Dissertation submitted in partial compliance with the requirements for the Master's degree in Technology: Homoeopathy, Technikon Natal, 1999. / The purpose of this study was to compare the relative effectiveness of miasmatic treatment as opposed to simillimum treatment in terms of the objective clinical findings in patients with acne vulgaris. / M

A microwave enhanced advanced oxidation process using hydrogen peroxide (MW/H₂O₂-AOP) was used for the release of nutrients and the destruction of solids from secondary municipal sewage sludge. The significant factors affecting the MW/H₂O₂-AOP that would yield maximum soluble substrates were studied. Using a computer statistical software package for experimental design and data analysis, four factors including microwave heating temperature, heating time, hydrogen peroxide dosage, and sludge solids content, were selected and examined. The initial sludge TS content and hydrogen peroxide dosage were the most significant factors for the solubilization of COD and nutrients release under the experimental conditions selected in this study. Overall, the maximum solubilization of nutrients was obtained at 2.5 % of total solids content, 2% of hydrogen peroxide by weight, 5 min. of microwave heating and 120 ºC. The effects of combination of microwave treatment and oxidative reagents on solids destruction and nutrients release were also investigated. Microwave enhanced advanced oxidation processes (MW-AOP), such as MW/O₃, MW/H₂O₂ and MW/H₂O₂/O₃, were conducted at 100 °C. In terms of nutrients release and solids reduction, the MW/H₂O₂/O₃-AOP yielded the best result. Subsequently, three factors including microwave heating temperature, hydrogen peroxide dosage, and ozone dosage, were investigated. The best result, in terms of the release of phosphate and ammonia, and solids reduction, was obtained with additions of 2 % hydrogen peroxide by weight and ozone dosage of 5.09 mg/ml, and operating at 120ºC. About 95%, 32% and 78% of TP, TKN and COD were released into the solution, respectively. The microwave enhanced advanced oxidation processes, with and without an addition of ferrous sulfate (MW/H₂O₂-AOP and MW/H₂O₂/Fe+²-AOP), were also studied for reducing solids, and solubilizing nutrients from the secondary sewage sludge. For the MW/H₂O₂/Fe+²-AOP, the best results of solubilization, in terms of orthophosphate, ammonia and soluble chemical oxygen demand, were obtained at treatment temperatures of 40 ºC, the yields decreased as the temperature was increased. The highest yields of solubilization were obtained at 60 ºC for orthophosphate, and at 80 ºC for both ammonia and soluble chemical oxygen demand. / Applied Science, Faculty of / Civil Engineering, Department of / Graduate

Acne is a common, chronic disorder that affects many adolescents. The most effective acne medication is systemic isotretinoin. It provides a permanent cure for many patients, but has various side effects. A South African Acne Treatment Guideline was introduced in 2005. Adherence to this guideline could lead to safer, more effective acne management. The primary aim of this study was to investigate the appropriateness of medications prescribed in the treatment of acne in South Africa, and to evaluate the safety and efficacy of systemic isotretinoin utilised by patients in the Nelson Mandela Metropole (NMM). A drug utilisation study (including 18 803 South African acne patients’ chronic prescription data between 2000 and 2005) and a patient questionnaire survey (including information from 57 patients in the NMM who used systemic isotretinoin) were conducted. Basic descriptive and interferential statistics were calculated. The drug utilisation study revealed that systemic antibiotics were the acne treatment prescribed to most (43.3 percent) patients, followed by 42.1 percent of patients on systemic isotretinoin, 33.2 percent on hormonal therapy and 18.9 percent on topical therapy. Topical retinoids were underused. The questionnaire survey indicated a lack of compliance by prescribers with guideline recommendations regarding the prescription (and accompanying counselling and monitoring) of isotretinoin. Incorrect cumulative doses were frequently prescribed, and a lack of proper implementation of pregnancy prevention measures was evident. The majority of isotretinoin patients reported a high efficacy of isotretinoin in clearing their acne.

