Faculty of Medicine and Health Sciences

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The vision of the Faculty of Medicine and Health Sciences is to be a dynamic, people-centred and inclusive environment, internationally recognised for its excellence in research, education and clinical training in medicine and health sciences, and for the contribution it makes to improving health and health care in South Africa, the African continent and beyond.

This faculty was known as the Faculty of Health Sciences until 30 April 2012.

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Browsing Faculty of Medicine and Health Sciences by browse.metadata.type "Masters"

Now showing 1 - 8 of 8
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    Case series on methamphetamine exposure in pregnancy : heart rhythm patterns of newborns in the first week of life
    (Stellenbosch : Stellenbosch University, 2020-12) Ebrahim, Mohamedraza; Kali, Gugulabatembunamahlubi; Fourie, Barend; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Paediatrics and Child Health.
    ENGLISH ABSTRACT: Methamphetamine use is a significant problem in the Western Cape province. Antenatal exposure of the foetus to methamphetamine has been reported to have deleterious effects, including effects on the cardiovascular system. In this case series, we report on thirteen infants who had been exposed to methamphetamine in utero, with last documented use ranging from 2 days to a month before delivery. The infants were either born at Tygerberg Hospital (TBH), or had been outborn and referred to TBH within 72 hours of birth. They all had methamphetamine screens in the urine and echocardiographic studies, and 9 neonates had 24-hour Holter electrocardiogram monitoring. Four (30.8%) of the neonates tested positive for methamphetamine. Five (38.5%) infants had acyanotic cardiac lesions diagnosed, and 2 (15.4%) had abnormal heart rhythm patterns. 3/5 (60%) of the cardiac lesions were most likely related to prematurity. Further large prospective studies are needed to clearly delineate the effects of methamphetamine exposure on the cardiovascular system in neonates.
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    The effect of an aquatic or land-based intervention programme on gross motor skills of selected children with Down syndrome
    (Stellenbosch : Stellenbosch University, 2017-12) Roodt, Odelia; Africa, Eileen Katherine; Ferreira, Suzanne; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Sport Science
    ENGLISH ABSTRACT: Children with Down Syndrome (DS) follow a unique pattern of motor development than neuro-typical children in their early years of development. They find it hard to acquire the movement skills that is expected of them and this leads to a possibility of leading a sedentary lifestyle during adolescence and later in life. According to researchers, an intervention program that focus on improving gross motor skills (GMS) can benefit children with DS tremendously. The primary aim of the study was to explore the effect of land and aquatic interventions over a 9-week period in children with DS to improve their GMS. The sample of convenience consisted of participants (N=31) between the age range of seven to 16 years, they were selected from four different schools in Somerset-West, Stellenbosch, Bellville and Mitchell’s Plain. The mentioned schools immediately showed interest in the study. Two schools participated in the land-based and the other two schools in the aquatic-based intervention program. The Bruininks-Oseretsky Test of Motor Proficiency (BOT-2) was used to assess the children’s gross motor skills to determine their strength and weaknesses. The BOT-2 assessed four composites, namely: fine manual control; manual coordination; body coordination; and strength and agility. The pre- and post-tests took two weeks to complete, whereas the aquatic- and land-based interventions were seven weeks long, with two, 40 minute sessions per week. The researcher compared the results of the aquatic and land programs. It was concluded that the land group’s GMS level was higher than the aquatic group at the pre- and post-tests. Both groups improved their overall score with the same amount of points and the researcher could, therefore, speculate that both intervention programs had an influence on their improvement. Both interventions could most likely be implemented at schools with learners that have special learning needs (SLN).
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    The efficacy and safety of diode laser cycloablation in the treatment of refractory glaucoma in a South African population
    (Stellenbosch : Stellenbosch University, 2022-04) Thomas, Jason Peter; Smit, Derrick; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Ophthalmology
    ENGLISH SUMMARY: The development of a safe and effective protocol for trans-scleral cyclophotocoagulation in a Southern African population presenting with refractory glaucoma to a tertiary eye care centre. prospective, non-randomised, observational study of patients attending the Eye Clinic at Tygerberg Hospital, Cape Town, South Africa between March 2018 and January 2020. 119 eyes of 105 eligible patients were treated during the study period. The mean laser power was 1766 ± 187 milliwatt per burn for a mean of 15.6 ± 2.9 burns per eye. Mean total delivered energy per eye was 55.28 ± 12.61 Joule. 64% of the patients who followed up for the entire six-month period had an intraocular pressure reduction of ≥ 30% and 42.2% of those followed up had an IOP of ≤ 22 mmHg. The pain scores reported by patients decreased significantly between pre-operatively and three months (coefficient -1.752, p<0.001) and between pre-operatively and six months (coefficient -1.498, p=0.002). There was not a statistically significant effect on the change in topical medication from pre-operatively to three months (coefficient = -0.089, p=0.186), nor from pre-operatively to six months (coefficient = -0.003, p=0.946). Oral acetazolamide use decreased from 50.4% of patients at the date of their initial cyclophotocoagulation treatment to 9.3% at three months and further to 7.8% at six months. One eye had a scleral perforation at the time of initial treatment; no further complications arose. An individualized, “pop-titrated” cyclophotocoagulation protocol is safe and effective for use in a Southern African population. Retreatment should be considered at three months if intraocular pressure is not adequately controlled.
