Masters Degrees (Family Medicine and Primary Care)

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Browsing Masters Degrees (Family Medicine and Primary Care) by browse.metadata.advisor "De Villiers, P. J. T."

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    The prevalence of hypertensive complications of pregnancy in Dora Nginza Hospital, Port Elizabeth, Eastern Cape
    (Stellenbosch : Stellenbosch University, 2010-12) Ojodun, Olumide; De Villiers, P. J. T.; University of Stellenbosch. Faculty of Health Sciences. Dept. of Interdisciplinary Health Sciences. Family Medicine and Primary Care.
    ENGLISH ABSTRACT: BACKGROUND: Hypertension and its complications is responsible for a significant proportion of maternal and neonatal morbidity and mortality worldwide. In Dora Nginza Hospital, clinical experience has shown that hypertension and its complications are common but despite this assumption, the overall prevalence of complications, social and demographic characteristics and various forms of presentations of hypertension in pregnancy is still largely unknown. OBJECTIVES: To determine the prevalence of complications, risk factors, social and demographic characteristics of hypertensive complications of pregnancy in Dora Nginza Hospital. STUDY DESIGN: The study is a retrospective descriptive study performed on medical records. The study was carried out by looking at records of patients admitted with hypertension in pregnancy over a 2 year period (2007-2008). MS Excel was used to capture the data and STATISTICA version 9 was used for data analysis. SETTING: Dora Nginza hospital, Port Elizabeth Hospitals Complex. MAIN OUTCOME MEASURES: The incidence, risk factors, maternal complications, perinatal outcome. RESULTS: A total of 22,711 deliveries were recorded in Dora Nginza hospital over the two year period (2007-2008). 1520 cases were complicated by hypertension giving an incidence of hypertension as 6.69% (66.9 per 1000 deliveries). The incidence of pre eclampsia is 35.40% and chronic hypertension 2.80%. Maternal complications occurred in 40.29% of the hypertensive women. Maternal deaths occurred in 0.79% (790 per 100000 deliveries) accounting for 38.71% of the total maternal deaths in the facility. Poor neonatal outcome was recorded in 5.90% of these women. The 2.30% stillbirths represent 3.30% of all fetal deaths in the facility for the study period. Prominent risk factors are age, race, low socioeconomic status, smoking and BMI CONCLUSION: Hypertensive disorders of pregnancy in Dora Nginza hospital is common and is an important cause of maternal and perinatal morbidity and mortality. Improved socioeconomic status, quality obstetric services which include early booking, proper antenatal care, early referral and proper documentation can minimise the effect of hypertension on pregnancy.
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    The prevalence of the known risk factors for teenage pregnancy amongst female teenage learners in Mount Ayliff, Eastern Cape, South Africa
    (Stellenbosch : Stellenbosch University, 2011-03) Okafor, Sylvester; De Villiers, P. J. T.; Stellenbosch University. Faculty of Health Sciences. Department of Interdisciplinary Health Sciences.
    ENGLISH SUMMARY :Background: Teenage pregnancy is a major health problem in South Africa. In Mount Ayliff hospital, Eastern Cape, teenage pregnancy accounts for about 15-20% of deliveries in maternity every month. Teenage pregnancy leads to disruption of education, unemployment, increased rate of STI/HIV infection, unsafe abortion, obstetrics complications and malnutrition amongst children. This study is aimed to determine the prevalence of the known risk factors for teenage pregnancy. Methodology: This is a descriptive study. A sample of teenage learners was randomly selected from grade 10 to 12 learners in Mount Ayliff high school. Anonymous, self administered questionnaires containing relevant questions on contraceptive knowledge/use, family structure, sexual behaviour, alcohol use and sexual abuse were used to collect data. Result: A total of 300 questionnaires were distributed but only 219 completed questionnaires qualified for analysis. In total, 47% of the respondents have had sexual intercourse with the opposite sex and the mean age for first sexual intercourse is 16 years. 65.3% of the respondents have knowledge of contraceptives while 33.8% do not. Among those who have had sexual intercourse before, 68.9% did not use any contraceptive in their first intercourse. Of the sexually active respondents, only 16.3% reported using contraceptive consistently during intercourse. Majority of the respondents (45.2%), were raised up by a single mother and 76.3% do not discuss sex with their parents. The source of information about sex is mainly from friends and media. It was also found that most of the respondents live with parent(s) who are unemployed. A very small fraction of the respondents (7.3%) have been sexually abused and another 7.3% reported indulging in alcohol. Conclusion: Poor knowledge/use of birth control methods, family structure and sexual behaviour are the major risk factors for teenage pregnancy that are prevalent among teenage learners in Mount Ayliff community.
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    Profile of diabetic complications amongst diabetics attending internal medicine outpatient department and family medicine outpatient department in Dora Nginza Hospital, PE hospital complex
    (Stellenbosch : University of Stellenbosch, 2015-04) Ajudua, Emmanuel Enuagwuna; De Villiers, P. J. T.; Okere, D. O.; University of Stellenbosch. Faculty of Health Sciences. Dept. of Interdisciplinary Health Sciences. Family Medicine and Primary Care.
    ENGLISH ABSTRACT: Introduction: Diabetes is the most prevalent endocrinology problem encountered in primary care practice. If recent trends showing a dramatic increase in prevalence (believed to be a consequence of a decline in physical activity and excessive caloric intake) continue, then the condition will soon affect nearly 20 million people in the U.S a reflection of the global trend. Effective management requires care that is thoughtful and meticulous, incorporating intensive patient education. Euglycemic control, with the level of glycosylated haemoglobin (HbA1c) kept below 7.0mmol/L, has emerged as a major treatment objective because of its association with a marked reduction in the risk for micro vascular complications. The primary physician is in the unique position to provide comprehensive care to the diabetic patient. Setting: The aim of this study is to evaluate the profile of complications arising due to diabetes mellitus among adult diabetics attending internal medicine outpatient department and family medicine/primary care outpatient department in the Dora Nginza hospital, PE hospital complex. Method: The study is a descriptive retrospective study in which names of patients were collated from clinic records of both clinics, files sought at the records department covering the period between Jan 2007 and Jan 2008 inclusive. Prevalence of statistical variables was generated using frequency tables, bar graphs, cross tabulations and chi square test. Results: Hyperglycemia was the major complication which predominantly was associated with high haemoglobin A1c (HbA1c) levels. However, some hyperglycaemic cases were also found to be associated with normal HbA1c. Complications were found to be more in type 2 diabetics. Patients with hypertension, obesity, smoking and alcohol use were observed to have a higher risk of developing diabetic complications. The findings on retinopathy in this study was inconclusive in view of the fact that patients sent for fundoscopy did not return with documented results from the sister hospital PE provincial hospital. Family Medicine outpatient department overall did better in patient care compared to the Internal Medicine outpatient department. Conclusion: The challenge for the primary care physician is to design a therapeutic program that is safe practical and acceptable to the patient. The ultimate goal of therapy is the prevention of micro vascular and macro vascular complications, consequence of diabetes that makes the condition a major risk factor for cardiovascular disease, stroke, visual impairment, renal failure, impotence, peripheral neuropathy, limb loss and ultimately death. These can be averted through appropriate education of both hospital staff, patients and their care givers. The recommendations made are based on the findings of the study.