Soil mesofauna as bioindicators to assess environmental disturbance at a platinum mine in South Africa.

South Africa is rich in mineral resources and is one of the leading raw material exporters in the world. Mining is essential for economic development, but also has detrimental environmental consequences in the form of chemical waste products which are being dumped as tailings material. The aim of this study was to establish whether mesofauna could be utilized to assess the influence of the tailings disposal facility on the surrounding soil environment. The sampled soil was chemically analyzed and the extracted mesofauna identified. High metal concentrations on the tailings dam (Cu, Cr and Ni), apparently had the greatest influence on the soil mesofauna. Only a few mite species were abundant at the two sites on the tailings dam, representing the prostigmatic-, cryptostigmatic- and the mesostigmatic-taxa. Metal pollution is evident in the sites on the tailings dam facility and the number of species generally increased towards the more natural environment.

Vasectomy under local anaesthesia performed free of charge as a family planning service: complications and results.

OBJECTIVE: To evaluate the safety and efficacy of vasectomy performed under local anaesthesia by junior doctors at a secondary level hospital as part of a free family planning service. METHOD: Men requesting vasectomy were counselled and given written instructions to use alternative contraception until two semen analyses 3 and 4 months after vasectomy had confirmed azoospermia. Bilateral vasectomy was performed as an outpatient procedure under local anaesthesia by junior urology registrars. Statistical analysis was performed using the Mann-Whitney, Kruskal-Wallis, Fisher's exact or Spearman's rank correlation tests as appropriate. RESULTS: Between January 2004 and December 2005, 479 men underwent vasectomy at Karl Bremer Hospital, Western Cape, South Africa; their average age was 36.1 (range 21 - 66) years, they had a median of 2 (range 0 - 10) children, and only 19% had 4 or more children. The average operation time was 15.5 (range 5 - 53) minutes. Complications occurred in 12.9%; these were pain (7.3%), swelling (5.4%), haematoma (1.3%), sepsis (1%), difficulty locating the vas (1%), vasovagal episode (0.6%), bleeding (0.6%), wound rupture (0.4%) and dysuria (0.2%) (some men had more than one complication). Of the men 63.3% returned for one semen analysis and 17.5% for a second. The vasectomy failure rate ranged from 0.4% (sperm persisting > 365 days after vasectomy) to 2.3% (sperm seen > 180 days after vasectomy and/or in the second semen specimen). No pregnancies were reported. The complication (5.6%) and failure rates (0%) were lowest for the registrar who had performed the smallest number of vasectomies and whose average operation time was longest. Comparing the first one-third of procedures performed by each of the doctors with the last one-third, there was a significant decrease in average operating times but not in complication rates. CONCLUSIONS: Vasectomy can be performed safely and effectively by junior doctors as an outpatient procedure under local anaesthesia, and should be actively promoted in South Africa as a safe and effective form of male contraception.

Penectomy with Simultaneous Compared to deferred Bilateral Inguinal Lymph Node Dissection for Squamous Cell Carcinoma of the Penis - Evaluation of Surgical Complications

Objective: In men with advanced squamous cell carcinoma of the penis; inguinal lymph node dissection is usually deferred for 6 weeks after primary penectomy. The rationale is that the penile lesion is usually infected and immediate lymphadenectomy may lead to a higher surgical complication rate. However; some patients do not return for deferred node dissection and then present much later with incurable metastatic disease. The aim of this study was to compare the complication rates of simultaneous versus deferred bilateral inguinal lymph node dissection. Patients and Methodsn: From October 1999 to September 2006; 29 men with histologically confirmed squamous cell carcinoma of the penis were treated. Penectomy with simultaneous bilateral inguinal lymph node dissection was performed in 18 patients with locally advanced primary lesions (cT2 in 8; cT3 in 10) and palpable inguinal nodes. The complications were compared with a previous study of 34 men who underwent bilateral inguinal lymph node dissection at a mean of 72 days after penectomy at Tygerberg Hospital during the period November 1983 to April 1995. Results: Post-operative complications occurred in 11 of 18 patients (61.1): lymphocele formation in 8; lymph leak in 1; wound dehiscence and skin edge necrosis in 5; wound sepsis in 1; lymphedema of the legs in 2; scrotal edema in 1 and cellulitis in 2 patients (more than one complication occurred in some patients). In the previously reported comparison group who had undergone deferred inguinal lymph node dissection at a mean of 72 days after penectomy; complications occurred in 26 of 34 (76.5) patients: wound sepsis in 12; wound dehiscence in 7; lymphocele in 7; lymph leak in 4; wound abscess in 3; necrosis of wound edges in 2 and hematoma formation in 1. Conclusion: Penectomy with simultaneous bilateral inguinal lymph node dissection in men with squamous cell carcinoma of the penis does not lead to a higher complication rate compared with primary penectomy and deferred inguinal lymph node dissection performed at a mean of 10 weeks after the primary procedure