Computed tomographic findings of the brain in adult HIV-infected patients at Doctor George Mukhari Academic Hospital, Ga-Rankuwa, Pretoria, South Africa

Background/Aim: The aim of this study is to determine the pattern of computed tomographic (CT) findings in HIV-infected patients referred for CT brain at Doctor George Mukhari Academic Hospital (DGMAH) and to correlate the CD4 counts with CT brain findings of the patients on antiretroviral (ARV) drugs, and those that are ARV naïve. Methods: A descriptive, retrospective review of CT brains obtained from 128 slices Philips and GE, CT scanners, medical records, and laboratory results of 364 adult HIV-infected patients over a 6-month period (October 1, 2016­March 31, 2017) was conducted at Radiology Department of DGMAH. Statistical analyses were made using a Statistical Program for Social Sciences software (SPSS version 19.0). Results: From the 364 CT brain findings of HIV-infected patients reviewed, 46.2% were male and 53.8% were female. The findings were as follows: brain atrophy (168; 46.2%); infarcts (55; 15.1%); hydrocephalus (24; 6.6%); white matter disease (18; 4.9%); mass lesions (13; 3.6%); rim enhancing lesions (12; 3.3%); intracranial bleed (11; 3.0%); tuberculous granuloma (32; 8.8%); tuberculous meningitis (15; 4.1%); and cryptococcal meningitis (2; 0.5%). Opportunistic infections and mass lesions still predominate at CD4 count <200 cells/mm3 although the reduction in the prevalence of opportunistic infections was observed. Brain infarct was seen at CD4 count <200 cells/mm3, and brain atrophy was seen at all CD4 count levels (median= 84 cells/mm3). Conclusion: This study was conducted in the post-highly active ARV therapy era, and the most common CT scan brain finding was brain atrophy, followed by brain infarct

Central obesity is an independent risk factor of poor glycaemic control at Dr George Mukhari Academic Hospital

Background: Results of previous studies on the effect on glycaemic control of anthropometric measures of obesity, some economic status variables and the presence of metabolic syndrome are not consistent and appear to differ among health institutions. The status of glycaemic control and some of its determinants was investigated among adult black patients with type-2 diabetes mellitus (T2DM) at Dr George Mukhari Academic Hospital (DGMAH).Method: A random sample of 176 adult black South African patients with T2DM attending the diabetic clinic at DGMAH was investigated in the current study. Fasting blood glucose, glycated haemoglobin (HbA1c), lipid profile components levels as well as anthropometric measures of obesity were measured using standard measuring procedures for these variables. Thepresence of metabolic syndrome was assessed according to the International Diabetic Federation criteria. Information related to patients' socioeconomic status was collected by means of a structured questionnaire. Associations between these factors and poor glycaemic control were assessed by means of binary and multivariate logisticanalysis. ResultsGlycaemic control was found to be very poor at DGMAH. As low as 16.6% of the study subjects achieved SEMDSA's 2012 recommended target HbA1c value of less than 7.0%. Whereas binary logistic analysis revealed that marital status, matriculation,increase waist circumference and duration of diabetes > 5 years may lead to poor glycaemic control, multivariate logistic regression analysis indicated that only increased waist circumference was independently associated with poor glycaemic control at DGMAH