Abstract The effects of dietary sucrose and systemic glucocorticoid treatment on the response of the pulpodentinal complex to dental caries were examined in an experimental rat model. The possible role of dentinal caries on dentin formation was also examined. After 5-6 weeks of a dietary and/or medication period, the areas of dentin formation and dentinal caries were quantified in the molars of growing animals. Also the number and severity of caries lesions were estimated. The 43% sucrose diet significantly reduced dentin formation and increased dentinal caries progression. Although glucocorticoid medication alone reduced dentin formation, without dietary sucrose it did not have an effect on caries. In combination of these two, glucocorticoids further increased the progression of dentinal caries, however without significant increase in the number of caries lesions. The cariogenic bacterial inoculation of rats fed a sucrose or control diet increased the progression of dentinal caries. The relationship between cariogenic bacteria and caries was not strong, but there was a stronger relationship between the total amount of dietary sucrose and dentinal caries. In addition to the overall reduction of dentin formation there was no difference in the amount of dentin formed between intact and carious fissures in the sucrose diet group. On the contrary, rats receiving the control diet positively responded to the dentinal caries by increasing dentin formation to prevent pulpal exposure. Whereas the high sucrose diet impaired both the deposition and mineralization of the dentin matrix, glucocorticoids affected matrix formation only. These results indicate that the functional alterations in the pulpo-dentinal complex might contribute to dentinal caries progression in a cariogenic environment, irrespective of the causative mechanism.

M. Tech. / Onychocryptosis is the diagnostic term for an ingrown toenail. It is a common and painful condition that occurs either when the nail grows into the skin on the lateral or medial side of the toe, or if the skin on the side of the toenail grows over the edge of the nail. Magnetis Polus Australis is a homoeopathic remedy recommended in the Homoeopathic Materia Medica specifically for the treatment of onychocryptosis. In previous studies, Rohl (2003) used the remedy Magnetis Polus Australis in a 7cH and a 30cH potency whereas Khan (2004) used it in a 200cH and a 1M potency. Their studies showed promising results but had sample sizes too small for definitive conclusions. In their respective studies, they recommend using Magnetis Polus Australis 2M in a single dose. The present study was aimed at determining the efficacy of Magnetis Polus Australis in treating symptoms of onychocryptosis such as pain in the big toe (hallux), tenderness to pressure, infection, erythema and oedema of the lateral nail fold in two different potencies, namely 30cH in repeated doses and 2M in a single dose. This study was a six week double-blind, placebo controlled study involving forty participants. Pre-diagnosed onychocryptosis participants were recruited and randomly divided into three groups. The first experimental group received a once-off dose of Magnetis Polus Australis 2M powder and a 50ml bottle of placebo liquid. The second experimental group received a once-off placebo powder and a 50ml bottle of 30cH Magnetis Polus Australis liquid. The control group received a once-off placebo powder and a 50ml bottle of placebo liquid. All powders were taken immediately in the presence of the researcher, whereas the 50ml liquids were taken home to be taken as ten drops under the tongue twice daily for the total six week study. After the initial consultation, there were two more follow-up consultations at three weekly intervals. At each follow-up consultation all symptoms of the condition were observed, namely pain in the big toe (hallux), tenderness to pressure, infection, erythema and oedema of the lateral nail fold, and were recorded in respect of each participant (Appendix D and E). At the end of the clinical trial all the recorded data were analyzed and compared using Fisher Exact Tests (FET) according to the symptoms of onychocryptosis. Results showed no significant difference between the experimental and control group and therefore did not confirm the efficacy of Magnetis Polus Australis as a specific treatment for the symptoms of onychocryptosis. The only finding was that the control had a significant improvement in pain as opposed to the experimental group. A possible explanation is that the experimental groups, especially the 2M group, demonstrated a homoeopathic aggravation. Further research on this topic is required with a larger sample group over a longer time period.

D.Litt. et Phil. / Encopresis is a complex problem which is often under-reported, and is not well known by the general public. The humiliating nature of the problem results in denial and a reluctance to seek help from professionals; parents will therefore rather attempt to solve the problem themselves. Research on the subject is relatively scarce, especially regarding effectiveness of treatment models. The etiological factors of this complex problem are interlinked and it is often difficult to identify the primary cause of the problem. A primarily physical problem may have secondary emotional implications, while a primarily emotional problem may result in a physical problem. The complex nature of encopresis results in referrals from one professional to the other, generally without great success; this has resulted in parents often becoming desperate to get effective help. Treatment in the past tended to be profession-orientated and fell either into a medical or a psychological approach, with little, if any, acknowledgement of the social factors. Only recently has the biopsychosocial approach been recognised and received more credit. The low success rate in the treatment of encopresis gave rise to the development of a holistic approach which attempts to address the problem in the context of the physical, behavioural, cognitive and emotional modalities in order to find appropriate assessment, diagnostic and management strategies. The purpose of the present study was to integrate these modalities and to develop a form of therapy tailored to the specific needs of the child. The holistic treatment model attempts to bring relief to children suffering from encopresis and their families who are burdened with the problem. The purpose was further to evaluate the effectiveness of the holistic treatment model with regard to the prevalence of encopresis, depressive symptomatology, parental involvement and self-image of the children. Standardised measuring instruments used were the "Reynolds Child Depression Scale", the "Bene Anthony Family Relations Test", as well as the "Human Figure Drawings". Experimental and control groups were used in order to compare the variables prior to any intervention. The experimental group received treatment while the control group received treatment only after completion of the post-tests. The purpose was to measure the degree of change as a result of the intervention. The experimental group improved significantly with regard to all the variables, while the control group showed no significant difference between the pre-test and post-test results. The study indicated a relatively high success rate using the holistic treatment approach. Promising results can be expected when applying this holistic form of treatment to other children with similar problems in an endeavour to alleviate the often silent burden carried by children with encopresis and by their families.

