M.Med. (Obstetrics and Gynaecology), Faculty of Health Sciences, University of the Witwatersrand, 2011 / Background Estimation of fetal weight during labour at term is frequently done to decide if there is a risk of cephalopelvic disproportion or shoulder dystocia. Estimation of fetal weight by clinical palpation has been shown to be as good as ultrasound in labour at term, giving estimates that are correct to within 10% of the birth weight in 60% to 70% of cases. Symphysis-fundal height (SFH) measurement may offer an easier method of fetal weight estimation, but no simple formula is currently available. The objective of this study was to validate a formula calculated from unpublished work done at Chris Hani Baragwanath hospital, where birth weight in g = 100 (SFH in cm – 5) for term intrapartum measurements. In that study, the formula gave estimates correct to within 10% of the birth weight in 67% of cases. Methods This was a prospective cross-sectional study done on women at term with singleton live cephalic presentations at the Charlotte Maxeke Johannesburg Academic Hospital and Chris Hani Baragwanath Hospital. All participants were in the active phase of the first stage of labour. The author performed abdominal palpation, and measured SFH twice, taking the average of the two measurements as the SFH. Maternal heights, weights, membrane status and level of the head were also recorded. The SFH measurements were transformed into estimated birth weights using the formula, and these were compared with the actual birth weights. 7 Results The researcher assessed 294 women, 289 of them being black African. The mean birth weight was 3221 g and the mean SFH was 37 cm, which equated to a mean estimated birth weight, using the formula, of 3200 g. Simple linear regression between SFH and birth weight gave a correlation coefficient (r) of 0.56. The mean percentage error in fetal weight estimation using the formula was 8.7%. Sixty-five per cent of estimations were found to fall within 10% of the actual birth weight. Fetal weight estimates were best (mean percentage error 6.8%) in the birth weight range of 3000 g to 3499 g, and worst at the extremes of term birth weight. Conclusion The birth weight formula was validated in this study, giving very similar results to those found in the original research that described the formula. The formula may be applied by clinicians in environments that serve populations similar to those that participated in this study.

Diss. (sammanfattning) Uppsala : Univ., 2000. / Härtill 5 uppsatser.

Note:

Wong Pui On Raymond. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2004. / Includes bibliographical references (leaves 105-120). / Abstracts in English and Chinese. / Contents --- p.i / Abstract --- p.vi / Statement of originality --- p.xii / Acknowledgments --- p.xiii / List of figures and tables --- p.xiv / Abbreviations --- p.xvii / Publications --- p.xx / Text / Chapter Chapter 1: --- Introduction and Objectives --- p.1 / Chapter 1.1 --- Neonatal Sepsis --- p.2 / Chapter 1.2 --- Markers of Infection --- p.4 / Chapter 1.2-1 --- Clinical markers for sepsis --- p.4 / Chapter 1.2-2 --- Cytokines as markers of sepsis --- p.7 / Chapter 1.2-3 --- Cell surface receptors as markers of sepsis --- p.8 / Chapter 1.3 --- The immune system in response to pathogen challenge --- p.10 / Chapter 1.3-1 --- Source of cytokines --- p.11 / Chapter 1.4 --- General outline of cytokines implicated in sepsis --- p.12 / Chapter 1.4-1 --- IL-2 --- p.13 / Chapter 1.4-2 --- IL-4 --- p.15 / Chapter 1.4-3 --- IL-5 --- p.16 / Chapter 1.4-4 --- IL-6 --- p.17 / Chapter 1.4-5 --- IL-10 --- p.18 / Chapter 1.4-6 --- IFN-γ --- p.19 / Chapter 1.4-7 --- TNF-α --- p.21 / Chapter 1.5 --- General outline of cell surface receptors implicated in sepsis --- p.23 / Chapter 1.5-1 --- CDllb --- p.23 / Chapter 1.5-2 --- CD64 --- p.24 / Chapter 1.5-3 --- CD45RO --- p.25 / Chapter 1.5-4 --- CD25 --- p.26 / Chapter 1.6 --- Aims of study --- p.27 / Chapter Chapter 2: --- Materials and methods --- p.31 / Chapter 2.1 --- Patients inclusion criteria and classification --- p.32 / Chapter 2.2 --- Sample collection and sepsis screening --- p.33 / Chapter 2.3 --- Quantitation of cell surface antigens --- p.35 / Chapter 2.3-1 --- Cell acquisition and calculation --- p.37 / Chapter 2.4 --- Quantitation of plasma cytokines --- p.38 / Chapter 2.4-1 --- Cytometric Beads Array assay --- p.40 / Chapter 2.5 --- Statistical Analysis --- p.41 / Chapter Chapter 3: --- "Cell surface and plasma cytokine markers for the diagnosis of late-onset sepsis in preterm, very low birthweight (VLBW) infants" --- p.51 / Chapter 3.1 --- Results --- p.52 / Chapter 3.1-1 --- Lymphocyte markers: CD25 and CD45RO --- p.52 / Chapter 3.1-2 --- Neutrophil markers --- p.53 / Chapter 3.1-2a --- CD64 --- p.54 / Chapter 3.1-2b --- CDllb --- p.55 / Chapter 3.1-3 --- Purified CDllb --- p.56 / Chapter 3.1-4 --- Comparison of cell surface markers --- p.56 / Chapter 3.1-5 --- Interluekin 6 (IL-6) and C-Reactive Protein (CRP) --- p.57 / Chapter 3.2 --- Combined analysis of diagnostic markers --- p.58 / Chapter 3.3 --- Discussion --- p.58 / Chapter Chapter 4: --- Proinflammatory and anti-inflammatory cytokine response in preterm very low birthweight infants (VLBW) with systemic infections --- p.82 / Chapter 4.1 --- Results --- p.83 / Chapter 4.1-1 --- Correlation of cytokine levels in infected patients --- p.84 / Chapter 4.2 --- Subgroup analysis --- p.85 / Chapter 4.2-1 --- Proinflammatory and anti-inflammatory cytokine ratios --- p.85 / Chapter 4.2.2 --- The deceased case --- p.86 / Chapter 4.3 --- Discussion --- p.87 / Chapter Chapter 5: --- General Discussion and Conclusions --- p.97 / Chapter 5.1 --- General Discussion --- p.98 / Chapter 5.1-1 --- Cell surface markers --- p.98 / Chapter 5.1-2 --- Infection markers with prognostic significance --- p.100 / Chapter 5.1-3 --- Limitations of infection markers in clinical applications --- p.100 / Chapter 5.2 --- Conclusions and future development --- p.102 / Chapter 5.2-1 --- Conclusions --- p.102 / Chapter 5.2-2 --- The future development --- p.102 / References --- p.105

