Impact of headaches on university students in Durban, South Africa.

BACKGROUND: Introspection into the factors that affect student success at higher education institutions has gained significant momentum in recent years. Teaching and learning has come under the spotlight with quality enhancement and teaching development funding focussing on student support, enhancing the student environment, and enhancing academics as teachers. Included in this are aspects that try to understand the student. An aspect that is not receiving attention is student health, specifically headaches which could impact student success. The aim of this study was to investigate the impact of primary headaches on student academic, family and social life at one higher education institution in South Africa. METHOD: Data was collected using a questionnaire based descriptive cross sectional survey. Multistage sampling using a ballot method allowed for sampling to obtain representation from across the institution. To achieve a 95 % confidence level, 384 students from across the university were invited to participate after informed consent. Data was analysed using Chi square tests at a probability of p < 0.05. RESULTS: Majority of the participants were undergraduates and non-smokers. Half of the population suffered from primary headaches. Headache sufferers experienced limited concentration due to an increased headache intensity during tests and/or the examination period. This negatively impacted on studying which was aggravated by consumption of caffeinated energy drinks, coffee and chocolate resulting in a less effective study session. Activities of daily living and participation in social events which usually leads to relaxation were neglected. Personal and emotional well-being was also negatively affected. Altered sleeping patterns and absence of study breaks also led to headaches. CONCLUSION: Headaches were found to impact on the students study and sleep patterns, their attention levels during lectures and their social and emotional life. Headaches negatively impacted on some participants leading to reduced focus on academic, family, social or leisure activities. Intensity of headaches increased during tests and examinations which could impact their success at University.

Incidence and profile of spinal tuberculosis in patients at the only public hospital admitting such patients in KwaZulu-Natal.

STUDY DESIGN: A retrospective chart review at the major provincial public hospital serving patients with spinal injuries/pathology. OBJECTIVES AND SETTING: To determine the incidence of spinal tuberculosis (Tb) and establish the profile of these patients treated at King George V Hospital (KGV) in KwaZulu-Natal, South Africa. METHODS: A total of 525 medical records for the period March 2005 to April 2006 were reviewed. Data from 104 files of Tb spine cases were categorized according to demographic details, medical conditions and length of stay in hospital. The South African mid-year 2006 census was used to calculate associations and risk rates for race, gender, adulthood, urbanization and employment and analyzed using the STATA version 9.0 statistical package. RESULTS: About 90% of the patients were African and 10% from other races. Females comprised 58% of the patients. The incidence of Tb spine is 1.02 per 100,000 and 3.13 per 100,000 for Africans and other races, respectively. The incidence rate is 1.17 per 100,000 females and 0.916 per 100,000 males. All the participants had a history of pulmonary Tb and 28% were human immunodeficiency virus positive. Thoracic spine was affected in 42% of the cases. About 32% presented with incomplete paraplegia. The average length of stay at this hospital for these patients was 41 days. CONCLUSIONS: About 20% of all patients seen for spinal conditions at KGV over the past year presented with Tb spine. A higher association between living in an urban area, adulthood (age 18+), being non-Black patients and the occurrence of spinal Tb was observed.

An alarming rate of drug-resistant tuberculosis at Ngwelezane Hospital in northern KwaZulu Natal, South Africa.

OBJECTIVE: To obtain a profile of tuberculosis (TB) cases caused by Mycobacterium tuberculosis in northern KwaZulu Natal (KZN) for 2001. METHOD: The demographic and drug resistance characteristics were determined. A total of 251 smear and culture confirmed cases was obtained and the resistance of three major anti-tuberculosis drugs was tested using the proportion method. RESULTS: The patients were mainly from Ngwelezane (57.8%), Stanger (23.5%) and Manguzi (18.7%); 59.0% were male; 54.2% of the isolates were obtained from new TB patients. The mean age of the TB patients was 29.6 years, with the maximum notification age range at 25-34 years. A high prevalence of drug-resistant and multiresistant TB was observed in this region. At least 55% of previously treated and 19% of new cases from all areas were resistant to at least one of the drugs tested. New patients from Ngwelezane and Manguzi area had a high prevalence of any rifampicin resistance (11.0%) and ethambutol resistance (3.9%), respectively. CONCLUSION: Our results indicate that the TB epidemic in northern KZN, especially in Ngwelezane, is severe. An infrastructure to educate stakeholders about the need to ensure consistency in treatment is needed.

School bag carriage and pain in school children.

