A 20-year (1996-2015) trend in deaths as a result of burns in the Transkei subregion of South Africa.

Background Deaths as a result of burns are unrecognised, under-reported and therefore under-estimated, especially in rural areas such as the Transkei subregion of South Africa. Burning to death is painful and preventable. Objective The aim of this study was to investigate a 20-year trend in deaths as a result of burns in the Transkei subregion of South Africa. Method A record review descriptive study was undertaken of all medico-legal autopsies performed from 1996 to 2015 at Mthatha Forensic Pathology Laboratory. Results In total 22,952 medico-legal autopsies were conducted at Mthatha Forensic Pathology Laboratory from 1996 to 2015. Of these, 689 (3%) were burn related. This gives an average of eight deaths resulting from burns per 100,000 of the population annually in this region. The highest rate (11.6/100,000) was recorded in 2007, and the lowest (3.3/100,000) in 2004. Males outnumbered females at a ratio of 1.6:1. Young children of aged 10 years old or younger accounted for 130 of the victims, amounting to a death rate of 1.51/100,000. Conclusion The number of deaths as a result of burning has more than doubled in the last 20 years (1996-2015) in the Transkei subregion of South Africa. Action to prevent these deaths is urgently required.

An epidemiology of sexual assault among elderly women in the Mthatha area of South Africa.

Background South Africa has one of the highest rates of rape in the world, but this barely seems to surprise anyone. It is extremely disturbing, especially when children and elderly women are raped. Women and children are usually the weakest group in society physically, as well as the most exposed to abuse and neglect. It should be the responsibility of a civil society to protect these vulnerable groups from harm. Objective This study investigated the trend of rapes among elderly women in the Mthatha area of South Africa. Method This was a retrospective descriptive study from the records of the Sinawe Centre. All cases of the rape of elderly women (i.e. those aged ≥65 years) between 2007 and 2011 were recorded. The Sinawe Centre is now a one-stop centre known as the Thuthuzela-Sinawe Centre, which is the only centre to deal with cases of rape in this area. Results A total 2579 adult victims of rape (i.e. those aged ≥16 years) were reported at the Sinawe Centre over a five-year period (2007-2011). Of these, 145 (5.6%) involved elderly women. The average rate of rape among elderly women was 20.7/10,000 adult women per year. There was an increase in elderly rape from 17.1/10,000 women in 2007 to 40/10,000 women in 2009. The highest percentage (45.5%) of women were aged between 65 and 70 years, and the lowest percentage (4.1%) were aged between 86 and 90 years. The highest number of cases (56; 38.6%) were reported in 2009 (p < .05; χ2 = 45.2). In the majority of cases (122; 84.2%), there was a single perpetrator. There were two perpetrators in 14 (9.6%) cases, and three or more perpetrators were recorded in nine (6.2%) rapes. A little more than half (74; 51%) were known to the victims. In 117 (83%) cases, the rape took place in the home. Human immunodeficiency virus infection was found to be prevalent in five (3.6%) cases of elderly rape. Conclusion There are a high number of rapes among elderly women in the Mthatha area of South Africa. It is a matter of serious concern, and needs urgent attention.

Urethrocutaneous fistula: a rare presentation of penile tuberculosis.

A man in his 50s presented with two urethrocutaneous fistulae with intermittent dribbling of urine from the opening of fistula on the surface of glans penis. A skin biopsy from indurated margin of fistula was suggestive of fibrosing granulomatous reaction. Anti-tubercular therapy was given with a diagnosis of penile tuberculosis and there was 50% improvement within two months of treatment.

A case report on near manual strangulation and glasgow coma scale.

BACKGROUND: Glasgow Coma Scale (GCS) is considered as a gold standard in estimating the prognosis of the comatose patient. The management of the patient relies heavily on this scale. The mechanism of injury must also be included in scoring of the GCS. Survival from strangulation is uncommon, and if it occurs, it is often associated with various complications such as neurological consequences. OBJECTIVE: To highlight a poor correlation with low GCS and ultimate outcome in cases of manual strangulation. CASE REPORT: This is a case report of young female adult who was raped and manually strangulated by a colleague during a training course for traditional healers. She was admitted with very low (3/15) Glasgow Coma Scale (GCS) and presumed to have a poor prognosis. She was rigorously ventilated in Intensive Care Unit (ICU), and was discharged from hospital after a week without any complications. The neck and genital injuries are described. This report discusses. CONCLUSION: A low Glasgow Coma Scale is not a predictive of poor prognosis in cases of manual strangulation.

Incidence of suicide among teenagers and young adolescent in Transkei, South Africa

Background: Transkei is the least developed of the former black homelands in South Africa and has a population of about 4 million. People in this area are poor and depend mainly on the income from migratory workers to the gold mines. Suicide is a complex problem; with no definitive causative agent that has been identified as yet. Suicide among teenagers and young adults is now emerging as an important mental health issue. Suicidal behaviour in the population is under- researched; and therefore under-reported.Method: This is a retrospective record review from 1993 to 2003; carried out in the Umtata General Hospital mortuary. About 1 000 medico-legal autopsies are conducted annually; and the mortuary caters for a population of about 400 000. Results: Of the 10 340 medico-legal autopsies; 398 (3.84) suicide cases were due to hanging. The number has increased from 5.2 per 100 000 of the population in 1993 to 16.2 in 2003. More than a half (55) of the hangings were of people less than 30 years of age; and less than one-quarter (23) of these victims were younger than 20 years. The rate in males has increased from 4.5 (1993) to 14 per 100 000; and in females from 0.7 to 2.2 per 100 000. The male/female ratio is recorded highest (9 : 1) in the 20- and 29-year age group. Conclusion: There is an increasing incidence of suicides among young adults. Suicidal tendency among teenagers and young adults is emerging as an important health issue that needs to be addressed

Analysis of novel soluble chromate and uranyl reductases and generation of an improved enzyme by directed evolution.

Most polluted sites contain mixed waste. This is especially true of the U.S. Department of Energy (DOE) waste sites which hold a complex mixture of heavy metals, radionuclides, and organic solvents. In such environments enzymes that can remediate multiple pollutants are advantageous. We report here evolution of an enzyme, ChrR6 (formerly referred to as Y6), which shows a markedly enhanced capacity for remediating two of the most serious and prevalent DOE contaminants, chromate and uranyl. ChrR6 is a soluble enzyme and reduces chromate and uranyl intracellularly. Thus, the reduced product is at least partially sequestered and nucleated, minimizing the chances of reoxidation. Only one amino acid change, (Tyr)128(Asn), was responsible for the observed improvement. We show here that ChrR6 makes Pseudomonas putida and Escherichia coli more efficient agents for bioremediation if the cellular permeability barrier to the metals is decreased.

Histopathological screening for silicosis in autopsy cases of the Umtata area of the Eastern Cape Province.

The aim of this study was to determine the distribution of lung diseases in the autopsy subjects brought for medicolegal examination in the Transkei area. Two hundred histopathological slides were examined microscopically. Of them, 46 subjects (23%) showed some kind of pathology. There were four kinds of lesions observed: dust reticulation (anthracosis), necrotizing granulomatous inflammation, tuberculosis and silicosis. Dust reticulation was observed in the lungs of 16 cases (8%), 14 of them (7%) were females and 2 males (1%), the deposition of carbon with some refractive silica particles seen in the lung fields predominated. These were the rural women aged 45-75 years. Narcotizing granulomatous inflammation of lungs that was probably tuberculosis and clear tuberculosis were found in 14 (7%) and 8 (4%) cases respectively.