The appropriate management of the habitat of the endangered and endemic White-spotted Ketsi Blue butterfly, Lepidochrysops ketsi leucomacula Henning & Henning, 1994, is necessary for its survival. Much of the life history and ecology of this butterfly are unknown. The oviposition plant was found to be Selago tarach-odes Hilliard and the plants that were observed to be visited by L. k. leucomacula for nectar all had pink flowers. Monitoring of two populations of L. k. leucomacula in protected areas commenced in March 2022. Surveillance and walked transects were the monitoring methods used. Observed threats to this endangered butterfly in protected areas were uncontrolled grazing by domestic livestock and mowing of its grassland habitat. Fencing of its grassland habitat may be a way to control these threats.

BACKGROUND: Neonatal hypoxic ischaemic encephalopathy (HIE) is a leading cause of term neonatal death worldwide, with a higher incidence in low- to middle-income settings OBJECTIVE: To investigate whether nucleated red blood cell (nRBC) counts could predict severity of HIE and outcomes in term neonates treated with therapeutic hypothermia (TH METHODS: We conducted a retrospective sub-study at Tygerberg Hospital in Cape Town, South Africa. The review included all cooled neonates' clinical records and blood samples from a National Health Laboratory Services database. One experienced neurodevelopmental expert assessed patients over a period of 12 months RESULTS: Twenty-five files out of a total of 100 were excluded owing to missing data. In accordance with the Thompson HIE score, the cohort was classified as mild (56%), moderate (27%), and severe (17%). All included patients (n=75) had full blood counts within 6 hours of delivery. nRBC were detected in 52% of the samples. There was no correlation between nRBC category and HIE severity (p=0.265). Raised nRBCs (>30 cells/100 white blood cells (WBCs)) were more frequent in infants who died than in those who survived (p=0.008). Infants with nRBC counts >30 cells/100 WBCs had an increased likelihood of having cerebral palsy or impaired neurodevelopment (p=0.013 CONCLUSION: The study demonstrated a significant association between an early increase in nRBC counts in HIE infants treated with TH, and both short- and long-term outcomes. A larger multicentre study is required to better understand the relationship between nRBC counts and HIE in the era of cooling in our local setting

ABSTRACT: The buccal adipose body (BAB) is a well- defined multilobulated adipose component, located bilaterally in the facial region, closely related to nervous and vascular structures. BAB removal is a widely studied procedure in the field of maxillofacial surgery, used mainly to cover defects. Its influence on facial aesthetics has started to popularize the removal of the BAB buccal extension to obtain a more stylized face, an intervention widely known as minimally invasive and without complications. The objective of this study was to collect and evaluate studies that report and evaluate complications associated with the removal of BAB for cosmetic reasons. The evidence was reviewed in the Medline databases via PubMed, Epistemonikos, Scopus, and Google Scholar, using predefined terms, selecting primary studies from case reports. 7 articles with a total of 10 patients were included; Of these, eight patients underwent this procedure in Brazil, one in the United States, and one in Chile. The distribution of the population was 3:7 between men and women with an average age of 35 years and a range between 23 to 49 years. In relation to the reported complications, 100 % of the patients presented facial asymmetry, 80 % presented facial edema, 30 % manifested sialocele, trismus 20 %, 40 % presented hematoma, 20 % compromised general state, 20 % presented dysphagia, in the cases of hypoesthesia, paresthesia, abscess, seroma, facial paralysis, odynophagia, fever were expressed in 10 % of the studied population. All the studies described a surgical reintervention after cosmetic removal of the bichat adipose body. The scarce literature and its low quality do not allow estimating the real percentage of possible complications, nor is it possible to determine their long-term results since there is no evidence of appropriate follow-up for these patients.

