M.Tech. / Estimates extrapolated from the UK, USA and Canada, suggest a prevalence of chronic constipation in South Africa of approximately 700-720,000 in a population of 44 million (Cure Research, 2007). According to Rivkin and Chagan (2006) these US statistics do not accurately represent the true incidence of the problem which is predominantly self managed. The yearly US sale of over the counter laxatives exceeds $600 million (2006). Allopathic treatments only temporarily alleviate constipation, and overuse of laxatives results in many side-effects. The objective of this study was to determine the efficacy of Constipation 6c®, in the treatment of symptoms of functional chronic constipation, in females using the modified Rome II criteria for chronic constipation. This double blinded study was conducted using matched pairs. Thirty female participants between the ages of 18-35 were recruited using advertisements placed at the Health Training Centre on the UJ Doornfontien campus and Weleda Pharmacy (Fourways). The study was conducted over six weeks, during which time the participants attended weekly consultations. At the first consultation participants signed an information and consent form (Appendix B). For the first week no medication was administrated, however participants were asked to complete a daily recording sheet rating their symptoms (Appendix D) based on the modified Rome II criteria for chronic functional constipation. At the second visit participants were match-paired according to age, severity of symptoms and duration of symptoms (Appendix K). Participants were randomly assigned to either the experimental or the placebo group by an independent administrator. During the follow up consultations participants received the complex homoeopathic remedy, Constipation 6c® or placebo, and were instructed to take five pillules three times a day, and to record changes in symptoms on the daily recording sheet (Appendix D). At each follow up visit, the researcher collected the daily recording sheets, completed a focused physical examination and documented any changes in symptoms.

M.Tech. (Chiropractic) / This study was undertaken to evaluate the effectiveness of chiropractic treatment of chronic lower back pain in conjunction with the use of the Cory knee cushion during sleep as compared with chiropractic treatment alone. The cushion is used in an attempt to improve sleeping posture. It was proposed that both treatment protocols would be effective, but that the combined therapy would show better results. An unblinded, controlled pilot study was conducted. Patients responding to advertisements were recruited from the general population. Thirty patients who conformed to the specified criteria and delimitations were accepted into the study and placed randomly in one of two possible treatment groups. One group received chiropractic adjustments in conjunction with the use of the Cory knee cushion during sleep, the other received chiropractic adjustments alone. Comparisons were performed by means of objective (lumbar spine range of motion) and subjective (Oswestry Pain and Disability Questionnaire, MCGiIl Pain Questionnaire and Visual Analogue Scale) assessments over the eight-week treatment period, with comparisons made at treatments one, four, seven, nine and ten. The results were recorded and the data was statistically analysed using two-sample ttests, paired t-tests, sign rank tests and Mann-Whitney tests. The results indicated that there was a generalised improvement in both of the treatment groups in terms of lumbar spine range of motion and pain relief. While group one attained a better range for rotation after the month break, this was an isolated improvement. Under the circumstances of the research, neither group showed considerably superior results over the other, as there was no statistically significant difference between the groups. Thus, the full benefit of sleeping with a cushion between the knees in an attempt to improve sleeping posture will need additional investigation in order to be of-use as an adjunct to chiropractic treatment.

