standard

Chronic Hepatic deficiency due to the ingestion of alcohol remains as one of the main causes of morbidity and mortality in our country. From it a variety of complications arise, one of them is the Hepatopulmonary Syndrome, which usually goes unnoticed and undiagnosed; this syndrome is distinguished by the presence of hypoxemia and pulmonary vasodilation. The gold standard to establish a diagnostic is contrast-enhanced Echocardiogram. No pathognomonic sign is known for this syndrome, which leads the present elaboration to evaluate the use of orthodeoxia by pulse oximetry as a screening test in the detection of Hepatopulmonary Syndrome cases. 

Introduction: Laparoscopic approach is emerging as a standard of care approach for management of masses amenable to partial nephrectomy. Laparoscopic partial nephrectomy is a challenging surgery and its successful performance depends on various factors. We aim to evaluate the influence of tumor characterestics on the operative performance for laparoscopic partial nephrectomy. Methods: Patients undergoing laparoscopic partial nephrectomy in our institution were recruited for this study. The tumor profile was evaluated by a senior radiologist from cross sectional imaging (computed tomography or magnetic resonance imaging). Tumor characerestics was defined by assessing tumor size, tumor location and RENAL score. The operative performance was evaluated in terms of warm ischemia time, blood loss, operation duration and any significant operative complications. Statistical inference was drawn. Results: 37 patients who underwent laparoscopic partial nephrectomy between January 2010 and June 2012 were included in this study. The mean tumor dimension was 3.81 cms. 21 tumors involved left kidney and 16 involved right kidney. 12 were located in upper pole, 8 were located in midpole and 17 were located in lower pole. The average RENAL score was 6.56. The mean warm ischemia time, blood loss and operation duration was 26.29 minutes (min), 256.76 millilitres (ml) and 208.11 min respectively. Statistically significant correlation was appreciated between tumor location (polar location, side, anterior/ posterior location) and RENAL score and operative parameters (warm ischemia time and operation duration). Tumor size did not have any correlation with the operative parameters. Conclusion: The operative performance of laparoscopic partial nephrectomy is significantly influenced by the tumor location and RENAL score.

Background: Laparoscopic cholecystectomy is gold standard and most widely performed surgery for gallstone disease all over the world. Surgeons entering into the field of laparoscopic surgery for the first time faces challenges that are different from those with experienced hands. We in this study tried to enumerate the various such challenges and also recommend few steps to counter them. Aims & Objectives: To study the challenges faced by new surgeons in laparoscopic cholecystectomy and recommendations to reduce them. Material & Methods: This study was carried out in a medical college in the department of General and Minimal Access surgery. In this retrospective study, ten general surgeons working as senior residents in in this medical college over a period of 3 years having never performed laparoscopic surgery in past were included. Results: A total of 50 cases, five operated by each surgeon with minimal assistance by senior surgeon in few cases. Operative time varied from 90 to 120 minutes. The various technical challenges faced by the new surgeon were in the Creation of Pneumoperitoneum, Creation of second port (epigastric port 10mm), Gallbladder Retraction and Dissection at calot’s triangle, Dissection at gallbladder bed and Removal of the gallbladder from epigastric port.it has been observed that following various simple steps will abate these technical difficulties for these beginners while doing laparoscopic cholecystectomy. Conclusion: Laparoscopic cholecystectomy is the most commonly performed minimal access surgical procedure nowadays and almost all the new surgeons enter the world of laparoscopic surgery via this surgery. Knowing and following the above recommendations will help them abate the technical challenges generally faced during the initial phase in the laparoscopic field.

