Media releases

‘Take fainting to heart’ this World Heart Rhythm Week

Inherited heart rhythm disorders a challenge requiring urgent attention in SA

Thursday, June 14 2018

It is well known that heart rhythm disorders (arrhythmias) occur in adults, but few are aware that it is a significant problem among many South African children as well. Children may be born with a heart disorder that causes electrical and functional problems in the heart and remain unaware into adulthood that they have a potentially dangerous health problem.

“There needs to be much greater awareness of heart rhythm disorders and congenital heart disease, which is a common birth defect occurring in children and can cause problems with the efficient functioning of the heart,” says Dr Adele Greyling, a paediatric cardiologist who practises at Netcare Greenacres Hospital in Port Elizabeth. She was speaking during World Heart Rhythm Week, which runs from 4 to 10 June 2018.

Pic: Dr Adele Greyling, an Eastern Cape paediatric cardiologist and heart rhythm specialist who practises at Netcare Greenacres Hospital in Port Elizabeth. She believes there needs to be greater awareness of heart rhythm disorders and congenital heart disease, which is a common birth defect occurring in children and can cause problems with the efficient functioning of the heart

Dr Greyling, who is the only paediatric cardiologist in the country to have been specifically trained in electrophysiology − the study of electrical problems of the heart and heart rhythm disorders – says that many children with congenital heart defects go undiagnosed and take these conditions into adulthood. She says that untreated congenital heart defects and arrhythmias may be detrimental to health and in some cases even result in heart failure.

“It has been estimated that about four out of every 1 000 babies are born with inherited heart defects, which provides some idea of the extent of the challenge posed by this condition within the Eastern Cape and nationally,” adds Dr Greyling.

“World Heart Rhythm Week provides a good opportunity to improve knowledge of the problem among all sectors of the population including patients, parents and primary healthcare providers. We need to equip people with the necessary knowledge to be able to identify inherited heart problems and heart rhythm disorders, and to know when and where to obtain help.”

The theme of World Heart Rhythm Week 2018 is ‘Take Fainting to Heart’, as fainting can be an indication that one is suffering from a heart rhythm disorder, and should not be ignored. Dr Greyling says that other symptoms may include heart palpitations, dizziness, light-headedness, discomfort in the chest, or general weakness. A child with an inherited heart rhythm disorder may fail to thrive.

“It has been suggested that some 55 children out of every 100 000 suffer from heart rhythm disorders internationally, and our incidence here in South Africa is likely to echo this. The most common of these are supraventricular tachycardias, which is an electrical problem in the upper chambers of the heart,” notes Dr Greyling, who is accredited as an electrophysiologist by the Cardiac Arrhythmia Society of South Africa.

“Heart damage and rhythm disorders may be caused by a number factors including certain infections and rheumatic heart disease, but heart rhythm problems are particularly common among those born with a complex congenital, or inherited, heart defect.

“A child may, for example, be born with an inherited defect such as a hole in the heart that may cause the heart to function improperly, or with an extra electrical pathway in their heart that might cause heart rhythm disturbances,” she explains.

“Tragically, although many of these inherited heart defects can be relatively easily corrected with a minimally invasive catheter procedure, even in the very youngest of babies, the condition often goes undetected for years.

“We are finding that in the Eastern Cape, as well as nationally, there is a growing population of patients with inherited heart conditions surviving to adulthood due to improved surgical care, which poses unique challenges and a higher incidence of arrhythmias.”

Dr Greyling, who also practises in the state sector in addition to Netcare Greenacres Hospital, says that while the catheters and devices such as pacemakers often need to be smaller for children, the principles and physiology of treating heart rhythm disorders in children are similar to those in adults.

Therefore, cardiologists who have specialised in electrophysiology for adults can and do treat children with rhythm disorders, and likewise Dr Greyling, as a paediatric cardiologist who has super-specialised in heart rhythm disorders, also sometimes treats adults with inherited heart defects and arrhythmia.

Dr Greyling and her team perform interventions to repair structural heart defects, electrophysiology procedures such as cardiac ablations, which involve correcting electrical heart problems and structural abnormalities, and also implant pacemakers and defibrillators.

According to Dr Greyling, each patient is completely different and treatment depends entirely on the nature of their specific problem. “At Netcare Greenacres Hospital we are fortunate to have a team of cardiologists and cardiothoracic surgeons who work together to resolve complex heart problems in children and adults. Sometimes we may need to repair structural defects before addressing the rhythm disorder, at other times a simple ablation procedure can resolve an electrical problem. Having experience in congenital heart disease is thus most useful when dealing with heart rhythm disorders in patients with inherited heart disease.”

Asked if the fields of paediatric cardiology and heart rhythm disorders receive sufficient attention in South Africa, she said that the short answer was “no”. “We do not have enough paediatric cardiologists, adult cardiologists or electrophysiologists, let alone paediatric and congenital electrophysiologists for the patient burden. Many towns in South Africa have no cardiologists at all and Netcare Greenacres Hospital is the only private unit in the Eastern Cape to offer both paediatric cardiology and electrophysiology services.”

Initially working as a paediatrician at Netcare Greenacres Hospital, Dr Greying qualified as paediatric cardiologist in 2014. She realised there was great need for specialists trained in electrophysiology and completed a fellowship in electrophysiology in Belgium. She has trained extensively abroad and under well-known Bay paediatric cardiologist, Dr Lungile Pepeta, who also has rooms at Netcare Greenacres Hospital. Also part of the heart rhythm team at the hospital is cardiologist and cardiac electrophysiologist Dr Neil Hendricks, who has been practising there since 2014.

