Diagnostic performance of dobutamine stress echocardiography: A South African experience

Dobutamine stress echocardiography (DSE) is a well-established modality for the diagnosis of coronary artery disease, but there are no reported diagnostic data in southern Africa. Objectives. To compare the safety, sensitivity and specificity of a South African (SA) DSE programme with larger, international series. Methods. All patients undergoing DSE from 2019 to 2021 at a single SA centre were included. A new wall motion abnormality (≥2 segments) signified inducible ischaemia. Results. A total of 106 patients (mean (standard deviation) age 61 (11) years, 68% male) were analysed. Six patients (6%) experienced chest pain during DSE and 4 (4%) developed an atrial arrhythmia. The sensitivity and specificity for epicardial coronary stenosis were 77% and 74%, respectively, changing to 82% and 72% when excluding those who had previous coronary artery bypass surgery. Conclusion. The sensitivity, specificity and safety of an SA DSE programme were comparable to international series. A DSE programme is feasible in a resource-constrained environment.

Management of psoriasis in Africa and the Middle East: a review of current opinion, practice and opportunities for improvement

Psoriasis is a common, chronic, systemic, inflammatory disease of the skin that is often associated with inflammatory musculoskeletal disease. Psoriasis impacts on affected individuals and on society at many levels, being associated with considerable economic burden and impaired quality of life. This article aims to provide dermatologists and their allied healthcare professionals, particularly those practicing in Africa and the Middle East, with a review of the current understanding of psoriasis, its treatment and impact, as a backdrop for further discussion of the management of psoriasis in these regions. Insight into the real-life, day-to-day challenges and unmet needs currently facing dermatologists in Africa and the Middle East is provided by the authors, most of whom are experienced dermatologists practicing in this region.

The use of a pour-on and spray dip containing Amitraz to control ticks (Acari : Ixodidae) on cattle

Knockdown and persistence efficacies of a pour-on containing Amitraz 1 % and Cypermethrin 1 % and a spray dip containing 12.5 % Amitraz were compared. Knock-down and persistence efficacies of the Amitraz spray dip against Rhipicephalus (Boophilus) decoloratus and Amblyomma hebraeum were significantly higher for the duration of the trial than those of the pour-on. In the case of Rhipicephalus appediculatus and Rhipicephalus evertsi evertsi, efficacy was significantly higher on Days 2 and 5. Resistance testing prior to the start of the trial indicated that R. (B.) decoloratus was resistant to both Cypermethrin and Amitraz, yet in the case of the spray dip excellent efficacy results were obtained. It is thought that the cattle's scruffy winter coat may have hindered the spread of the pour-on, but that the thorough wetting and especially the higher concentration of active ingredient applied via the spray dip allowed this formulation to be effective. These results show that under certain conditions a spray dip containing 12.5 % Amitraz may be more effective than a pour-on containing 1 % Amitraz and 1 % Cypermethrin, despite apparent in vitro resistance.