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Objective:Design:Setting:Participants:Results:Conclusion:to investigate the predictors of vitamin D (vitD) status of undernourished and well-nourished children aged under five years in the North West Province of South Africa.this cross-sectional study assessed sociodemographic data, nutritional supplement intake, vitD-rich food consumption, and sunlight exposure via a structured questionnaire. Venous blood samples were collected to evaluate vitD, iron, and inflammatory markers.the maternal and child wellness departments of six community clinics in the JB Marks Municipality.121 undernourished and 51 well-nourished children, 6–59 months old.The prevalence of serum 25(OH)D < 30 ng/ml was 20.3%, 19.9%, and 21.6% in the total, undernourished, and well-nourished groups, respectively. The total mean 25(OH)D concentration was 38.41 ± 9.64 ng/ml. Age showed a negative association trend with 25(OH)D in the well-nourished group (β: −0.172, 95% CI −0.353, 0.010, p = 0.063), while household income was inversely associated with 25(OH)D (β = −1.86, 95%CI = −2.99, −0.733, p = 0.001) in the total group. Among the undernourished children, iron-deficiency anaemia (IDA) was associated with almost five times greater odds for 25(OH)D < 30 ng/ml (OR: 4.646, 95% CI 1.339, 16.123, p = 0.016). Intake of vitD supplements, therapeutic foods, multivitamins, and formula milk was associated with significantly higher 25(OH)D concentrations and was adjusted for in subsequent analyses. Additionally, consumption of eggs more than once a month was associated with higher 25(OH)D levels in the well-nourished children aged 24–59 months. Nutritional status, inflammation, and sunlight exposure were not associated with 25(OH)D concentrations.vitD insufficiency exists in both the undernourished and the well-nourished. Age, egg consumption, and IDA should be considered in the correction of vitD insufficiency in children.Trial registration: Pan African Clinical Trial Registry identifier: PACTR202110646172601.. [ABSTRACT FROM AUTHOR]

Primary sclerosing cholangitis is an often fatal inflammatory disease affecting the bile ducts. To date, there is no satisfactory treatment for this condition; in particular, drug treatment has not proven efficacious, and surgical treatment is at too preliminary a stage to draw firm conclusions. To further evaluate the effectiveness of using endoscopic methods to implant a drainage device, a study was carried out in which six patients with jaundice (an externally detectable symptom of liver or biliary system abnormalities) and known or suspected primary sclerosing cholangitis underwent placement of an endoprosthesis. In this case, the endoscopic procedure involves viewing and manipulating the liver and bile ducts by means of a flexible fiber-optic endoscope inserted through the esophagus into the small intestine; the endoprosthesis is a tube-like device implanted in the constricted bile ducts to allow bile flow from the liver to the intestine. Five of the six patients showed dramatic improvement within several weeks of endoprosthesis placement; both clinical indices and blood chemistry results indicated a significant improvement in liver function. The remaining patient required a liver transplant five months following surgery, owing to continued deterioration of liver function. During follow-up periods ranging from 12 to 49 months in the five improved patients, the endoscopically placed endoprostheses continued to provide relief from the symptoms of cholangitis; bile duct diameters were twice their presurgery sizes. Three of the patients developed infections at the time of initial endoprosthesis insertion; surgical drainage was necessary in one case. This technique yields higher success rates than have been reported with either traditional surgical or percutaneous methods (through the abdomen). In addition, the likelihood of complications interfering with possible future liver transplants is less with endoscopic methods. (Consumer Summary produced by Reliance Medical Information, Inc.)