Acute carbon monoxide (CO) poisoning is caused by the inhalation of large quantity of CO within short time leading to morbidity and mortality. In this study, a total of eighteen (18) rabbits were divided into three (3) groups of six (6) animals each. The first group first group was poisoned with CO and labelled carbon monoxide death (CD). The second group of animals was killed prior to exposure to CO and labelled disguised death (DD), while the third was the control group (CG). The vitreous humour samples were collected from all the animals using standard methodologies. The vitreous humour total protein and albumin were estimated while its globulin content and albumin/globulin ratio were derived mathematically. Pearson correlation analyses were used to establish relationships between vitreous protein profile components and the acute graded carbon monoxide concentrations. Results indicated a significant increase (P<0.05) in vitreous total protein and globulin of the studied groups. This observation was more pronounced in the CD group of animals. Therefore the marked elevation of vitreous total protein and globulin may serve as a useful tool in the confirmation of death due to carbon monoxide poisoning.

Introduction: Fractures of both the anterior and posterior pelvic ring are common injuries in polytrauma and the elderly that extend beyond those of simple low-impact trauma. While conventional X-rays predominantly show the ventral aspect of the injury, computed tomography often detect additional fractures of the sacrum. A large number of these fractures are B-injuries by AO, mainly compression fractures at an advanced age. In addition, the prevalence of pelvic insufficiency fractures caused by osteoporosis rather than subsequent to an obvious trauma is increasing, with such an injury often associated with pain that impairs mobilization. The standard sacroiliac screw fixation is often characterized by loosening and thus failure of the osteosynthesis especially in osteoporotic bone of elderly patients. Method: A new alternative surgical minimal invasive technique, the “iliosacral bridging”, stabilizes the fractures of the sacrum with an internal fixation from S1 pedicle of the uninjured side to the ilium on the affected side. The combination of this internal fixation with the standard single sacroiliac screw on the injured side allows an immediate full weight bearing and pain free mobilization. We present a case series of 8 patients. Results: The clinical and radiological analysis analogous to the pelvic-outcome-score brought forward that 2 patients showed an excellent and 2 patient a good result. The other 4 patients achieved sufficient results. Conclusions: The “iliosacral bridging” we have introduced in the present study provides evidence of an expected increased stability of the pelvis after B-injuries

Age estimations process is not standardized worldwide. However, there is a wide agreement about the most suitable methods currently available. Up until now, the procedure of creating expert reports and to implement quality assurance in age estimation are variable. Aim: The aim of this paper was to examine expert age estimation reports from around the world and identify the similarities and shortcomings present, which will help in providing recommendations to improve the reporting to reach standardization in expert age estimation reports. Methods and Material: A questionnaire was developed to explore whether there is a universal consensus in writing age estimation reports. Countries participated in the survey were: Afghanistan, Australia, France, Indonesia, Italy, New Zealand, Norway, Paraguay, Saudi Arabia, Spain, Switzerland, United Arab Emirates, United Kingdom, and the United States of America. Areas investigated by the survey included: Information about the individual in question and the entity requesting the assessment, if age interval is given along with if statistics were described in the report, if population reference data are used and reported and finally if the format of the report is standardized within each country. Results: The results of this survey suggest that there is a high degree of individual variation in age estimation reports, sometimes even within the same country. While the majority of participants report the main findings, some important information is still missing. The statistical information remains extremely varied. Conclusion: Although a resolution is not obvious, it is hoped that this study will promote further research and discussion on reporting age estimation. International guidelines on quality assurance in age estimation reports are urgently needed. Information to be reported should be specified on an international level and the exact report format to be used could be left to the national societies.

