Dr. Frans Ropi Ndotora is a Consultant General Surgeon and Laparoscopic at the Department of General Surgery, Steve Biko Academic Hospital in Pretoria.
Dr. Frans is currently a member of the College of Surgeons South Africa, The Society of Asian Academic Surgeons, and Endoscopic and Laparoscopic Surgeons of Asia. Dr. Frans is an ambassador of the Senadhipan Education Foundation in Namibia. He is currently registered with the Health Professions Council of South Africa.
He is the author of The Agreement of FNA and Final histology tumors of the Salivary gland in Pretoria.
His main professional and scientific interests focus on trauma, laparoscopic surgery and Upper GIT Surgery.
Traumatic Brain Injury (TBI) is one of the major causes of morbidly and mortality in developing countries and contribute to major global health issue, thus imposing significant economic burden on societies and families. Every community is affected by TBI. There are various causes: falls, sport injuries, vehicle collisions, domestic violence and war/military incidents can result in injuries across a spectrum of severity in different age group. The severity /grading of TBI (Mild, Moderate and Severe) varies from person to person, depending on the force dynamic of injury and patients’ anatomy and physiology. TBI can cause an array of physical and mental health concerns. And it is a growing issue. There are many distinct pathophysiological processes following TBI. Both pre-hospital and emergency (in-hospital) management is crucial in management of TBI. The treatment intervention is based on the classification/degree of TBI, patient specific, goal-oriented approach aimed at helping the patients to increase their ability to recovery.
Published
Jan 2025
Snakebite envenoming affects millions of people worldwide and is a significant source of mortality, primarily in rural and agricultural communities of tropical and subtropical countries. According to the WHO, there are approximately 5.4 million snakebites and 1.8–2.7 million cases of envenomation globally each year, including deaths and around three times as many individuals suffering from permanent disfigurement and/or disabilities, including limb amputations. Regions such as Sub-Saharan Africa, Southeast Asia, and South Asia experience the highest incidence of snakebite annually. Several factors contribute to the risk of snakebite, including occupations that result I frequent exposure to snakes, such as agricultural work, farming, and herding, living in rural areas with proximity to snake habitats, and insufficient knowledge about snakebite prevention. The lack of identification of venomous snakes and appropriate first aid measures, initial management by traditional healers, delay in reaching hospitals and limited access to healthcare, including antivenoms, in rural areas further exacerbate the consequences of snakebite envenoming. The management plan is based on clinical syndromes. First Aid and General Measures applicable to any case: urgent transport to a medical facility, reassure victim, removal of constricting clothing and jewelry from bite area and/or limb . Bring the snake to the hospital if possible (species diagnosis aids treatment), Start CPR if a neurotoxic paralysis occurs with cardiac & respiratory arrest. Administering oxygen O2 and ensuring a patent airway in ALL Cases.Administering oral Analgesia (Paracetamol).If possible Starting IV Fluids: Ringers. Hypertonic saline may be necessary in hypovolemic patients (children). Elevating of the affected limb (avoid over-elevation and stretching to prevent nerve injury and reduced blood flow). The use of antivenom treatment is key in the initial phase of the snake bite.
Published
Oct 2024
Trauma constitutes a significant burden of mortality and disability globally, with the greatest impact felt in low to middle-income countries. Worldwide, there are 2.5 million trauma-related deaths annually, and in developing nations, preventable trauma fatalities can reach as high as 70%. However, advancements over the past decade have led to a decline in mortality associated with polytrauma cases. Defined algorithms, such as the ATLS approach, have played a pivotal role in improving pre-hospital and in-hospital trauma care, directly influencing patient outcomes. For polytrauma patients, defined as those with two or more significant injuries, prompt and efficient delivery to a care center is crucial. The severity of injuries is assessed using the Injury Severity Score (ISS), with three or more points in two or more anatomical AIS regions, alongside physiological parameters, indicating significant injury. The priorities in trauma care encompass airway management, cervical spine immobilization, hemorrhage control, fluid resuscitation, and timely transport to an appropriate healthcare facility. Challenges persist due to resource constraints, predominantly in personnel and equipment availability, compounded by layman-administered pre-hospital care and civilian-provided transportation. Grouping patients based on treatment needs and resource availability correlates with improved outcomes for critically injured individuals. Common mechanisms of injury include traffic accidents, falls from height, gunshot and knife wounds, blunt trauma, and burns. The ATLS protocol guides primary assessment, emphasizing airway management, breathing, circulation, disability assessment, and environmental exposure. In-hospital treatment priorities focus on mitigating immediate life-threatening injuries, employing strategies such as permissive hypotension, haemostatic resuscitation, and damage control surgery. The use of tranexamic acid, as demonstrated in the CRASH 2 and CRASH 3 trials, further underscores advancements in trauma management.
Published
Aug 2024
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