RESUMEN: El cuerpo adiposo de la boca (CAB) es un componente adiposo multilobulado bien delimitado, localizado de manera bilateral en la región facial íntimamente relacionado a estructuras nerviosas y vasculares. La remoción de CAB es un procedimiento ampliamente estudiado en el campo de la cirugía maxilofacial, utilizado principalmente para cubrir defectos. Su influencia en la estética facial ha iniciado una popularización de la remoción de la extensión bucal de CAB para obtener un rostro más estilizado, intervención difundida como poco invasiva y sin complicaciones. El objetivo de este estudio fue recopilar y evaluar estudios que reporten y evalúen complicaciones asociadas a la remoción por razones estéticas de CAB. Se revisó la evidencia en las bases de datos Medline vía PubMed, Epistemonikos, Scopus y Google Scholar, utilizando términos predefinidos, seleccionando estudios primarios de reportes de casos. Se incluyeron 7 artículos con un total de 10 pacientes; de estos, ocho pacientes se realizaron este procedimiento en Brasil, uno en Estados Unidos y uno en Chile. La distribución de la población fue de 3:7 entre hombres y mujeres con edad promedio de 35 años y un rango entre los 23 a los 49 años. En relación a las complicaciones reportadas, 100 % de los pacientes presentaron asimetría facial, un 80 % presentó edema facial, 30 % manifestaron sialocele, Trismus 20 %, 40 % presentó hematoma, 20 % compromiso del estado general, 20 % presentaron disfagia, en los casos de hipoestesia, parestesia, absceso, seroma, parálisis facial, odinofagia, fiebre se expresaron en 10 % de la población estudiada. En todos los estudios se describió una reintervención quirúrgica posterior a la remoción estética del cuerpo adiposo de bichat. La escasa literatura y la baja calidad de esta, no permite estimar el porcentaje real de posibles complicaciones, tampoco es posible determinar sus resultados a largo plazo ya que no existe en la evidencia un seguimiento apropiado para estos pacientes.

In 2019, Discovery Health published a risk adjustment model to determine standardised mortality rates across South African private hospital systems, with the aim of contributing towards quality improvement in the private healthcare sector. However, the model suffers from limitations due to its design and its reliance on administrative data. The publication's aim of facilitating transparency is unfortunately undermined by shortcomings in reporting. When designing a risk prediction model, patient-proximate variables with a sound theoretical or proven association with the outcome of interest should be used. The addition of key condition-specific clinical data points at the time of hospital admission will dramatically improve model performance. Performance could be further improved by using summary risk prediction scores such as the EUROSCORE II for coronary artery bypass graft surgery or the GRACE risk score for acute coronary syndrome. In general, model reporting should conform to published reporting standards, and attempts should be made to test model validity by using sensitivity analyses. In particular, the limitations of machine learning prediction models should be understood, and these models should be appropriately developed, evaluated and reported.

This study aimed to determine the seroprevalence levels of Toxoplasma gondii in small ruminants (goats and sheep) and the associated risk factors in the Khomas region of Namibia. A total of 299 and 345 sheep and goat sera from 22 farming establishments were tested, respectively. An IDEXX Toxotest Ab®, a commercial ELISA kit, was used to screen for IgG antibodies to T.gondii. Overall, 3.68% (11/299) of the sheep sera were positive, and 61.54% (8/13) of the sheep flocks tested had at least one positive animal. Only one of the 345 goat sera from 19 flocks was positive, giving animal-level and herd-level prevalences of 0.29% and 5.26%, respectively. Sheep flocks had significantly greater animal-level and flock-level prevalences than goats (p < 0.05) and were 13.14 times more likely to be seropositive (OR = 13.14; CI 95%: 1.686-102.382) than goat flocks. A questionnaire was also administered to identify any putative risk factors associated with seropositivity. Eight risk factors were evaluated, including the total number of goats, total number of sheep, farm size, average rainfall, presence of wild Felidae (African lions, caracals, cheetahs and leopards), presence of domesticated and stray cats and history of abortions in the flocks. Seropositivity to T. gondii in sheep was positively associated with the total number at the farming establishment, history of abortions and farm size (p < 0.05), but not with goats. The study determined that sheep in the Khomas region were probably more exposed to T. gondii infection than goats. It also found T. gondii seroprevalences that were much lower than those in similar studies from other countries in the sub-region and elsewhere.

BACKGROUND: Fibromyalgia Syndrome (FMS) has been linked to decreased social functioning, poor mental health, and quality of life (QOL). Increased physical functioning and activity can result in improvements in social, mental and overall health, as well as lowered depression and anxiety levels OBJECTIVES: The aim of this study was to determine physical activity levels and QOL amongst patients diagnosed with fibromyalgia in the Johannesburg region of South Africa METHODS: The research design was cross-sectional. Descriptive and quantitative data were collected. FMS patients (n=38) completed an online questionnaire on the Google Forms platform. The questionnaire was comprised of four components, namely Demographics, the Global Physical Activity Questionnaire (GPAQ), the Fibromyalgia Impact Questionnaire (FIQR), and the Short Form-36 (SF-36). During data analysis, descriptive characteristics and correlations were computed. The significance level was set at p < 0.05 RESULTS: Results revealed high FIQR scores (67%) accompanied with low QOL scores (<50% in all domains). There was no correlation between physical activity and FIQR, and physical activity and QOL CONCLUSION: High scores on the impact of FMS were associated with lower overall QOL scores. However, the relationship between physical activity, and the impact of FMS and QOL remain inconclusive