Background: C-type natriuretic peptide (CNP) was isolated from porcine brain and is a 22-amino acid peptide which belongs to the natriuretic peptide (NP) family. Even though this peptide shares structural similarity to other endogenous NPs including atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP) its receptor selectivity is different from other NPs. The present study was undertaken to investigate the expression of C-type natriuretic peptide (CNP) and its specific guanylyl cyclase (GC)-coupled receptor in the granulosa cells of the pig ovarian follicle. Results: Specific 125I-[Tyr0]-CNP(1-22) binding sites were localized in the granulosa cell layer of the ovarian follicle with an apparent dissociation constant (Kd>) and a maximal binding capacity (Bmax) of 1.41±0.39 nM and 2.75±0.65 fmol/mm2 respectively. Binding of 125I-[Tyr0]-CNP(1-22) to these sites was also prevented by atrial natriuretic peptide (ANP(1-28)), brain natriuretic peptide (BNP(1-26)) and des[Gln18,Ser19,Gly20, Leu21,Gly22] ANP(4-23) (C-ANP). Production of 3’,5’-cyclic guanosine monophosphate (cGMP) by particulate GC in the granulosa cell membranes was stimulated by natriuretic peptides (NPs) with a rank order of potency of CNP(1-22)>>BNP(1-26)>ANP(1-28). HS-142-1, a selective antagonist of the two recognized GC-coupled NPRs, inhibited CNP(1-22)-stimulated cGMP production in granulosa cell membranes in a dose-dependent manner. Also mRNAs for all three recognized NPRs were detected in granulosa cells using reverse transcriptase-polymerase chain reaction (RT-PCR). Serial dilution curves of granulosa cell extracts were parallel to the standard curve of synthetic CNP. Conclusion: These results indicate that CNP and its specific receptor are expressed in the granulosa cells of the pig ovary, and suggest that CNP may be a local autocrine and/or paracrine regulator via activation of its specific GC-coupled receptor, NPR-B.

Contemporary forensic science hinges on DNA analysis to link an individual to a crime scene. Sources of DNA include bodily fluids, including saliva. Amylase is a primary enzyme in human saliva and thus, if detected, indicates possible presence of human saliva. Amylase paper can be used to map apparent saliva and thus provide a source from which DNA can be extracted and analyzed. In this study, the sensitivity of amylase paper was tested, firstly, using dilutions of an amylase standard and subsequently also tested using fresh human saliva. Three trials total were conducted, the first two using an amylase standard and a third using fresh saliva. The first two trials demonstrated firstly that detection of amylase is dependent on the material upon which amylase is deposited. The third trial demonstrated that amylase levels in human saliva may drop significantly somewhere around 48-72 hours. All trials were consistent in the concentration of amylase that Seratec Amylase Paper will detect.

Colon cancer (CC) screening is important for diagnosing early stage for malignancy and therefore potentially reduces mortality from this disease because the cancer could be cured at the early disease stage. Early detection is needed if accurate and cost effective diagnostic methods are available. Mortality from colon cancer is theoretically preventable through screening. The Current screening method, the immunological fecal occult blood test, FOBTi, lacks sensitivity and requires dietary restriction, which impedes compliance. Moreover colonoscopy is invasive and costly, which decreases compliance, and in certain cases could lead to mortality. Compared to the FOBT test, a noninvasive sensitive screen that does not require dietary restriction would be more convenient. Colonoscopy screening is recommended for colorectal cancer (CRC). Although it is a reliable screening method, colonoscopy is an invasive test, often accompanied by abdominal pain, has potential complications and has high cost, which have hampered its application worldwide. A screening approach that uses the relatively stable and nondegradable microRNA molecules when extracted from either the noninvasive human stool, or the semi-invasive blood samples by available commercial kits and manipulated thereafter, would be more preferable than a transcriptomic messenger (m)RNA-, a mutation DNA-, an epigenetic-or a proteomic-based test. That approach utilizes reverse transcriptase (RT), followed by a modified quantitative real-time polymerase chain reaction (qPCR). To compensate for exosomal miRNAs that would not be measured, a parallel test could be performed on stool or plasma’s total RNAs, and corrections for exosomal loss are made to obtain accurate results. Ultimately, a chip would be developed to facilitate diagnosis, as has been carried out for the quantification of genetically modified organisms (GMOs) in foods. The gold standard to which the miRNA test is compared to is colonoscopy. If laboratory performance criteria are met, a miRNA test in human stool or blood samples based on high throughput automated technologies and quantitative expression measurements currently employed in the diagnostic clinical laboratory, would eventually be advanced to the clinical setting, making a noticeable impact on the prevention of colon cancer.

The National Programme for Prevention and Control of Deafness (NPCD) was launched in 2006 by Government of India, but despite its phase wise implementation, the community oriented ear care has not been properly realized in view of existing IPHS Standards 2012 at PHC Level. So understanding of its real impact after implementation is desired. Therefore the Impact of Implementation status of community oriented ear care at the primary health system level on NPCD in India needs exploration.