Severe acute malnutrition (SAM) is associated with a complex pattern of various clinical conditions. We investigated how risk factors cluster in children with SAM, the relationship between clusters of risk factors and mortality as well as length of stay in children with SAM. A prospective observational study design was used. Data were extracted from medical records of 601 infants and children aged 0–59 months admitted and treated for SAM in three Ghanaian referral hospital between June 2013 and June 2018. Among the 601 medical records extracted, ninety-nine died. Three clusters of medical features clearly emerged from data analyses. Firstly, an association was defined by eye signs, pallor, diarrhoea and vomiting with gastrointestinal infections and malaria. In this cluster, pallor and eye signs were related to 2- to 5-fold increased mortality risk. Secondly, HIV, oedema, fast pulse, respiratory infections and tuberculosis; among those features, HIV increased child mortality risk by 2-fold. Thirdly, shock, convulsions, dermatitis, cold hands and feet, weak pulse, urinary tract infections and irritability were clustered. Among those features, cold hands and feet, dermatitis, convulsions and shock increased child mortality risk in a range of 2- to 9-fold. Medical conditions and clinical signs in children diagnosed with SAM associate in patterns and are related to clinical outcomes. [ABSTRACT FROM AUTHOR]

The conflict between the objectives of the Consumer Protection Act 68 of 2008 – to protect consumers and ensure accessible and transparent redress – and the purpose of the parol evidence rule – to exclude extrinsic evidence and observe the maxim pact servanda sunt ‒ is evident and forms the basis of this article. The purpose of consumer protection legislation is to balance the rights of consumers and suppliers, to protect the interests of consumers and to ensure efficient redress for consumers who have been wronged. The parol evidence rule, which is still in effect in South Africa, prohibits extrinsic evidence in a dispute to interpret a written agreement between parties to ensure certainty on the terms and conditions agreed to in writing. In practice, the parol evidence rule can disadvantage consumers who enter into standard-form contracts, as they normally are in an inferior bargaining position and cannot negotiate the individual terms and conditions of consumer agreements. It is obvious that the strict enforcement of the parol evidence rule in consumer agreements could lead to unjust results in consumer disputes. The provisions of the Consumer Protection Act 68 of 2008 are discussed to establish the extent of the limitation of the parol evidence rule therein. Then, the Consumer Rights Act, 2015 in the United Kingdom is considered to establish the tendency to limit the application of the rule in foreign consumer legislation, and to compare that to the position in South Africa. This article discusses whether the restriction or limitation of the parol evidence rule in the Consumer Protection Act is efficient in reaching the aims and objectives of the Act. [ABSTRACT FROM AUTHOR]

All infant formulas must support the normal growth and development of infants, and this needs to be scientifically demonstrated. Formulas have to contain sufficient amounts of basic nutrients, and so are nutritionally interchangeable, with no evidence indicating that one brand is superior to another. [ABSTRACT FROM AUTHOR]

Chronic pain is often associated with impaired muscle strength and limited physical activity and performance, resulting in impaired physical functioning. This study aimed to determine whether voluntary participation in a structured 6-week hydrotherapy exercise programme would improve pain management, functionality and quality of life in an elderly population (n = 22; 77.7 ± 6.6 y) suffering from chronic pain and living in nursing homes in Tshwane. The experimental group (n = 13) attended hydrotherapy classes twice a week for six weeks, while the control group (n = 9) did not. Questionnaires were completed (Chronic Pain Grade, Functional Status Index, and the SF 36), and functional testing performed, in both groups at weeks 0, 3 and 6. The experimental group reported reduced pain intensity at week 3 (p = 0.051); reduced pain-induced disability at week 6 (p = 0.080); reduced assisted help required for activities of daily living (ADL) at week 3 (p = 0.040); reduced difficulty on performing ADL at week 3 (p = 0.012) and reduced pain experienced with ADL at week 3 (p = 0.007) and week 6 (p = 0.014). Improvements in upper body strength and agility were demonstrated. Improvements in subscales for quality of life were demonstrated at weeks 3 and 6. The control group showed no statistically significant changes in the above parameters. In conclusion, participation in structured hydrotherapy classes has been shown in this small study to be a beneficial intervention strategy for managing chronic pain in the elderly. [ABSTRACT FROM AUTHOR]

The following case study was discussed during the fourth-year dietetics evaluation process at North-West University, Potchefstroom Campus. It is a relection of the opinion of the dietitians, students and lecturers involved, describes the actions taken during the nutritional management of the case, and is based on current literature and guidelines relevant to the topic. [ABSTRACT FROM AUTHOR]