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A dissertation presented in partial compliance with the requirements for the Master's Degree in Technology: Chiropractic, Durban Institute of Technology, 2005. / The paucity of clinical research into the cause of canine hip dysplasia, efficacy and effects of the different treatment protocols available for the management of symptoms, as well as the differing presentations, has led to a continued variation in standardized care for this condition. The aim of this study was to contribute further information on the use of instrument manipulation as an alternative or adjunctive means of managing the symptoms of canine hip dysplasia. Both manual and instrument manipulation have effectively been used in the short-term management of human musculoskeletal pconditions, it was hypothesized that the use of instrument manipulation would benefit the canine patient. The use of human based studies was a guideline, as no previous chiropractic studies have been conducted on the canine subject. / M

ABSTRACT Fetal abnormalities are congenital abnormalities that are identified prenatally, which may be structural or functional in nature. Genetic counselling is a non-directive and non-judgmental process of information-giving, at the same time as providing psychosocial support. It is offered to women and their partners who have a fetal abnormality detected during pregnancy. When a fetal abnormality is detected, the patient can sometimes be offered a termination of pregnancy, and the decision of whether or not to continue the pregnancy is made by the patient. The first aim of this research was to conduct an audit of the genetic counselling service provided by the Division of Human Genetics, NHLS and WITS, in order to assess the level of service being offered to patients with diagnosed fetal abnormalities. The second aim of the research was to determine what factors, if any, influenced the decision patients made regarding whether to continue or interrupt their pregnancy. One hundred and seventy one files of women, who received genetic counselling for an identified fetal abnormality during pregnancy from the division between 2002 and 2006, were included in the retrospective clinical audit. The patients seen for genetic counselling represent 1.1 % of the estimated number of women in Johannesburg who could have had abnormalities detected prenatally, based on the prevalence of congenital disorders in the area and an ultrasound prenatal detection rate of 56.2 %. Two thirds of patients who were offered TOP chose to terminate their pregnancy. The most clinically significant predictor of the decision to terminate an affected pregnancy was found to be an earlier gestation at offer of TOP, which suggests that earlier detection and diagnosis of abnormalities is beneficial to patients. Overall, 62 % of patients were not offered genetic counselling follow-up appointments after conclusion of their pregnancy. The genetic counselling service offered to patients thus needs to be improved, in particular, the follow-up service patients receive after TOP or delivery is not adequate.

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Abstract not available

The notion surfaces that, as fish evolved, left the sea and colonised the land, they then needed not only a supply of tears for their ocular surface to function, but also a means by which tears could be eliminated. The fascinating study of abnormalities of this system, which are common, frequently debilitating, and can be challenging to manage, is the purpose of this thesis. An attempt has been made initially to assess our current state of knowledge in the Introduction. In subsequent chapters, new concepts including plerolacrima, temporal plical shift and videoreflective dacryomeniscometry are introduced; some of these should prove useful clinically. Quality of life in affected preoperative and postoperative cohorts is then assessed. Original publications have been achieved in all but one of the following subsections. Conjunctivochalasis in watery eye patients has been examined for the first time in a sizeable study clinically and histopathologically. The lateral tarsal strip procedure has been described as a new method of dealing with the punctal apposition syndrome. A new assessment for success in dacryocystorhinostomy (DCR) surgery, the Valsalva bubble test, has been carried out. Tear osmolality has been studied in watery eye cohorts and compared with normal controls; this study suggests that tear production decreases significantly with obstructed lacrimal outflow. Videoreflective dacryomeniscometry has shown that watery eye patients have a higher tear meniscus than normal controls, and that this normalises following DCR surgery. Lower eyelid tensometry has been shown in patients to be unchanged compared with normal controls. Computerised tomography of the lacrimal drainage region has been used to study patients with nasolacrimal duct obstruction. The detailed clinical mechanics of syringing the canaliculus have been described. Transcaruncular medial orbitotomy surgery for laxity of the medial canthal tendon has been tested in human cadavers, and evaluated in adult living humans. In summary, this thesis may be regarded as a tentative approach to a re-evaluation of the clinical management of the watery eye.

"January 2004" / Includes bibliographical references (leaves 178-201) / Accompanying CD-ROM contains raw data for the thesis / Systems requirements for accompanying CD-ROM: IBM PC or compatible; CD-ROM drive; Adobe acrobat reader / xv, 201 leaves : ill. (some col.), plates (col.) ; 30 cm. + 1 CD-ROM (col. ill. ; 4 3/4 in.) / Title page, contents and abstract only. The complete thesis in print form is available from the University Library. / Thesis (Ph.D.)--University of Adelaide, Dept. of Obstetrics and Gynaecology, 2004

Graduation date: 2005