M.Tech. (Homoeopathy) / Allergic Rhinitis (AR) is the inflammation of the nasal and often conjunctival mucous membrane. It manifests due to the exposure of inhaled allergic agents and results in an immunoglobulin E (lgE) mediated reaction (DiPiro et al., 2002; Shargel et al., 2001). Allergic rhinitis is characterised by four principle symptoms, watery rhinorrhoea, nasal obstruction, nasal itching and sneezing (Min, 2010). In addition to the cardinal symptoms experienced during AR other common symptoms include postnasal drip, pruritic eyes; ears; nose and palate (Kemp, 2009). Although allergic rhinitis is not life threatening, the adverse impact on quality of life is significant. Those affected by allergic rhinitis are restricted in their ability to carry out their normal daily activities (Nelson, 2007; Wilson et al., 2002). Sleep, social interaction, emotional well being as well as cognitive and psychomotor function are affected by allergic rhinitis, and can lead to impaired learning ability. Serious disorders such as eczema, asthma, sinusitis, otitis media, nasal polyposis, respiratory infections and orthodontic malocclusions are. frequently linked with allergic rhinitis (DiPiro et al., 2002; Kemp, 2009)., The therapeutic goal for patients suffering with allergic rhinitis is to prevent or minimise symptoms, using treatment with minimal or no side effects and of reasonable expense, so that patients may maintain a normal lifestyle (DiPiro et aI., 2002). One of the most frequent indications for which homoeopathic treatment is sought after is for respiratory allergies (Ramchandani, 2009). Thus it has been proposed that the remedies contained within Otirin Nasal Spray"; namely Allium cepa, Euphrasia officinalis, Luffa operculata and Sabadilla officinarummay be effective as a treatment for allergic rhinitis (Vermeulen, 2000). Otirin Nasal Spray" is a homoeopathic complex preparation indicated for allergic rhinitis. No specific research has been conducted on this product to determine its efficacy in this condition (Medford, 2008). The aim of this research study was to determine the efficacy of Otirin Nasal Spray" in the treatment of allergic rhinitis with regard to the severity Of symptoms; specifically on the symptoms relating to the nose, eyes, throat, mouth and ears. Diary cards and questionnaires were completed, making use of the severity of symptoms scores to grade the symptoms. This research study was a quantitative" double-blind, placebo-controlled study and included thirty participants suffering from AR. Participants volunteered to participate in the study, were over the age of eighteen and consented to the procedures of the research study. Participants involved in the study were randomly divided into a treatment (experimental) group and a control (placebo) group. The treatment group received the Otirin Nasal Spray'" as opposed to the control group who received the placebo nasal spray (saline nasal spray). The research study was conducted over a period of four weeks at the UJ Health Centre. Participants were instructed to complete an individual "Treatment Diary Card" (Appendix E) during each hayfever attack by scoring the severity of each symptom they suffered from. During the final consultation the "Response to Treatment Questionnaire" (Appendix F) was completed under the researcher's supervision. This questionnaire required participants to score an amelioration, aggravation, no change or not applicable for each symptom, as well as other associated symptoms. Results acquired from the research study were statistically analysed by Statkon at the University of Johannesburg by means of descriptive statistics, parametric and non-parametric tests. The parametric test included the Independent Samples TTest. Non-parametric tests included the Friedman Test, Wilcoxon Signed Rank, and Mann-Whitney U Test. This research study determined that the homoeopathically prepared Otirin Nasal Spray" did have a statistically significant effect in the treatment of allergic rhinitis symptoms. A trend towards a decrease in the severity of the participant's symptoms was observed, in particular for rhinorrhoea, sneezing, nasal blockage/congestion, pruritic/itchy eyes and postnasal drip.

M.Tech. / Purpose: Lateral epicondylitis has been identified as one of the most common conditions affecting the upper limb. The exact pathophysiology of this condition is still under investigation; however it is believed to be an overuse injury which affects the common extensor tendon at the tenoperiosteal and/or the musculotendonous junctions. Despite the frequent occurrence of lateral epicondylitis and its considerable symptoms there is little scientific evidence to support the effectiveness of any treatment methods. As yet one treatment method has not been proved more effective than the other. The purpose of this comparative study was to determine whether manipulation combined with dry needling of the common extensor tendon and extensor muscle belly of the forearm, was more effective than cross friction of the common extensor tendon combined with manipulation with regards to a decrease in pain and an increase in pressure pain threshold. Method: This study consisted of 32 participants between the ages of 18 – 40. Possible participants were examined and accepted according to the inclusion and exclusion criteria. Once accepted the participants were assigned into two groups each consisting of equal amounts of males and females. The first group received manipulation of their elbow combined with dry needling of their common extensor tendon and extensor muscle belly of their forearm. The second group also received manipulation of their elbow but this was combined with cross friction of their common extensor tendon. Procedure: Each participant received six treatment sessions and one follow up session. Objective data and subjective data was taken at the beginning of the first, fourth and seventh session. Objective data consisted of algometer readings that were taken on the common extensor tendon, the lateral epicondyle of the humerus and the extensor muscle belly. The subjective data collected was in the form of the Numerical Pain Rating Scale and the short form of the McGill Pain Questionnaire. The manipulation of the elbow was then administered based on the restrictions identified during motion palpation. This was followed by either dry needling of the common extensor tendon and the extensor muscle belly of the forearm or cross v friction of the common extensor tendon. The information collected was analysed by means of Friedman and Wilcoxon Signed Rank tests.Results: Statistically significant improvements in all measurements were noted over the course of the treatments for all participants in both groups. However there was no statistically significant difference between the improvements of the dry needling group compared to that of the cross friction group. Conclusion: The results illustrate the effectiveness of the individual treatments over the treatment period. However it is still inconclusive whether one treatment method is more effective than the other. As this study was directed to a small group of participants, accurate conclusions could not be formulated to prove the effectiveness of one treatment method over that of another. Due to the insignificant findings obtained in this study, further studies need to be performed to determine which method of treatment is most effective when treating lateral epicondylitis.

