In this edition of Modern Medicine, we include a special feature on Gastroenterology & Obesity, as well as pieces on ENT, Ethics and Woundcare along with our top-quality News section.
Take a moment to go through the edition; simply click on the links below and enjoy the publication.
Applying Antimicrobial Strategies in Wound Care Practice | A Review of the Evidence
Antimicrobial resistance is increasing due to an overreliance on antimicrobials to treat and manage infections. Chronic wounds are particularly vulnerable to infections and harbour complex microbial
communities, increasing the risk of secondary infections caused by antimicrobial resistant bacteria. Accurate and early diagnosis of infection ensures appropriate treatment interventions and a
reduction in the likelihood that antibiotic use is required. Despite this, the overuse of antibiotic treatment in wound care is still evident. Antimicrobial stewardship describes a structured approach to managing antimicrobial resistance through educating healthcare professionals about antimicrobial use to improve patient outcomes and minimise the spread of infections. However, the evidence suggests that healthcare professionals experience barriers when attempting to implement such strategies in their practice. This review aimed to explore the current barriers to antimicrobial stewardship in wound care clinical practice and discuss the strategies that can be applied to successfully maximise infection prevention.
How We Breathe | Nasal Congestion and Treatment Strategies
Nasal congestion is more than a blocked nose – patient perceptions of pressure, mucus and airflow often diverge sharply from clinical definitions, complicating diagnosis and management. Immunotherapy and
immunomodulation should be considered early in cases of persistent allergic disease to prioritise long-term disease modification over short-term strategies such as nasal sprays. Understanding the interplay between physiology, inflammation and patient experience is key to avoiding misdiagnosis and selecting effective, individualised treatment strategies. Smoking, vaping and intranasal drug use can cause symptoms or exacerbate other aetiologies and impair treatment outcomes. Recognising functional disorders, conversion disorders and nasal hyperreactivity is essential to avoid unnecessary surgery and patient dissatisfaction.
A Clinical Approach to Managing Obesity | 2026 Update
Obesity is a complex chronic disease that is strongly associated with an increased risk of all-cause mortality. Routine screening is required to assess the complications of obesity. Preconception counselling is crucial as many women are unaware of the potential adverse effects of obesity on both maternal and offspring outcomes. Even small reductions in body weight can reduce the complications of obesity. Therapies for optimising weight and metabolic health should be guided by an individual’s body mass index (with consideration of body composition), comorbidities, and the presence and severity of obesity-associated complications.
Dexlansoprazole for GORD Symptoms in GLP-1 RA Use
Obesity is a chronic, relapsing and multifactorial disease that affects approximately 650 million adults and 340 million children globally. GLP-1 RAs are increasingly prescribed for type 2 diabetes and weight
management in adults with overweight or obesity. Whilst these medications offer significant therapeutic benefits, gastrointestinal side effects, including acid reflux and heartburn, are commonly reported. Management includes eating smaller meals, avoiding trigger foods, remaining upright after eating and using antacids or proton pump inhibitors if needed.
Healthcare Will Always Need the Human Touch
In the modern landscape of healthcare, we routinely witness a dangerous conflation: the belief that pouring money into medical infrastructure is synonymous with caring for the sick. We build towering, state-of-the-art medical centres, install multi-million-rand diagnostic machines, and prescribe cutting-edge pharmaceuticals. Yet, walk into any hospital corridor or outpatient clinic and you will find an epidemic of loneliness and fear. We are funding the industry of medicine, but we are starving the art of healing.
In this edition of Modern Medicine, we include a special feature on womens health, as well as pieces on haematology, pulmonology and many more.
We encourage you to have a look through the below edition, and to give them a read – we think you’ll find them interesting.
Heavy Menstrual Bleeding and Iron Deficiency | Breaking the Vicious Cycle
Heavy menstrual bleeding (HMB) is a common cause of chronic iron loss and iron deficiency, which may be symptomatic even when haemoglobin level is normal. Ferritin testing is essential and assessment of HMB should include quality of life and underlying causes, rather than only blood loss estimates. Investigations should be guided by symptoms, examination findings and risk factors. Management of HMB must both restore iron stores and reduce ongoing menstrual blood loss to prevent recurrence. Of the medical treatment options for blood loss, the 52mg levonorgestrel intrauterine device offers the greatest reduction. Early recognition of low iron levels, plus treatment of both iron stores and menstrual blood loss, helps prevent recurrence and improves wellbeing.
Hormone Replacement Therapy During and After Menopause
Hormone replacement therapy (HRT) has been used in clinical practice for decades as a therapeutic
approach for mitigating menopausal symptoms. The primary objective of HRT is to alleviate
menopausal symptoms during the perimenopausal and menopausal phases. The symptoms mostly
encompass vasomotor and genitourinary issues resulting from the deficiency of oestrogen and
progesterone. These symptoms include hot flashes, night sweats, vaginal dryness, mood swings,
sleep disturbances, depressive episodes, skin and metabolic changes.
Prescribing Menopausal Hormone Therapy | A Practical and Evidence-Based Approach to Treatment
Around three-quarters of women experience menopausal symptoms, predominantly vasomotor symptoms. Menopausal hormone therapy (MHT) is the most effective treatment for these and other direct consequences of menopause, such as bone loss. Although nonoral oestrogen is widely considered
to be the preferred option, oral oestrogen is a safe and effective option for most women who do not absorb or cannot tolerate transdermal oestrogen formulations. Micronised progesterone and dydrogesterone may be better tolerated than other progestogens, but studies are needed to determine
the breast safety of these progestogens beyond three to five years of use with concurrent oestrogen therapy. Easy access to safe and effective MHT is imperative for improving quality of life and long-term health outcomes for women in midlife.
