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Association between clinical characteristics and TB investigation results in HIV-infected children treated for TB at a government sector paediatric HIV clinic in Soweto, South AfricaFairlie, Lee January 2014 (has links)
A research report submitted to the Faculty of Health Sciences, University of the Witwatersrand, in fulfillment of the Masters of Medicine in Paediatrics (MMED) / Paediatric HIV Clinic, Harriet Shezi Children's Clinic in an academic hospital, Chris Hani Baragwanath Hospital, Soweto, South Africa.
OBJECTIVE: To describe and compare clinical, immunological and virological characteristics of HIV-infected children co-treated for TB, comparing those investigated microbiologically and those not, with a detailed description of microbiological TB investigation results
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A study of vaccination status, weights and birthplace of children aged 12 to 23 months in the Mosvold Health Ward of KwaZuluBuchmann, Eckhart Johannes January 1992 (has links)
A dissertation submitted to the Faculty
of Medicine, University df the Witwatersrand
in fulfilment of the requirements for the
degree of Master of Science in Medicine
Johannesburg 1992. / The objective of the research reported in this thesis was
to describe the vaccination coverage of children aged 12 to
23 months in the Mosvold Health Ward of northern Kwa-Zulu.
The Expanded Programme on Immunisation cluster sample
technique was used. Simultaneous measurements of the
children's weights and arm circumferences were done, and
their birthplaces noted.
Vaccination coverage rates were generally low; 74 to 83
per cent of the children had had BCG, 47 to 56 per cent had
had three doses of DPT, 48 to 57 per cent had had three
doses of polio and 47 to 56 per cent had had one dose of
measles vaccine. Forty-eight per cent of the children had
been born at home. Fifteen per cent had weights which Were
more than two standard deviations below the median
weight-for-age according to NCHS curves, 11 per cent had
arm circumferences of 13,5 centimetres or less. The
results are compared with other findings from else Where in
southern Africa.
Relevant literature on vaccination coverage improvement and
the measurement thereof, is reviewed. Recommendations are
made for increasing coverage rates in the Mosvold Health
Ward) • / MT2017
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Acute endomyocardial disease in infants and children : the relationship between acute myocarditis and endocardial fibroelastosisJoffe, Hymie Simon January 1979 (has links)
This prospective study of acute myocarditis (AM) and endocardial fibroelastosis (EFE) was prompted by their common occurrence in infants and children in Cape Town, and by the persisting controversy regarding the possible relationship of these two conditions to each other, and to idiopathic, chronic, congestive cardiomyopathy (COCM). Patients with AM and EFE were analysed concurrently and over the long-term. The following hypotheses were investigated: A) that AM and EFE represent different phases of a common disease process, and B) that either AM or EFE evolves into COCM. From 1st June 1970 to 31st December 1976 (a study period of 6 years 7 months), 140 consecutive patients with AM or EFE were evaluated, and continually observed until 31st March 1979 (a total observation period of 8 years 10 months). Because there is no definitive, non-invasive, in-vivo diagnostic test for AM or EFE, an inclusive diagnosis of acute endomyocardial disease (EMD) was made in 123 patients who fulfilled all 4 rigid clinical criteria, i.e. a short history ( < 1 month), clinical evidence of myocardial involvement (heart failure, gallop rhythm or shock), radiological cardiomegaly (CTR > 0.55), and ST/T wave changes on electrocardiogram (ECG). Acute EMD was confirmed in all 20 patients who came to autopsy. A further 17 patients with insufficient clinical data had EMD at post-mortem.
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The identification of vestibular processing dysfunction in disorders of sensory integrationPenberthy, Marie Louise 20 April 2017 (has links)
No description available.
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Effectiveness of the palatal orthopedic appliance in treatment of the unilateral cleft lip and palate patientRobbins, Gregory A. January 1988 (has links)
Indiana University-Purdue University Indianapolis (IUPUI) / Obturator therapy has been proposed for many years as an aid
in maxillary orthopedics for the complete unilateral cleft lip and
palate infant. The obturator appliance had the added benefit of providing
a false palate against which the infant can suckle. This has
aided in the feeding of these infants to assure adequate nutrition
with the least effort for parent and child. The current study
assessed three aspects of obturator therapy at James Whitcomb Riley
Hospital for Children, Indianapolis, Indiana.
Parental evaluations of the obturator proved to be very positive.
Almost all parents (96%) rated it as beneficial and would recommend
its use to other parents with cleft lip and palate infants. Weight
gain analysis over the first nine months of life demonstrated that
these infants were only slightly below the average for birth weight.
At three and nine months of age, a number (69% and 56% respectively)
had maintained their original weight percentile rankings or had just
dropped into the next lower category. Thus, many of the infants were
able to achieve adequate nutrition, a problem noted by many authors
when obturator therapy was not used. It should be emphasized that
each infant underwent either one or two major surgical procedures
during this time period.
Arch symmetry assessments at one, four and ten months showed
a gradual reduction in lateral posterior crossbite, canine crossbite,
and anterior crossbite tendency. Although the arches still showed
some collapse at the end of ten months of age, the pattern was much
better than at initial presentation with values much closer to normal.
