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Uterine anomalies are often identified during pregnancy, during infertility evaluation or pregnancy miscarriage and have been associated with an increased risk of adverse pregnancy outcomes. Although some studies have documented the rare occurrence of spontaneous twin pregnancy in each horn of a bicornuate uterus, this is the first time this is being documented in Kenya, to the best of our knowledge. This is a rare occurrence and reporting of this case adds to the documentation of such cases.

This is a case report for a 30-year-old female, para 2+0 at 34 weeks 4 days by dates, who presented with features of labour. Upon examination, she had normal vital signs and a fundal height of 38 weeks with multiple foetal parts both in cephalic presentation and two foetal heart rates within normal range. Her antenatal profile was non-contributory and had undergone two ultrasounds that confirmed twin gestation with no other notable findings.Management and outcome The patient had a spontaneous vertex delivery of the first twin with a good outcome. There was a delay in the delivery of the second twin and a caesarean section was done with an indication of non-reassuring foetal status and low-lying placenta. The bicornuate uterus was accidentally identified during the surgery. The outcome was good, with an APGAR score of 6 in the first minute and 9 at 10 min.

Although this is a rare occurrence, we would like to sensitise healthcare workers in rural low- to middle-income countries that this can occur, and they should attempt to increase antenatal diagnosis as it can influence the mode of delivery.

Although this is a rare occurrence, we would like to sensitise healthcare workers in rural low- to middle-income countries that this can occur, and they should attempt to increase antenatal diagnosis as it can influence the mode of delivery.

Pain is the most common presenting complaint in patients visiting a healthcare facility. Healthcare professionals need adequate knowledge of pain to be able to manage it effectively.

The aim of this study was to determine the pain knowledge and attitudes of the 2018 final-year medical students at the University of Cape Town (UCT).

This study was conducted by the Department of Anaesthesia and Perioperative Medicine in the Faculty of Health Sciences, UCT, South Africa, with final-year medical students.

Unruh's Modified Pain Knowledge and Attitudes (MPKA) questionnaire was utilised to collect data in a cross-sectional survey using an Internet-based electronic format.

A total of 104 students out of 232 students in the class (44.8%) participated in the study. The total median score on the MPKA questionnaire was 46 (interquartile range [IQR] 44-50.5) out of 57, or 80.7% (IQR 77.2-88.6%). The participants performed worst in the section on the pharmacological management of pain with median scores of 6 (IQR 4-8) (55%) correct out of 11 questions.

Pain knowledge, especially with regard to the pharmacological aspects of pain management, has some important deficiencies in these final-year medical students. It appears that the undergraduate curriculum and teaching thereof would benefit from a review of the pain curriculum.

Pain knowledge, especially with regard to the pharmacological aspects of pain management, has some important deficiencies in these final-year medical students. It appears that the undergraduate curriculum and teaching thereof would benefit from a review of the pain curriculum.

Patient satisfaction is one of the key outcome measures of healthcare services.Aim and Setting To explore factors that influence women's satisfaction with peri-partum care at Bertha Gxowa district hospital, South African primary care.

A cross-sectional study involving 260 women was conducted. A structured questionnaire collected information from participants on pain relief, health education provided by healthcare providers, privacy, cleanliness of the ward and their participation in decision-making about care received in the peri-partum period.

Most respondents were co-habiting with their partners (100, 38%) and had completed only secondary school education (119, 46%). The average participant age was 27 years, with an average parity of two children. Most participants were satisfied with the privacy (218, 84%) and the general cleanliness of the wards (233, 90%). However, large proportions of women were dissatisfied with the information given to them by doctors (104, 55%) and nurses (89, 37%), and the rest were unsure. Sodiumpalmitate About 189 (73%) participants were dissatisfied with the extent of their participation in decision-making about their own care. The study had a caesarean rate of 53 (20%). Compared to normal vaginal delivery, participants who had caesarean section were significantly more likely to report being satisfied with pain relief during labour (p 0.001).

The study findings showed varying levels of satisfaction with different aspects of peri-partum care and suggested the need for better pain relief during vaginal delivery, information sharing by doctors and patient emancipation for decision-making about their own care.

The study findings showed varying levels of satisfaction with different aspects of peri-partum care and suggested the need for better pain relief during vaginal delivery, information sharing by doctors and patient emancipation for decision-making about their own care.

While antiretroviral therapy (ART) has markedly increased survival in people living with human immunodeficiency virus (PLHIV), emerging trends of co-existence of non-communicable diseases (NCDs) and HIV could negate the gains already achieved in controlling HIV.

The study aimed to determine the prevalence of hypertension and diabetes mellitus in PLHIV on ART in Gweru district.

Six high-volume ART sites in Gweru district under Midlands province in Zimbabwe.

This was a cross-sectional study. Screening and data collection occurred over a 3-month cycle when all patients were expected to have visited the ART sites for their monthly ART drug supply. The process also allowed the identification of health system challenges regarding data management for HIV-NCD comorbidity. Poisson regression analysis was used to calculate NCD prevalence ratio (PR) in PLHIV.

Nearly 18 000 PLHIV registered for ART were identified. Hypertension (19.5%) and diabetes mellitus (8.4%) were the most common NCDs identified with a high proportion of those who did not know their diagnosis (over 50%).