Guidelines

24 entries

Speciality / institutional guidelines

VL Monitoring Algorithm for Clients on TLD Click here to open the above PDF Click here for Routine HIV VL Monitoring on ART Click here for Enhanced Adherence Support Click here for Drug Dosing Chart Click here for Drug Interactions with DTG and Rifampicin-containing TB Treatment Click here for ABCDE assessment of an Elevated Viral Load Click here for Management of Confirmed Virological Failure on TLD 2023 ART Clinica→
VL Non-Suppression Algorithm for Pregnant and Breastfeeding Women on TLD Click on the image to enlarge. The shorter 4-week interval between doing the first VL above 50 and the repeat VL is preferred wherever possible. However, if the first elevated VL is the delivery-VL, the next visit may only occur at the 6-week post-natal visit. Due to their high genetic barrier, resistance to a first-line DTG-containing (TLD1) regimen is extremely rare. If other reasons for→
Vaccines for Umrah & Hajj: Updated May 2018Vaccines for Umrah & Hajj: Updated May 2018→
Vaginal Bleeding in a ChildSurgery depends on the cause, e.g. myomectomy or hysterectomy for fibroids (below), or hysterectomy for persistent excessive bleeding not responding to drug treatment. N.B. a small submucous fibroid may lead to heavy bleeding and may be resected by hysteroscope. Endometrial ablation can be considered in some units for bleeding from a normal uterus – i.e. when the uterus is of normal size and no specific cause is found. If there is marked dysmenorrhoea there is less satisfaction with ablation. Many different types of ablation exist. Pregnancy after ablation is contra-indicated, and specified as such in consent. Uterine artery embolisation may be offered in some units. Pregnancy after is cautiously allowed. Catheterisation and occlusion of both uterines is achieved via the femoral artery. A watery blood stained discharge follows, which is very rarely associated with overwhelming sepsis. MANAGEMENT OF MULTIFIBROID UTERUS Drug treatment (as for excessive vaginal bleeding) may control haemorrhage sufficiently to avert hysterectomy, at least in the short term. 1. Do not force a hysterectomy an unwilling patient 2. Consider myomectomy. Consent for a myomectomy must include specific mention of proceeding to hysterectomy if there are intraoperative problems 3. Consider alternatives: Uterine artery embolization(UAE) or High Intensity Focused Ultrasound(HIFU) for suitable patients who want to preserve their fertility. UAE may shrink the uterus by 50%. Pregnancy Following UAE may have complications(IUGR, prem labour, placenta accreta). This should enter consent. HIFU has not to date been used much on the larger uterus(the current limit is 18 weeks size). Always discuss with a consultant. 4. Where fertility is an issue, consider other causes. N.B. if, for a person with bleeding, there is a delay while awaiting an operation or a procedure and that person is not maintained on progestagens and haematinics, when the procedure is due there will be anaemia and it will be cancelled.→
Vaginal DischargeThis booklet is intended as a practical guide to patient care for registrars, medical officers, interns and medical students attached to the gynaecology units at the University of the Witwatersrand Academic Hospitals. Anyone can use it.→
Vaginal Discharge (PVD)Infection Vaginal Discharge (PVD) Brief outline/clinical setting PVD does not necessarily mean there is PID or bacterial vaginosis. Detailed history and clinical examination is warranted to exclude sinister causes of PVD like Ca Cervix. If infective cause-ALWAYS treat partner/s All PVD in prepubertal girls and children (below age of consent) to be discussed with an ED-CONSULTANT and REFERRED to G→
Vaginal Discharge and Vaginal Discharge SyndromeVaginal Discharge and Vaginal Discharge Syndrome→
Valid Informed Consent to Sedation and Analgesia for Medical or Dental ProceduresValid informed consent ( Appendix 3 ) is a complex process. The General Dental Council (GDC), UK, provides valuable principles and standards for the dental team regarding consent for dental procedures. 6 It should be documented that appropriate consent was obtained from the patient, or a responsible person (parent/caregiver), according to local and international requirements. Before the process c→
Varicella (Chicken Pox)Varicella (Chicken Pox)→