A 32-year-old G4P301LC3 woman presents to the office for a visit, with a 6-day history of vaginal discharge with an unpleasant odor. On speculum examination, the discharge was green in color and frothy in appearance. Is noticed vulvar erythema, edema, and pruritus, also is noted the characteristic erythematous, punctate epithelial papillae or “strawberry” appearance of the cervix. Vaginal pH was 6.2. Diagnosis of Trichomonas vaginalis is made via wet prep microscopic examination of vaginal swabs.But also, for diagnosis help even the exam with the speculum, concretely “strawberry” appearance of the cervix. The diagnosis is confirmed by culture.Trichomoniasis is a sexually transmitted infection [1,2], that caused by trichomonas vaginalis. Trichomonas vaginalis is a unicellular, anaerobic flagellated protozoan, that inhabits the lower genitourinary tracts of women and men, but that can cause vaginitis. Clinical findings of Trichomonas vaginalis include a profuse discharge with an unpleasant odor. The discharge may be yellow, gray, or green in color and may be frothy in appearance. Vaginal pH is in the 6 to 7.Vulvar erythema, edema, and pruritus can also be noted. The characteristic erythematous, punctate epithelial papillae or “strawberry” appearance of the cervix is apparent in only 10% of cases. Symptoms are usually worse immediately after menses because of the transient increase in vaginal pH at that time. Diagnosis of Trichomonas vaginalis is made via wet prep microscopic examination of vaginal swabs. Other, more sensitive tests are available, including nucleic acid probe study and immunochromatographic capillary flow dipstick technology. The diagnosis can be confirmed when necessary with culture, which is the most sensitive and specific study. Nucleic acid amplification tests (NAATs) have replaced culture as the gold standard. T vaginalis NAATs have been validated in asymptomatic and symptomatic women and are a highly sensitive test [3]. Because the Trichomonas vaginalis is a sexually transmitted infection, both partners should be treated to prevent reinfection. The mainstay of treatment for Trichomonas vaginalis infections is metronidazole. Treatment schemes can be:

Aim: Percutaneous core needle biopsy (CNB) is considered the gold standard technique for initial histological diagnosis of suspicious breast lesions seen on screening mammogram, but it is less reliable for diagnosing atypical ductal hyperplasia (ADH) due to significant rates of diagnosis upstaging to malignant disease after excision biopsy. The purpose of this study was to identify factors that predict diagnosis upstage to carcinoma in patients diagnosed with ADH on core biopsy. Methods: A retrospective database search identified 52 consecutive CNB of suspicious breast lesions revealing pure ADH. Inclusion criteria included asymptomatic women presenting for screening mammogram, who subsequently underwent surgical excision. Logistic regression analysis evaluated clinical, radiological, and histological factors. Results: A total of 52 patients with ADH on CNB were identified who met our criteria. Twenty-six of 52 patients (50%) were upstaged to ductal carcinoma in situ or invasive carcinoma, based on histological interpretation of the surgically excised specimen. Lesion size was showed to be a statistically significant predictor on univariable logistic regression analysis. Multivariate logistic regression analysis revealed Asian ethnicity and lesion size as independent predictors of malignancy (p = 0.050 and 0.011, respectively). Conversely, women of Middle Eastern and European origin and lesions < 15 mm on mammography were negative predictors of malignancy. Conclusion: Lesion size ≥ 15 mm on mammography and Asian ethnicity are independent risk factors for breast carcinoma in asymptomatic patients diagnosed with ADH on CNB.