Levels of diabetic care in primary health care settings in South Africa have been found to be sub-optimal. Knowledge deficits and inadequate practices have been implicated in the poor quality of local diabetes care. Type 2 diabetes and hypertension are commonly associated chronic conditions hence to optimise diabetic care, tight control of blood pressure is essential. Although guidelines for the overall management of diabetes in a primary health care setting have been published (Working Group of the National Diabetes Advisory Board, 1997; Society for Endocrinology, Metabolism and Diabetes of South Africa, 2002a), adherence to these guidelines has not yet been optimised in the primary health care setting. The objectives of the study were: to design and implement an educational intervention aimed at nursing staff, based on the South African guidelines for type 2 diabetes and hypertension, at a public sector primary health care clinic; to determine the impact of the educational intervention on the level of knowledge and attitudes of the nursing staff, and on the level of diabetic and blood pressure control achieved in the patient population, and to determine the impact of the educational intervention on pharmacological management of patients. A questionnaire was used to quantitatively assess the nursing staffs’ knowledge of the management of type 2 diabetes and hypertension at a primary health care level. A qualitative evaluation of the nursing staff attitudes was obtained using focus group interviews. The educational intervention, in the form of lectures and based on national diabetes and hypertension guidelines (Working Group of the National Diabetes Advisory Board, 1997; Society for Endocrinology, Metabolism and Diabetes of South Africa, 2002a; Milne et al., 2003), was then implemented and directed at the nursing staff at a primary health care clinic. A post-intervention evaluation was performed after four months by repeating the questionnaire and focus group interviews. Comparisons between the pre- and post-intervention questionnaire and focus group interviews evaluated the impact of the educational intervention on the knowledge and attitudes of nursing staff towards the management of type 2 diabetes. Pre- and post-intervention patient data was collected from patient medical files and compared to determine if the management of diabetes and hypertension improved in the patient population after the implementation of the educational intervention. The patient population consisted of 103 patients. The educational intervention resulted in an extremely significant improvement in the level of knowledge of the nursing staff [93 correct responses (28.3 percent; n = 329 (pre-intervention)) vs 223 correct responses (67.8 percent; n = 329 (post-intervention)); p < 0.0001, Fisher’s Exact test]. The educational intervention resulted in improved attitudes of nursing staff towards the management of diabetes. Ideal random blood glucose concentrations improved significantly [16 percent; n = 100 (pre-intervention) vs 22 percent; n = 100 (post-intervention); p = 0.0003; Student t test]. The number of patients with a compromised HbA1c level (> 8 percent) decreased by 2 [51; 49.5 percent, n = 103 (pre-intervention) vs 49, 47.5 percent, n = 103 (post-intervention)] which was not a significant improvement. Ideal blood pressure control improved by one from 38 patients [36.9 percent; n = 103 (pre-intervention)] to 39 patients [37.9 percent; n = 103 (post-intervention)] which was not significant. Optimal change of pharmacological management following the referral of an uncontrolled diabetic patient was only noted for 18 patients (20.2 percent, n = 89) referred in the post-intervention phase. Clinical inertia was identified as a major limitation to the optimisation of diabetes care. Implementation of an educational intervention based on the South African diabetes and hypertension guidelines at a public sector primary health care clinic was successful in improving the knowledge levels and attitudes of nursing staff

The search for the cure for cancer is currently a multi-billion dollar industry and the search for the elusive “magic bullet”, i.e. the perfect cancer drug that would interact therapeutically with cancerous tissues while having a minimal effect on healthy cells, is the topic of many research studies in the world today. A large number of novel drugs or drug complexes and conjugates are being synthesized and subjected to rigorous evaluation in the race to find the perfect cure. ECDG (Ethylene diCysteine DeoxyGlucose) seems to have promising cancer targeting ability. Even though this compound has been described in a few publications, we could not find any reference to the current use of ECDG in oncology clinics, either as a therapeutic agent, or as a diagnostic tool for imaging purposes. It was also not possible to purchase pure ECDG anywhere in the world. This prompted us to further investigate ECDG as a possible candidate for cancer targeting research, either as an imaging agent for cancer diagnosis or complexed with an anti-cancer agent for therapeutic purposes. Detailed investigations done in our laboratory can be divided into the following categories: - Development of a synthetic method for ECDG on a multigram scale ; - Purification of prepared ECDG not using the described dialysis method that only allows the purification of small quantities of ECDG (mg scale) ; Detailed investigation of the chemistry involved in the preparation of pure ECDG and its metal complexes ; - Investigation of the stability of ECDG and its metal complexes that is essential data required for any pharmaceutical agent ; - Preparation of ECDG complexes for use as a diagnostic tool, i.e. complexation with 99mTc ; Investigation of the bio distribution of ECDG-ReO complexes ; - Preparation of an ECDG kit as a diagnostic tool for use in oncology clinics. The development of novel aromatic ligands having similar characteristics compared to ECDG, containing an N2S2 chromophore as donor atoms, to further investigate their targeting capabilities, have also been investigated. All intermediates and final compounds were characterized mainly by ESI MS, in some cases IR and NMR whenever available. Successful preparation and purification of ECDG ands its metal complexes was achieved and extensively characterized and evaluated. Efforts directed towards the development of ECDG at NECSA, South Africa, were also rewarded with significant success. Furthermore, significant development regarding the synthesis of two novel compounds with ECDG-like characteristics was also completed.