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    Exploring continuing professional development in critical care : registered nurses’ perspectives of elements influencing completion of a CPD programme in a South African private hospital group
    (Stellenbosch : Stellenbosch University, 2021-03) Van Heerden, Wilma-Jean; Bell, Janet; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Nursing & Midwifery.
    ENGLISH SUMMARY : Background: Continuing professional development is education throughout the duration of professional life to maintain competence and increase professional proficiency and expertise. A complex reality of nursing practice in South Africa is that approximately 25% of nurses working in the critical care environment hold a critical care qualification. Therefore, healthcare services have to rely mostly on novice registered nurses and those new to this environment to care for the critically ill. In this context some South African private and public hospitals initiated structured internal continuing professional development programmes to offer a way of knowledge and skills improvement for nurses working in critical care environments without a critical care qualification. A private healthcare group has offered a well-established structured continuing professional development programme in fundamental critical care nursing since 2003 to develop appropriate knowledge, gain practice exposure and clinical skills nurses may be unfamiliar with. In addition this programme has the aim to enhance safe and quality patient care as well as to avoid errors. The aim of this study was to explore and describe the perspectives of registered nurses of elements that influence their successful completion of a continuing professional development programme in critical care nursing to strengthen the fit for purpose of this programme. The assumption by Knowles that adult learners are selfdirected, and is motivated by information new and relevant in their personal lives or jobs, formed the basis in the conceptual framework for this study. Method: A qualitative exploratory, descriptive research design was used by means of employment of semi-structured individual interviews. The target population was identified as RNs who participated in and completed a critical care continuing professional development programme within this private hospital group from the beginning of 2017 to the end of 2018. The accessible population was registered nurses who participated in the critical care continuing professional development programme in the Western Cape, Johannesburg, and Tshwane regions. A sample size of 14 participants concluded data saturation by means of a self-created openended interview guide. Findings: The following three themes and related sub-themes emerged and concluded the data analysed: 1. Participants perceived a multitude of supporting elements to successfully complete this critical care continuing professional development programme namely readiness to learn, support and communication. 2. Similarly elements that detracted participants from successful completion of this continuing professional development programme were experienced as obstacles intra-person and also obstacles extra-person. 3. Participants finally provided their recommendations on elements that may be adapted to strengthen the fit for purpose of this programme. These elements concluded changes to be made by registered nurses themselves internally and changes to be made external to registered nurses. Relevant literature and recommendations offered by the participants were used to formulate recommendations. Action steps for management, nurse educators and registered nurses to complete this continuing professional development programme successfully were formulated.
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    Genetic manipulation of mycobacterial strains using different techniques to determine the role of specific mutations associated with drug resistance
    (2021-09-06) Otum, Christian Chukwuezugo; Klopper, Marisa; Streicher, Lizma; Williams, Monique; van Rie, Annelies
    Functional genomic studies are limited by difficulties surrounding the construction of in vitro Mycobacterium tuberculosis mutants using site-directed mutagenesis. We aimed to use different mutagenesis techniques to insert different point mutations into M. tuberculosis to determine their roles in drug-resistance, or for further physiological investigations in future studies. In this study we showed proof-of-concept in M. smegmatis on the feasibility of constructing double point mutations using two-step homologous recombineering. Our results showed that it is possible to sequentially introduce two independent point mutations in different genes of the same genome by homologous recombineering. This was achieved in M. smegmatis with katG Pro347His and gyrA Ala288Asp point mutations, which was confirmed to be resistant to isoniazid (INH; ˃4 μg/ml) and ofloxacin (OFX; 0.5μg/ml). Furthermore, homologous recombination and homologous recombineering were used to attempt to insert a point mutation in M. tuberculosis H37Rv for investigation of the alternative roles of the inhA promoter C-15T mutation. We achieved the construction of the inhA promoter mutant with homologous recombination. A Luria Delbrück assay was also employed to study whether a drug-resistant genetic