IZINDABA Arthroscopy offers no benefit in subacromial shoulder painShoulder arthroscopy is widely used, although its benefits are far from clear.Impingement of the rotator cuff tendons occurs frequently in patients aged >40 years and usually presents as a painful arc.As long ago as 1972, open decompression of the area was proposed, removing osseous spurs, often combined with tendon release and a bursectomy.This is generally now an arthroscopic procedure, frequently undertaken.A recent multicentre trial that covered 32 hospitals and 51 surgeons in the UK was reported in The Lancet.Eligible patients had subacromial pain for at least 3 months, with intact rotator cuff tendons, and had completed conservative management including exercise therapy and at least one steroid injection.Participants were randomly assigned to arthroscopic subacromial decompression, investigational arthroscopy only (which was a placebo), or no intervention.Surgical groups had better outcomes from shoulder pain and function compared with no treatment, but this difference was not clinically important.In addition, surgical decompression appeared to offer no benefit over arthroscopy only.These findings bring into question the value of this operation for these indications, of which patients should be aware when offered surgery.
This manuscript describes the process and impact of strengthening the WHO Regional Office for Africa (WHO AFRO)'s COVID-19 vaccination information system. This system plays a critical role in tracking vaccination coverage, guiding resource allocation and supporting vaccination campaign roll-out for countries in the African region. Recognising existing data management issues, including complex reporting prone to human error, compromised data quality and underutilisation of collected data, WHO AFRO introduced significant system improvements during the COVID-19 pandemic. These improvements include shifting from an Excel-based to an online Azure-based data collection system, automating data processing and validation, and expansion of collected data. These changes have led to improvements in data quality and quantity including a decrease in data non-validity, missingness, and record duplication, and expansion of data collection forms to include a greater number of data fields, offering a more comprehensive understanding of vaccination efforts. Finally, the creation of accessible information products-including an interactive public dashboard, a weekly data pack and a public monthly bulletin-has improved data use and reach to relevant partners. These resources provide crucial insights into the region's vaccination progress at national and subnational levels, thereby enabling data-driven decision-making to improve programme performance. Overall, the strengthening of the WHO AFRO COVID-19 vaccination information system can serve as a model for similar efforts in other WHO regions and contexts. The impact of system strengthening on data quality demonstrated here underscores the vital role of robust data collection, capacity building and management systems in achieving high-quality data on vaccine distribution and coverage. Continued investment in information systems is essential for effective and equitable public health efforts.
Co-infection with Streptococcus pneumoniae and Listeria monocytogenes in an immunocompromised patient 1.Combined bacteraemia with S. pneumoniae and L. monocytogenes is very common.2. Ampicillin should be added to antibiotic regimens to improve patient outcome if L. monocytogenes infection is suspected.
Aresearcher at the University of the Witwatersrand, South Africa, is under investigation after admitting to scientific misconduct. The Feb 3 announcement of an internal inquiry came in the wake of a US audit of a randomised trial of high-dose chemotherapy for metastatic breast cancer done by Werner Bezwoda.
Four main factors necessitate the development of new drugs for the treatment of TB.INADEQUACY 1. e 6-months standard regimen requires a signicant time to cure dis-ease and has a signicant side eect prole, both of which result in poor compliance.
'/%3e%3cpath fill='%23fff' d='m8.751-17.959 10.11 11.373L3.997-9.844l13.94-6.1-7.692 13.129z'/%3e%3c/svg%3e)
'%3e%3cg id='b'%3e%3cpath id='a' d='M0-8v8h4z' transform='rotate(18 0 -8)'/%3e%3cuse xlink:href='%23a' transform='scale(-1 1)'/%3e%3c/g%3e%3cuse xlink:href='%23b' transform='rotate(72)'/%3e%3cuse xlink:href='%23b' transform='rotate(144)'/%3e%3cuse xlink:href='%23b' transform='rotate(216)'/%3e%3cuse xlink:href='%23b' transform='rotate(288)'/%3e%3c/g%3e%3c/svg%3e)
 scale(.21174)'%3e%3cpath d='m52.487 177.086 13.018 11.852 11.762-11.762 11.896 12.266 12.846-11.358 11.827 12.43 13.339-11.013 10.897 12.728 13.27-10.145 13.947 12.319'/%3e%3ccircle cx='89.425' cy='154.584' r='5.167'/%3e%3ccircle cx='111.237' cy='156.047' r='5.167'/%3e%3ccircle cx='30.05' cy='16.5' r='4'/%3e%3c/g%3e%3c/svg%3e)