BackgroundSouth Africa aims to end all preventable deaths of children under the age of five as pa... more BackgroundSouth Africa aims to end all preventable deaths of children under the age of five as part of their commitment to the Sustainable Development Goals. More than half of these mortalities occur in the neonatal period with perinatal asphyxia as one of the leading causes. This study investigated and identified the characteristics of perinatal asphyxia and its contributing factors at a district hospital in Cape Town.MethodsA retrospective descriptive case series was performed and included all suspected cases of perinatal asphyxia referred from the Mitchells Plain District Hospital (MPH) to a specialised centre in the years 2016–2018. A data collection tool was used to extract information. Data were processed with Statistical Package for the Social Sciences 25 (SPSS) to produce descriptive statistics and to investigate associations between variables using the chi-square tests.ResultsThe study included 29 cases of suspected perinatal asphyxia. Ten cases (34.5%) had abnormal amplitude electroencephalograms (aEEGs) indicative of hypoxic ischaemic encephalopathy (HIE) and four (13.8%) demised before day seven of life. Non-operative deliveries (p = 0.005), lack of a doctor at the time of delivery (p = 0.004) and neonatal chest compressions (p = 0.044) were associated with abnormal aEEGs. Babies with Thompson score of equal to or more than 12 (p = 0.006), neonatal seizures (p = 0.036) and delayed arrival at referral hospital (p = 0.005) were associated with abnormal aEEG findings. Mortality was associated with Thompson score equal to or more than 12 (p = 0.007) and the need for neonatal intubation at delivery (p = 0.016).ConclusionSignificant reversible factors were identified in the peri- and post-partum periods. More capacitated staff would have the greatest impact on outcomes. The profile of HIE is exceedingly complex and challenges the resources and services of district level of care. Therefore, these factors should be targeted for future development and investment to improve outcomes from district hospitals.
The ‘Mastering your Fellowship’ series provides examples of the question format encountered in th... more The ‘Mastering your Fellowship’ series provides examples of the question format encountered in the written and clinical examinations, Part A of the Fellowship of the College of Family Physicians of South Africa (FCFP [SA]) examination. The series is aimed at helping family medicine registrars prepare for this examination.
Background South Africa (SA) is on the brink of implementing workplace-based assessments (WBA) in... more Background South Africa (SA) is on the brink of implementing workplace-based assessments (WBA) in all medical specialist training programmes in the country. Despite the fact that competency-based medical education (CBME) has been in place for about two decades, WBA offers new and interesting challenges. The literature indicates that WBA has resource, regulatory, educational and social complexities. Implementing WBA would therefore require a careful approach to this complex challenge. To date, insufficient exploration of WBA practices, experiences, perceptions, and aspirations in healthcare have been undertaken in South Africa or Africa. The aim of this study was to identify factors that could impact WBA implementation from the perspectives of medical specialist educators. The outcomes being reported are themes derived from reported potential barriers and enablers to WBA implementation in the SA context. Methods This paper reports on the qualitative data generated from a mixed method...
BackgroundSouth Africa aims to end all preventable deaths of children under the age of five as pa... more BackgroundSouth Africa aims to end all preventable deaths of children under the age of five as part of their commitment to the Sustainable Development Goals. More than half of these mortalities occur in the neonatal period with perinatal asphyxia as one of the leading causes. This study investigated and identified the characteristics of perinatal asphyxia and its contributing factors at a district hospital in Cape Town.MethodsA retrospective descriptive case series was performed and included all suspected cases of perinatal asphyxia referred from the Mitchells Plain District Hospital (MPH) to a specialised centre in the years 2016–2018. A data collection tool was used to extract information. Data were processed with Statistical Package for the Social Sciences 25 (SPSS) to produce descriptive statistics and to investigate associations between variables using the chi-square tests.ResultsThe study included 29 cases of suspected perinatal asphyxia. Ten cases (34.5%) had abnormal amplitude electroencephalograms (aEEGs) indicative of hypoxic ischaemic encephalopathy (HIE) and four (13.8%) demised before day seven of life. Non-operative deliveries (p = 0.005), lack of a doctor at the time of delivery (p = 0.004) and neonatal chest compressions (p = 0.044) were associated with abnormal aEEGs. Babies with Thompson score of equal to or more than 12 (p = 0.006), neonatal seizures (p = 0.036) and delayed arrival at referral hospital (p = 0.005) were associated with abnormal aEEG findings. Mortality was associated with Thompson score equal to or more than 12 (p = 0.007) and the need for neonatal intubation at delivery (p = 0.016).ConclusionSignificant reversible factors were identified in the peri- and post-partum periods. More capacitated staff would have the greatest impact on outcomes. The profile of HIE is exceedingly complex and challenges the resources and services of district level of care. Therefore, these factors should be targeted for future development and investment to improve outcomes from district hospitals.
The ‘Mastering your Fellowship’ series provides examples of the question format encountered in th... more The ‘Mastering your Fellowship’ series provides examples of the question format encountered in the written and clinical examinations, Part A of the Fellowship of the College of Family Physicians of South Africa (FCFP [SA]) examination. The series is aimed at helping family medicine registrars prepare for this examination.
Background South Africa (SA) is on the brink of implementing workplace-based assessments (WBA) in... more Background South Africa (SA) is on the brink of implementing workplace-based assessments (WBA) in all medical specialist training programmes in the country. Despite the fact that competency-based medical education (CBME) has been in place for about two decades, WBA offers new and interesting challenges. The literature indicates that WBA has resource, regulatory, educational and social complexities. Implementing WBA would therefore require a careful approach to this complex challenge. To date, insufficient exploration of WBA practices, experiences, perceptions, and aspirations in healthcare have been undertaken in South Africa or Africa. The aim of this study was to identify factors that could impact WBA implementation from the perspectives of medical specialist educators. The outcomes being reported are themes derived from reported potential barriers and enablers to WBA implementation in the SA context. Methods This paper reports on the qualitative data generated from a mixed method...
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