background would preferentially result in the acquisition of inhA promoter mutations in an ofloxacin (OFX) resistant M. tuberculosis Beijing mutant strain (B01) with a gyrA Asp94Gly compared to its progenitor strain. The Luria Delbrück assay showed that it may be impossible to induce inhA promoter mutations by INH selection pressure in an in vitro system in the strain genetic backgrounds chosen for this study. We also investigated the association of two different mutations, rv0678 Thr33Ala and atpE Ile66Val, with bedaquiline (BDQ) and clofazimine (CLZ) resistance. This was done by the insertion of each of these mutations into M. tuberculosis H37Rv by homologous recombineering and recombination, respectively in separate experiments. Whole genome sequencing was used to confirm the genetic background of all the genetically manipulated in vitro M. tuberculosis mutants, as well as the progenitor. BDQ, CFZ and INH MIC determination for the mutant isolates was achieved using the Mycobacterium Growth Indicator Tube (MGIT) system to show the association between the manipulated genotypes and their phenotypes. The MGIT MIC determination confirmed that the inhA promoter C-15T mutation confers low-level INH resistance (MIC of ≥0.1μg/ml), while rv0678 Thr33Ala mediates high-level BDQ and CFZ resistance (MIC of ≥1.0μg/ml) and atpE Ile66Val confers low-level BDQ (MIC of 0.25μg/ml) and CFZ resistance (MIC of 0.5μg/ml). In conclusion, homologous recombination and homologous recombineering were both efficient in generating mycobacterial mutants. However, homologous recombination proved more efficient in M. tuberculosis than homologous recombineering. Proof-of-concept in M. smegmatis demonstrated that double katG (Pro347His) | gyrA (Ala288Asp) point mutations can be introduced in a single strain. While in vitro phenotypic drug susceptibility testing confirmed that katG (Pro347His) caused high-level INH resistance, and gyrA (Ala288Asp) caused low-level OFX resistance in M. smegmatis. The M. tuberculosis inhA C-15T mutation caused low-level INH resistance in vitro. However, C-15T mutation appears to not be acquired spontaneously during in vitro INH selection. While M. tuberculosis rv0678 Thr33Ala and atpE Ile66Val mutations caused an increase in the MIC values for BDQ and CFZ, compared to the wild-type progenitor.
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    Radiolographic assessment of lower limb alignment in South African children
    (Stellenbosch : Stellenbosch University, 2022-07) Foxcroft, William Donnavan; Du Toit, Jacques; Burger, Marilize Cornelle; Ferreira, Nando; Faculty of Medicine and Health Sciences. Dept. of Surgical Sciences. Orthopaedic Surgery.
    ENGLISH ABSTRACT: Background: Radiographic measurements on full length standing lower limb views are the standard for lower limb deformity analysis. Published measurements of Paley et al. on lower limb alignment is the gold standard but was derived from small adult samples. There are no radiographic measurements reported exclusively of children of South African descent. The study aimed to establish normal values of lower limb alignment and joint orientation angles in South African children between 5 and 18 years old, at specific age intervals and to compare these measurements to the values as derived from Paley et al. Methods: A cross-sectional radiographic study including all 5-18 year old children who underwent full-length anteroposterior radiographs between 2012 and 2020 was conducted. Radiographic measurements were done as described by Paley. Differences in measurements obtained and those reported by Paley et al.1 were investigated using a T-test for a single mean against a reference constant, using an alpha level of 0.05. Results: A total of 190 patients (110 male; 80 female) with a mean age of 10.0 ± 3.3 years were included. The medial neck-shaft angle (MNSA), mechanical and anatomical lateral distal femoral angle (LDFA) and lateral distal tibia angle (LDTA) remained consistent throughout the age groups. Significant differences between Paley’s published values and our cohort were observed for the median mechanical axis deviation (MAD), MNSA and medial proximal tibia angle (MPTA). The median MAD across age groups was -2.2 mm (IQR -6.4 – 1.5) with all subgroups showing a lateral MAD (valgus alignment), compared to the median MAD of +9.7mm (varus alignment) from Paley et al.1 The MNSA had a mean of 135.7°, compared to 129.7° from Paley. The mean MPTA was 89.7°, compared to Paley’s 87.2°. The MPTA had minimal change throughout the age groups. Conclusion: Significant differences were seen in the mean/median of our MAD, MNSA and MPTA compared to Paley’s work. Our MAD have a sustained valgus tibio-femoral angulation throughout our population. Our MNSA have more pronounced valgus with minimal change throughout growth. The increasing MPTA leads to a more valgus joint line when compared to other studies. Other measured values are comparable with previously published adult and paediatric populations. We were able to develop set values that could be the norm for paediatric joint orientation angles in the South African population.
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    The Role of Dectin-2 during infection with Mycobacteria that are able to survive in Macrophages
    (2018-11-26) Miss Sieberhagen, Jeanie; Dr Baker, Bienyameen; Prof Wiid, Ian