M.Tech. / The aim of this study was to compare the effectiveness of cervical adjustment therapy, dry needling of the levator scapulae muscle and a combination of the two in the treatment of chronic mechanical neck pain. Forty-five patients were recruited via posters and advertisements from in and around the University of Johannesburg. The participants had to present with bilateral neck pain, decreased range of motion and an active levator scapulae muscles trigger point, which was diagnosed using range of motion and trigger point examination. The participants were randomly allocated into three groups of fifteen participants each. Prior to treatment a full case history, physical examination and cervical regional examination were performed to ensure that the patients were eligible to partake in the clinical trial. Group 1 was the adjusting group; group 2 was the combination group while group 3 was the needling group. Participants were treated five times over a period of three weeks. The objective measurements used in this clinical trial involved a cervical range of motion instrument (C.R.O.M., Performance Attainment Associates) and an algometer (Wagner Instruments). Subjective measurements were achieved using the Neck Pain and Disability Index (Appendix G) and the Numerical Pain Rating Scale (Appendix H). Each measurement was taken prior to treatment on the first and third visits and after treatment on the fifth visit with three measurements per participant overall. The statistical analysis was conducted using the Kruskal-Wallis, Friedman and Wilcoxon tests to compare data. The results indicated that the three groups responded favourably to their respective treatments. Overall, this study has indicated that dry needling of the Levator scapulae muscle provides no statistically significant contribution to the conservative treatment of mechanical neck pain caused by levator scapulae trigger points.

No description available.

No description available.

No description available.

No description available.

No description available.

Magister Curationis / Herbal and homeopathic compounds have been used to aid in childbearing and pregnancy for centuries. Much of this information is anecdotal and lacks scientific support, making it difficult to evaluate safety and efficacy. Increased public interest in alternative treatments leads to the need for a systematic review on the topic. Herbal remedies are most often used to treat the most common pregnancy-related problems like nausea, stretch marks and varicose veins. In contrast to this, concerns have also been raised about the adverse effects of these remedies. The primary objective of this research project was to conduct a systematic review to assess the maternal and neonatal outcomes of ingested herbal and homeopathic remedies using during pregnancy, birth and breastfeeding. / South Africa

It is estimated by the World Health Organization (WHO) that by 2040 neurodegenerative disorders will collectively surpass cancer as the primary cause of death in industrialised countries (WHO,2006). Natural flora represents one of the most important therapeutic sources in modern drug discovery, however only a limited number of plant species have been screened for their neuroprotective value. The neuroprotective potential of eleven Algerian and two South African medicinal plant extracts were assessed in this study, aiming to identify promising candidates for future research. Neurodegenerative disorders such as Parkinson’s disease are characterised by distinct biochemical features, including protein misfolding/-aggregation, excessive oxidative stress and apoptotic cell death. As such, medicinal plant extracts were screened for biological properties directly relevant to neurodegeneration. The capacity to induce autophagy was also investigated as mounting evidence suggests that activation of this pathway may reduce abnormal protein aggregation and promote neuronal survival.

