Mthatha General Hospital

The Second World War motivated researchers to investigate faster ways to perform calculation to solve practical problems. This led to research into the development of digital computers to determine if they could provide faster methods of computation. We discuss the first digital computers including the Atanasoff-Berry computer developed in the United States, the ENIAC and EDVAC developed in the United States, the Colossus computer developed in England, Zuse’s computers developed in Germany and the Manchester Mark I computer developed in England.

OBJECTIVES:This study aimed to identify the impact of the coronavirus disease 2019 (COVID-19) pandemic on changes in the trend and quality of adverse drug reaction (ADR) reports in the Japanese Adverse Drug Events Report (JADER) database using the vigiGrade completeness score as an indicator. METHODS:A JADER dataset consisting of ADR reports from April 2004 to March 2025 was used. VigiGrade completeness scores were determined for ADR reports, and the quality of the reports was assessed as 'well documented' or not, depending on the score obtained. KEY FINDINGS:Of 969 520 ADR reports, 393 168 submitted between the fourth quarter of 2018 and the fourth quarter of 2024 were included. The number of ADR reports declined in the first quarter of 2020 but peaked in the second quarter of 2021. The proportion of 'well-documented' reports remained between ~20% and 30% during most quarters, but increased to ~40% in the first and second quarters of 2021, during which COVID-19 vaccine-related reports accounted for 29.0% and 39.2% of all reports, respectively. This surge in vaccine-related submissions coincided with a temporary improvement in documentation quality. CONCLUSIONS:The COVID-19 pandemic and the increase in ADR reports related to COVID-19 vaccines have affected the trends and quality of reporting in the JADER database. Notably, a substantial increase in vaccine-related ADRs during mass immunization corresponded with a temporary rise in reporting quality. These findings highlight the importance of maintaining robust pharmacovigilance systems that can adapt to large-scale public health interventions and sustain data quality during future emergencies.

BACKGROUND/AIM:The usefulness of robot-assisted surgery for elderly colorectal cancer patients remains controversial. The aim of this study was to examine the impact of the surgical approach on short-term prognosis in patients aged ≥80 years. PATIENTS AND METHODS:A total of 1,115 colorectal cancer patients aged ≥80 years who underwent surgery at 6 hospitals between 2016 and 2024 were included in the study. Patients were divided into three groups according to surgical approach: robotic surgery (R group, n=55), laparoscopic surgery (L group, n=910), and open surgery (O group, n=150). Patient characteristics and surgical outcomes were compared among the three groups. RESULTS:The O group had higher proportions of patients with a body mass index (BMI) <25 kg/m2 (R vs. L vs. O: 72.7% vs. 80.8% vs. 87.3%, p=0.040), a performance status ≥3 (9.1% vs. 18.6% vs. 27.3%, p=0.006), an operation time <240 min (47.3% vs. 59.1% vs. 79.3%, p<0.001), and postoperative complications (9.1% vs. 23.0% vs. 27.3%, p=0.022). Multivariable analysis demonstrated that robotic surgery [odds ratio (OR)=0.243, 95% confidence interval (CI)=0.088-0.668, p=0.006] and BMI <25 kg/m2 (OR=0.626, 95% CI=0.419-0.936, p=0.032) were associated with a reduced risk of postoperative complications. CONCLUSION:Robotic-assisted colorectal surgery in elderly patients is safe, with relatively few complications.

Vedolizumab clearance (CL) outperforms serum trough concentrations in predicting therapeutic outcomes in Crohn's disease. Higher CL was significantly associated with reduced remission rates, supporting CL as a pharmacokinetic marker for optimizing vedolizumab therapy.

Background: The first metacarpal extension osteotomy (FMEO) is an effective surgical procedure for thumb carpometacarpal (CMC) arthritis, but a dedicated fixation implant was not yet available. The Shamoji plate is a newly developed anatomical locking implant for FMEO. We report the short-term postoperative results of FMEO using the Shamoji plate in patients with early to moderate stage of CMC arthritis of the thumb. Methods: We reviewed 17 thumbs in 17 patients who underwent FMEO using the Shamoji plate. At the initial time of diagnosis, all cases were classified as Eaton stage 2 of CMC joint arthritis. The postoperative follow-up period ranged from 5 to 18 months, with an average of 10.1 months. An L-sized Shamoji plate (30 mm, six locking screws and one cortical screw) with a 30° bend was used most. Postoperatively, active range-of-motion exercises started the following day after surgery. Clinical outcomes and realignment of CMC joint on plain radiograph and computed tomography were evaluated. Results: An average operation time was 52 minutes. Plain radiographs showed early bone union in all patients with an average time of 3.3 months. Visual analogue scale, tip pinch strength and Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) score were significantly improved postoperatively. The flexion angle of the metacarpophalangeal joint decreased approximately 10°. The metacarpals were dorsally realigned 23°-25° after FMEO. The dorsal subluxation angle and % subluxation were significantly improved, indicating a significant improvement in malalignment of the CMC joint. Conclusions: The Shamoji plate is a sufficient internal fixation implant with good short-term results in terms of osteotomy angle, bone healing, pain relief, functional recovery and realignment of the CMC joint. FMEO by use of Shamoji plate is expected to provide reliable clinical outcomes for patients with the CMC joint arthritis in Eaton stage 2. Level of Evidence: Level IV (Therapeutic).