Netcare Greenacres Hospital general manager, André Bothma, says that Dr Greyling makes an invaluable contribution not only to the multidisciplinary cardiac team at the hospital, but also to heart medicine in the Eastern Cape province. “South Africa’s first ever paediatric cardiologist to also specialise in heart rhythm disorders, and the country’s first woman electrophysiologist, Dr Greyling’s skills and wonderful passion for medicine have benefitted many patients.

“Dr Greyling is an inspirational cardiologist who is determined to contribute to tackling the twin problems of congenital heart disorders and rhythm disorders in the Nelson Mandela Bay area and Eastern Cape province. Netcare Greenacres Hospital cardiac centre is most grateful to offer her services and those of the other cardiac specialists practising at the hospital,” concludes Bothma.

 

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Issued by:         MNA on behalf of Netcare Greenacres Hospital
Contact: Martina Nicholson, Graeme Swinney, Meggan Saville and Estene Lotriet-Vorster
Telephone: (011) 469 3016
Email: martina@mnapr.co.za, graeme@mnapr.co.za, meggan@mnapr.co.za or estene@mnapr.co.za

 

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New artificial urinary sphincter used for the first time in South Africa

Latest generation device offer better outcomes for men with severe urinary incontinence

Thursday, June 14 2018

A new type of artificial urinary sphincter has been used for the first time in South Africa at a private hospital in Pretoria to treat men with severe urinary incontinence, the loss of bladder control.

The device, a Victo adjustable artificial urinary sphincter, has been surgically implanted in a minimally invasive procedure by a team led by urologist, Dr Johan Venter at Netcare Pretoria East Hospital, announced Jacques du Plessis, managing director of the Netcare hospital division, today.

According to Du Plessis, this latest generation artificial sphincter was especially sent to South Africa from abroad at the request of Dr Venter. Dr Venter urgently requested the technology from local distributors in order to treat a Krugersdorp man who suffered stress incontinence problems, which is when bladder control is lost during a cough, sneeze or activity such as lifting.

“An artificial urinary sphincter is widely considered the gold standard of treatment for complete urinary incontinence in men who have suffered irreparable damage to the urinary sphincter,” explains Dr Venter.

“We were, however, particularly impressed by this new-generation artificial urinary sphincter option, our investigations revealing that it was the best new alternative available globally for cases such as this one. Some of the advantages it offers include that it is easy for patients to use and it does not require further invasive surgeries should it require adjustment in future.”

“The first procedure in South Africa using this new technology was completed successfully two weeks ago. The patient is doing well, having been discharged a day after their procedure. The artificial sphincter is activated after approximately six weeks after implantation, once we are sure the patients have fully healed and accepted the device,” adds Dr Venter.

“We will be performing a further procedure using this compact artificial sphincter on a Pretoria man with severe urinary stress incontinence soon, and will now be offering it as a standard urinary sphincter replacement option at Netcare Pretoria East Hospital,” he observes.

Du Plessis thanked Dr Venter and his team at the hospital for introducing the new technology in South Africa, which was designed to overcome shortcomings identified with older generation devices. 

“Dr Venter has always shown himself to be a pioneering and highly talented urology specialist. He has once again broken new ground by introducing this new artificial urinary sphincter option, which I understand is being rolled out now and is increasingly used around the world, particularly in Europe, because of the advantages it offers over other similar technologies,” notes Du Plessis.

plains that the Victo device has a pump that is palpated by the patient when he needs to urinate. This is made of soft silicone that is easy for the patient to operate and serves to deactivate the cuff of the sphincter so the patient can pass urine normally.

“The entire device is implanted and it is compact, limiting the size of the foreign object within the body. Among the other characteristics of the technology that we appreciate is that it offers two configurations, the Victo and Victo+, and four cuff sizes are available for each to provide a better fit for each patient’s anatomy, which can vary considerably.

“These cuffs should be less likely to go on to leak in the longer term, and while we have yet to have the benefit of longer term medical studies, it should offer a more sustainable solution to severe urinary stress incontinence in men with damaged than other previous types of artificial sphincters,” points out Dr Venter.

The Victo+ has a stress relief balloon added to provide occlusion, or pressure, automatically if there are increases in abdominal pressure.

Dr Venter says various factors can potentially cause damage to the urinary sphincter and pelvic floor in men, including on-going bladder or bowel problems, constipation, heavy lifting and can occasionally be a complication of prostatectomy, the surgical removal of the prostate gland to treat cancer.

Dr Erich Bock, director of Netcare’s North East region, says that the new implant is an important development for urinary medicine, enabling improved outcomes for male patients who suffer severe urinary stress incontinence caused by a damaged urinary sphincter.

“This brand new device was only introduced to the international market late in 2016 and by all indications it will be the most sustainable and practical solution, offering appropriate patients a substantially improved quality of life,” adds Dr Bock.

“We congratulate Dr Venter and Netcare Pretoria East Hospital for introducing this advanced technology to the benefit of our patients in the region,” he concludes.