Type 2 diabetes mellitus (T2DM) is rapidly emerging as one of the greatest global health issues of the 21st century. Insulin-resistance is a condition associated with T2DM and in the cell it is defined as the inadequate strength of insulin signalling from the insulin receptor downstream to the final substrates of insulin action involved in multiple metabolic, gene expression, and mitogenic aspects of cellular function. To investigate the potential mechanisms involved in the development of insulin-resistance, two in vitro liver cell models were established using palmitate or a combination of insulin and fructose as inducers. The development of insulin-resistance was determined via the capacity of the hepatocytes to maintain normal glucose metabolism functionality by measuring hepatic gluconeogenesis and glycogenolysis. It was established that the treatments induced the development of insulinresistance after 24 hours chronic exposure. Previous studies have investigated the potential of Sutherlandia frutescens extracts as therapeutic agents for insulin-resistance. The aim of this study was thus to investigate the ability of a hot aqueous extract of S. frutescens to reverse the insulin-resistant state, via measuring gluconeogenesis and glycogenolysis, the associated changes in cellular physiology (lipid accumulation, oxidative stress, and acetyl- CoA levels), and changes in mRNA expression. The results showed that S. frutescens had a significant effect on reversing the insulin-resistant state in both models of insulin-resistance. Furthermore, S. frutescens was capable of reducing lipid accumulation in the form of triacylglycerol in the high insulin/fructose model, while this was unaffected in the palmitate model. However, S. frutescens did reduce the accumulation of diacylglycerol in the palmitate model. Oxidative stress, seen to be associated with the insulin-resistant state, was successfully treated using the extract, as indicated by a reduction in reactive oxygen species. However no change was seen in the nitric oxide levels, in either model. Interestingly, although S. frutescens had no effect on the level of acetyl-CoA in the insulin/fructose model, it was found to increase this in the palmitate model. It is suggested that this may be due to increased β-oxidation and metabolic activity induced by the extract. The analysis of mRNA expression gave some insight into possible mechanisms by which insulin-resistance develops, although the results were inconclusive due to high variability in samples and the possibility of the RNA being compromised. Future studies will address this issue. The results of this study reflect different proposed clinical causes of insulin-resistance through the responses seen in the two cell models. These indicate that liver steatosis and insulin-resistance are induced by high palmitate as well as high insulin and fructose levels, and reversed by S. frutescens. Therefore the potential of S. frutescens to be used as a therapeutic agent in the treatment of insulin-resistance is indicated by this study.

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No description available.

Adopting a social problems framework, the relation between certain sociological factors and rehabilitation was analyzed for a group of alcoholic patients treated at an out-patient clinic. It was hypothesized that favourable socio-economic characteristics, such as being married and living with wife, being employed, living in acceptable housing, were related to treatment success. Six such factors, one of them a motivational index,were incorporated into a prognostic index by a Danish researcher. This index was replicated with data gathered during interviews with 155 male patients for a follow-up study during 1962/63. Treatment results and factors associated with treatment were analyzed both quantitatively and qualitatively. Stepwise regressions showed that socio-economic data combined into an index did not predict treatment outcome with any degree of accuracy for the Canadian sample. Housing, type of spirit consumed and age emerged as a "best" predictor, accounting for roughly 8 per cent of the variance involved in successful treatment outcome. The hypothesis was not confirmed that socio-economic factors are associated with rehabilitation, but it was found that certain social control factors, which are associated with socio-economic factors, are conducive to rehabilitation if treatment is given at out-patient clinics. The inferences drawn from the findings suggested both certain theoretical and practical implications for treatment. These were spelled out in some detail following Talcott Parsons' theory of social control and deviance, and definitions of illness and health in the light of North American values and social structure. / Arts, Faculty of / Sociology, Department of / Graduate

Because the Indian Act is central to any discussion of Indian Affairs in Canada, it forms the focus of this study. This is not intended to be a study of law or jurisprudence. It reviews the welfare implications of the Indian Act in as orderly a sequence as possible, and applies social welfare concepts to the Canadian Indian, which are not yet customarily applied when his status is being evaluated. To do this, it is necessary not only to review the present Indian Act, but the original Indian Act, and appropriate reports, surveys and studies of Indian affairs from 1875 to the present. Its primary focus, however, is on the Indian today who is looking to full citizenship as never before. After an examination of the general background, the method is to evaluate the property rights and citizenship rights of Indians. An understanding of these rights is basic to any study of Indian affairs. Social assistance and child welfare are also perused and compared with existing standards of welfare. Chapter III deals with three fundamental social services: education, health and housing. The results indicate continuing evidence of what is, in effect, second-class citizenship for the Canadian Indian. In several areas, typical services and treatment are below those afforded most other Canadians. Some guides to a new approach are indicated, aimed at stimulating underdeveloped skills, and enlarging opportunities, which will enable Indians to attain equality with their fellow Canadians. / Arts, Faculty of / Social Work, School of / Graduate