Tag: 20/10/21

Former Health Minister Mkhize Hits Back at SIU

Photo by Bill Oxford on Unsplash

An impending legal battle is on the horizon between former Health Minister Dr Zweli Mkhize, the Special Investigating Unit (SIU) and President Cyril Ramaphosa over the government’s Digital Vibes scandal. Dr Mkhize has accused both of having a predetermined conclusion about his alleged involvement in the embattled government contractor.

Dr Mkhize has approached the North Gauteng Court to review and set aside findings and recommendations made against him by the SIU. He has also sought to declare the conduct of the SIU unlawful and unconstitutional. This comes after the SIU investigated alleged irregularities in a tender contract awarded by the national Department of Health to Digital Vibes.

In SIU supplementary documents dated September 30 and filed in Pretoria, the SIU claimed that Dr Mkhize had directly benefited from Digital Vibes transactions as the company paid for electrical repair work at his homes, and also that Dr Mkhize’s family and some of his close associates benefited from the tender and another contract worth R150 million.

SIU spokesperson Kaizer Kganyago confirmed receipt of 800 pages of court documents on Monday, and stated they were ready to oppose them in court.

Dr Mkhize went through some of the SIU’s key findings. alleging that they were markedly different from those put to him during its interrogation.

Dr Mkhize claims he did not derive any personal benefit from Digital Vibes or persons associated with it, and that the SIU failed to address his version of events and withheld evidence he provided to it. Furthermore, he claims he was “ambushed” during questioning as he had no advance warning of the allegations made. He claims some of the key findings by the SIU, in its referral to President Cyril Ramaphosa, were markedly different from those put to him during its interrogation, saying  the SIU failed to disclose allegations made against him by his subordinate, the former Health Department DG, Dr Sandile Buthelezi, on which the findings were drawn.
Mkhize further said that had his submissions and evidence been taken into account by the SIU, the organisation would have come to a different conclusion regarding his alleged involvement in the appointment of Digital Vibes.

Ramaphosa’s spokesperson, Tyrone Seale, said that the Presidency was aware of the matter, but had not been served with papers.

Source: IOL

Telemedicine Popular Among People with Cancer Undergoing Radiotherapy

Source: Pixabay

Researchers reviewing patient surveys before and during the COVID pandemic found that nearly half preferred telemedicine and that general patient satisfaction scores were equally high for both video conferencing and office visits.

The study, published in the Journal of the National Comprehensive Cancer Network, assessed patient satisfaction and preferences for telemedicine. It found that 45% of people with cancer preferred telemedicine, while 34% preferred office visits, and 21% had no preference.

The researchers reviewed survey responses from 1077 radiation oncology patients across seven centres, with questionnaires based on office and telemedicine visits between December 2019 and June 2020. In terms of patient satisfaction, most reported either no difference or improvement with telemedicine overall (91%) compared to office visits, with similar results for their confidence in their physician (90%), understanding their treatment plans (88%), and confidence their cancer will be treated appropriately (87%).

Co-lead author Narek Shaverdian, MD, MSK Department of Radiation Oncology said: “These findings provide some evidence that there is a role for telemedicine beyond the COVID-19 pandemic and that it can be a particularly useful tool for certain patients – especially those who may have challenges coming on-site for an appointment. Giving patients flexibility and options by being able to see them both in-person and through telemedicine can improve access to care.”

Notably, two-thirds of respondents considered telemedicine to be a superior option when it came to treatment-related costs, such as travel and lost wages.

Co-lead author Erin F. Gillespie, MD, MSK Department of Radiation Oncology said, “An individual visit to the physician’s office can be costly—including transportation, parking, and time off from other activities. Telemedicine takes away most of this cost and inconvenience, and could therefore reduce the overall burden of engaging with the healthcare system. Also, the ability for family and friends to join the conversation from any location can be game-changing.”

The researchers found patient responses varied significantly between video conferencing versus audio. Patients who had telephone-only appointments were more likely to say they thought they would benefit more from an in-person visit.

“Telemedicine can be a resource to increase access to care, but only if patients have and can use these video capabilities,” said Dr. Shaverdian. “There is so much that you learn just by seeing a patient and using visual cues to guide a discussion. A voice-only encounter with a patient you’ve never met before is challenging.”

“Digital tools like telemedicine have the unfortunate potential consequence of paradoxically increasing disparities in access to care,” noted Dr. Gillespie. “But the counter to that is there will be some disadvantaged patients that would not have accessed the system at all, either due to technologic barriers or travel time, and now can connect at least by phone, which is an important and positive change.”

Source: National Comprehensive Cancer Network

Studies Find Females More Susceptible To Addiction

Photo by Tim Mossholder on Unsplash

Several new studies focusing on sex differences in pain and addiction suggest that females could be more susceptible to drug addiction and addiction-like behaviours than males. Researchers also investigated how sleep deprivation affected the likelihood of relapse, partly driven by hormone differences in females and males. The studies will be presented at the American Physiological Society’s seventh conference on New Trends in Sex and Gender Medicine from 19 to 22 October.

