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1.
S Afr Med J ; 112(6): 433-436, 2022 05 31.
Article in English | MEDLINE | ID: mdl-36217873

ABSTRACT

BACKGROUND: Dobutamine stress echocardiography (DSE) is a well-established modality for the diagnosis of coronary artery disease, but there are no reported diagnostic data in southern Africa. Objectives. To compare the safety, sensitivity and specificity of a South African (SA) DSE programme with larger, international series. Methods. All patients undergoing DSE from 2019 to 2021 at a single SA centre were included. A new wall motion abnormality (≥2 segments) signified inducible ischaemia. Results. A total of 106 patients (mean (standard deviation) age 61 (11) years, 68% male) were analysed. Six patients (6%) experienced chest pain during DSE and 4 (4%) developed an atrial arrhythmia. The sensitivity and specificity for epicardial coronary stenosis were 77% and 74%, respectively, changing to 82% and 72% when excluding those who had previous coronary artery bypass surgery. Conclusion. The sensitivity, specificity and safety of an SA DSE programme were comparable to international series. A DSE programme is feasible in a resource-constrained environment.


Subject(s)
Dobutamine , Echocardiography, Stress , Aged , Echocardiography/methods , Female , Humans , Male , Middle Aged , Sensitivity and Specificity , South Africa
2.
J Psychiatr Ment Health Nurs ; 20(8): 687-95, 2013 Oct.
Article in English | MEDLINE | ID: mdl-22988983

ABSTRACT

In developing countries such as South Africa, not much is known about the prevalence of assaults and seclusion occurring in mental health wards over time. Here, we describe a 5-year trend in assaults and seclusions, stratified by gender, at Stikland Hospital, South Africa. A retrospective review of clinical records of patients admitted to the acute psychiatric admission wards at Stikland and involved in assault and secluded was undertaken between 1 January 2005 and 31 December 2010. Data on the number of patient and staff assaults as well as seclusions, gender, age, marital status, level of education, level of income, duration of hospital admission and primary psychiatric diagnosis were collected. Significantly (P < 0.01) more men than women engaged in patient assaults, while significantly (P < 0.01) more men were secluded than women. On a monthly basis, the number of gender-stratified patient assaults and seclusions significantly increased (P < 0.01) throughout the study period. In conclusion, we show here that gender had a significant effect on both patient assault and seclusion numbers, which increased towards the end of the study period. Monitoring of these events is therefore important to continuously improve quality of care.


Subject(s)
Aggression/psychology , Developing Countries , Mental Disorders/nursing , Mental Disorders/psychology , Patient Isolation/psychology , Patient Isolation/statistics & numerical data , Psychiatric Department, Hospital/statistics & numerical data , Adolescent , Adult , Aged , Bipolar Disorder/epidemiology , Bipolar Disorder/nursing , Bipolar Disorder/psychology , Female , Humans , Male , Marijuana Abuse/epidemiology , Marijuana Abuse/nursing , Marijuana Abuse/psychology , Mental Disorders/epidemiology , Middle Aged , Retrospective Studies , Schizophrenia/epidemiology , Schizophrenia/nursing , Schizophrenic Psychology , Sex Factors , South Africa , Utilization Review/statistics & numerical data , Young Adult
3.
Arch Androl ; 31(2): 127-31, 1993.
Article in English | MEDLINE | ID: mdl-8215692

ABSTRACT

The aim of this study was to evaluate the influence of sperm morphology, swim-up concentration, and insemination volume on pregnancy outcome in patients undergoing gamete intrafallopian transfer (GIFT) treatment in whom the male partner had a morphology of less than 14%. Only patients who received four oocytes were entered into this study (n = 103). In all cases the swim-up procedure time was standardized to 1 h and the insemination concentration was standardized to 500,000 per oviduct. There was no significant difference in pregnancy rate when normal morphology, swim-up concentration, or insemination volume were used as predictors. In the P pattern group (< 4% normal forms) only four of the 28 (14%) patients had ongoing pregnancies, whereas in the G pattern group (5% to 14% normal forms) 16 out of 75 (21%) had ongoing pregnancies (P vs G, p > 0.05; not significant). The fertilization rate among excess oocytes in the P pattern group was 18% but was 39% (p < .0001) in the G pattern group. When an attempt was made to compensate for low morphology by increasing insemination concentration no significant difference in the pregnancy rate between the P and G pattern groups in the GIFT program was recorded. This was not the case when the in vitro fertilization rate was used as an endpoint. Insemination volume and swim-up concentration played no role in pregnancy rate.


