Systemic corticosteroids (CS) are often used in treatment of Crohn's disease and are usually considered the main cause of osteoporosis in patients with Crohn's disease. The aim of this paper was to assess the influence of CS on development of osteoporosis in Crohn's disease. In this study bone mass density (BMD) was analyzed in 43 patients with Crohn's disease. Most of the examined patients (72.1%) used CS for more than 3 months. Osteoporosis was diagnosed in 30.2% of patients, and osteopenia in 44.2% of patients. There were no statistically significant difference in BMD among patients who were on CS and the ones who were not. In the group of newly diagnosed patients 60% had reduced bone density, opposing 61.6% of patients with previously diagnosed disease. There was no statistically significant difference among those two groups of patients. Risk factor such as corticosteroid therapy is not independent risk factor for reduced BMD. Newly diagnosed patients have high prevalence of reduced BMD and they were not on CS therapy, which suggest that possible inflammatory nature of the disease is a possible risk factor for reduced BMD in Crohn's disease.

Clopidogrel is a thienopyridine that irreversibly inhibits platelet P2Y12 receptors and adenosine diphosphate (ADP) mediated platelet aggregation. It is a prodrug that requires activation in the liver by cytochrome P450 enzymes (CYP3A4, CYP3A5, CYP1A2, CYP2C9, CYP2C19, and/or CYP2B6) . Dual antiplatelet therapy with clopidogrel and aspirin has become the mainstay of treatment of patients with acute coronary syndromes undergoing percutaneous coronary intervention .

Executive summary. National mental health policy: SASOP extends its support for the process of formalising a national mental health policy as well as for the principles and content of the current draft policy. Psychiatry and mental health: psychiatrists should play a central role, along with the other mental health disciplines, in the strategic and operational planning of mental health services at local, provincial and national level. Infrastructure and human resources: it is essential that the state takes up its responsibility to provide adequate structures, systems and funds for the specified services and facilities on national, provincial and facility level, as a matter of urgency. Standard treatment guidelines (STGs) and essential drug lists (EDLs) : close collaboration and co-ordination should occur between the processes of establishing SASOP and national treatment guidelines, as well as the related decisions on EDLs for different levels. HIV/AIDS in children: national HIV programmes have to promote awareness of the neurocognitive problems and psychiatric morbidity associated with HIV in children. HIV/AIDS in adults: the need for routine screening of all HIV-positive individuals for mental health and cognitive impairments should also be emphasised as many adult patients have a mental illness, either before or as a consequence of HIV infection, constituting a ‘special needs’ group. Substance abuse and addiction: the adequate diagnosis and management of related substance abuse and addiction problems should fall within the domain of the health sector and, in particular, that of mental health and psychiatry. Community psychiatry and referral levels: the rendering of ambulatory specialist psychiatric services on a community-centred basis should be regarded as a key strategy to make these services more accessible to users closer to where they live. Recovery and re-integration: a recovery framework such that personal recovery outcomes, among others, become the universal goals by which we measure service provision, should be adopted as soon as possible. Culture, mental health and psychiatry: culture, religion and spirituality should be considered in the current approach to the local practice and training of specialist psychiatry, within the professional and ethical scope of the discipline. Forensic psychiatry: an important and significant field within the scope of state-employed psychiatrists, with 3 recognised groups of patients (persons referred for forensic psychiatric observation, state patients, and mentally ill prisoners), each with specific needs, problems and possible solutions. Security in psychiatric hospitals and units: it is necessary to protect public sector mental healthcare practitioners from assault and injury as a result of performing their clinical duties by, among others, ensuring that adequate security procedures are implemented, appropriate for the level of care required, and that appointed security staff members are appropriately trained and equipped.