A research report submitted to Faculty of Health Sciences, as a requirement for completion of Masters of Medicine in Paediatrics, University of the Witwatersrand, Johannesburg, 2018 / Background. Candidemia is a significant cause of morbidity and mortality in infants. The mortality rate ranges between 21% and 76%. Non-albicans candida (NAC) is increasing in incidence and resistance to azoles. Very low birth weight (VLBW) infants have numerous risk factors which predispose them as a group to invasive candidemia. Methods. A retrospective case control study of candidemia in VLBW infants admitted to the neonatal unit at Charlotte Maxeke Johannesburg Hospital (CMJAH) between 01 January 2015 to 31 December 2017 was undertaken. Clinical and demographic characteristics of VLBW infants who developed candidemia, commonest Candida species, antifungal susceptibility profiles and outcomes defined as death were identified. 71 infants with confirmed positive blood cultures for candidemia from the NHLS database were selected and each case was allocated 3 controls; the final sample comprised 284 infants. Results. Bacterial sepsis, chronic lung disease (CLD), necrotising enterocolitis (NEC) and NEC surgery, other surgery, anaemia and ventilation, all showed a strong association with development of candidemia in the infants. The most common isolate was Candida parapsilosis (59.1%), followed by Candida albicans (30.9%). The cases of candidemia overall and NAC isolates increased over the study years. Resistance to azoles by NAC was demonstrated. Mortality was 31.2% and 28.2% in controls and cases respectively. The difference in death between the two groups was not statistically significant. 7 A research report submitted to Faculty of Health Sciences WITS, as a requirement for completion of Masters of Medicine; Paediatrics. Johannesburg, South Africa 2018. Conclusions. The study demonstrated a predominance of NAC isolates, increasing rate of candidemia and increased resistance to azoles. Stricter infection control measures and medical intervention strategies should be implemented / GR 2020

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Thesis MMed (Paediatrics), Faculty of Health Sciences, University of the Witwatersrand / INTRODUCTION: Improved survival of VLBW infants is raising several management issues. An example is that of growth and growth monitoring. AIM OF THE STUDY: To assess the growth of a cohort of VLBW infants born at CMJAH from term CGA to 20 months CGA. METHODS: A retrospective chart review was conducted on 139 VLBW infants (birth weight ≤ 1500g) born at CMJAH between 1 July 2006 and 28 February 2007. RESULTS: Comparison with a term growth reference showed initial growth failure followed by gradual catch up growth but with persistent deficits in length for age. Comparison with international VLBW references showed similar growth for weight and head circumference for age but with deficits in length for age. Growth parameters of the study sample were similar to those of other South African VLBW infants. CONCLUSION: Growth and growth monitoring in VLBW infants is complicated by characteristic growth patterns, high associated morbidity, controversies surrounding ideal growth and lack of an ideal growth reference. Significant deficits in length for age in the study sample may have been due to the large proportion of infants born SGA and the high prevalence of stunting in South African children. Current recommendations for growth monitoring of VLBW infants include the use of a VLBW reference up to two years CGA followed by a term growth reference thereafter

A research report submitted to the Faculty of Health Sciences Witwatersrand University, Johannesburg in partial fulfillment of the requirements for the degree of Master of Medicine in Family Medicine Johannesburg, South Africa 2017 / Background: Low birth weight (LBW) is an important risk factor for infant developmental problems, morbidity and mortality. Low birth weight babies are twenty times more likely to die during the neonatal period than their normal weight counterparts. Although risk factors for low birth weight vary from one community to another, maternal risk factors for low birth weight in the South Rand Hospital (Johannesburg, Gauteng) catchment area have not been investigated. The objective of this study was to determine maternal risk factors for low birth weight in South Rand Hospital, Johannesburg. Method: This 1: 1 matched case-control study was conducted on a total of 480 mothers who delivered babies at South Rand Hospital between 1 January 2013 and 31 December 2014. The cases were 240 mothers who delivered singleton term live LBW babies. They were matched with an equal number of controls. Results: Conditional logistic regression showed that, no anaemia in the third trimester (OR=0.54, 95% CI= 0.30-0.99), immigration status (OR= 0.46, 95% CI= 0.25- 0.85) and four or more antenatal care clinic attendance (OR=0.36, 95% C.I= 0.12- 0.76) were protective factors, while smoking during pregnancy (OR= 8.69, 95% CI= 2.70-28.35) predisposes to delivering a LBW baby. Conclusion: The results showed that smoking during pregnancy is a risk factor for LBW, while maternal third-trimester haemoglobin level of 11g/dl or more, immigrant status, and more than three ANC visits were protective factors for delivering LBW baby. / MT2017

No description available.