This study used a rat model to investigate the connection between opioid abstinence and persistent sleep loss and its impact on the body’s central stress response system. Researchers specifically found persistent sleep disruption may cause or perpetuate abnormalities in their hypothalamic-pituitary adrenal axis. These abnormalities increase the risk of vulnerability to relapse during oxycodone abstinence in some individuals. Scientists are now working to identify susceptibility factors that play a role in boosting the risk of relapse. Adequate sleep may be critical for successful recovery from opioid addiction.

Researchers conducting this study explored how the opioid epidemic in the US continues and evolved during the ongoing COVID pandemic. Women have made up the majority of those prescribed opioids for pain treatment. Prescribed opioids for pain management became the primary conduit to abuse and addiction for women, and the researchers found that mitigations in opioid prescriptions have been followed by increases in the use of other substances, such as heroin and fentanyl, in both men and women. While the rate of opioid use and overdose is higher in men, women have a higher rate of overdose death. Understanding how opioid use and addiction differ in their effect on men and women is key to ending the epidemic.

A rat model was also used to evaluate sex differences in vulnerability to addiction. Their results indicate activation of a specific subset of receptors for oestrogens enhances established cocaine-seeking behaviors in female rats. In male rats, the preference for cocaine under the same circumstances was reduced, involving the area of the brain linked to compulsive behaviours. Females show a greater response than males to stimulants such as amphetamine and cocaine in part due to the gonadal hormone oestradiol, which is one of the three forms of oestrogen. The hope is these results will lead to a better understanding of the mechanisms of addiction-related behaviors and the development of sex-specific treatments for addiction.

Source: American Physiological Society

Scientists Discover a New Sense for Sugars

Source: Unsplash

In a study published in PLOS ONE, scientists report the identification of a new human sensory ability to detect sugars in the mouth with a kind of a molecular ‘calorie detector’. It could help explain why artificially sweetened beverages just don’t have the same appeal as ones containing sugar.

“Our mouth can identify when a sweetener has the potential to deliver calories versus a non-caloric sweetener, which cannot,” said first author Paul Breslin, PhD, a Monell investigator and a professor of Nutritional Sciences at Rutgers University.

The paper describes the first-in-human demonstration of a signaling pathway that uses the sugar glucose, a component of table sugar and high fructose corn syrup, to signal the presence of calories, in addition to the well-studied sweet-taste receptor in taste buds. Glucose is present in many foods, and has been consumed by humans in the form of honey, fruit and other sugar-rich foods.

“Humans love fruit and sugar, as do many other apes, which obtain most of their calories from sugar,” said Prof Breslin.

Recent findings from Monell showed taste bud cells in mice could identify when a sweetener has calories to burn, which prompted the researchers to see whether the ability to sense glucose in the human mouth may also involve this additional pathway. The team wanted to know if the calorie detector is functional, and if it could affect our responses to dietary sugar.

“Now that we know this calorie-detecting taste system is operating in humans, it could help explain the overall preference for sugared beverages over non-caloric sweetener beverages,” said Prof Breslin.

In a series of three human-taste experiments, the team compared oral glucose sensitivity to the ability to sense the artificial sweetener sucralose and to a special form of glucose that cannot be metabolised. “Overall, there are two sweet-sensing pathways in the mouth: one for sweet taste, and another for detecting potential energy-burning sugars,” said coauthor Linda J. Flammer, PhD, a senior research associate at Monell.

The fact that diet fizzy drinks never captured a major share of the beverage market always puzzled Prof Breslin, but he now has a hint: “Diet drinks are not as satisfying as sugared beverages. As a public health initiative, might we get beverages and foods with lower sugar levels to be more rewarding? Now that we know there is this second glucose-sensing system in the mouth, maybe we can tap into it to make healthier beverages that people enjoy drinking.”

Sugar calories are sensed in the gut and blood after swallowing, but this study shows that sugars are identified as different from non-caloric sweeteners in the mouth. “It is remarkable that we evolved a mechanism not only to taste oral sugars as sweet, but also to sense that they have a metabolic or caloric signal,” said Breslin. “This means that the mouth is much smarter than we realised and that it will be difficult to trick it by simply providing non-caloric sweeteners.”

Source: Monell Chemical Senses Center

Inquiry Accuses Brazilian President of ‘Crimes Against Humanity’

Image by Quicknews

A draft of a major inquiry into the Brazilian government’s handling of the COVID pandemic has recommended that the country’s President Bolsonaro should be charged with several serious crimes over his actions.

The report will be the culmination of a six-month inquiry that has revealed scandals and corruption in the country’s government.

