Graduation - 2022 - December (Open Access)

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Barrier to cervical cancer screening in Gwanda district, Zimbabwe: A mixed method analysis
(2022-02-24) Mantula, Fennie; Sewram, Vikash; Toefy, Yoesrie
Clinical and laboratory characteristics of ocular syphilis and neurosyphilis among individuals with and without HIV infection
(2022) Mathew, Dony Korah; Smit, Derrick
Summary BACKGROUND/AIMS: In the era of increasing incidence of syphilis globally, ocular syphilis is re-emerging as an important cause of uveitis. The aim of this study was to determine the clinical and laboratory characteristics of ocular- and neurosyphilis among individuals with and without HIV infection. METHODS: Retrospective analysis of patients diagnosed with ocular syphilis presenting to Tygerberg Hospital, South Africa, over a 5-year period ending December 2018. RESULTS: Two-hundred-and-fifteen eyes of 146 patients were included. HIV co-infection was present in 52.1% of the patients, with 23.7% of these patients being newly diagnosed on presentation. The median age was 36.5 + 9.8 years. Bilateral involvement occurred in 47.3%; with 68.1% of these patients being HIV positive. The most frequent form of intraocular inflammation was posterior uveitis (40.9%), followed by panuveitis (38.1%); both of which were more predominant in HIV-positive eyes. Seventy-four percent of all eyes had a visual acuity < 20/50 and 40% < 20/200 at presentation. A lumbar puncture was performed in 113 patients (77.4%). Sixteen patients had confirmed neurosyphilis and 27 probable neurosyphilis according to the UpToDate algorithms. CONCLUSION: This study included the largest number of ocular syphilis cases with the largest proportion of HIV infection to date. Forty-three of 146 patients (29.5%) had neurosyphilis. HIV status must be determined in all patients with ocular syphilis since almost ¼ of patients were newly diagnosed with HIV infection by doing so.
Clinical determinants distinguishing communicating and non-communicating hydrocephalus in childhood tuberculous meningitis at presentation
(2022-12) Bovula, Siyabulela; Solomons, Regan; Van Toorn, Ronald
ABSTRACT Introduction: Hydrocephalus occurs in up to 80% of children with tuberculous meningitis (TBM), of which the majority (70-80%) is of a communicating nature. Communicating hydrocephalus develops when cerebrospinal fluid (CSF) obstruction occurs at the level of the tentorium, whilst non-communicating hydrocephalus emanates from basal exudates that obstruct the outflow foramina of the fourth ventricle. Identifying the type of hydrocephalus is of critical importance since communicating hydrocephalus can be medically treated with diuretics whilst non-communicating hydrocephalus requires surgical CSF diversion. Conventional neuroimaging does not allow differentiation of the type of hydrocephalus. In resource-limited settings, air-encephalography is the only investigative modality that allows differentiation.
CXCL13, CXCL10 and CXCL8 as indicators of ocular and neurological involvement in patients with ocular syphilis: An observational descriptive study
(2022) Van der Merwe, Laurie Wiid; Smit, Derrick
ABSTRACT Aim To investigate the role of the chemokines CXCL13, CXCL10 and CXCL8 in the diagnosis of ocular‐ and neurosyphilis by examining the serum, aqueous humour (AH) and cerebrospinal fluid (CSF) of patients with ocular syphilis. Methods An observational descriptive study was performed prospectively at Tygerberg Academic Hospital in Cape Town, South Africa from 1 February 2018 till 31 January 2021 which enrolled 23 participants. Upon diagnosis of ocular syphilis, the HIV status of each patient was determined, and 3 samples (AH, serum and CSF) were collected to measure the levels of CXCL13, CXCL10 and CXCL8 in each. Results The mean concentrations of all 3 biomarkers were higher in the AH and CSF than in the serum. The mean concentrations of the 3 measured biomarkers were markedly different when comparing both AH and CSF levels to serum levels. The level of CXCL13 measured in the AH correlated well with the concentrations found in the CSF of patients with neurosyphilis. In patients with neurosyphilis, mean AH levels of CXCL13 and CXCL10 were markedly higher than in serum while mean CSF levels of CXCL10 were also markedly higher than in serum. Also, the AH/serum ratio of CXCL13 and CXCL10, as well as the CSF/serum ratio of CXCL10, was much higher in patients with neurosyphilis than without. In patients with HIV infection, mean AH CXCL13 levels were much higher than in patients without HIV infection. Conclusion The levels of CXCL13, CXCL10 and CXCL8 in the AH of patients with neurosyphilis are similar to previously reported levels in the CSF of patients with neurosyphilis and can potentially be an adjunct in the diagnosis of ocular syphilis. Patients with ocular syphilis who tested negative for neurosyphilis with conventional CSF testing showed features of neurosyphilis when analysing the CSF chemokines.