VariousDeferasirox Folinic acid, intravenous Lanthanum carbonate, Sevelamer Mesna ATC Code V03AC03 Medicine Deferasirox ( film-coated and dispersible tablets considered equivalent ) Indication Treatment of transfusional iron overload NEMLC Recommendation Approved Added as an oral alternative to deferoxamine Review Indicators n/a Date Ratified 30 November 2023 Film-coated tablet update ( Previousl→
Venous Thromboembolism (VTE) ProphylaxisVenous Thromboembolism (VTE) Prophylaxis→
Venous Umbilical CatheterisationManagement guidelines for students, interns and registrars on a variety of routine and emergency situations in our neonatal service at Tygerberg Children’s Hospital. Published in 2014.→
Ventilation Concepts: OverviewVentilation Concepts→
Ventilation Specifics: Normal Lungs / Lung Injury (Pneumonia/ARDS)Ventilation is frequently commenced in the Emergency Centre following intubation. The following suggested principles for specific medical conditions are based on the pathophysiology of the condition and settings should be tailored to each patient individually.→
Ventilation Specifics: Obstructive Lung Disease (COPD / Asthma)Ventilation is frequently commenced in the Emergency Centre following intubation. The following suggested principles for specific medical conditions are based on the pathophysiology of the condition and settings should be tailored to each patient individually.→
Ventilator Associated PneumoniaVAP Bundles→
Vincent’s AnginaInfection Vincent’s angina Brief outline/clinical setting Vincent’s angina refers to acute necrotizing ulcerative lesions of the oral mucosal membranes and tonsils, with bleeding inflammation and halitosis Aetiologies/organisms Organisms involved are polymycrobial but often include Fusobacterium necrophorum, Treponema, Selenomonas, Prevotella Optimal antimicrobial selection Amoxicilli→
Viral Load Monitoring ScheduleClick on the image to enlarge. Click here for VL Non-Suppression Algorithm . Click here for Management of a High Maternal Viral Load after Delivery . Click here for the pdf . South African National Department of Health, Guideline for Vertical Transmission Prevention of Communicable Infections, Version 2_August 2023→
Visit Schedule for Adults, Adolescents and Children 5 Years and Older on ARTClick here to open the above PDF Click here for Baseline Clinical Assessments Click here for Baseline Lab Assessments Click here for Monitoring of ART Click here for Annexure 3 - Enhanced Adherence Counselling 2023 ART Clinical Guidelines for the Management of HIV in Adults, Pregnancy and Breastfeeding, Adolescents, Children, Infants and Neonates June 2023 Version 4 Upload date: 04/08/2023→
Visit Schedule for Integrated Care for Clients already on ART when diagnosed with Drug-sensitive TBClick here to Visit Schedule for Integrated Care for Clients already on ART when diagnosed with Drug-sensitive TB 2023 ART Clinical Guidelines for the Management of HIV in Adults, Pregnancy and Breastfeeding, Adolescents, Children, Infants and Neonates June 2023 Version 4 Upload date: 04/08/2023→
Visit Schedule for Integrated Care for the Mother-baby Pair Living with HIVVisit Schedule for Integrated Care for the Mother living with HIV and her HIV-exposed Infant (HEI) The principles are as follows: Wherever possible, try to align the mother’s ART, VL monitoring, and contraception visits with that of the child’s visit schedule so the mother-baby pair need only attend the facility once for both consultations on the same day Wherever possible, allow the mother and b→
Visit Schedule for Integrated Care for the Mother-baby Pair Living with HIVClick here to view the Visit Schedule for Integrated Care for the Mother-baby Pair Living with HIV 2023 ART Clinical Guidelines for the Management of HIV in Adults, Pregnancy and Breastfeeding, Adolescents, Children, Infants and Neonates June 2023 Version 4 Upload date: 04/08/2023→
Vulval Skin Problems, Dysplasias & VulvodyniaThis booklet is intended as a practical guide to patient care for registrars, medical officers, interns and medical students attached to the gynaecology units at the University of the Witwatersrand Academic Hospitals. Anyone can use it.→
Vulvar CancerThis guideline is intended as a practical guide to patient care for registrars, medical officers, interns and medical students attached to the gynaecology units at the University of the Witwatersrand Academic Hospitals. Anyone can use it.→