PURPOSE: In South Africa (SA), anecdotal evidence for the incidence of shoulder, back and neck pain in school children is alarming but no scientific studies have confirmed this impression. The purpose of the present study was to determine the relationship between pain and school bag carriage in scholars in Durban, SA. METHOD: A study was carried out at four different schools in the Verulam and Chatsworth Regions in Kwa-Zulu Natal, SA. Schools were selected by convenience. One hundred and seventy six scholars between the ages of 11 and 14 years correctly filled out a questionnaire with open-ended and closed-ended questions. Each child also had his/her body and bag weight measured. RESULTS: In this study, most of the scholars experienced shoulder and a combination of shoulder and other bodily pain. The majority of the children carried backpacks over two shoulders. The type of bag carried was significantly related to pain experienced (0.00). A significantly larger number of female scholars experienced pain. CONCLUSION: The shoulder and other bodily pain experienced by the sample of scholars are strongly related to the type of bag and the gender of the children. More in-depth studies into identifying risk factors for bodily pains in school children are indicated.

Physiotherapists and human immunodeficiency virus/acquired immune deficiency syndrome: knowledge and prevention: a study in Durban, South Africa.

This study determined what physiotherapists in Durban, South Africa know about human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS), their attitudes towards patients and how they cope as individuals. Data were collected using a validated questionnaire. One-hundred-and-fourteen physiotherapists in Durban hospitals participated in the study. Seventy-two per cent of the questionnaires met the criteria for analysis. Ninety per cent of the participants believed that they knew about HIV/AIDS, but only 78% could identify all viral transmission modes. Of the 38 physiotherapists who believed that they knew the stages of an HIV infection, only 11% actually knew the stages, 28% could not explain them and 61% were vaguely aware. Fifty-six per cent of the respondents had treated patients who had died from HIV/AIDS. Only 38% of physiotherapists were completely at ease when treating HIV/AIDS patients despite the fact that 98% believed that physiotherapy was an integral component of the management of an AIDS patient. Fifty-one per cent of the respondents were unaware of support structures provided by their employers. The authors conclude that the perceptions of physiotherapists about their knowledge about HIV/AIDS do not stand up to scrutiny. Significantly more attention should be paid to the development, implementation and evaluation of the effectiveness of educational programmes on HIV/AIDS for physiotherapists in the workplace.

Anti-diarrhoeal evaluation of some medicinal plants used by Zulu traditional healers.

Aqueous and methanolic extracts of several medicinal plants, Psidium guajava (leaves), Aristea spp., Iridaceae family (stem), Bridelia micrantha (bark) and Eleutherina bulbosa (bulb), used by Zulu traditional healers were evaluated for anti-diarrhoeal activity against different experimental models of diarrhoea in rats as well as for anti-microbial activity against different pathogenic microorganisms that cause diarrhoea. The methanolic extract of P. guajava (leaves) was the only agent showing significant inhibitory activities against the growths of Salmonella spp. (two isolates), Shigella spp. (S. flexneri, S. virchow and S. dysenteriae) and enteropathogenic Escherechia coli (two isolates). The methanolic extract of B. micrantha (Bark) demonstrated weak inhibitory activities against S. flexneri and S. plesiomonas. Based on the results in experimental rat models, there were significant reductions in faecal output and frequency of droppings when plant extracts were administered compared with castor-oil treated rats. All plant extracts also significantly retarded the propulsion of charcoal meal and significantly inhibited the PGE(2)-induced enteropooling. The results have confirmed the effectiveness of all these Zulu medicinal plants as anti-diarrhoeal agents.

Abdominal motor unit activity during respiratory and nonrespiratory tasks.

Abdominal muscles serve multiple roles, but the functional organization of their motoneurons remains unclear. To gain insight, we recorded single motor unit potentials from the internal oblique (IO) and transversus abdominis (TA) muscles of three standing subjects during quiet breathing, a leg lift, and an expiratory threshold load. Inspiratory airflow, recorded from a pneumotachometer, provided tidal volumes and respiratory cycle timing. Fine wires, implanted under ultrasonic imaging, detected single motor unit potentials that were visually distinguished by their spike morphology. From the number of spikes, firing profiles, times of occurrence in the respiratory cycle, and their onset, instantaneous, mean, and peak firing frequencies we deduced that 1) breathing patterns varied across tasks, 2) different motor units were recruited for each task with essentially no overlap, 3) their firing displayed prominent expiratory activity during each task, and 4) the recruitment levels and discharge patterns of IO and TA were different. We conclude that the IO and TA motor pools receive a strong central respiratory drive, yet each pool receives its own distinct, task-dependent synaptic input.

An evaluation of the functional status of the residents of a geriatric residential facility in South Africa.

An increase in dependent elderly people together with a change in social structure from extended to nuclear families is resulting in institutionalization of the elderly. Since training of health care personnel is not keeping pace with the demands for health care, many institutions for the elderly are forced to function without the necessary health personnel. The purpose of the present study was to examine the functional status of the residents of one geriatric facility without health care personnel in Durban, South Africa. Functional status of each of the 101 residents was assessed using the Barthel Index. The results show that although overall Barthel Index scores showed that ageing or pathology did not influence numbers of functional elderly, individual analysis of items indicated that the majority of the residents could not perform basic functional tasks like feeding, bathing and climbing stairs.