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Issued by:      MNA on behalf of Netcare Pretoria East Hospital
Contact:        Martina Nicholson, Graeme Swinney, Meggan Saville and Estene Lotriet-Vorster
Telephone:     (011) 469 3016
Email:           martina@mnapr.co.za, graeme@mnapr.co.za, meggan@mnapr.co.za or estene@mnapr.co.za

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Winter illnesses and your child: when should you be concerned?

How to distinguish between many winter ailments with the same common symptoms

Monday, June 11 2018

It is winter and along with the cold weather comes the usual bout of childhood illnesses. The season can prove especially challenging for parents of babies and young children who are more vulnerable when it comes to typical winter ailments. With so many of these illnesses sharing common symptoms, it can be hard to determine what illness your child has.

Dr Omolemo Percy Kitchin, a paediatric pulmonologist practising at Netcare Waterfall City Hospital, says understanding the basics when it comes to the different types of common winter ailments can go a long way towards assisting parents in navigating typical winter ailments. These basics include the common signs and symptoms, management, prevention, control and when it is advisable to see a doctor.  

According to Dr Kitchin the most common winter illnesses among children include:

  • Coryza: inflammation of the lining of the nasal cavity, better known as the “common cold’. It is derived from Greek word Ko’ruza, meaning nasal mucus.
  • Influenza: an infectious disease caused by the influenza virus, and is commonly referred to as flu.
  • Allergic rhinitis: inflammation of the nose, sometimes referred to as hay fever.
  • Bronchiolitis: inflammation of the bronchioles (small airways).
  • Asthma: chronic inflammation of the bronchi (larger airways).

One of the key factors that Dr Kitchin highlights is the overuse of antibiotics for the treatment of illnesses. Many parents automatically expect a prescription for antibiotics to treat colds and other viral infections. Not only will antibiotics not have the desired effect, it can have dangerous side effects and adds to the worldwide problem of antibiotic resistance.

“Common colds, influenza and bronchiolitis are caused by viruses and therefore do not require antibiotics to treat them. Parents and caregivers tend to think that an antibiotic will solve the problem. However, antibiotics are only effective in treating bacteria and not viruses.

“Influenza is potentially the most dangerous of the three conditions, specifically when it results in secondary complications such as pneumonia, which if very severe might require admission to the hospital and or the intensive care unit. This is more common in individuals with compromised immune systems. Compromised individuals should have a yearly flu vaccination which should limit the severity of the condition,” Dr Kitchin says.

According to Dr Kitchin, the public often confuses coryza and influenza. “Generally, when people say they have flu, they are actually referring to coryza or the common cold caused by the rhino virus. Symptoms include a sore throat, cough, runny and/or blocked nose, and possibly fever.”

“Influenza has similar symptoms to the common cold, but could also include painful muscles, rigours, a general feeling of being unwell accompanied by a severe lack of energy. Influenza can result in secondary complications such as pneumonia, ear infections and sepsis. Unfortunately, coryza and influenza have to work its way out of the body,” Dr Kitchin adds.

“Children under the age of two are frequently susceptible to bronchiolitis. It presents with a cough, fast breathing, difficulty in breathing, chest in-drawing and fever, and is commonly triggered by the respiratory syncytial virus (RSV) in 90% of cases. Para-influenza and other viruses causing a common cold and influenza, may also be involved,” notes Dr Kitchin.

Allergic rhinitis or hay fever, as it is commonly known, often originates from seasons when there is a lot of pollen in the air. It may also be caused by allergic reactions to other substances.

“Patients present with a cough, especially at night, an itchy and runny nose with clear secretions that can be greenish in colour, watery and itchy eyes, and sometimes swelling of the eyelids. Patients can, in addition, present with dark discolouration under the eyelids,” Dr Kitchin explains.

Asthma may present with a cough that is worse at night, a tight chest and wheezing. Dr Kitchin says, “Approximately 40% of patients with asthma have allergic rhinitis, so these conditions often co-exist and form part of what we refer to as a united airway. Taking a good history of asthma is very important, as the chest is usually clear on examination by a medical practitioner, unless the patient has acute symptoms. Asthma is consequently often missed.”

How are these illnesses managed?

Dr Kitchin explains that a common cold or flu is treated symptomatically with nasal decongestants, fever control, nutritious meals and quality sleep. The virus will work itself out of the system, over time.

“Allergic rhinitis may be treated with nasal cortisone spray and a non-sedating antihistamine. For bronchiolitis, which is firstly treated symptomatically, patients might benefit from admission to hospital and oxygen via a nasal tube if the respiratory distress becomes severe. Asthma should be treated with controller pump inhalation steroids through a spacer in young children, and a reliever in case of emergencies,” he adds.

“Asthma can be well controlled by using inhaled steroids, and hay fever through intranasal steroids,” Dr Kitchin explains.

To limit the risk of bronchiolitis, which cannot be prevented by itself, national guidelines recommend the use of prophylaxis before the respiratory syncytial virus (RSV) season starts for high-risk patients.

“High-risk children can be defined as premature babies and children with congenital cyanotic heart disease. Such children are born with an abnormally developed heart and blood vessels, resulting in low oxygen supply to the organs,” he says.

There are many simple ways in which you can control the spread of illnesses. “Teaching and implementing regular hand washing routines, ensuring your children receive good nutrition and establishing a healthy environment, will go a long way in preventing illnesses common in winter. Avoiding environmental risk factors and tobacco smoke, ensuring that your child's vaccinations are up to date, and getting a flu shot before the start of the winter season, are also advisable,” concludes Dr Kitchin.

