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Background: The World Health Organization Surgical Safety Checklist (WHO Checklist) fosters communication and teamwork among the perioperative team; however, perceptions influence its acceptance and use. This study explores the perceptions of the perioperative team regarding the WHO Checklist in operating theatres at the University of the Witwatersrand (Wits) affiliated hospitals. Methods: A qualitative, contextual, and exploratory research design was employed. Purposive sampling was used to invite theatre nurses, anaesthetists, and surgeons to participate. Focus group interviews were held for each group, which were audio-recorded and transcribed verbatim. Thematic analysis was used to analyse the data. Results: Ten nurses, six anaesthetists, and four surgeons participated in the focus group interviews. Four themes relating to patient safety were identified: the prevalence of power struggles in theatre, a breakdown in communication, a culture of silence, and inadequate and siloed training. The metaphor of a daily flight plagued by turbulence describes the perceptions of the interviewed perioperative teams, which may result in serious adverse events. Conclusion: In a complex system, such as a hospital theatre environment, introducing a simple tool, such as the WHO Checklist, is perceived to have a limited impact on patient safety if the underlying supportive network is not intact. This study demonstrates the importance of interpersonal relationships, changing teams, lack of integration of teams, processes, and training on the use of the WHO Checklist as a safety tool in a South African hospital setting. A prevailing culture of safety is a prerequisite for the successful implementation and use of the WHO Checklist. [ABSTRACT FROM AUTHOR]

Background: Resuscitation trolleys with equipment and medicines for emergencies are required in all clinical areas in hospitals. Emergency medicines kept separately are more likely to expire than non-emergency medicines, as these are generally used less frequently. An updated list of essential emergency medicines was implemented in 2016 at an academic hospital in central South Africa. The aim of this study was to determine the frequency of both the use and the expiry, with associated financial losses, of the emergency medicines on this list. Methods: A prospective, descriptive study was conducted over a six-month period in 2019. Forms accompanying the emergency packs were returned to the pharmacy whenever packs expired or were opened. These forms were collected and the type and quantity of medicines either used or expired were recorded. Results: In total, 168 of the returned forms were included. The most frequently used emergency medicines were adrenaline, sodium bicarbonate and Ringer's lactate. Adrenaline use was recorded on 52.8% and 25% of the forms from the adult/paediatric and neonatal emergency packs, respectively. Medicines that were never used included: betamethasone, Darrow's half-strength solution and most of the neonatal pack medications. Neonatal emergency medicine packs were rarely used and the neonatal fluid packs were never used. The total cost of the expired medicines was R7 960.29 (US$569.41 at the time of the study). Adrenaline was the medication that expired most frequently but the greatest financial losses occurred from expired sodium bicarbonate. Conclusion: The total financial losses were low but can be reduced further. The contents of the emergency packs should be reviewed to possibly reduce the amount of items used infrequently. Also, the removal of those items not recommended in emergency care guidelines could be considered. Ensuring the policy was followed of returning unused medicines close to expiry and redistributing these to high-use areas would further reduce wastage. [ABSTRACT FROM AUTHOR]

Background: The educational environment impacts various aspects of students' professional development and well-being and is an important aspect of medical education programmes. Limited research investigating the theatre educational environment has been identified in South Africa. This study aims to describe the educational environment in theatre for registrars in the Department of Anaesthesiology at the University of the Witwatersrand (Wits). Methods: A prospective, descriptive study design was followed, involving anaesthetic registrars at Wits, using the adapted Anaesthetic Theatre Educational Environment Measure (ATEEM) questionnaire between April and June 2019. A convenience sampling method was implemented to administer the anonymous questionnaire. Categorical variables were described using numbers and percentages. Descriptive statistics were used to calculate the total scores. The independent t-test or analysis of variance test was used to make comparisons. Results: A total of 85 (78.7%) anaesthetic registrars participated in this study. The mean total (SD) adapted ATEEM score was 116.5 (16.9) out of a total of 164. The total scores for male and female registrars were 118.4 (13.5) and 115.3 (18.7) respectively (p = 0.419). First-year registrars scored 121.6 (14.3), second years 111.1 (19.0), third years 111.4 (14.6) and fourth years 122.3 (18.7) (p = 0.003). Junior and senior registrars scored 117.1 (17.0) and 115.7 (17.1) respectively (p = 0.708). The three hospitals were scored 112.3 (19.5), 119.8 (16.4) and 115.4 (12.0) respectively (p = 0.187). The mean scores for the five domains were autonomy 25.4/32 (3.1), perception of atmosphere 31.6/44 (5.4), workload/supervision/support 17.3/28 (3.5), perception of teachers and teaching 14.3/20 (2.9), and learning opportunities and orientation to learning 27.9/40 (5.1). Conclusion: The theatre educational environment is perceived as more positive than negative, but with room for improvement. With the availability of a validated instrument to assess the educational environment quantitatively, regular quality assessments of the educational environment should be included in the training institution's practice. [ABSTRACT FROM AUTHOR]

This prospective longitudinal study investigated the progression of haematological changes in 32 transfused and 54 non-transfused dogs naturally infected with Babesia rossi over the 1st 6 days following diagnosis and treatment. The effect of patient age on the results of complete blood counts was determined. Haematology data were analysed at presentation and at 24 hours, 3 days and 6 days after presentation. Dogs were treated with diminazene aceturate at diagnosis and a blood transfusion was given if deemed clinically required. Mildly to moderately regenerative normocytic normochromic anaemia was observed in all dogs throughout the study period. Transfused dogs more often had an inflammatory leukogram at presentation and at 24 hours, than dogs that were not trans- fused. In dogs with a left shift, a concurrent normal or decreased segmented neutrophil count was found more commonly than neutrophilia. Severe thrombocytopenia that resolved within a week was common. Blood transfusion alleviated the anaemia, but had no significant effect on white blood cell or platelet responses. Blood cell responses were not significantly influenced by age. In conclusion, the red blood cell and white blood cell responses were less than expected in dogs with babesiosis, given the degree of anaemia and inflammation present. The magnitude of thrombocytopenia and rapid return of the platelet count to normal suggested a possible immune-mediated mechanism for the thrombocytopenia. [ABSTRACT FROM AUTHOR]