M.Tech. (Homoeopathy) / More than 90% of all injuries that occurs while participating in sport will either be a strain or a contusion. Strains occur when the muscle is subjected to excessive tensile forces that lead to overstraining of the muscle fibres, resulting in tearing (Järvinen et al., 2007:318). Symptoms of minor muscle strains (first and second degree strains) include pain on isometric movements and on stretching the affected muscles (Magee, 2008:28). Homoeopathic remedies may be useful in the treatment of exercise induced muscle strain, however there is very little research done to date on its efficacy (Jones & Wilson, 2010:11). This study aimed to determine the efficacy of a complex homoeopathic topical cream for pain relief from acute exercise induced minor muscle strains. The complex consisted of Arnica montana, Bellis perennis, Bryonia alba, Rhus toxicodendron and Ruta graveolens. Pain levels were measured on a visual analogue pain scale, and pain relief was rated relative to baseline. Participants rated their satisfaction with the cream at the end of the study. This study was conducted on thirty adult volunteers who met the inclusion and exclusion criteria. This was a double-blind placebo controlled study that was conducted over a period of three days. Once participants were accepted into the study they were placed in matched pairs according to pain severity to ensure equal distribution in both groups. Group A, the control group, received the un-medicated aqueous cream while group B, the treatment group, received the homoeopathically medicated aqueous cream. The cream was applied seven times in total to the affected area. Statistical analyses were done to determine if any significant changes occurred in either group or between the two groups over time.

Breast cancer is one of the leading causes of death, with mortality rate estimates of 465 000 deaths per annum. It is estimated that 1.3 million women are diagnosed with the disease each year especially in the developing countries. Current chemotherapy relies on the use of high doses of non-specific toxic agents that possess adverse side effects and compromise patient’s compliance and adherence to treatment. Paclitaxel, one of the common drugs used in breast cancer chemotherapy results in sensory and motor neuropathy, whilst hormonal therapy e.g. Herceptin causes severe cardiovascular, gastrointestinal and cutaneous side effects. There has been a demand in developing newer cancer agents that demonstrate selective cytoxicity with minimal effect on normal body tissue. Numerous studies have shown that marine organisms produce a wide range of halogenated compounds that possess cytotoxic properties, and hence can be a source of new drug hits or leads for cancer therapy. Halomon, a polyhalogenated monoterpene from Portieria hornemannii, displayed interesting activity against brain, renal and lung cancer tumours with selective/differential cytotoxicity. This inspired us to focus our project on halogenated monoterpenes isolated from the same Rhodophyta class as P. hornemannii but with particular attention to Plocamium species. Several metabolites have been isolated from P. cornutum, P. corallorhiza and P. suhrii that possess interesting cytotoxicities against a breast cancer cell line (MCF7) and an oesophageal cancer line (WHCO1). The aim of the project was therefore centred at isolating target compounds for preliminary structure-activity studies against a breast cancer cell line, and use this information to synthesize a series of analogues that are more stable than the natural products and yet as active using a fragment-based type approach to map out pharmacophoric elements. Five metabolites were isolated from P. cornutum and five from P. corallorhiza. Cell-based assays were conducted using an MTT assay kit against MCF7 and MDA-MB-231 breast cancer cell lines and (1E,3E,5S,6R)-1,5,6-trichloro-2-(dichloromethyl)-6-methylocta-1,3,7-triene, isolated from P. cornutum was the most active with IC50 values of 3.0 μM and 6.15 μM respectively. Introduction of a terminal aromatic ring to enhance stability, together with varying substituents (H, CH3, CF3, Br, CN, CHO, CHCl2) on position 7 of the molecule, gave rise to a series of cinnamate ester derivatives inspired by (1E,3E,5S,6R)-1,5,6-trichloro-2-(dichloromethyl)-6-methylocta-1,3,7-triene. The analogues were synthesized from their benzaldehyde precursors via Aldol condensation, esterification and Wittig reactions. Their carboxylic acid counterparts were synthesized by hydrolysis of the parent esters in an attempt to promote water solubilities of the analogues. Biological activity assays were then conducted with the cinnamate analogues against the MDA-MB-231 breast cancer cell line using an MTT assay kit. Ester derivatives with -CHO and -CHCl2 functionalities had IC50 values of 43.45 μM and 100.01 μM respectively whilst the other ester derivatives were inactive. It was concluded that either an aldehyde (-CHO) or gem-dichlorides (-CHCl2) is specifically required for cytotoxic activity to be observed. None of the carboxylic acids were active which could have been due to failure of the compounds to enter the breast cancer cells and reach the target site because of their polar nature. Compounds with -CHO and -CHCl2 functionalities were therefore selected for future SARs studies.