BACKGROUND: By using complementary therapies, such as exercise rehabilitation during and after cancer treatment, breast cancer patients and survivors can improve their quality of life and overall health while also negating the deleterious effects of breast cancer and its treatment. OBJECTIVES: The aim of this study was to determine the physical activity levels of female breast cancer patients and survivors in Ekurhuleni, South Africa. METHODS: The International Global Physical Activity Questionnaire (2002) determined participants' physical activity levels during work, travel and leisure. The questionnaire was disseminated to medical facilities in hard copy format and online via the Google Forms platform. Statistics were computed using the Statistical Package for Social Science (SPSS) with the level of significance set at 95% (p < 0.05 RESULTS: One hundred female breast cancer patients and survivors with a mean age of 55 years from Ekurhuleni, South Africa. participated in this study. The findings reflected that most participants (59%) were meeting the American College of Sports Medicine's physical activity guidelines when considering activity done during work, travel and leisure. No significant difference was seen in physical activity participation between breast cancer patients and breast cancer survivors, or those attending private and public facilities. CONCLUSION: For the breast cancer patient, physical activity and exercise may be a promising and effective adjuvant treatment both during and after anticancer therapies, improving quality of life, playing a role in increasing treatment tolerance, mitigating a range of symptoms and side effects brought on by cancer diagnosis and treatments and enhancing outcomes.

BACKGROUND There is interest in lingering non-specific symptoms after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, referred to as Long coronavirus disease 2019 (Long COVID-19). It remains unknown whether the risk of Long COVID-19 is associated with pre-existing comorbidities or initial COVID-19 severity, including infections due to new Omicron lineages which predominated in 2023. OBJECTIVES The aim of this case report was to characterize the clinical features of acute XBB.1.5 infection followed by Long COVID-19. METHODS We followed a 73-year old female resident of Rio de Janeiro with laboratory-confirmed SARS-CoV-2 during acute infection and subsequent months. The SARS-CoV-2 lineage was determined by genome sequencing. FINDINGS The participant denied comorbidities and had completed a two-dose vaccination schedule followed by two booster doses eight months prior to SARS-CoV-2 infection. Primary infection by viral lineage XBB.1.5. was clinically mild, but the participant subsequently reported persistent fatigue. MAIN CONCLUSIONS This case demonstrates that Long COVID-19 may develop even after mild disease due to SARS-CoV-2 in fully vaccinated and boosted individuals without comorbidities. Continued monitoring of new SARS-CoV-2 lineages and associated clinical outcomes is warranted. Measures to prevent infection should continue to be implemented including development of new vaccines and antivirals effective against novel variants.

RESUMEN Las actitudes del público sobre la genética parecen depender del contexto local. Analizamos las respuestas de una encuesta suministrada en 2015 a 293 residentes de Luján, una ciudad de la provincia de Buenos Aires, Argentina, quienes autoevaluaron su conocimiento sobre genética y su confianza en las pruebas genéticas. La encuesta integraba un proyecto de investigación más amplio en el que los adultos participantes que dieron su consentimiento compartieron información demográfica y genealógica y proporcionaron muestras de saliva para un estudio de ancestría genética. Cuando se les preguntó sobre su conocimiento y confianza, los participantes informaron tener poco conocimiento sobre genética, pero mucha confianza en las pruebas genéticas. Historias muy conocidas de los medios de comunicación sobre investigaciones genéticas forenses basadas en el ADN para identificar a las víctimas de la represión estatal durante la dictadura militar pueden haber contribuido a la alta autoevaluación del propio conocimiento genético manifestado por algunos participantes, independientemente de su nivel educativo. Nuestro análisis proporciona información que podría utilizarse como base para comenzar a desentrañar los niveles actuales de confianza pública en la genética en una región del Sur Global donde las pruebas genéticas se han generalizado, pero el conocimiento y confianza de las personas sobre genética están poco estudiados.

ABSTRACT Public attitudes about genetics appear to depend on the local context. We analyzed survey responses obtained in 2015 from 293 residents of Luján, a city in the province of Buenos Aires, Argentina, who self-assessed their knowledge about genetics and their trust in genetic tests. The survey integrated a larger research project for which consenting adult participants shared demographic and genealogical information and provided saliva samples for genetic ancestry analyses. Participants reported little knowledge but high trust in genetic testing when questioned about knowledge and trust. Well-known media stories of DNA-based forensic genetic investigations to identify the victims of state repression during the military dictatorship may have contributed to the high self-assessment of their genetic knowledge expressed by some participants, regardless of educational attainment. Our analysis provides information that could be used as a baseline to begin unraveling the current level of public trust in genetics in a region of the Global South where genetic testing has become widespread, but people’s knowledge of and trust in genetics remain poorly studied.