This study was conducted to determine the effect of feeding high milk volumes on the growth rate, health and cross-sucking behaviour in group-fed Jersey calves. Three-day-old heifers (n = 120) in a seasonal calving dairy herd were randomly assigned to one of 6 treatment groups. Three groups received high milk volumes (HMV), consisting of ad libitum milk or milk replacer feeding twice a day, while 3 groups received restricted milk volumes (RMV), consisting of 2 t twice daily, during the pre-weaning period. After a pre-weaning period during which feeding was reduced to once daily, all calves were weaned at 42 days and monitored until 60 days of age. Adjusting for birth mass, birth date, dam parity and sire, average daily mass gain (ADG), both pre-weaning (days 0-42) and overall (days 0-60), was higher in HMV than in RMV calves (P < 0.001). After weaning, growth rates showed no differences and at 60 days of age the HMV calves maintained a 6.74 kg advantage in mean body mass (P < 0.001). The mean intake of dry starter feed was higher in RMV than in HMV calves. Overall feed conversion rate of HMV calves was 9.6% better than RMV calves. However, the variable cost per kg mass gain was 12 % higher for HMV calves. In the RMV groups 75 % of calves showed cross-sucking behaviour pre-weaning and 18 % post-weaning, whereas in HMV calves the proportions were 2 % and 7 %, respectively. There was no significant effect of milk volume on the incidence of diarrhoea. We conclude that the feeding of high volumes of milk to Jersey calves has a positive effect on growth rate, without compromising health or reducing solid feed intake after weaning. However, the higher cost of such a feeding system may limit its implementation. [ABSTRACT FROM AUTHOR]

Two adult Dorper ewes developed an oesophageal obstruction (choke) by consuming a pelleted ration. The history, clinical signs and method of treatment were recorded in each case. One case was treated surgically via rumenotomy and the other conservatively. Both ewes recovered uneventfully and no recurrence was observed. Reasons for the compaction of the pelleted ration in the oesophagus are discussed. [ABSTRACT FROM AUTHOR]

The objective of this study was to describe the changes in plasma glucose concentration in 20 severely injured dogs suffering from dog bite wounds over a period of 72 hours from the initiation of trauma. Historical, signalment, clinical and haematological factors were investigated for their possible effect on plasma glucose concentration. Haematology was repeated every 24 hours and plasma glucose concentrations were measured at 8-hourly intervals post-trauma. On admission, 1 dog was hypoglycaemic, 8 were normoglycaemic and 11 were hyperglycaemic. No dogs showed hypoglycaemia at any other stage during the study period. The median blood glucose concentrations at each of the 10 collection points, excluding the 56-hour and 64-hour collection points, were in the hyperglycaemic range (5.8- 6.2 mmol/ℓ). Puppies and thin dogs had significantly higher median plasma glucose concentrations than adult and fat dogs respectively (P < 0.05 for both). Fifteen dogs survived the 72-hour study period. Overall 13 dogs (81.3 %) made a full recovery after treatment. Three of 4 dogs that presented in a collapsed state died, whereas all dogs admitted as merely depressed or alert survived (P = 0.004). The high incidence of hyper-glycaemia can possibly be explained by the 'diabetes of injury" phenomenon. However, hyperglycaemia in this group of dogs was marginal and potential benefits of insulin therapy are unlikely to outweigh the risk of adverse effects such as hypoglycaemia. [ABSTRACT FROM AUTHOR]

The extent of trauma in a patient can be difficult for a clinician to quantify. A prospective study was performed on 2 groups of dogs undergoing either ovariohysterectomy or hemilaminectomy. The serum activity of creatine kinase and serum concentration of C-reactive protein were evaluated preoperatively and then at 4, 6, 8, 12, 24 and 48 hours postoperatively in both groups. The results were compared statistically both within and between the 2 groups. A wide range of results was found at each time point for both analytes although there were no significant differences for either analyte between the 2 surgical groups preoperatively. Thereafter there were significant differences in creatine kinase activity levels between the 2 groups. C-reactive protein concentration results were very similar in the 2 groups with no statistical difference at any time point. The results of this study suggest that the evaluation of CK and CRP at any one time point in a traumatised animal is of limited value. However, the evaluation of the trend of these 2 analytes, even over a relatively short time period, may allow for useful prognostication in clinical cases. [ABSTRACT FROM AUTHOR]

The article presents a cross-sectional, observational study which examines the relationship between the outcome and C-reactive protein (CRP) concentration and the magnitude of CRP after 24 hours. The study was undertaken in 75 dogs naturally infected with Babesia rossi and diagnosed through polymerase chain reaction and reverse line blot. Findings showed that CPR concentration is not linked to Babesia rossi's infection in dogs and inflammation is not the cause of the disease's severity.

The article presents a study that investigates on the different types of intramammary infection (IMI) rate of cows that undergone blanket dry cow therapy. The study was carried out by randomly assigning six intramammary antimicrobial products to 162 cows wherein intramammary infection occurrence was evaluated as well as the cure rate. The study reveals that efficacy of antimicrobial intramammary efficacy depends on the different products used and helps prevent IMI prevalence.