Ends

 

Recommended further reading:

https://pdfs.semanticscholar.org/1ea3/0340baab1415966266b2061c748e346f00b3.pdf

Issued by:            Martina Nicholson Associates (MNA) on behalf of Netcare Waterfall City Hospital

Contact:              Martina Nicholson, Graeme Swinney, Meggan Saville and Estene Lotriet-Vorster

Telephone:          (011) 469 3016

Email:                   martina@mnapr.co.za, graeme@mnapr.co.za, meggan@mnapr.co.za or estene@mnapr.co.za

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Competition Tribunal approves Netcare’s acquisition of Lakeview Hospital

Lakeview Hospital provides a range of multidisciplinary healthcare services

Wednesday, June 6 2018

Private healthcare group Netcare today announced that the Competition Tribunal has approved its acquisition of Lakeview Hospital.

“We are continuously exploring ways to improve our service offering to patients, and  are excited that the acquisition of Lakeview Hospital augurs well for the future of both Netcare and Lakeview, as the hospital is ideally positioned to enhance Netcare’s service offering to our patients in the greater East Rand,” said Jacques du Plessis, managing director of Netcare’s hospital division.

The previously privately owned Lakeview Hospital is a 94-bed facility, conveniently located in Benoni next to the N12 Highway and in close proximity to the Tom Jones off-ramp. The hospital, which opened in 2010, primarily serves the East Rand communities of Benoni, Brakpan, Boksburg and Springs.

“Lakeview Hospital provides a range of multidisciplinary healthcare services, and is particularly well-known for its state-of-the-art 20-bed mother and child unit and six-bed neonatal ICU. Advanced orthopaedic surgery is another focus area and the hospital is at present looking to establish an orthopaedic and spinal centre of excellence,” added Du Plessis.

Other facilities at Lakeview Hospital include an eight-bed adult intensive care unit, medical and surgical wards, a paediatric unit as well as a day surgical facility. The hospital also has four theatres, one of which is equipped with laminar flow technology, a 24-hour emergency department, radiology and pathology services, as well as a pharmacy.

Du Plessis concluded by saying that Lakeview Hospital ideally complements the other Netcare hospitals in the greater East Rand. “We look forward to growing our combined healthcare service offering together with the Lakeview team in the coming years in order to ensure greater accessibility to private healthcare services in the region.”

Ends.

Notes to journalists

About Netcare  

Netcare (JSE: NTC) operates the largest private hospital, primary healthcare, emergency medical services and renal care networks in South Africa. In addition to its world-class acute private hospital services in SA, Netcare provides:

  • cancer services including radiosurgery, radiotherapy, chemotherapy, bone marrow transplant and robotic-assisted surgery;
  • primary healthcare services through Medicross;
  • emergency medical services through Netcare 911;
  • occupational health and employee wellness services through Netcare Occupational Health;
  • mental health and psychiatric services through Akeso; and
  • renal dialysis through National Renal Care (NRC).

 

Netcare also has the distinction of being a leading private trainer of emergency medical and nursing personnel in the country.

Netcare’s core value is care. From this value flow four others, namely dignity, participation, truth and passion. We work hard to entrench these values in every action, decision and intervention we take with our patients, their families, our colleagues and communities.

For more information visit www.netcare.co.za.

Issued by:     Martina Nicholson Associates (MNA) on behalf of Netcare
Contact:        Martina Nicholson, Graeme Swinney, Meggan Saville or Estene Lotriet-Vorster
Telephone:    (011) 469 3016
Email:           martina@mnapr.co.za, graeme@mnapr.co.za, meggan@mnapr.co.za or estene@mnapr.co.za

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Laparoscopic workshop keeps SA surgeons up to date with latest techniques

Minimally invasive approach increasingly used to treat colorectal cancer

Wednesday, June 6 2018

An educational laparoscopic colorectal cancer workshop which involved live procedures to demonstrate the latest in surgical techniques, was held at Netcare Pretoria East Hospital recently.
 
A total of 55 surgeons and interventional specialists from the private and public sectors in South Africa attended the workshop hosted by the hospital and highly experienced local laparoscopic surgeon, Dr Michael Heyns. The specialists were provided with the opportunity to participate in an interactive discussion during two live procedures.

According to Dr Heyns, who has participated in a number of advanced laparoscopic training courses in Europe and locally, minimally invasive laparoscopic procedures are increasingly being used to excise and treat colorectal cancers, and new approaches and imaging technologies are continuously being introduced to assist in improving outcomes.

He said the workshop, which was CPD (Continuing Professional Development) accredited, largely aimed to demonstrate how advanced new imaging and visualisation techniques and technologies assist in the diagnosis and guidance of laparoscopic colorectal procedures.

It focused in particular on the clinical applications of indocyanine green (ICG) enhanced fluorescence in this type of surgery. Specialists had the opportunity to ask questions and share their knowledge and expertise during this interactive forum.

“The ICG fluorescence imaging system is proving safe and adding significant value in diagnosing, planning and decision-making in colorectal laparoscopic procedures, and is increasingly being used in appropriate cases internationally.

“As a result of the advantages it offers, including enhanced visualisation of blood supply, this approach may well become a standard for appropriate cases in the near future,” added Dr Heyns.

Dr Heyns, who offers regular laparoscopic colorectal cancer workshops at Netcare Pretoria East Hospital for specialists across South Africa, said that such workshops were a way for him to “give something back” to his profession, by imparting skills he had learned during his many years as a laparoscopic surgeon.