ABSTRACT: The supernumerary tooth of nasal location is a pathology of low prevalence in the population with different forms and clinical symptoms. It is important to establish a diagnosis regarding its clinical and radiological characteristics in order to carry out adequate surgical treatment planning, with few or no post-intervention complications. Case presentation: This study reports the case of a 10-year-old boy, with no morbid history, who presented a supernumerary tooth, found radiographically in the midline. CBCT showed a mesiodens in the nasal septum, tilted and inverted palatal, partially erupted covered by nasal mucosa, with its crown facing the nasal cavity in relation to the nostrils. The tooth was extracted under general anesthesia using a transoral approach through a vestibulotomy. The nasal supernumerary tooth is a rare pathology. It is important to know its clinical and radiographic characteristics since they will determine the type of approach to be used. The degree of eruption, the distance to the anterior nasal spine and its associated symptoms are essential to determine whether the surgical approach is intraoral or extraoral.

RESUMEN: El diente supernumerario de ubicación nasal es una patología de baja prevalencia en la población con diferentes formas y sintomatología clínica. Es importante establecer un diagnóstico respecto a sus características clínicas y radiológicas para realizar una planificación de tratamiento quirúrgica adecuada, con nula o escasas complicaciones post intervención. Presentación del caso: En el presente estudio se reporta el caso de un niño de 10 años de edad, sin antecedentes mórbidos, que recurre al servicio por presentar un diente supernumerario en la línea media hallado radiográficamente. El CBCT demuestra un mesiodens en el septum nasal, palatal inclinado e invertido, parcialmente erupcionado cubierto por mucosa nasal, con su corona en sentido a la cavidad nasal en relación a las fosas nasales. El diente fue extraído con anestesia general mediante un abordaje transoral a través de una vestibulotomía. El diente supernumerario nasal es una patología poco prevalente. Es importante conocer sus características clínicas y radiográficas ya que determinarán el tipo de abordaje a realizar. El grado de erupción, la distancia a la espina nasal anterior y su sintomatología asociada son fundamentales para determinar si el abordaje quirúrgico es intraoral o extraoral.

BACKGROUND: Little epidemiological research on rheumatoid arthritis (RA) has been done in Africa, suggesting that it is an uncommon illness. In rural South Africa, RA has an overall prevalence of 0.07% and a prevalence of 2.5% in urban areas; therefore, it is not as uncommon as perceived by the lack of research. Patient-centred programmes to improve physical function have been lacking and, as a result, the prior assumption was that physical activity should be avoided. OBJECTIVES: To determine pain and physical activity levels among RA patients between the ages of 18 to 50 years in South Africa. METHODS: A combination of two questionnaires were used, namely, the Global Physical Activity Questionnaire (2002) and the Pain Outcomes Questionnaire (2003). The collated questionnaires were distributed by rheumatologists and on social media platforms to RA patients between the ages of 18 to 50 years old living in South Africa. This study had a sample size of 105 participants, with participation occurring through the online Google forms platform. RESULTS: One hundred and five participants with RA were recruited with an average age of 38±9 years. Most of the participants were females (93.3%). Seventy-two percent of the sample was classified as physically active, where work, leisure and travel activities were considered. No significant correlation between pain and physical activity was evident (r=0.10; p=0.311). Results showed significant correlations between pain and personal grooming (r=0.30; p=0.002), pain and ambulation (r=0.60; p=0.000), and pain and stair climbing (r=0.60; p=0.000. CONCLUSION: Physical activity has proven to have multiple benefits for those suffering with RA. In this South African sample of RA patients, the majority were classified as physically active, and pain did not affect the activity levels of the involved participants. This study opens further research questions regarding RA prevalence in South Africa, and the type and intensity of physical activity that would be beneficial for RA.

