Andre Marais

Conditions frequently self-treated with herbal remedies by patients visiting a tertiary hospital in Gauteng, South Africa

Background: Herbal medications are used worldwide for a variety of diseases and conditions. Patients often elect not to disclose their herbal use history, or health care practitioners fail to enquire about specific alternative therapy. The aim of this study was to assess the conditions most frequently self-treated with herbal remedies by patients visiting a tertiary hospital in Garankuwa, South Africa. Methods: Patients attending an out-patient’s clinic at the Dr George Mukhari Academic Hospital were given a questionnaire regarding their use of herbal remedies for various reasons. Assessment was done on past, current, and possible future use of herbal interventions. These interventions were categorised into acute medical conditions, chronic ailments, and cultural uses. Results: Respiratory tract infections were most frequently treated (34%). Other highly ranked uses included protection from evil spirits (32%) and for HIV/AIDS (29%). Digestive ailments (27%), hypertension (18%), and general malaise (17%) accounted for the remainder. Previous herbal use amounted to 74%, but only 30% indicated that they would use herbal medication in future. Conclusions: Traditional medication plays an important role in many communities in South Africa. For this reason health care workers need to be aware of the conditions most frequently self-treated with herbal remedies. Having knowledge about the incidence of herbal treatment for a specific condition could alert the health care practitioner to possible reasons for unidentifiable drug interactions, adverse events, treatment failure, or even death.

The use of methylphenidate as a cognitive enhancer by health sciences students at a South African university: - a pilot study

This project was presented at the annual congress of the South African Society for Basic and Clinical Pharmacology, held at the University of the Witwatersrand in September 2015. A conference abstract was published in a supplementary edition of the South African Journal of Infectious Diseases.

The pharmacological management of erectile dysfunction

Background : Hypothyroidism is a common clinical condition confronting all healthcare practitioners yet there remains uncertainty about the optimal medication and optimum treatment targets. In addition, many patients remain symptomatic despite using recommended medications and attaining recommended treatment targets. Methods : All endocrinologists in South Africa who consented to be part of the guideline process were assigned various aspects of the management of patients with thyroid disease. In each section the current literature was reviewed and the level of evidence was graded. This information was then presented at a guideline meeting. Where evidence was lacking a consensus among participants was adopted. Results : This guideline provides 11 recommendations for the management of primary hypothyroidism, secondary hypothyroidism and subclinical hypothyroidism in adults. Conclusions : This is the first South African guideline for the management of hypothyroidism in adults and represents a comprehensive review of the current literature in an attempt to provide evidence-based guidance for all healthcare practitioners regarding the many clinical aspects encountered when managing patients with hypothyroidism.Objectives: To determine differences in the control of multiple diabetes control parameters in a select group of subjects with type 2 diabetes (T2DM) after a four-year follow-up period. Design: Cross-sectional study. Setting and subjects: The initial 2009 study population consisted of 666 T2DM patients of whom only 261 (39.2%) were audited at the Charlotte Maxeke Johannesburg Academic Hospital. Outcome measures: Using a public sector database, retrospective data were obtained on the treatment of participants with T2DM attending a tertiary care setting and a descriptive analysis was done. Results: The mean age was 64 (SD 10.6) years, women represented 55% of the cohort and the mean duration of diabetes was 16 years (range 2–40 years) in 2013. Fewer patients achieved an HbA1c goal (of < 7%) in 2013 (15.5%) compared with 2009 (25.4%), whilst an additional 13.7% and 25.0% of the 261 patients reached blood pressure targets (< 140/80 mmHg) and LDL-C targets (< 2.5 mmol/L), respectively. Conclusion: Overall, more patients in the study reached blood pressure and LDL-C targets but there were difficulties in achieving optimal glycaemic levels over the four-year period. This study highlights the complexities of managing risk factors in T2DM, especially glucose control.Thyroid gland disturbances are the second most common endocrine disorder after diabetes mellitus. Given that approximately 200 million people in the world have some form of thyroid disease, it is no wonder that thyroid function tests, i.e. thyrotropin and free thyroxine (T4), currently account for a significant portion of the routine workload of clinical chemistry laboratories. This was not the case more than 100 years ago.