Subject(s)
Gamete Intrafallopian Transfer , Semen/physiology , Female , Humans , Male , Pregnancy , Sperm Count
4.
J Assist Reprod Genet ; 10(2): 141-4, 1993 Feb.
Article in English | MEDLINE | ID: mdl-8339018

ABSTRACT

PURPOSE: It may sometimes be necessary to regulate cycles in assisted reproduction. Cycles can be regulated with gonadotropin releasing hormone (GnRHa) agonist but other methods can also be used. The aim of this study was to compare the pregnancy rate in a gamete intrafallopian transfer (GIFT) program in patients receiving a contraceptive pill/Clomid/human menopausal gonadotropin (hMG) regimen (study group), with the standard Clomid/hMG regime (control group). Fifty one patients in the study group were carefully matched for patient age, infertility diagnosis (female), semen parameters, number of follicles, and number of oocytes transferred into consideration with a control group. RESULTS: The overall pregnancy rate was 21.6% (11/51) in the study group and 47% (24/51) in the control group (P = 0.01). However, the ongoing pregnancy rate in the two groups did not differ significantly, 11.8% (6/51) vs 27.5% (14/51) (P = 0.08). In the study group, 7.8% of patients had to be seen over a weekend, compared to 13.7% in the control group (not significant). CONCLUSION: From the findings we conclude that, although this method of controlling cycles can be useful in selected patients, it is not the ultimate method.


Subject(s)
Clomiphene/pharmacology , Desogestrel/pharmacology , Gamete Intrafallopian Transfer , Menotropins/pharmacology , Ovulation Induction , Adult , Clomiphene/administration & dosage , Desogestrel/administration & dosage , Drug Therapy, Combination , Female , Humans , Infertility, Female/drug therapy , Male , Menotropins/administration & dosage , Pregnancy , Retrospective Studies
5.
Fertil Steril ; 58(3): 581-6, 1992 Sep.
Article in English | MEDLINE | ID: mdl-1521655

ABSTRACT

OBJECTIVE: To determine the effect of oocyte maturity on pregnancy rate (PR) in patients undergoing gamete intrafallopian transfer (GIFT) procedures for infertility and in whom male partners had either normozoospermia or teratozoospermia. DESIGN: A prospective study using a combination of clomiphene citrate and human menopausal gonadotropin for ovulation induction was carried out. Five hundred thirty-seven GIFT treatment cycles were analyzed, and 423 cycles yielded four or more oocytes. Patients were divided into two groups according to the sperm morphology: those with less than 14% normal forms and those with greater than 14% normal morphology (as judged by strict criteria). These two groups were divided into a further five subcategories depending on the number of metaphase II oocytes transferred. RESULTS: In the group less than 14% normal forms (category I; 4 metaphase I oocytes replaced), three pregnancies resulted from 33 cycles (9.09%), and in category V (4 metaphase II oocytes transferred) the PR was 15% (14/95) per cycle. In the group with greater than 14% normal forms, in category I, the PR was 16% (3/19) per cycle, and in category V, the PR was 33% (20/61) per cycle. The effect of morphology (less than 14% normal forms versus greater than 14% normal forms) on pregnancy outcome is significant (P = 0.0161). The overall effect of increasing the number of metaphase II oocytes on the pregnancy outcome was not significant (P = 0.1098). However, in the group with greater than 14% normal forms, there was a significant improvement in PR (P = 0.04) in category V. CONCLUSION: During this prospective study, it was shown that sperm morphology plays a significant role in the pregnancy outcome in a GIFT program.


Subject(s)
Gamete Intrafallopian Transfer , Infertility, Male/therapy , Oocytes/physiology , Spermatozoa/abnormalities , Female , Humans , Male , Metaphase , Pregnancy
6.
Hum Reprod ; 7(2): 242-7, 1992 Feb.
Article in English | MEDLINE | ID: mdl-1577939

ABSTRACT

The prediction of human fertilization is an important aspect of research protocols dealing with male fertility. Sperm DNA has been reported to be an indicator of human sperm fertility potential. The Acridine Orange test for evaluation of sperm DNA has been employed during the present study to determine its relationship with human sperm morphology and fertilization in vitro. Seventy-six patients from the in-vitro fertilization (IVF) and/or gamete intra-Fallopian transfer (GIFT) programme were randomly selected for the study. All patients had a routine semen analysis, sperm DNA evaluation and underwent standard IVF procedures at the time of the study. The results indicated a moderate positive correlation (r = 0.38, P = 0.0006) between results of the Acridine Orange test and normal sperm morphology. Patients with an Acridine Orange test value exceeding 24% had significantly higher oocyte fertilization rates than patients with lower values, for metaphase I (74 versus 51%, P = 0.0008) and for metaphase II oocytes (88 versus 60%, P = 0.0001). Sperm morphology, however, proved to be a more significant predictor of fertilization in vitro compared to the Acridine Orange test.