Submitted in partial compliance with requirements for Master`s Degree in Technology: Homoeopathy, Durban University of Technology, Durban, South Africa, 2017. / Allergic rhinitis (AR) is a symptomatic disorder of the nose characterized by inflammation of the nasal mucosa. It consists of a group of disorders that are all typified by the presence of one or more of the following: nasal itching, congestion, sneezing and rhinorrhoea (Wallace et. al., 2008). Allergic rhinitis can result in decreased quality of life, decreased sleep quantity, obstructive sleep apnoea and impaired performance at work and school (Blaiss, 2010: 375-380). According to Small and Kim (2011) allergic rhinitis (AR) is the most common allergic condition and one of the most common of all minor afflictions. It affects between 10- 20% of all people in the United States, and the prevalence of the disorder is increasing. This may result in significant impairment to quality of life, sleep and work performance (Small and Kim 2011). A therapeutic goal for patients suffering from allergic rhinitis is to prevent or minimise symptoms, using treatment with minimal effects or no side effects and of reasonable expenses, so that patients may maintain a normal life style (DiPiroet al.2002). Homoeopathy is a complete system of medicine developed by German physician and chemist, Dr Samuel Hahnemann (1755-1843). It is based on the following theories, first the doctrine of signature that disease is curable by those drugs which produce effect on the body similar to the symptoms of the disease “similia similibus currantur”; second that the effects of the drug are increased by giving it in a minute dose, which is obtained by dilution or trituration to an extreme limit and thirdly the notion that chronic disease are only manifestation of suppressed itch or psora (Ernst 2016). Similasan Nasal Allergy Relief Spray® is commercially available as a homoeopathic nasal spray. It is based on the principle of "let likes cure likes" or the Law of Similars. According to the company, this product is 100% natural, and contains active ingredients with non-drowsy effects which relieves allergic congestion, itching and runny nose, and it is preservative free (Similasan Corporation 1999-2015). Similasan Nasal Allergy ReliefSpray® mist gently stimulates the body's natural ability to relieve allergic congestion, itchy, runny nose and rhinitis caused by pollen, pet dander, dust and mould spores. Furthermore, the Similasan Nasal Allergy ReliefSpray® mists is non-habit forming and will not cause reliance or a rebound effect. The ingredients are: Cardiospermum 6X, Galphimiaglauca 6X, Luffa operculata 6X, Sabadilla 6X (SimilasanCoorporation 1999-2015). The aim of this double-blind randomised controlled study is to determine the efficacy of the homoeopathic Similasan Nasal Allergy Relief Spray® in the management of allergic rhinitis. Outcomes were monitored using questionnaires and a daily log book. This was a quantitative study which included thirty participants suffering from allergic rhinitis. Participants volunteered to participate in the study, were over the age of eighteen and consented to the procedure of the study. Participants involved in the research study were randomly divided into treatment group and placebo group. The treatment group received Similasan Nasal Allergy Relief Spray® and the placebo group received a saline nasal spray. The research study was conducted over a period of four weeks at the Durban University of Technology Homoeopathic Day Clinic. Participants were instructed to rate their symptoms before, during and after taking treatment (Appendix, C and D). The parametric test used in this study was Independent Samples T- Test. Non-parametric tests included ANOVA and Pearson chi-square. Rhinorrhoea, sneezing, itching of the eyes and nasal congestion showed a statistically significant results but some of the participant’s symptoms deteriorated after a period of improvement. This research determined that Similisan Nasal Allergy Relief Spray ® didn’t have a significant effect in treating allergic rhinitis in terms of the CARAT questionnaire. / M