Background: Laparoscopic cholecystectomy (LC), is one of the most commonly performed surgical procedures worldwide, it is accepted as the gold standard in the treatment of symptomatic gallstones for its minimal invasiveness, less pain and early recovery. Purpose: To predict the difficulty of laparoscopic cholecystectomy in patients according to the recently published scoring system and select the difficult cases to be done by a senior surgeon. Patients: This is a prospective cohort study. This study took place Oct 6th University Hospital and Kasr El Aini Hospital, Cairo university; the study involved 120 patients admitted with calcular cholecystitis, arranged for laparoscopic cholecystectomy. Methods: Laparoscopic cholecystectomy after applying the scoring system. Results: In our study we found that age, sex and ultrasonographic data were significant predictive factors for assessment preoperatively difficult cases that will be operated upon. We found 14 patients above 50 years who scored to be difficult and very difficult were at outcome difficult, only three patients converted to open surgery over fifty. Conclusion: We can report that obese patient who were over fifty with history of previous upper abdominal surgery and ultrasonographic picture showed thick walled GB and pericholecystic collection had high risk of conversion. At this study scoring system was used for prediction of difficult laparoscopic cholecystectomy sensitivity was 93.75% and specificity was 52.94% of the scoring system at score 5 for prediction of easy or difficult laparoscopic cholecystectomy.

In order to provide theoretical foundation for forestation of Phyllostachys bambusoides f. shouzhu Yi, the site factors, and the morphological character and biomass of standard bamboo were investigated in 16 sample spots of bamboo forest in Liangping county, Chongqing City, and then the effects of site factors on the clonal growth was discussed. Three site factors as the slope position, altitude, species diversity, had significant effects on the clonal growth of the bamboo. The effects of the gradient, slope aspect, humus thickness, and soil thickness were little, but that of slope aspects was not significant. The altitude of above 800 m, the upper slope, the steep slope and slope, and the thin soil were not suitable for its clonal growth. The results showed that (1) the main site factors affecting the growth of P. bambusoides f. shouzhu were slope position, soil thickness and humus thickness; (2) The forestation site of P. bambusoides f. shouzhu should be selected at the flat ground and the gentle slope of the hills below altitude of 800 m, and the slope position of the forestation site should be selected at the mid and lower position of a hill; (3) Soil thickness and humus thickness should be kept at a suitable level; (4) The diversity of plant species in the bamboo forest should be kept at a suitable level for keeping its growth environment.

The calyces of Hibiscus sabdariffa have been used by many communities as herbal tea. Their anthocyanin contents have been reported as the key component in anti-obesity studies. This present work reported results of anthocyanin content of calyces in two varieties of H. sabdariffa collected from Sabak Bernam, Selangor, Malaysia. The samples have been authenticated in the Herbarium, Institute of Bioscience, University Putra Malaysia prior to the study. The samples were processed and the ground dry raw material and its aqueous extract were analyzed using Fourier Transform Infrared (FTIR) and Two-Dimensional Infrared (2DIR). The short hybrid calyces (FT11-15A) raw material spectrum showed more than 80% similarity with long wild variety calyces (FT11-15B) when using “Compare” in analysis. The differences of both samples were obviously shown in their aqueous extract spectra. The peak at 1672 cm-1 and 841 cm-1 showed that tri-substituted double bond in FT11-15B aqueous extract was not present in FT11-15A aqueous extract spectra, whereby a double peak was assigned at 1221 cm-1 referred to anti symmetry stretching of aromatic and vinyl =C-O-C- with other =C-O- and 1192 cm-1 is assigned In-plane δ C-H in FT11-15A aqueous extract. The peak at 1071 cm-1 assigned as bonding C-H in plane bending of phenyl of both samples was the only peak comparable with standard delphinidin and cyanidin which are used for qualification and quantification of sample content. Aqueous extract spectra of both samples showed higher number of peaks detected compared with raw material spectra, which was attributed to the higher solubility of anthocyanins in water. The 2DIR correlation spectroscopy is advantageous in enhancing the qualitative analysis of herbal products. The anthocyanin content in both varieties of H. sabdariffa in descending amount is delphinidin-3-O-sambubioside (DS), cyanidin-3-O-sambubioside (CS), delphenidin-3-O-glucoside (DG) and lastly cyanidin-3-O-glucoside (CG). FT11-15A has more content of DS and DG of raw material and CG of water extract plus TFA than FT11-15B, whereby, FT11-15B has more content of CS, CG of raw material and DS, DG, CS of water extract plus TFA than FT11-15A.