Subject(s)
Acridine Orange , Spermatozoa/cytology , Fertilization in Vitro , Humans , In Vitro Techniques , Male , Sperm Count , Sperm Motility
7.
Arch Androl ; 26(2): 67-70, 1991.
Article in English | MEDLINE | ID: mdl-2036050

ABSTRACT

Lead and organophosphates can exert a toxic action on the male reproductive function. A cross-sectional study involving 40 men was undertaken to investigate the effect of these toxins on sperm morphology. Based on the percentage of morphologically normal spermatozoa, subjects were divided into two groups. The control group (sperm morphology greater than or equal to 20% normal forms) consisted of 18 patients, and the study group (sperm morphology less than 5% normal forms) consisted of 22 patients. Lead, pseudocholinesterase, dibucaine, and fluoride levels were measured in blood samples of these men. The 22 men with low morphologically normal forms (less than 5%) did not display significantly different levels of the abovementioned substances compared to the control group.


Subject(s)
Lead/pharmacology , Organophosphorus Compounds/pharmacology , Spermatozoa/cytology , Butyrylcholinesterase/blood , Dibucaine/blood , Fluorides/blood , Humans , Male , Spermatozoa/drug effects
8.
Arch Androl ; 26(1): 25-9, 1991.
Article in English | MEDLINE | ID: mdl-2009027

ABSTRACT

The effect of alcohol on spermatogenesis and sperm morphology has been of interest to many andrologists. Six adult male vervet monkeys were utilized to evaluate the effect of ethanol on semen quality. A decrease of the percentage of normal spermatozoa was observed after 10 months of exposure to alcohol.


Subject(s)
Ethanol/pharmacology , Spermatozoa/drug effects , Animals , Chlorocebus aethiops , Dose-Response Relationship, Drug , Ethanol/administration & dosage , Male , Sperm Count , Spermatogenesis/drug effects , Spermatozoa/cytology
9.
S Afr Med J ; 77(12): 634-6, 1990 Jun 16.
Article in English | MEDLINE | ID: mdl-2193405

ABSTRACT

The results of the in vitro fertilisation programme at Tygerberg Hospital for the period April 1983 to January 1988 are presented. Of the 1117 laparoscopies performed, 825 patients reached the transfer stage. A live-birth rate of 9.3% was achieved. The pregnancy rate after transfer of 4 embryos was 25.9% compared with 15.4% after 2 embryos and 10.8% after 3 embryos (P = less than 0.0001). The multiple pregnancy rate was 2.8% in the group receiving 2 embryos and 11.7% and 10.4% in those receiving 3 and 4 embryos, respectively. Of the 77 successful pregnancies (90 babies), 1 baby died at 34 weeks' gestation as the result of abruptio placentae due to preeclampsia and 1 cot death occurred. The only congenital abnormality encountered was a cleft palate.


Subject(s)
Fertilization in Vitro , Female , Humans , South Africa
10.
S Afr Med J ; 77(12): 630-1, 1990 Jun 16.
Article in English | MEDLINE | ID: mdl-2113716

ABSTRACT

Infertility is a common presenting symptom in women with genital tuberculosis. A study was undertaken to determine the prevalence and characteristics of this disease among the infertile patients (A and B income group) attending the Reproductive Biology Unit at Tygerberg Hospital. Between June 1986 and December 1987, the menstrual fluid from 451 infertile women was cultured for Mycobacterium tuberculosis using Löwenstein-Jensen medium. A prevalence of 7.98% (36/451) was found. Laparoscopic examination of the pelvis revealed bilateral tubal occlusion in 3 patients (8.3%); peritubular adhesions were present in 17 patients (47.2%). In the remaining 16 patients (44.5%), the pelvis was considered normal. No culture-positive patient gave a history of previous infection or contact with tuberculosis. Radiography of the chest and histological examination of the endometrium showed no evidence of infection. Of the 34 patients treated, 13 (38.2%) became pregnant after antituberculosis treatment was completed. If tuberculosis occurs in a population, menstrual fluid of infertile women should be cultured routinely for M. tuberculosis, especially if there is evidence of tubal damage.


Subject(s)
Infertility, Female/etiology , Tuberculosis, Female Genital/complications , Adolescent , Adult , Body Fluids/microbiology , Female , Humans , Menstruation , Mycobacterium tuberculosis/isolation & purification
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