According to the general manager of Netcare Pretoria East Hospital, Rolien Kuhne, the hospital had received much positive feedback from the participants attending the workshop.

“Dr Heyns is a key member of the surgical team at the hospital, performing a range of procedures including breast cancer, endocrine and hernia repair surgeries, among others. He has a special interest in laparoscopic colorectal surgery and has performed hundreds of procedures within this area of expertise,” she added.

“We are most grateful to him for organising these educational events and for sharing his extensive knowledge and experience with his colleagues and the wider medical fraternity in South Africa,” she concluded.

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Issued by:   MNA on behalf of Netcare Pretoria East Hospital
Contact:    Martina Nicholson, Graeme Swinney, Meggan Saville and Estene Lotriet-Vorster
Telephone:  (011) 469 3016
Email:    martina@mnapr.co.za, graeme@mnapr.co.za, meggan@mnapr.co.za or estene@mnapr.co.
za

 

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New laser treatment for enlarged prostate now offered in South Africa

Laser procedure used to resolve urine blockage problems in older men

Monday, June 4 2018

A laser procedure to treat enlarged prostate, the most common non-cancerous prostate medical condition to develop in men by the time they reach their 60s, has been introduced to South Africa for the first time at Netcare Parklands Hospital in Durban.

The procedure, the holmium laser enucleation of the prostate (HoLEP), was recently successfully performed for the first time in the country by urologist, Dr Amit Kalpee, and his team on a Durban man with a severely enlarged prostate, a condition known as benign prostatic hyperplasia (BPH).

“A severely enlarged prostate causes uncomfortable urinary symptoms. HoLEP involves using a special high-powered laser to remove the gland and any tissue that causes obstruction of the urethra, through which the urine drains,” explains Dr Kalpee, who completed the European HoLEP Masterclass and is the first HoLEP surgeon in South Africa.

“This resolves symptoms such as urine blockage, which can in turn cause bladder and urinary tract infections and potentially serious kidney complications if left untreated,” he adds.

“The procedure is done under anaesthetic with the assistance of a tiny camera which together with the laser instrument is mounted on a fine telescopic rod that is inserted into the urethra via the penis.”

Dr Kalpee says HoLEP is a modern alternative to the standard procedure known as transurethral resection of the prostate procedure (TURP) for bladder outflow obstruction due to enlarged prostate. HoLEP requires specialist training and takes slightly longer to complete than a TURP, but it is less invasive and has a number of advantages over this standard procedure.

“There is less bleeding than after a TURP, and patients are often ready to be discharged from hospital the day after the procedure, much sooner than if a TURP was performed. Because enucleation is a much more precise procedure with the entire gland removed, recurrence of the problem does not occur. With HoLEP there is also no size limit of the prostate that can be treated,” explains Dr Kalpee, who has to date performed more than a dozen of these procedures.

Mr Dhanapalan Pillay, a patient who recently underwent HoLEP at Netcare Parklands Hospital, says that he is most grateful to have had the benefit offered by the new procedure. The 74-year-old from Durban admitted that prior to the procedure he was “quite scared, as I really didn’t know what to expect”.

“I have previously had two TURP procedures to assist with bladder flow obstruction, both of which were quite uncomfortable and took quite some time to recover from,” added Mr Pillay.

“I was therefore most pleasantly surprised by my experience with HoLEP. I had very little pain and bleeding after the operation and was up and about the afternoon following the operation, which was way beyond my expectations.”

“Now my symptoms have largely been resolved, my life is back to normal and I am walking every morning. I am most grateful to Dr Kalpee and his team at Netcare Parklands Hospital for performing this procedure, which has made a great difference to my life.”

According to Dr Kalpee, it is normal for a man’s prostate to enlarge with age, as the cells of the prostate begin to swell. It is estimated that half of men over the age of 50 will suffer from at least some BPH symptoms. Medication is usually used initially to treat these symptoms but unfortunately has limitations.

In some cases the prostate becomes large enough to occlude, or obstruct, the urethra, making it difficult to pass urine, as occurred in Mr Pillay’s case. It may cause weak urine flow and prevent the individual from emptying their bladder completely, resulting in the need to go to the toilet much more often.

“HoLEP is particularly indicated in men with large non-cancerous prostates where medication is either proving ineffective or causes side-effects. It is also safe for older men on blood thinning medication such as warfarin, aspirin or clopidogrel,” points out Dr Kalpee.

“It is normal to have some blood in the urine after the HoLEP procedure, so it is advisable to drink plenty of water for a few days while it clears. A catheter [a tube which drains the bladder] is inserted for between 12 to 24 hours until the urine clears. Prostate fragments are sent for laboratory analysis to ensure that they are not cancerous.

“The procedure does not generally affect erectile function or continence, although the possible urinary symptoms may take a few weeks to settle down afterwards. Patients are advised to take it easy and to avoid straining or heavy lifting for four weeks after the procedure.”

Netcare coastal region director, Craig Murphy, says that the introduction of HoLEP at Netcare Parklands Hospital is a welcome development in urology and private medicine in KwaZulu-Natal.

“This procedure brings hope to those large numbers of older men who are looking for relief from debilitating BPH symptoms, and Dr Kalpee and his team at Netcare Parklands Hospital are to be congratulated for introducing it to the benefit of our patients,” he concluded. 