Research targeting the chemically dependent woman has received little attention, even though the research indicates a convergence of male and female drinking norms. Research centered on the special issues of the chemically dependent woman also needs to be extended beyond the scope of actual alcohol and drug abuse and resulting treatment to include information on what issues women face in their recovery process. The findings would help treatment providers design more successful interventions for this population. This study used qualitative methods to investigate issues that 12 chemically dependent women, ranging in actual time in recovery from first to third year post inpatient treatment, discussed as part of a 16 week therapy group. Their recorded responses were transcribed and analyzed, using Glaser and Strauss' methods of comparative analysis, comparing the women between three groups desiginated by the divisions of first, second, and third year post inpatient treatment. The findings indicate that all share many of the same issues, however there are marked differences between the groups. All the women had difficulties with intra- and interrelationships, finding it difficult to maintain a healthy recovery in spite of the problems they confronted in experiencing reality without mind-altering substances. Many issues were influenced by the subjects' family of origin history and sex-role orientation. Conflicts in role obligations resulting in work, family, parenting, and relationship problems surfaced. All the women were aware of additional substance and compulsive dependencies that they would like to eliminate; however, avoiding relapse of their alcohol/drug addiction was the major concern for most. The findings reveal that the longer women spent time actively undertaking a concerted program of recovery, the more they experienced integration into the rest of society, and that the acquisition of life skills and resolution of the past were important factors to the success of this integration. The categories and theme issues that emerged from the analysis have implications for social work practice, policy, and further research. / Arts, Faculty of / Social Work, School of / Graduate

D.Phil. / This enquiry represents an attempt to understand the ways in which the ecology of ideas surrounding HIV and Aids in post-apartheid South Africa functions discursively to silence people living with the dis-ease. In this regard, it seeks to understand how the range of subject positions available to people with HIV and Aids influences their opportunities for treatment and disclosure. The meanings emerging from this enquiry have implications for interventions aimed at people living with HIV and Aids, in that they challenge the liberal humanism underpinning a Western individualist paradigm which constructs people as ‘rational’ and ‘responsible’ on the basis that such constructions tend to attribute guilt or moral culpability to people living with HIV and Aids. The conversations and narratives elicited in the process of this enquiry suggest that such discourses constitute a form of disciplinary power in a Foucauldian sense, positioning people living with HIV and Aids defensively and limiting their options for ‘positive’ self-definition by foreclosing available subject positions, thereby contributing to the spread of HIV and Aids. Hence, this enquiry focuses on social constructions of morality and the impact of these on participants’ attempts to maintain key relationships that afford them a ‘positive’ sense of them-selves. Thus, it looks at experiences of connection and dis-connection and explores the ways in which efforts to retain ‘relatedness’ in order to maximise possibilities for the co-construction of a ‘moral self’ mediate opportunities for disclosure and treatment options. The enquiry aimed to assist participants in deconstructing dominant social constructions of HIV and Aids implicit in cultural and political discourse by applying a critical, poststructuralist and discourse-analytic lens in order that they might resist moral attributions based on liberal humanism and access their own voices in narrating the experience of living with HIV and Aids in keeping with their lived experience. My aim in this regard was to resurrect alternative or previously silenced accounts and to open up spaces for a multiplicity of meanings associated with HIV and Aids to emerge and be heard, toward the end of breaking the silence and creating a conversational space in which people’s meanings could simultaneously be heard and challenged through dialogue.Ultimately, this enquiry highlights the importance of attempting to understand the local and idiosyncratic nature of people’s constructions of HIV and Aids, which are often a hybrid mix of ideas and meanings circulating within social, cultural and political discourse. It also underscores the salience of considering people’s lives in context and particularly their need to maintain relationships that afford a positive sense of self. This is reflected in the tendency for participants to construct their identities in relation to significant others and for these relationships to mediate decision making in relation to HIV and Aids by availing or foreclosing certain subject positions, depending on the discourses within which they are situated.

M.Tech. / Allergic rhinitis, otherwise referred to as hay fever, is a common allergic reaction affecting the nose, throat, eyes, and respiratory system, of persons of all ages and both sexes. This study attempted to demonstrate the effect of the homoeopathically prepared remedy Sabadilla officinarum 30CH and Sabadilla officinarum 200CH in the treatment of allergic rhinitis. Thirty participants were selected for this one hour, double-blind, placebo-controlled study. The participants were randomly placed into one of three groups of ten, consisting of the control group, and the two experimental groups. The control group received the placebo medication. The first experimental group received Sabadilla officinarum 30CH, and the second experimental group received Sabadilla officinarum 200CH. The patients were all supplied with: a stat dose of medication to use at the time of an allergic rhinitis attack, a diary card on which to score the severity of their symptoms at the time of such an attack, and a response to treatment questionnaire to fill in after the completion of their treatment. The results were statistically analysed using the Wilcoxon Signed Ranks Test, the Kruskal Wallis Test, and descriptive statistics. The results show that treatment with Sabadilla officinarum 30CH and 200CH had a significant effect in improving the symptoms of allergic rhinitis.