Standardized method of seed treatment is of prime importance in the production of groundnut. The study was to carry out control trial using bark extract (aqueous and ethanol) and oil (seed) of mahogany (Khaya senegalensis) on seven (7) isolated fungi from two groundnut varieties (peruvian and valencia). The result shows that both mahogany bark and seed extracts are capable of inhibiting mycelial growth of all the isolates. There was no significant variation between the aqueous and ethanol bark extracts in-vitro, however the in-vivo test shows a significant difference between the aqueous and the ethanol bark extract in which the ethanol extract reduced growth of the pathogens more than the aqueous. For all the pathogens except Rhizopus stolonifer there was no growth between 50% to 100% concentration of the Khaya senegalensis oil in-vitro, however in-vivo control at 50% produced scanty to moderate growth for all the pathogens except Rhizopus stolonifer on peruvian, while there was full coverage on the seeds of valencia variety with Aspergillus niger and Rhizopus stolonifer having total coverage though Pseudaiiescheria boydii and Cylindrocarpon lichenicola were effectively inhibited and showed no growth at the 50% and 100%. Further research to focus on the quantifying the chemical constituents and formulation are suggested.

Background: Nutritional status of expectant women is an important indicator of healthy pregnancy and an ideal birth weight of the infant. The present study is an attempt to understand food eating practices and related taboos among the Paite women and whether or how these practices influence weight gain among infants during their first year of life. Methods: The longitudinal study was conducted for a period of 16 months between November 2010 and February 2012) among 186 Paite mother-infant pairs. Women who had completed 37 to 42 weeks of pregnancy were included. Infant’s weights were measured using standard technique and information on mothers’ food related practices was recorded during the house visit using a structured schedule. Standard statistical methods were used for description and analysis. Results: A peculiar practice, ‘pica’ was observed among a few women. A number of food taboos were found to be followed by the ‘Paite’ women during course of their pregnancy. Conclusion: No significant difference was noticed in the mean weight of babies from birth through the age of 1 year between mothers practicing and not practicing food taboos. However, it was found that the mean weight of the babies throughout the study period was comparatively higher among non-taboo mothers. It could be suggested that women must be counseled during their antenatal and postnatal visits to the maternity clinics and hospitals about dietary practices and their anticipated impact on health of the newborns.

Introduction: Sepsis is an important cause of morbidity and mortality among neonates. Neonatal sepsis can alter the glucose level and both hypoglycemia and hyperglycemia may occur. A high or low blood glucose level may have a significant effect on the outcomes in patients of neonatal sepsis. Aims: The aim of the study to see the glycaemic status and its effect on outcome of neonatal sepsis. Material and Methods: This hospital based prospective observational cross-sectional study was conducted in Neonatal Intensive Care Unit in Universal College of Medical Sciences, a tertiary care hospital over a period of 4 months, from May 2019 to August 2019. A total of 220 Neonates suspected sepsis under the age of 28 days admitted in NICU, were studied and included in our study. Clinically suspected neonatal sepsis cases were enrolled in the study. Venous blood was collected before giving any intravenous fluid, dextrose or antibiotics and blood sugar, complete blood counts, CRP levels and blood culture were send to laboratory within half hour of collection. All patients included in this study were treated accordingly and followed up strictly. Blood glucose level and mortality of neonates having hypoglycemia, hyperglycemia were analyzed among CRP and culture positive patients. Quantitative data were expressed as mean and standard deviation. Qualitative data were expressed as frequency and percentage and comparison carried by Chi-square (χ2) test. Results: A total of 220 patients clinically diagnosed as neonatal sepsis were studied. 118 (53.6%) patients were found CRP positive and 56 (25.5%) patients were blood culture positive. Glycaemic status was analyzed among CRP and culture positive patients. Majority (55.9%) patients were found normoglycemic, 35.5% were found hypoglycemic and 8.6% were found hyperglycaemic in this study. 182 (82.73%) patients were cured and 38 (17.27%) died. Mortality was high in hypoglycaemic patients (34.4%) compared with normoglycaemic patients (9.82%), but the difference was not statistically significant (p > 0.05) between two groups, the mortality was high in hyperglycaemic patients (58.33%) compared with normoglycaemic patients (9.82%) and the difference was statistically significant (p < 0.05) between two groups. Conclusion: Alteration of glycaemic status occurred in septic newborn. Mortality is higher among the septic newborn with hyperglycemia. The present study found that majority of neonate with sepsis had high mortality rate when blood glucose level were either more than 145 mg/dl or less than 45 mg/dl. This signifies the importance of meticulous blood glucose estimation in cases of neonatal sepsis to improve mortality outcome.

