Biomarkers like procalcitonin (PCT) are an important antimicrobial stewardship tool for critically ill patients. There is little evidence regarding the use of PCT-guided antibiotic algorithms in developing countries. Evidence is also lacking for PCT-based antibiotic algorithms in surgical trauma patients admitted to the intensive care unit (ICU). A prospective, two period cross-over study was conducted in a surgical trauma intensive care unit in South Africa. In the first period, 40 patients were recruited into the control group and antibiotics were discontinued as per standard of care. In the second period, 40 patients were recruited into the procalcitonin group and antibiotics were discontinued if the PCT decreased by ≥ 80% from the peak PCT level, or to an absolute value of less than 0.5 μg/L. Antibiotic duration of treatment was the primary outcome. Patients were followed up for 28 days from the first sepsis event. For the first sepsis event the PCT group had a mean antibiotic duration of 9.3 days while the control group had a mean duration of 10.9 days ( = 0.10). Patients in the intervention group had higher mean (SD) antibiotic free days alive of 7.7 (6.57) days compared to the control group mean (SD) of 3.8 (5.22) days, ( = 0.004). In-hospital mortality rate was lower in the intervention group (15%) compared to the control group (30%) and was statistically significant ( = 0.045). There was no significant difference in duration of antibiotic treatment between the two groups. However, the PCT group had more antibiotic free days alive and lower in-hospital mortality compared to the control group. There was no significant difference in duration of antibiotic treatment between the two groups. However, the PCT group had more antibiotic free days alive and lower in-hospital mortality compared to the control group. The outcome in infants and young children of intestinal obstruction due to intussusception is well documented in high-income countries. Our aim was to investigate the current pattern of presentation, management and outcome of childhood intussusception in a middle-income country using a multicentre approach. Records of children managed for intussusception in three centres in South West Nigeria were retrospectively reviewed and analysed. One hundred and ninety children managed for intussusception were analysed. The male-to-female ratio was 1.81. The median age was 7 months with a peak age incidence of 3-6 months. Peak incidence was recorded during the dry season. Passage of bloody stool, vomiting, abdominal pain and fever were the most common presenting features. Seventy-three (38.4%) of the patients presented with the classic triad. The median duration of symptoms was three days and only 19 (10.1%) patients presented in less than 24 hours. Ileocolic intussusception was the most common anatomic type, occurring in 166 (87.4%) patients, and was significantly associated with age. Twenty-two (56.4%) had successful hydrostatic reduction, while 165 (88.2%) required surgery. Forty (21.1%) patients suffered postoperative complications. Eleven (5.8%) of the patients died. The median duration of hospital stay was six days, and this correlated with the duration of symptoms and the length of hospital stay. Delayed presentation is a persisting challenge in the management of childhood intussusception in Nigeria. Prompt referral to a paediatric surgeon may reduce the surgery rate, associated morbidity and the length of hospital stay. Delayed presentation is a persisting challenge in the management of childhood intussusception in Nigeria. Prompt referral to a paediatric surgeon may reduce the surgery rate, associated morbidity and the length of hospital stay. Thyroid nodules are common. Most patients with indeterminate fine needle aspiration cytology (FNAC) results are subjected to thyroidectomy for fear of malignancy. However, only 20-30% of these cases are found to be malignant. The aim was to determine the value of thyroid ultrasound in diagnosing malignancy in patients with indeterminate fine needle aspiration cytology results in our practice. Fine needle aspiration was performed after ultrasound, thereby preventing architectural distortion of the nodule and to ensure that the most suspicious nodule was biopsied. A retrospective review of records of patients who presented to two University of Pretoria academic hospitals, in South Africa, from 2001 to 2015 with nodular thyroid goitre was undertaken. Patients had a thyroid ultrasound scan, FNAC and had undergone thyroid surgery. Records of 104 patients were retrospectively evaluated. Patients were predominantly female (93.3%). Histology report was available for 101 of the 104 patient records. Malignancy waed to the diversity of ultrasonographers in our practice. It is recommended that there should be a dedicated thyroid ultrasonographer for a better and consistent TIRADS classification that surgeons can rely on for guiding surgical intervention. Obesity is a significant health problem in South Africa. Surgery is the most effective means of durable weight loss for the morbidly obese. Of the surgical options, laparoscopic adjustable gastric banding is the most controversial. We aimed to assess a single surgeon's experience with a specific band. A retrospective observational study of a continuous cohort of laparoscopic adjustable gastric Cousin Bioring band placements from a single private South African hospital was conducted. Three hundred and fifty bands were placed in 347 patients, 75% were female. Variables analysed were BMI obesity class, comorbidities, weight loss, diabetes resolution, adherence to aftercare, patient satisfaction, complications and death. Outcomes were assessed in 343 patients (4 patients lost to follow-up). The mean follow-up was 39 months (IQR 29-66 months). The mean preoperative BMI was 43.3 kg/m (IQR 37.4-47.6 kg/m ). Most weight loss occurred in the first year, and 66% achieved > 40% excess weight loss. https://www.selleckchem.com/products/kpt-330.html Resolution of type 2 diabetes and prediabetes occurred in 56.4% and 89.8% of patients respectively. Increasing age ( = 0.002), class 3 obesity ( < 0.001) and suboptimal aftercare ( < 0.001) were associated with failure. One patient developed band erosion and 40 developed band slippage, 34 of whom underwent secondary surgery (32 removals, 2 revisions). All complications were grade I-III. There was no high grade complication, and no death. Bioring gastric banding achieved moderately good weight loss and resolution of type 2 diabetes with a low complication rate. BMI > 60 and suboptimal aftercare predicted poor outcome. 60 and suboptimal aftercare predicted poor outcome.