Sight under pressure – a brief review of glaucoma

Glaucoma is a group of diseases in which increased intraocular pressure negatively affects the optic nerve. Failure to diagnose it early and treat it effectively may lead to permanent vision loss. Globally, glaucoma is the primary cause of irreversible blindness and the second most common cause of irreversible moderate and severe vision impairment. This short review aims to provide an overview of the disease and how general practitioners may contribute to its management.

The pharmacological management of depression

According to the Diagnostic and Statistical Manual Disorders (DSM-5) major depressive disorder (MDD) is diagnosed when either depressed mood or loss of interest and at least four of the following: weight/appetite changes, insomnia or hypersomnia, psychomotor agitation or retardation, fatigue, feeling of guilt or worthlessness, executive dysfunction and suicidal ideation is present. The history of manic episodes being present or absent in a depressed patient is important since different treatment approaches need to be considered. Depressive symptoms must be present for a period of at least two weeks in order to make a clinical diagnosis. MDD is typically a recurrent disorder with an estimated relapse rate of approximately 50–85%.

Ensuring prompt detection and effective treatment of all malaria infections in South Africa

South Africa has made significant progress towards interrupting the local transmission of malaria since adopting a malaria elimination agenda in 2012. Endemic malaria transmission is currently limited to focal areas, predominately along the shared international borders of three endemic provinces, KwaZulu- Natal, Limpopo, and Mpumalanga (Figure 1). The World Health Organization (WHO) recently acknowledged the advances made, including South Africa in its E-2025 initiative. Through this initiative, 25 countries with very low malaria transmission receive WHO support to eliminate malaria by 2025.

Opioids in anaesthesia

Analgesia is one of the three main pillars of anaesthesia and creating a pain-free surgical environment is essential (Figure 1). Opioids are used quite often to achieve surgical analgesia. However, their role has evolved dramatically over the years. From being the mainstay of analgesia to being incorporated into a multimodal form of analgesia, opioid use in anaesthesia remains unsurpassable. “Opiates” are the natural compounds extracted from the opium poppy as well as the synthetic or semi-synthetic derivatives.


Psoriasis is a genetically determined inflammatory disease of the skin, joints or both. It is a complex genetic disease with the involvement of several environmental factors. Psoriasis is characterised by marked epidermal proliferation and abnormal differentiation with immune activation of keratinocytes, followed by numerous inflammatory and immune disorders involving both innate and acquired immunity. Approximately 30% of patients with psoriasis have a positive family history of psoriasis.

Severity of and associated triggers for acute asthma attack in patients presenting to an emergency department

Asthma is a major public health problem worldwide, which generates significant healthcare costs and has high morbidity and mortality rates. The World Health Organization (WHO) estimated that between 100 and 150 million people worldwide suffer from asthma, and over 180 000 deaths occur annually. In the United States of America (USA), it is estimated that approximately 18.7 million adults (8.2%) had asthma according to 2010 data from the experts of the United States Centers for Disease Control and Prevention (CDC). The Republic of South Africa (RSA), with 8.1% prevalence over all ages, ranked 25th worldwide, and the asthma case fatality rate in the country is reported as being the fourth highest in the world, with 1.5% deaths annually. Recently, it has been documented that South Africa has the highest prevalence of asthma in Africa. Adeloye et al. conducted a systematic review to ascertain an estimate prevalence of asthma in Africa in which they included 45 studies covering most parts of Africa (RSA: 11 studies, Nigeria: 8 studies, Ethiopia:  studies, Kenya: 5 studies, and 4 studies in each in Algeria, Morocco and Tunisia). They found that the cumulative prevalence of asthma was highest in the RSA.6 Asthma morbidity and mortality are potentially preventable with optimal control of chronic asthma and appropriate management of asthma exacerbation.

Focus on olanzapine

Olanzapine is indicated for the management of manifestations of psychotic disorders, acute episodes of moderate to severe mania, and prevention of recurrence of manic or depressive episodes of bipolar disorder.

Chronic pain management gets a new impact player

Chronic pain management remains one of the challenges in the medical profession. Adding to conundrums such as balancing medicine use with quality of life, is the reality that the central nervous system can become stuck in a centrally sensitised pain state. Central sensitisation – as this process is called – changes a person’s pain sensitivity, allowing the perception of pain to continue even after an injury has healed. This is because pain thresholds are lowered, leading to a heightened perception of pain. Stimuli that are normally painless can produce pain, while stimuli that produce pain will produce pain at much higher levels (hyperalgesia).

Pharma Dynamics expands its erectile dysfunction offering

Pharma Dynamics, a leading provider of affordable, effective generic medication, has launched Tadalafil Dyna for the treatment of erectile dysfunction (ED), which makes up the fourth product in its urology basket. Tadalafil Dyna comes at a significant cost-saving of 56% less than the originator.

Pharma Dynamics launches Rubaz – a new combo contraceptive

Leading generics provider, Pharma Dynamics, continues to empower women with the launch of Rubaz – a new cost-effective combination oral contraceptive (COC), which is now available on prescription. Rubaz combines oestrogen (ethinylestradiol 0,02 mg) and progestin (drospirenone 3 mg), which is used as a birth control pill to prevent pregnancy in women with the added benefit of treating acne, and the symptoms of premenstrual dysphoric disorder (PMDD).

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South African General Practitioner - 2023 Vol 4 No 2