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Issued by:         MNA on behalf of Netcare Parklands Hospital
Contact: Martina Nicholson, Graeme Swinney, Meggan Saville and Estene Lotriet-Vorster
Telephone: (011) 469 3016
Email: martina@mnapr.co.za, graeme@mnapr.co.za, meggan@mnapr.co.za or estene@mnapr.co.za

 

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Port Alfred Hospital placed on divert

Emergency department at Port Alfred Hospital will be on divert

Thursday, May 31 2018

Members of the public are advised that the emergency department at Port Alfred Hospital will be on divert from Wednesday, 13 June 2018 until further notice.

“People requiring urgent medical attention are advised to either contact their family doctor or go to the emergency department at Settlers Hospital in Grahamstown for assistance.

The province’s Department of Health (DoH) and Nalithemba are jointly responsible for staffing of Port Alfred Hospital’s emergency department, which serves both private and public sector patients. The temporary closure of the facility is due to industrial action by the DoH staff members, and unfortunately beyond Nalithemba management’s control,” says Marianne Stiglingh, clinical services manager of the public private partnership facility.

“Emergency medical services providers, doctors, Settlers Hospital and other relevant stakeholders have been notified that Port Alfred Hospital is on divert to Settlers Hospital until further notice,” adds Stiglingh.

“From our side, we have to place the emergency department on divert until the staff members return to work unconditionally, in order not to compromise clinical patient care or patient safety,” Stiglingh concluded.

 

Ends
 

Issued by: MNA on behalf of Nalithemba
Contact: Martina Nicholson, Graeme Swinney, Meggan Saville and Estene Lotriet
Telephone: (011) 469 3016
Email: martina@mnapr.co.za, graeme@mnapr.co.za, meggan@mnapr.co.za or estene@mnapr.co.za

 

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Man who survived impalement on crowbar to do Comrades

Daniel de Wet dedicates his race to trauma surgeon, hospital team and rescue workers

Thursday, May 31 2018

When Daniel de Wet regained consciousness in Netcare Milpark Hospital after a 1.8-metre metal industrial crowbar penetrated his body 3.5km underground at a mine in Carletonville, he never imagined that he would now be making final preparations for taking part in his first Comrades Marathon since the accident.

“Just three-and-a-half years ago, my wife and colleagues were praying for my survival, and when I was able to walk out of the hospital only 19 days later, we regarded it as a miracle from God. To think that I have now successfully qualified to take on the Comrades Marathon once more is truly remarkable and every day I am so grateful for the recovery I have made,” Mr De Wet says.

Pic: Daniel de Wet and his wife Lizl on day 15 of his 19-day recovery at Netcare Milpark Hospital. Mr De Wet was impaled by a metal industrial crowbar while working at a gold mine near Carletonville, Gauteng.

“Day by day, I have regained my strength and this year I have managed to qualify for the 2018 Comrades Marathon. I am dedicating my run to every single rescue worker, paramedic, firefighter, and especially to Netcare 911, Netcare Milpark Hospital and trauma surgeon Professor Kenneth Boffard.”

“Before my accident in 2015, I ran the Comrades Marathon six times, and during my initial recovery after the accident it seemed to me that I would never be able to take part in this gruelling ultramarathon ever again,” Mr De Wet notes.

On 10 June, however, he will be taking on the challenge of this year’s Comrades Marathon with his running club, the Carleton Harriers, wearing race number 49470.

An unusual injury
One afternoon in January 2015, engineering supervisor Mr De Wet was working on washing out a dam 3.5km underground at a mine in Carletonville, using an extended crowbar to stir up the mud, when he suddenly slipped. Mr De Wet looked down and, to his utter disbelief, saw that the metal bar had penetrated his body entering his groin area and coming out of his back, just below his shoulder blade.

He recalls how the mine’s rescue team had to carry him perched awkwardly in a sitting position on a stretcher, as the metal bar protruding from his body was almost level with Mr De Wet’s feet, making it impossible for him lie down.

“I was talking the whole time, trying to keep the other guys calm,” he remembers. Having been brought up to surface level at a pace that would ensure that he did not suffer any adverse decompression effects, commonly known as ‘the bends’, he was airlifted to Netcare Milpark Hospital’s world-class, level-one trauma centre by an experienced team of Netcare 911 paramedics.

When he arrived two surgical teams, led by renowned trauma surgeons, Professor Boffard and Professor Elias Degiannis, were ready to operate: one team concentrating on his injuries in the abdomen and one on those in the chest area.

Once the extended crowbar was pulled completely free of Mr De Wet’s body, the doctors saw that the impalement had caused significant damage, destroying one kidney and damaging his small bowel and numerous blood vessels. Although Mr De Wet lost a kidney, he made rapid progress and was discharged from hospital just 19 days later.

As a token of his appreciation, Mr De Wet presented the 1.8 metre metal rod that was removed from his body as a gift to Professor Boffard and Netcare Milpark Hospital. 

Ready to take on Comrades again
Mr De Wet acknowledges that the ultramarathon will be a challenge. “I think the hardest aspect is when you realize that you are running out of time to complete the race but your legs are so tired but you just need to find the strength to push yourself to make up time.”

“This year the race starts in Pietermaritzburg, and I prefer the ‘down run’, although the Comrades is never a walk in the park,” he says.