Development of Thermal Performance Testing Capability for Alternative Masonry Walls
(Stellenbosch : Stellenbosch University, 2022-11) Voss, Ashleigh Jean; De Villiers, Wibke; Stellenbosch University. Faculty of Engineering. Dept. of Civil Engineering.
ENGLISH ABSTRACT: Construction industries worldwide are feeling the pressure to move towards more sustainable methods of construction and materials. In South Africa, this pressure is being applied by the revision of national building regulations and requirements, specifically the implementation of SANS 10400-XA 'Energy Usage in Buildings', which intends to improve the energy efficiency and energy use within the built environment by regulating material thermal properties. In addition to this, there is continuous research being done within South African institutions to develop alternative building materials, however there are limited options regarding testing the thermal properties of these materials as building elements. Without these properties, the acceptance of these new materials for use in construction is unlikely. Currently, there are no known operational testing facilities within South Africa with the ability to test building element thermal properties. This study aims to provide such a testing facility, in order to aid the development of alternative construction materials by determining the relevant thermal properties needed to be used in construction. The following study contains the detailed design and construction of a vertical guarded hot box (GHB) testing apparatus, for the purpose of measuring material thermal properties, namely, the thermal resistance (R-value), thermal conductivity (k-value) and thermal transmittance (U-value). Subsequently, this study includes the testing of two specimens, specifically two types of masonry walls and the resultant thermal properties. The hot box in question was designed according to the requirements of ASTM C1363-11 and was developed from a pre-existing version of the apparatus that functioned inadequately. Hot boxes are designed to create a highly controlled environment and induce a constant temperature gradient across a specimen of unknown thermal properties. The hot box is then capable of measuring the heat being transferred through the specimen using the basic principles of one- dimensional heat transfer within a steady state environment. A thorough review of the ASTM requirements, the pre-existing apparatus and its problem areas, as well as a literature investigation into other hot box case studies was undertaken. This led to a series of new design decisions, which are documented in detail, including the construction process and final product. The functionality of the apparatus was tested, with focus lent to the heating control methods, namely PID versus on/off control, and the resultant temperature distribution and consistency. A calibration procedure was outlined and completed successfully for the purposes of masonry wall testing. This was followed by the testing of concrete masonry units (CON) and adobe (ADB) units in the form of o,95m x O,95m walls. These tests were completed successfully and R-values of 0,18 m2 •c/W and O,21m2 •c/W were determined for the CON and ADB walls respectively, both of which do not meet the SANS 10400- XA requirement of to 0,6 m2 •C/W.
An Exploratory Study of Women Leadership in the South African Charismatic Church Through an African Women Practical Theology Lens
(2022-12-05) Keletso, Yende; Nell, Ian
Irrigation as Dead Space Management for Fracture Related Type I Intramedullary Chronic Osteomyelitis
(2022) Grey, Jan-Petrus; Ferreira, Nando; Burger, Marilize Cornelle
ABSTRACT Introduction: Dead space management following intramedullary debridement and reaming can be challenging and several alternatives have been described. The main objective of this study was to investigate the clinical outcome and resolution rate in patients treated for fracture related Cierny and Mader anatomical type 1 intramedullary chronic osteomyelitis by means of continuous irrigation (modified Lautenbach system) as dead space management following intramedullary reaming. Material and Method: A consecutive series of thirty patients with Cierny and Mader type 1 chronic osteomyelitis, treated between May 2016 and September 2019, were evaluated retrospectively. Patient history and clinical information, including imaging and laboratory results, were reviewed. Treatment procedures and antibiotic profiles were also recorded. Results: The initial cohort included 30 cases with 18 tibias, 11 femurs and one humerus. Seven patients were excluded; three patients did not return for follow up and four patients had less than six months follow up. Of the remaining 23 patients, 91% (21/23) achieved resolution of infection over a median follow up period of 16 months (Interquartile range, IQR 7-21 months). Infecting organisms where isolated in 65% (15/23). The median duration of hospital stay was 6 days (IQR 4-7 days). Post-operative complications were noted in two cases and involved a tibial and femoral refracture, respectively. Both patients however achieved union without recurrence of infection following surgical intervention. Conclusion: Continuous irrigation is a cost-effective single-stage surgical option for dead space management during the treatment of intramedullary chronic osteomyelitis. It provides the advantage of instilling high dose intramedullary antibiotics and negates the need for a second surgical procedure while achieving similar outcomes than other dead space management techniques.