The standard anti-retroviral drugs (ARVs) used for the treatment of HIV/AIDS have significant side effects resulting in a lack of adherence and the emergence of multidrug resistant viral strains. These drugs are also expensive, making it essential to investigate all alternatives to classical HIV/AIDS treatment. A wide variety of nonconventional medicines are used by patients for the treatment HIV and for symptoms associated with HIV. So long as they are safe and effective, traditional, complementary and alternative medicines (TCAMs) may be considered more advantageous for developing countries as they are relatively cheap, more accessible and widely accepted by local populations. The aim of this study was to determine the prevalence of TCAM use in HIV-positive patients, prior to, and during ARV therapy. The study was exploratory, cross sectional and observational in nature. Participants were selected via convenience sampling from the Nelson Mandela Bay Municipality, and included 244 HIV-positive patients, 29 health care professionals (HCPs) and 30 traditional, complementary and alternative practitioners (TCAMPs). A wide variety of TCAMs were used by the sample population. These medicines were more commonly used by non-ARV patients (36 percent) compared with ARV patients (22 percent). A significant statistical difference in TCAM use between the ARV and non- ARV population was found in relation to education, employment, period of status awareness, patient opinion of personal health and the reasons for TCAM use. Amongst the HCPs, 24 percent recommended TCAM use prior to ARVs, and 55 percent were aware of patients self-prescribing before and during ARV treatment. Amongst the TCAMPs, 90 percent provided a wide range of TCAMs for HIV, with some giving consideration to conventional management. TCAMs are commonly used by HIV-positive patients on ARVs, as well as by those not on ARVs. These medicines are also the preferred form of treatment for those not seeking conventional treatment. TCAMs are widely available and recommended by TCAMPs as well as some HCPs. Due to public health concerns, clinical trials of the widely used TCAMs are crucial in order to establish the safety and efficacy of these medicines in HIV.

The incidence of Type 2 Diabetes Mellittus (T2DM) is increasing world wide. In Africa the limited access to health care and the insidious course of the disease lead to more severe illness and diabetic complications. There is a need to find alternative approaches to treatment and prevention that address the problems and needs of Africa. Sutherlandia frutescens (S.frutescens) is a traditional herbal plant with known anti-diabetic properties, the precise mechanism of action of S.frutescens is not known. In order to develop new approaches for treatment and prevention of T2DM the pathophysiology of T2DM must be understood. T2DM is the final outcome of a multi-organ disease characterized by early defects in muscle, adipocytes, hepatocytes and pancreatic β-cells. In this study the role of the liver was investigated because of its central role in glucose and lipid metabolism. It is hard to differentiate between all the influences in an in vivo model, so the aim of this study was to develop an in vitro model of T2DM in Chang liver cells and to determine if S.frutescens can reverse the state of insulin resistance in this model. Different culture media conditions were screened to identify a method that can be used as the T2DM model in Chang liver cells. Serum free medium (MCBD-201) supplemented with human diabetic serum, (2.5%-10%), high insulin concentrations (0.1μM-1μM), high fructose concentrations (1-10mM). and a combination of high insulin and high fructose was used for this screening. Chang liver cells cultured in MCBD-201 medium supplemented with 1mM fructose and 0.1μM insulin showed reduced glucose uptake and increased lipid accumulation. The effect of two S.frutescens extracts, two anti-diabetic drugs, metformin and ciglitazone, and a hypolipidemic drug ciprofibrate were determined and shown to increase glucose uptake and reduce lipid accumulation. It was postulated that exposing the cells to excess nutrients in the form of high fructose would stimulate the cells to become adipogenic and accumulate lipids, which would interfere with the glucose uptake and induce insulin resistance. Gene expression of PPARγ, PPARα, and SREBP-1 transcription factors regulating lipid metabolism was determined in Chang liver cells cultured in insulin resistance inducing medium over a 48 hour time course. The expression of PPARγ, known to stimulate adipogenesis was increased after 6, 24 and 48 hours of exposure (P(H1)<0.0001). The expression of PPARα, known to stimulate β-oxidation expression, was significantly decreased after 24 hours of exposure (P(H1)<0.0001). The presence of the plant extracts in the insulin resistance inducing media protect against this increase in adipogenesis and decrease in β-oxidation after 48 hours of exposure by increasing PPARα expression and decreasing PPARγ expression. A PCR Array was performed which identified 32 more potential molecular targets of S.frutescens. Five of the 32 targets identified with the PCR Array were validated using qRT-PCR. These genes play a role in lipid and glucose metabolism and protection against oxidative stress and inflammation. In summary a cellular model of insulin resistace in hepatocytes has been established and the capacity of S.frutescens to reverse this process has been demonstrated by acting as a dual PPARγ/α agonist. New genes have been identified in the development of insulin resistance and as targets of S.frutescens.