Background: The number of childhood cancer survivors (CCSs) is increasing due to improved survival. Most suffer at least one treatment-related late effect, even decades after treatment, thus lifelong long-term follow-up (LTFU) care is a necessity. Currently no standardized LTFU programme for CCSs exists in South Africa. Study purpose: This study investigated current LTFU care of CCSs in South Africa. Methods: A survey was conducted amongst 31 South African paediatric oncologists using the SurveyMonkeyTM online tool. Information obtained included: training/experience, LTFU practices, late effects knowledge and opinion regarding the importance of a standardized LTFU programme. Results: The response rate was 74% (23/31). Respondents had an average of 9 years’ experience. All (22/23; 96%) regarded LTFU as important. Only half (12/23; 52%) discussed late effects at diagnosis. Infertility and second malignancy risks were discussed by a third. Less than half (48%) used LTFU guidelines; the majority (9/11; 82%) adjusted them to the local context. Most survivors were followed by a paediatric oncologist (17/23; 74%). About half of respondents (47.8%) shared LTFU with colleagues in private practice (50%), secondary (66.7%) or primary care facilities (25%). Almost half of respondents (10/23; 43.5%) regarded their late effects knowledge and LTFU experience as good, 8/23 (34.8%) as adequate and 3/23 (13%) as inadequate. All agreed that a national LTFU programme would be very important (87%) or important (13%). Almost half of the respondents (48%) understood what a Survivorship Passport was. Conclusion: It is essential to develop a national standardized LTFU programme for CCSs in South Africa to ensure appropriate care for all survivors.

Hypoxis hemerocallidea Lam is one of the 43 Hypoxis species in South Africa, marketed extensively as over the counter herbal product for the management of several diseases. The plant commercial products link efficacy to hypoxoside 4, its aglycone (rooperol), or β-sitosterol. This study investigated antibacterial and anti-oxidant activities of four other molecules and two extracts from the Hypoxis plant. Visual antioxidant limit of detection and free radical scavenging activities of test samples were determined using 20 mM hydrogen peroxide, 0.4 mM DPPH or ferric reducing antioxidant power assay. Quantitative free radical was determine by spectrophotometric method while antibacterial activity was evaluated using MICs against uropathogens: S. aureus (ATCC25923), S. marcescens (ATCC 14041), P. aeruginosa (ATCC 9721), P. mirabilis (ATCC 33583) and E. coli (ATCC 10536). Anti-oxidant activities visual limit of detection of 0.06 mg/mL and percentage free radical scavenging activity (IC50 = 0.048 - 0.032 mg/ml) for pure compounds 1 - 4 and (IC50 = 0.037 - 0.039 mg/ml) for extracts were obtained. The reducing power IC50 ranged between 0.15 - 0.23 mg/ml for extracts and 0.11-0.35 mg/ml for standards. Antibacterial potentials show a noteworthy to moderate MIC values of 0.20 - 1.56 mg/ml against S. aureus (ATCC 25923), S. marcescens (ATCC 14041), P. aeruginosa (ATCC 9721), P. mirabilis (ATCC 33583) and E. coli (ATCC 10536). Galpinoside 5, hemerocalloside 3 and curculigoside C 2 are the other active compounds in Hypoxis plant.