African Journals OnLine  
South African Family Practice incorporating Geneeskunde (SAFP/G)

Volume 45 No.5 June 2003
ABSTRACTS

Fine Needle Aspiration Biopsy in a Rural Family Practice

O’Mahony D. MBBCh, DCH, DTM&H, DPH, Dip Mid COG (SA), FRCGP

Family Practitioner, Bridge Street, Port St Johns

Banach L. MDPhd, MIAC

Associate Professor, Department of Pathology, and Director, Telemedicine Unit, Faculty of Health Sciences, University of Transkei, Umtata

* Correspondence: D. O’Mahony, PO Box 27, Port St Johns, South Africa 5120, [email protected]

Abstract

Background: Fine Needle Aspiration Biopsy (FNAB) is a safe economic method of obtaining tissue from a suspicious mass for diagnostic purposes. This study describes the results of FNAB in a family practice in a poor rural community.

Methods: Any patient with a suspicious mass that the family practitioner considered could be safely aspirated percutaneously underwent FNAB. Masses for aspiration were located by means of palpation or ultrasound scan. A 21-gauge 1½-inch or 23-gauge 1¼-inch needle, attached to a 10mL disposable plastic syringe, was used for FNAB of superficial masses. For percutaneous FNAB of deep-seated organs and masses, a 23 gauge 1¼-inch needle or 3½-inch spinal needle was used. The aspirate was spread on slides and sent for cytopathology analysis

Results: The cytological diagnoses from 187 FNAB were: malignant 47 (25%) suspicious of malignancy 14 (7%), atypia 10 (5%), tuberculosis 31 (17%) and benign 60 (33%). Twenty-five (13%) were inadequate. The biopsy sites and number *%) were: lymph nodes 97 (52%), liver 30 (16%), subcutaneous masses 25 (13%), lung 18 (10%), thyroid 5 (3%), breast 8 (4%) and other 4 (2%). The yield for a diagnosis of malignancy or TB was 42%.

Conclusions: FNAB is a procedure that can be efficiently performed by a family practitioner and has a substantial diagnostic yield in rural practice in a developing country.

SA Fam Pract 2003:45(5):9-11

Keywords: Fine needle aspirations, biopsy, cytology, tumours, general practice.

Knowledge, attitudes and practices of general practitioners in the Free State regarding the management of children with Attention Deficit Hyperactivity Disorder (ADHD)

Venter A FCP, PhD., Van der Linde GP,PhD.

Department of Paediatrics and Child Health, Faculty of Health Sciences

Joubert G, BA, MSc

Department of Biostatistics, Faculty of Health Sciences, University of the Free State

Correspondence: Prof A Venter, Department of Paediatrics and Child Health, Faculty of Health Sciences, University of the Free State, P O Box 339 (G69), Bloemfontein, 9300, Tel: (051) 405 3181, Fax: (051) 444 3230, email: [email protected]

Abstract

Background: The aim of the study was to determine the knowledge, attitudes and practice of general practicioners (GP’s) in the Free State regarding the management of children with Attention Deficit/Hyperactivity Disorder (ADHD).

Methods: Four hundred and nineteen GP’s were identified in the Free State. Each GP was sent a survey questionnaire with a letter explaining the objectives and aims of the research. The questionnaire explored four themes: demographic data; attitudes to caring for children with ADHD; management of these children and knowledge and practice regarding the use of stimulants.

Results: Three hundred and eighty four GP’s were eligible to complete the questionnaire, of which 147 (38.2%) were returned, and 143 were available for analysis. About 50% of the respondents manage children with ADHD in their practice. A quarter of the doctors enjoy treating these children, half do not mind and a quarter dislike it, and try to avoid seeing these children. Obstacles that were identified include the fact that they are time consuming, disrupt schedules, parents are difficult and reimbursement poor. There were few ‘alternative’ beliefs regarding the aetiology and management of ADHD, although there were some unexpected replies regarding treatment modalities.

Conclusions: Although the doctors know what interventions are important and to whom these children should be referred, in the majority of cases referrals appear to be restricted to those professionals available in the local community. Methylphenidate was the most commonly prescribed stimulant. General practitioners had a good idea of its effects and contra- indications, and some idea of its pharmacological action. There were not adequate knowledge regarding the significant side effects of oral administration of methylphenidate.

SA Fam Pract 2003:45(5):12-17

Keywords: Attention deficit hyperactivity disorder, General Practitioners