BACKGROUND: South African (SA) children from disadvantaged communities are plagued by a double burden of under- and over-nutrition. The resulting overweight and obesity on the one hand, and stunting on the other, are risk factors for chronic diseases in adulthoodOBJECTIVE: To determine the effect of school-based interventions on body composition of grade-4 children from lower socioeconomic communities in the Gqeberha region, SAMETHODS: A cluster-randomised controlled trial was carried out with children from 8 schools. Schools were randomly assigned, either to a 10-week school-based intervention (4 schools) or a control condition (4 schools). The intervention comprised several arms, with each intervention school receiving a different combination of the following measures: physical activity, health and hygiene education, and nutrition education with supplementation. Effects on children's body composition were evaluated using standardised, quality-controlled methods. Height and weight were assessed to calculate body mass index (BMI), and percentage body fat was measured via thickness of skinfolds (triceps and subscapularRESULTS: Overall, 898 children (458 boys and 440 girls) aged 8 - 11 years participated in the trial. Children's BMI, BMI-for-age and percentage body fat increased significantly over time. Increases were similar in boys and girls. Body fat remained unchanged in underweight children, whereas increases occurred in normal weight and (particularly) overweight/obese peers. In normal-weight children, the physical activity intervention (either alone or combined with health education) mitigated increments in body fat levels. A similar pattern was observed in overweight/obese children, but only in the physical activity intervention cohort aloneCONCLUSION: Our study shows that normal-weight children are at risk of becoming overweight and children who are already overweight/ obese are at even greater risk of gaining weight. The physical activity intervention (alone or in combination with health education) can mitigate increases in body fat in normal-weight children as well as in overweight/obese children. Our findings reveal that school-based physical activity, nutrition and health and hygiene interventions can have beneficial effects on children's body composition. Further analyses are needed to examine how (school-based) physical activity interventions should be designed to improve children's health in lower socioeconomic areas

BACKGROUND: Since the start of the COVID-19 pandemic, surgical operations have been drastically reduced in South Africa (SA). Guidelines on surgical prioritisation during COVID-19 have been published, but are specific to high-income countries. There is a pressing need for context-specific guidelines and a validated tool for prioritising surgical cases during the COVID-19 pandemic. In March 2020, the South African National Surgical Obstetric Anaesthesia Plan Task Team was asked by the National Department of Health to establish a national framework for COVID-19 surgical prioritisation.OBJECTIVES: To develop a national framework for COVID-19 surgical prioritisation, including a set of recommendations and a risk calculator for operative care.METHODS: The surgical prioritisation framework was developed in three stages: (i) a literature review of international, national and local recommendations on COVID-19 and surgical care was conducted; (ii) a set of recommendations was drawn up based on the available literature and through consensus of the COVID-19 Task Team; and (iii) a COVID-19 surgical risk calculator was developed and evaluated.RESULTS: A total of 30 documents were identified from which recommendations around prioritisation of surgical care were used to draw up six recommendations for preoperative COVID-19 screening and testing as well as the use of appropriate personal protective equipment. Ninety-nine perioperative practitioners from eight SA provinces evaluated the COVID-19 surgical risk calculator, which had high acceptability and a high level of concordance (81%) with current clinical practice.CONCLUSIONS: This national framework on COVID-19 surgical prioritisation can help hospital teams make ethical, equitable and personalised decisions whether to proceed with or delay surgical operations during this unprecedented epidemic.

BACKGROUND. Trauma care places a significant burden on the South African (SA) healthcare system, and this has not changed significantly in recent history. We speculated that the COVID-19 lockdown regulations (travel restriction and alcohol ban) would affect trauma patterns.OBJECTIVES. To compare the burden and nature of trauma over the COVID-19 lockdown period with the equivalent period over the past 5 years using routinely collected data from the Pietermaritzburg Metropolitan Trauma Service in KwaZulu-Natal Province, SA.METHODS. All trauma patients admitted to Grey's Hospital in Pietermaritzburg between 23 March 2015 and 31 May 2020 were identified and reviewed.RESULTS. A total of 8 859 trauma patients were admitted over the 6-year period, with a total of 1 676 admitted during the periods 23 March -31 May. These 1 676 formed the study cohort. Of these patients, 998 had sustained blunt trauma, 665 penetrating trauma, and 13 a combination of blunt and penetrating trauma. A total of 14 categories of blunt trauma were reviewed, of which the three most common were assault, motor vehicle accidents (MVAs) and pedestrian vehicle accidents (PVAs). Between 23 March and 31 May 2020, a total of 23 patients were victims of blunt assault. The median number of assault victims over the equivalent period during the previous 5 years was 48. The 5 preceding years had a median of 56 MVAs and 33 PVAs, compared with 23 and 10 during the lockdown. The median number of gunshot wound (GSW) victims for the preceding years was 41, compared with 30 during the lockdown. During the lockdown, 24 stab wound victims were admitted, compared with a median of 73 for the preceding years. The proportion of females who sustained penetrating trauma and blunt assault increased significantly during the lockdown. The proportion of females sustaining a GSW or blunt trauma secondary to an MVA remained constant.CONCLUSIONS. The study showed that during the period of lockdown in SA there was a significant decrease in MVAs, PVAs and interpersonal violence. Assaults involving a knife seemed to decrease dramatically, but the rate of GSWs remained constant.