Excerpts leaked to the media indicate that the panel wants Bolsonaro to face nine charges, though initial recommendations that the president be charged with homicide and genocide against indigenous groups were dropped on Tuesday.

The massive and highly unusual 1200 page report urges charges of crimes against humanity, forging documents and incitement to crime. It blames Bolsonaro’s policies for the deaths of 300 000 Brazilians, about half of the current COVID death toll in Brazil, which is the world’s second largest. He repeatedly pushed unproven drugs such as hydroxychloroquine long after they had found to be ineffective.

Despite the serious allegations, what this means for Bolsonaro is unclear, according to the BBC’s South America correspondent Katy Watson.

The draft report will still have to be voted on by the Senate commission, where it could be vetoed and altered. Given the political realities of Brazil, it is unclear if these will ever lead to criminal charges.
President Bolsonaro has dismissed the Congressional inquiry as politically motivated, and has frequently spoken out against COVID interventions such as lockdowns, masks and vaccinations.

In March this year, he infamously told Brazilians to “stop whining” about COVID, a day after the country saw a record rise in deaths over a 24-hour period.

However, Mr Bolsonaro’s popularity has already been dented by the pandemic, and this report could make life much harder for him if he wants to run for a second term in Brazil’s 2022 elections.

Speaking to the BBC in advance of the publication of the report, the inquiry rapporteur, Senator Renan Calheiros, said that the panel wanted to punish those who contributed to “this massacre of Brazilians”.

Source: BBC News

Wits Opens Advanced Surgical Skills Lab

Photo by Clodagh da Paixao on Unsplash

To help address the critical shortage of expert medical specialists in the country, including surgeons, Wits University opened the Wits Advanced Surgical Skills Lab. It has been estimated that the country needs double the number of surgeons to meet its needs, a situation worsened by losing many surgical experts to the competitive overseas market due to the lack of sufficient highly specialised facilities, infrastructure, and advanced academic training programmes.

“Wits trains more doctors, surgeons, specialists and sub-specialists than any other university in southern Africa. The new R22-million Wits Advanced Surgical Skills Lab will help to enhance the training of surgeons, across disciplines, in a state-of-the-art environment, with the best equipment available,” said Professor Damon Bizos, Head of Wits Surgical Gastroenterology, and the Clinical Head of Surgery at the Wits Donald Gordon Medical Centre. “We need to replenish these specialised skills and replicate them in adequate measure in order to deliver essential services to South Africans and Africans.”

Located on the ninth floor of the Faculty of Health Sciences building in Parktown, the Wits Advanced Surgical Skills Lab officially opened on Tuesday, 12 October 2021. The state-of-the-art facility is designed in line with international best standards. along with teaching facilities that make the Wits surgical training programme one of the best in the world.

“If we fail to replenish the pool of surgeons in South Africa, both the training of all South African doctors and the delivery of healthcare for all will be compromised. The loss of these skills will result in the loss of services in both the private and public sectors,” said Professor Zeblon Vilakazi, Wits Vice-Chancellor and Principal. “South Africa needs to retain highly skilled and specialised surgeons. By creating opportunities for doctors to undergo highly specialised training locally, rather than abroad, the likelihood of losing these doctors to other countries is lessened.”

The Wits Advanced Surgical Skills Lab will be able to provide the interdisciplinary training needs of surgical disciplines including general surgery; orthopaedics; gynaecology; ear, nose and throat; cardiothoracic; urology; maxillofacial; ophthalmologic; neuro; and plastic surgery. It will also include the training of specialists, doctors, nurses and other allied health practitioners.

“The basic and intermediate courses will help inculcate basic surgical competence and skills development, whilst advanced courses will ensure that experienced practitioners remain at the forefront of advances in the field,” added Prof Bizos. “We will offer access to in-house training as well as industry-sponsored surgical training courses and symposia. Train-the-trainer programmes and research into skills training will also be integral.”

The Wits Advanced Surgical Skills Laboratory boasts a large ‘wet lab’ with eight stations; laparoscopic towers and endoscopy (upper endoscopy and colonoscopy); has facilities available for training on cadavers; lead-lined walls to accommodate imaging; a new lecture room for 35 participants; and full audiovisual and videoconferencing facilities.

“Access to safe, high-quality surgery care remains an ongoing challenge in South Africa and beyond. There is a well-defined unmet need, and the training of surgeons and surgical care providers is an essential component of the strategy to improve surgical care and address the unmet need. Modern day approaches to training require that we must address both the technical competency and non-technical skills of the surgeon. This must be achieved in a standardised and measurable way. To do so has meant that we, as the trainers of the next generation of practitioners, must embrace new technologies and training opportunities,” said Professor Martin Smith, the Head of the Department of Surgery in the Faculty of Health Sciences at Wits University. “We are very grateful that through the support of the University and the contributions of a number of donors we have been able to establish a facility to enhance and improve this training.”

Source: Wits University