (is a significant cause of death in South Africa (resulting in a massive financial burden on the economy of the country. Delayed diagnosis is a problem in low and middle income countries and can unintentionally cause other patients and personnel exposure, especially in enclosed areas such as theatres. The short and long term consequences of occupational acquired TB affect the health care worker s physical, physiological, and financial health. This might put much strain on the health care workers themselves, their families and the health care system. Method: This was a retrospective descriptive study done in May 2020, investigating all patients over the age of thirteen years that underwent surgery at Pelonomi Tertiary Hospital for one month (from 1 November 2019 till 30 November 2019) to evaluate how many of these patients might have had active tuberculosis (known or unknown) on the day that they underwent surgery. All available laboratory TB test results of the patients were included from three months before the documented surgery date and up to three months post the surgery date. Any patient with a documented positive TB laboratory test result during this period and not on TB treatment for at least two weeks, was considered potentially infectious. Results: A total of 583 patients underwent surgery in November 2019. Of these 583 patients, 21 had a TB test done during the mentioned period, and results were captured on the Natio nal Health Laboratory Service database. Only one patient of the total 21 who was tested for tuberculosis had a positive TB test, which was done on the day of surgery. On admission, the patient presented with a lower respiratory tract infection before receiving his open L4 biopsy for possible infective spondylolysis surgery. The staff screened the patient for pulmonary TB (and an Xpert ® MTB/RIF Ultra (Xpert ® Ultra) test was done on 12/11/2019. The Xpert ® Ultra results reported on 13/11/2019 were positive and sensitive to Rifampicin, and the patient was subsequently started on treatment. On the day of surgery, the patient was assumed to only have a bacterial lower respiratory tract infection and was not managed a s a TB infected patient, and the necessary precautions were not taken, leading to exposure of the theatre staff and other patients to PTB. Conclusion: The proportion of undiagnosed TB infection under patients who were perioperatively tested was 4,8%. However, since only patients who were expected to be admitted to ICU after surgery or who had respiratory symptoms before surgery were tested for TB, this study could not determine the prevalence of TB in patients receiving surgery.Item Open Access The prevalence of skin scars on patients previously given intramuscular diclofenac injections, attending Universitas Academic Hospital Pain Clinic: a descriptive study(University of the Free State, 2016) Tarloff, D.; Lamacraft, G.INTRODUCTION: An incidental finding of scarring after intramuscular Diclofenac was made at the Pain Clinic, Universitas Academic Hospital, Bloemfontein. The primary objective of our study was to document the prevalence of scars caused by these injections and to determine how patients obtained intramuscular diclofenac and who administered it to them. METHODS: A descriptive study was performed at the Pain Clinic. Informed consent was obtained and all patients attending (1st December 2013 – 31st August 2014) were included. Patients completed a questionnaire and the attending doctor examined the injection site. Data captured at examination included: site of injection(s) and skin changes. RESULTS: 131 patients were enrolled and data analysis was performed on 118 patients (these patients were completely sure injection they had received was diclofenac). Scarring was identified in 8.5% of the study population. The majority of patients received the IM diclofenac from general practitioners (41.5%), private pharmacists (30.6%) and hospital pharmacies (15%). Only 17.5% of the patients always had a prescription and 78.8% had not been warned against skin scars. Associated complications included pain, pruritus, erythema at the injection site, ulceration or skin damage, scarring and nausea. Four patients required medical treatment for a skin ulcer or abscess and 2 of these patients required surgical treatment. DISCUSSION: This study shows that the prevalence of scarring after intramuscular diclofenac injections in our study population is 8.5%. In the population studied, 28.2% of patients had the drug administered by an unqualified person, and only 17.5% always had a prescription. This study shows that 78.8% of the study population had never been warned about skin scars as a potential side effect.