Improvements in arch symmetry was expected as the maxilla grew.
From the results of this study, obturator therapy appears to be beneficial
in maxillary orthopedics by helping to maintain adequate weight
gain and gain parental acceptance.
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Combined paediatric liver-kidney transplantation: analysis of our experienceStrobele, Bernd 27 August 2014 (has links)
Thesis (M.Med.(General Surgery)--University of the Witwatersrand, Faculty of Health Sciences, 2014. / Background. Renal insufficiency is increasingly common in end-stage liver disease and allocation
of livers to this category of patient has escalated. The frequency of combined liver-kidney
transplantation (CLKT) has consequently increased. Indications for CLKT in children differ from
those for adults and typically include rare congenital conditions; subsequently limited numbers of
this procedure have been performed in paediatric patients worldwide. Scant literature exists on the
subject.
Methods. Subsequent to institutional approval, a retrospective chart analysis of all paediatric
CLKTs performed at the Transplant Unit, Wits Donald Gordon Medical Centre, University of the
Witwatersrand, Johannesburg, South Africa between January 2005 and July 2013 was conducted.
Results. Defining children as younger than 18 years of age, 43 patients had received a liver
transplant since 2005, of whom 8 received a CLKT. Indications included autosomal recessive
polycystic kidney disease (n=3), primary hyperoxaluria type 1 (n=4) and heterozygous factor H
deficiency with atypical haemolytic uraemic syndrome (n=1). Graft combinations included whole
liver and one kidney (n=5), whole liver and two kidneys (n=1) and left lateral liver segment and one
kidney (n=2), all from deceased donors. Patient age ranged from 4 to 17 years (median 9) and
included 4 females and 4 males. Weight ranged from 13 to 42 kg (median 22.5). We describe one
in-hospital mortality. The remaining 7 patients were long-term survivors with a survival range from
6 to 65 months.
Conclusions. Although rarely indicated in children, CLKT is an effective treatment option,
appropriately utilising a scarce resource and significantly improving quality of life in the recipient.
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The impact of past and present energy, macronutrient and micronutrient intake on the incidence of dental caries among 5-year-old urban black South African childrenMackeown, Jennifer Margaret 20 May 2014 (has links)
There is a general agreement that food habits change over time. This has been clearly shown
in studies conducted in first world countries, but until recently this information has been
lacking in South Africa, particularly among preschool children, although nutrition
information is available on dietary intake at a particular point of time in some groups.
Changing food habits may affect disease. With the rapidly changing socio-political situation
in South Africa diet too must have changed and one cannot rely on previous nutritional
information. New reliable information is needed to help plan future health needs of all South
Africans.
Dietary intake in association with dental health has been studied by numerous investigators.
Regarding energy and specific nutrients, studies have thus far shown no relationship of
energy to dental caries incidence; carbohydrate, particularly sugars, have shown both
positive and negative relationships to caries incidence and indirectly dietary fats may be
associated with low caries because fat and sugar intake are inversely proportional to each
other. The role of trace elements has varied from caries promoting to cariostatic. It is clear
though that because of the complex nature of the caries process, carbohydrate intake,
together with other macro- and micronutrients, does not fully explain the development of
this disease. This could be influenced by the fact that most of the studies conducted on diet
and dental health have been cross-sectional. The Vipeholm study in Sweden, the Hopewood
House study in Australia and more recently the Michigan study in the United States are the
only longitudinal studies that have examined the association between diet and dental caries
incidence and both the Vipeholm and Hopewood House studied only selected groups in
institutions. Until now no true longitudinal study had been conducted among South African
preschool children regarding the association between diet and the development of dental
caries. The Birth-to-Ten study is the first such longitudinal study that selected a random
sample representative of the population groups in the country and has provided unique
information on the longitudinal dietary intake together with the dental health at 1- and 5-
years. In addition no South African study has looked at the impact of past diet on the
present dental health of the same South African children and the Birth-to-Ten study
provided this opportunity.
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Knowledge, attitudes and practices of mothers/caregivers regarding oral rehydration therapy at Johan Heyns Community Health Center, Sedibeng DistrictOnwukwe, Sergius Chuks January 2014 (has links)
A research report submitted to the Faculty of Health Sciences,
University of the Witwatersrand, Johannesburg
in partial fulfilment of the requirements for the award of a degree of
Master of Medicine in Family Medicine / BACKGROUND: Diarrhea is an important health problem and has remained a threat to the lives of children under 5 years old especially in developing regions of the world. Presently, it is estimated that about 1.5 million of these children die every year from diarrhea that would have been prevented by giving oral rehydration therapy (ORT). The value of ORT in treating diarrhea has remained unquestionable but emerging evidence still points to unsatisfactory uptake. This study assessed the knowledge, attitudes and practices of mothers/caregivers regarding oral rehydration therapy at Johan Heyns community health center, Vanderbijlpark.
OBJECTIVE: To assess the knowledge, attitudes and practices of mothers/caregivers regarding oral rehydration therapy at Johan Heyns community health center.
