Unravelling the complexities of the human microbiome: current trends in microbiome research for medical practitioners

The human microbiome can be defined as a collection of dynamic microbial ecosystems that inhabit various internal and external parts of the body, where coevolution with its host plays a crucial role in health promotion. It is currently a well-established research focus area and has become a topic of great scientific and public interest. A simple PubMed search revealed that 90% of our existing published knowledge base on the topic has emerged in the last decade, with 60% of all publications occurring in the last five years. It is apparent that the field of human microbiome research is a rapidly expanding subject of interest that should be noted. Innovations in DNA sequencing technologies and computerised analysis have led to the accurate identification of microbial populations, yielding unparalleled insights into their involvement in human health and disease. By acknowledging these developments, medical practitioners may be able to capitalise on the potential of microbiome research in providing evidence-based and personalised care to patients. Recent trends in microbiome research will be highlighted in this editorial, with a focus on its value to medical practitioners.

Hypertension – back to basics

BP is in a typical normally distributed biological variable curve (Bell shaped) with values at the high end of the distribution curve considered to be elevated BP defined as hypertension. In a large observational study involving one million adults in 61 prospective trials, there was a proportionate increase in CV risk starting at an SBP level of 115 mmHg and a DBP of 75 mmHg. For every 20 mmHg increase in SBP and 10 mmHg increase in DBP, there is a twofold relative increase in stroke mortality and a two-fold relative increase in mortality from coronary artery disease and other vascular diseases. The absolute CV risk also depends on the presence of other CV risk factors and/or target organ damage as shown, e.g., in the ongoing Framingham Heart Study. 

Hormone Replacement Therapy for the South African healthcare provider: Part I

In this first part the of the series the most common symptoms of the peri- and postmenopausal period – osteoporosis, venous thromboembolism, implications for liver disease and the lipid profile, as well as the carbohydrate metabolism – will be discussed. The second part will focus on stroke, the cardiovascular implications of hormone replacement therapy (HRT), as well as the malignancies that are commonly encountered and influenced by HRT in peri- and postmenopausal women. Attention will also be given to abnormal uterine bleeding and postmenopausal bleeding. Thirdly, preference will be given to hormonal and non-hormonal treatment options, the different routes of hormone administration and the safety implications of the different treatment options. In the last part the series general pointers and a summary of indications and contraindications for the use of HRT will be discussed.

Management of otitis externa

Otitis externa is defined as inflammation of the external auditory canal and may extend beyond the ear canal to involve the pinna and surrounding soft tissue. A number of subtypes can be distinguished (Table I) based on patients’ signs, symptoms, clinical history and time course of the disease.

From dirt to data: plant extraction modalities and techniques

Obtaining quantitative information on plant development over different time periods and different socio-cultural areas is crucial for understanding the rationale of plant use in research. Bioprospecting is the identification of valuable biochemical compounds, with the aim of developing new or improving existing medicine. Through analysis of chemical composition of different parts of plants, one can determine biological activity of significant compounds present with the aim of drug discovery with therapeutic and commercial value. However, appropriate guidelines for the analysis of traditional medicine should be maintained and should be used in a way that is culturally sensitive, accessible and one should consider the potential impact of traditional medicine on biodiversity and conservation.

Rather safe than sorry – the role of general practitioners in preventing pancreatitis

Pancreatitis is a complex disease that varies in severity and course and involves autodigestion of the pancreas. The pancreatic tissue injury resulting from pancreatic enzymes leads to functional abnormalities in the gland. As a result, long-term sequelae may affect other organ systems in the form of metabolic disorders and exocrine pancreatic insufficiency (EPI).

Effective chronic pain management using wearable, pulsed shortwave therapy

Globally, an estimated 20% of individuals are affected by chronic pain. A recent local study showed a similar trend – estimating that one in five South African adults is affected by chronic pain. Chronic pain accounts for 15–20% of visits to physicians. The International Association for the Study of Pain (IASP) defines pain as ‘an unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage’. Chronic pain is defined as pain that lasts more than three to six months.


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South African General Practitioner - 2023 Vol 4 No 3

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