“I am fortunate to have an amazing support base, particularly my wife, and there are so many people encouraging me. I have many friends and guys who run with me, and they have helped me through the difficult times.”


Lodox scan images show how the industrial crowbar penetrated Mr De Wet's body, going in between his legs and coming out his back, just below his shoulder blade.

“I will never forget what the Netcare Milpark Hospital team and Professor Boffard did for me in saving my life. I still feel blessed every single day to be alive. I would really like to thank every person who dedicates himself or herself to saving lives and giving people like me a second chance,” he concluded.

Ends

Issued by:           Martina Nicholson Associates (MNA) on behalf of Netcare Milpark Hospital and Netcare 911
Contact:               Martina Nicholson, Graeme Swinney, Meggan Saville or Estene Lotriet-Voster
Telephone:        (011) 469 3016
Email:                   martina@mnapr.co.za, graeme@mnapr.co.za, meggan@mnapr.co.za, or estene@mnapr.co.za

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Intensive care ambulance designed especially for children now operational

Netcare 911’s new paediatric intensive care ambulance proves its worth

Tuesday, May 29 2018

A new Netcare 911 paediatric intensive care ambulance has been specially designed and equipped to safely transport critically ill children who need to be transferred between hospitals to receive specialised care at an appropriate medical facility.

“The Netcare 911 team identified a need for such an ambulance as children have very specific needs,” says Shalen Ramduth, director of business development and support services at Netcare 911, and one of the prime movers behind the introduction of the new vehicle.

Pic: The new Netcare 911 paediatric intensive care ambulance has been specially designed and equipped to safely transport critically ill children who need to be transferred between hospitals to receive specialised care at an appropriate medical facility.

“A great deal of thought went into the design, with every consideration being given to ensuring that we can safely care for our critically ill young charges and that they are comfortable while being transported. The result is a dedicated paediatric intensive care ambulance, which we understand is the first of its kind in the country,” notes Ramduth.

Ramduth explains that Netcare 911 operates a number of intensive care ambulances staffed by paramedics experienced in critical care, for patients whose health is so compromised that they require an intensive care environment while en route between hospitals to, as far as possible, ensure that they remain stable and safe during their transfer.

“These ambulances have highly specialised life support equipment and essentially provide an intensive care environment for patients. Since their introduction a couple of years ago, they have safely transported hundreds of patients between hospitals,” he adds.

“While our standard ICU ambulances can be used to transfer paediatric patients, we wanted to develop an ambulance that was specifically suited to meet the needs and requirements of child patients. The new paediatric intensive care ambulance can therefore also accommodate medical technologies specifically for children.

It can, for example, carry a paediatric corporeal membrane oxygenation (ECMO) machine, for children who require both heart and respiratory support. Provision is also made to incorporate an incubator for babies who may require this form of support.

“The design of the ambulance supports a sterile ICU environment and the vehicle is routinely decontaminated through a rigorous infection prevention programme to maintain this.

“For the comfort of the child over longer distance transfers, the interior of the vehicle has been decorated with familiar cartoon characters and has warmer lighting in order to provide an environment that is as familiar, tranquil and as calming as possible. There is also a fold-down DVD entertainment system, and a bar fridge has been fitted to keep refreshments cool.”

According to Ramduth, the new Netcare 911 paediatric ambulance was commissioned some four weeks ago and has already proved to be an invaluable resource, having been used to safely transport a number of sick young patients requiring intensive care en route.

“The ambulance has been used successfully for transfers from centres not only around Gauteng but also from as far afield as the North West, Limpopo, Mpumalanga and the Free State provinces.


For the comfort of the child over longer distance transfers, the interior of the Netcare 911 paediatric intensive care ambulance has been decorated with cartoon characters and has warmer lighting in order to provide an environment that is as familiar, tranquil and as calming as possible.


The interior of the Netcare 911 paediatric intensive care ambulance accommodates medical technologies specifically for paediatric patients.

Like the other Netcare 911 intensive care ambulances, the paediatric team attending to children during transportation, is specifically trained and has highly specialised skills, to seamlessly transfer critically ill or injured paediatric patients between medical facilities.

“We are using our more experienced advanced life support paramedics for our paediatric team, who, in addition to having undergone special ICU training, are known to work exceptionally well with children. These crews ensure sick and highly vulnerable paediatric patients are in the best possible hands during transfer,” observes Ramduth.

The paediatric ICU ambulance, a modified Volkswagen Crafter, has been fitted with attractive and comfortable racing-car type bucket seats with three-point harnesses. These are used by the critical care paramedics attending to the patient as well as any passengers, such as a parent, who may need to accompany the patient on the journey.

 “The VW Crafter was selected for its long wheelbase and spacious cabin, which gives the paramedic team plenty of room in which to work and space for specialised equipment to be carried if necessary. It offers a high degree of comfort for the patient and critical care team, particularly over longer distance transfers. The vehicle is furthermore reliable and offers excellent road holding characteristics and occupant safety,” says Ramduth.

 “Nothing is more important to Netcare 911 than our vulnerable patients and we have developed units such as paediatric ICU ambulances, to ensure they are provided with quality and safe care,” he concludes.

Ends

Issued by:           MNA on behalf of Netcare 911
Contact:               Martina Nicholson, Graeme Swinney, Meggan Saville and Estene Lotriet-Vorster
Telephone:        (011) 469 3016
Email:                   martina@mnapr.co.za, graeme@mnapr.co.za, meggan@mnapr.co.za or estene@mnapr.co.za

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Metabolic surgery can have numerous health benefits

Surgical intervention can resolve conditions associated with obesity

Monday, May 21 2018

Many South Africans have the misconception that metabolic surgery is done purely to achieve weight loss for cosmetic reasons.