Near-field dispersion modelling of discharged effluents under various hydrodynamic conditions.
(2022-11-21) Surajpal, Tarryn; Diedericks, Gerhardus; Smit, Francois
Prevalence of Pathological Neck of Femur Fractures in Patients undergoing Arthroplasty at a Tertiary Referral Hospital
(2022) Khan, Suhayl Amed; Jordaan, Daniel Jacobus; Burger, Marilize Cornelle
Abstract Background: This study aimed to determine the prevalence of pathological neck of femur (NOF) fractures at a tertiary referral hospital through histological examination of specimens in all NOF fracture patients undergoing hip arthroplasty. A secondary aim was to determine whether the current practice of sending all femoral heads for histological evaluation, to avoid missing unsuspected malignancies, is financially warranted. Methods: A retrospective folder review of patients who underwent arthroplasty for NOF fractures was conducted. Patients with suspected pathological fractures were managed by the divisional Bone Tumour Unit whilst fragility traumatic fractures were managed by the Arthroplasty Unit. All femoral heads were sent for histological analysis regardless of suspicion of pathological fracture. Quotes from the public and private sector were sought to determine cost implications of sending femoral head specimens for histology Results: A total of 311 patients were included. Of these, 11 patients (3,5%) had suspected pathological fractures, with fragility/traumatic fractures being diagnosed in the remaining 300 patients (96.5%). Histology results were available for 195 patients (62.7%) including all of the patients with suspected pathological fractures. No unexpected malignant histological results were observed whilst 9 of the suspected pathological fracture group had pathological fractures, confirmed with histology. Conclusion: Pathological lesions were identified in 2.9% of patients undergoing arthroplasty for NOF fractures in our population, which is higher than other reports in the literature. Routine histological screening of femoral heads to exclude pathological fracture might not be necessary and cost effective, as pathological lesions can accurately be identified by clinical and radiographic evaluation.
Quantifying river losses on the Sundays River between Darlington Dam and Korhaans Drift Weir through hydrodynamic modelling
(Stellenbosch : Stellenbosch University, 2022-11) Nel, Aldré; Basson, Gerrit; Stellenbosch University. Faculty of Engineering. Dept. of Civil Engineering.
ENGLISH ABSTRACT: The Sundays River, downstream of Darlington Dam in the Eastern Cape of South Africa, forms part of an inter-basin transfer scheme operated by the Lower Sundays River Water User Association (LSRWUA) to supply bulk water to the Sundays River Valley Municipality (SRVM), the Nelson Mandela Bay Metro (NMBM) as well as the predominantly citrus irrigators in the Sundays River Valley. An increase in agricultural development, population growth and persistent drought necessitates an increase in efficiency in managing water resources. This study aimed to quantify transfer losses over the 2021/2022 water year along the Sundays River between Darlington Dam and Korhaans Drift Weir where raw water is diverted into a formal canal scheme for supply purposes. A one-dimensional (1D) hydrodynamic model was set up, calibrated, and validated to quantify transfer losses which were assumed to consist primarily of evaporation (E) and evapotranspiration (ET). Acoustic Doppler Current Profiler (ADCP) measurements were conducted on the Parshall flumes at Darlington Dam and Korhaans Drift Weir to verify discharge tables for modelling purposes. The ADCP results yielded, on average, 13 % lower flows and 16 % higher flows compared to corresponding discharge tables obtained from the Department of Water and Sanitation (DWS) at Darlington Dam and Korhaans Drift respectively under routine water supply discharges. The hydrodynamic model results estimated transfer losses to range between 2.0 % and 5.3 % of the total volume diverted at Korhaans Drift. Variations in transfer losses were seasonal and found to be less compared to similar studies conducted on other South African rivers. Spillage at Korhaans Drift Weir into the Sundays River is considered a loss to the inter-basin transfer scheme. A water balance exercise conducted for the water year concluded that 62.157 million m³ of water spilled at the weir. This volume was largely attributed to Darlington Dam overflowing upstream of the weir. Volumes of water spilling at Korhaans Drift Weir while Darlington Dam was not overflowing suggested scope for improved water management practices. An Excel spreadsheet-based water management tool was developed from the results of this study to aid in efficiently managing releases from Darlington Dam and diversions at the Korhaans Drift Weir. The tool was generated to allow future revisions as additional research clarifies assumptions made in this study.
The Time of Activism: An ethnographic study on the Philippi Horticultural Area (PHA) Campaign and its practices of “working” time and representation in Cape Town
(2022-11-11) Wingfield, Matthew Michael; Robins, Steven Lance

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