METHODS: This study was a descriptive cross sectional study involving mothers/caregivers’ attended to by the primary health care (PHC) nurses at the Integrated management of childhood illnesses (IMCI) clinic of a large community health center in Sedibeng district. Respondents were systematically recruited until a sample size of 377 was reached. A face to face questionnaire was used to collect data on demography, knowledge, attitudes, practices and response to diarrhea from the participants. The data collected was analyzed by the use of descriptive statistics, chi-square test and Fisher’s exact test. The main outcome measures were the level of ORT knowledge of mothers/caregivers, attitudes, practices and response to diarrhea.
RESULTS: Most of the caregivers were mothers (88.3%) who had completed matric (72.5%) and were unemployed (60.6%). The mean age was 30 years. About 53.3% of the caregivers gave ORT as an initial response to diarrhea, 30.2% took their child to the
clinic/hospital, while 4% gave orthodox or traditional medicine. The majority of the caregivers (89.4%) had heard of ORT. The main source of ORT information was clinic/hospital (89.6%). Most of the caregivers (81.7%) said ORT stops diarrhea while 18.3% said it stops dehydration. Many of the caregivers (66%) had used ORT. The caregivers’ORT knowledge was significantly associated with attitude and (P= 0.0000). A small proportion of the caregivers (29%) had problems preparing ORT at home. Most of the caregivers’ children (75.5%) did not like the taste of ORT. The ORT attitude of caregivers was significantly associated with knowledge and practice (P=0.0000; P=0.0127). Less than half (33.7%, n=127) of the entire study sample (n=377) and about half (50%, n=127) of the caregivers who claimed that they could prepare ORT (67.4%, n=254) was able to prepare a correct recipe. Over half (54.2%) of the caregivers stopped giving ORT or did not know what to do when vomiting starts. A large number of the caregivers (72.7%) continued feeding their child at the onset of diarrhea. Many of the caregivers (82.8%) used only ORT at the onset of diarrhea while few (17.2%) added some unconventional remedies. There was no association between ORT practice and ORT knowledge (P=0.4797).
CONCLUSION: This study shows a significant association between ORT knowledge and attitude, and also between ORT attitude and practice. There was no correlation between ORT knowledge and practice, therefore ORT knowledge did not satisfactorily translate to the practice. Majority of the caregivers could not prepare ORT correctly and either stopped giving ORT or did not know what to do when vomiting starts. The reported use of unconventional remedies like raw egg and custard by some caregivers to treat diarrhea at home is disturbing. It is obvious that much work still needs to be
done to improve home treatment of diarrhea using ORT; a good starting point is to initiate new strategies aimed at improving caregivers’ education on the different aspects of ORT.
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An evaluation of the Sunshine Centre Toy Library : Does the Toy Library provide an appropriate toy lending and supportive service to parents of children who have special needsAshford, Bridget Joan January 2016 (has links)
A research report submitted to the Faculty of Medicine, University of Witwatersrand (Johannesburg), in partial fulfilment of the requirements for the degree of Master of Science in Occupational Therapy. Johannesburg 1992. / Toy Libraries exist to promote the principle that play DOES matter to the developing child. The Sunshine Centre Toy Library in Johannesburg functions as a supplementary early intervention service for parents who have children with special needs.[Abbreviated Abstract. Open document to view full version] / GR2016
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Preliminary investigation into the exercise endurance of HIV infected school going children aged seven to ten yearsWalker, Alison-Jane 20 April 2015 (has links)
A research report submitted to the Faculty of Health Sciences, University of the Witwatersrand, Johannesburg in partial fulfilment of the requirements for the degree of Master of Science Physiotherapy. Johannesburg, 2014 / HIV is a global epidemic with the majority of people infected living in Sub-Saharan Africa. The era of Highly-Active Antiretroviral Therapy has resulted in HIV infected children living longer lives and more commonly reaching school going age. These children are expected to participate at the same level as their peers despite the numerous effects that HIV and HAART have on the body. The aim of this cross sectional comparative study was to compare the exercise endurance of a group of HIV infected children to that of their uninfected peers.
Sixty children aged between seven and ten years were enrolled in the study; 30 HIV infected children and 30 children not infected with HIV. Children were assessed using the six minute walk test (6MWT) according to American Thoracic Society guidelines.
The two groups were well matched in terms of socio-economic status, gender and age. Statistically significant differences were found when comparing anthropometric measurements of height and weight with HIV infected participants being shorter and weighing less than their non-infected peers. The distance walked in the 6MWT was significantly reduced in the HIV infected participants with these children walking 57.86 metres less than the non-infected participants. It was also found that HIV infected children had significantly lower heart rates at all stages of testing. Correlations were found between the distance walked in the 6MWT and average and maximum heart rates.
This study confirms that the exercise endurance of a group of HIV infected children is significantly reduced when compared to their age matched non-infected peers. It indicates the need for further investigation into the exercise endurance in HIV-infected children in a larger more representative sample of the population. Further investigation into the possible benefits of the prescription of exercise programmes in children needs to be done.
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