“In fact, metabolic surgery shows a high degree of success in assisting to resolve the medical conditions associated with obesity including impaired glucose tolerance; metabolic syndrome and type 2 diabetes,” says Dr Gert du Toit, surgeon, Durban Metabolic Surgery Centre, Netcare St Augustine’s Hospital.

According to the International Diabetes Federation (IDF), approximately 1.8 million South Africans were living with diabetes in 2017, and globally there are 425 million people living with the disease.1

“This highlights the magnitude of the global health challenge posed by the deadly combination of obesity and diabetes. There is a strong correlation between the rise in obesity and the explosion in type 2 diabetes and other lifestyle-related chronic health conditions,” notes Dr du Toit.

He says that other health conditions often associated with obesity include ischaemic heart disease; sleep apnoea; certain kinds of cancers; osteoarthritis and mobility problems.

“Where patients are treated and properly supported pre- and post-operatively by a multidisciplinary team of medical practitioners, metabolic surgery presents a safe and viable treatment option for obese individuals,” adds Dr du Toit.

“If undertaken at a metabolic centre that is accredited by the South African Society for Surgery, Obesity and Metabolism [SASSO], the surgical approach not only achieves outstanding weight loss results, but also a high degree of success in resolving conditions associated with obesity including metabolic syndrome, impaired glucose tolerance, as well as type II diabetes.”

The American Diabetes Association (ADA) states: “Many people who undergo metabolic surgery experience major improvements in glycaemia, and a reduction in cardiovascular risk factors, making it a highly effective treatment for type 2 diabetes and an effective means of diabetes prevention.”2

Dr du Toit concurs, noting that early surgical intervention shows outstanding potential in preventing the obese patient from proceeding from impaired glucose tolerance (pre-diabetes) to full-blown type 2 diabetes, and that it furthermore improves outcomes.

A recent study published in the Biomedical Journal of Science and Technology Research3 points out that metabolic surgery in type 2 diabetes patients’ results in:

  • Better glycaemic control;
  • Reduction in medication use;
  • Reduction in cardiovascular disease risk;
  • Reduction in heart attack, stroke, cancers and in overall mortality rates; and
  • Improved weight loss and quality of life.

The randomised, controlled STAMPEDE trial, published in the New England Journal of Medicine (NEJM), compared medical and surgical therapy and the results thereof,reported similar findings.4,5

Dr du Toit says that metabolic surgery often achieves a complete remission in diabetes, but this depends on factors such as how long the patient has had the disease. “The best outcomes are achieved in patients who have not had diabetes for more than five years, so early diagnosis is important.”

Recognising the advantages of early intervention, Discovery Medical Scheme, revised its funding requirements for metabolic surgery for 2018, reducing the patient Body Mass Index (BMI) requirement from 35 to 30.

“This is a significant development and recognition of the important preventative role metabolic surgery can play, particularly with regard to pre-diabetes and type 2 diabetes, which can cause irreversible damage to blood vessels and organs.

“This decision, which was made following negotiations with endocrinologist Professor Tess van der Merwe, SASSO chair and director of the Centres of Excellence for Metabolic Medicine and Surgery of South Africa, highlights that metabolic surgery treatment makes economic sense for many patients, and we expect other medical schemes will follow in covering metabolic procedures in future,” says Dr du Toit.

Before the decision is taken to recommend metabolic surgery, SASSO-accredited facilities insist that the prospective patient undergo a thorough physiological and psychological evaluation to ascertain their suitability for the treatment.

“As there can be numerous highly complex physiological and psychological causes of obesity, and each person has a completely different constitution and metabolic makeup, every case is different and not everyone can have, or will respond well, to the treatment,” says Dr du Toit.

“In the majority of cases, where patients are treated and properly supported before and after surgery by a multidisciplinary team and the surgery is safe for the patient, life-changing results are achieved. It should be understood that metabolic surgery is not a quick-fix solution for obesity, however. It requires a long-term commitment to a proper post-surgery diet and an on-going follow-up programme, ” asserts Dr Du Toit.

Over and above the laparoscopic surgeons, the multidisciplinary teams at SASSO centres include highly experienced endocrinologists, physicians, dieticians, psychiatrists and/or psychologists, and biokineticists.

“Such a team is able to take a comprehensive and holistic approach to weight loss, and determine the most practical solutions for each individual patient. The three main types of metabolic surgery offered at SASSO-accredited facilities in South Africa are all minimally invasive and are undertaken laparoscopically through small incisions in the skin.

“A high degree of disease resolution and very low complication rates are achieved at dedicated multi-disciplinary metabolic surgical centres. For those who qualify for this treatment, metabolic surgery is a tried and proven option,” concludes Dr Du Toit.

References


Ends

Issued by:           Martina Nicholson Associates (MNA) on behalf of Netcare St Augustine’s Hospital
Contact:               Martina Nicholson, Graeme Swinney, Meggan Saville and Estene Lotriet-Vorster
Telephone:        (011) 469 3016
Email:                   martina@mnapr.co.za, graeme@mnapr.co.za, meggan@mnapr.co.za or estene@mnapr.co.za

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