M.Cur. / In 1995, the South African Department of Health described tuberculosis (TB) as South Africa's number one health problem. The Directly Observed Treatment Short-course (DOTS) strategy was thereafter implemented as a way of managing TB patients. One of its key elements is a network of trained treatment supporters who are able to support and observe TB patients swallow their treatment. In Alexandra Township a group of treatment supporters was trained in 1998 and another in 2002 but have subsequently I left the community based DOTS programme. ,..~ Why do treatment supporters leave the community based DOTS programme? What can be done to make treatment supporters stay on the community based DOTS programme? An exploratory, descriptive, qualitative contextual study was undertaken to determine the factors: • that interfere with the retention of treatment supporters within the community based DOTS programme in Alexandra Township; • that can facilitate the retention of treatment supporters on the community based DOTS programme; and • to formulate strategies that can be used to promote the retention of treatment supporters within the community based DOTS programme in Alexandra Township. Community nurses, treatment supporters and members of the Anti-TB Association were selected for the study. Focus group interviews were conducted with all three sample groups. The following questions comprised the focus group discussions with all respondents: • What do you think makes treatment supporters leave the community based DOTS programme in Alexandra Township?; and • What do you think should be done to make treatment supporters stay within the community based DOTS programme in Alexandra Towns hip? iii Under.,the following categories factors that interfere as well as factors that can facilitate the retention of treatment supporters were identified: • factors relating to the working relationship between community nurses and treatment supporters; • factors relating to the training of treatment supporters; • factors relating to the management of the community based DOTS programme in Alexandra township. I Data was analysed by using Kerlinger's (1986:477-483) method of content analysis. Strategies for the retention of treatment supporters within the community based DOTS programme in Alexandra Township were formulated. These were based on the study findings and the reviewed literature.

M.Tech. (Chiropractic) / This study was conducted in order to determine if Chiropractic Spinal Manipulative Therapy (SMT) to the lumbar spine and Sacroiliac joints can accelerate the recovery process of the Hamstring and Quadriceps femoris muscle and thus enabling the athlete to sustain endurance levels for a longer period of time. Participants used were recruited from the cycling community by means of word of mouth. Thirty participants that matched the inclusion criteria were included in the study. The participants were then randomly divided into two groups, a Test Group and a Control Group, of fifteen participants each. Motion and static palpation was used to detect spinal restrictions. The Test Group received Chiropractic SMT to the restricted lumbar vertebral segments and the Sacroiliac joints after the first test was completed. The participants then underwent a 30 minute recovery period after which they were re-tested. The Control Group received no treatment after the first test, but still had a 30 minute recovery period after which they were re-tested. Objective measurements were taken by making use of Cybex Isokinetic Dynamometer. The objective measurement indicated that there was an increase in muscle endurance of the Quadriceps femoris and Hamstring muscle groups for both the test and the Control Group. When the increase in Hamstring and Quadriceps femoris muscle endurance was compared between the Test and Control Group, it was the Control Group that showed a more significant increase in Quadriceps femoris muscle endurance which was greater than the increase of the Quadriceps femoris muscle endurance in the Test Group. The Control Group also showed a greater increase mean endurance of the Quadriceps femoris and Hamstring muscle. In conclusion to the study, muscle endurance in cyclists can be increased by rest alone and does not require Chiropractic SMT to restricted spinal segments.

M.Dip.Tech. (Homoeopathy) / The aim of the study was to compare the effectiveness of the Homoeopathic simplex Zincum metallicum in a D6 potency with the Homoeopathic complex treatment Spascupreel in Restless leg syndrome sufferers in terms ofpatient response to treatment. It was hypothesised that the Homoeopathic simplex Zincum metallicum in a D6 potency.Both the homoeopathic simplex Zincum metallicum D6 preparation and homoeopathic complex Spascupreel preparation was found to bring about an improvement in the symptoms ofrestless leg syndrome. However Zincum metallicum D6 showed a much greater improvement that was statistically significant. and the Homoeopathic complex Spascupreel would result in a substantial improvement in all the clinical aspects ofRestless leg syndrome sufferers, and that it could be used as an alternative to "conventional" treatment in many cases. The study, conducted over a period of 3 months, was a clinical trial, in which a placebo control group was compared with two experimental groups. Convenience sampling was used to draw patients into the trial. Volunteers responded to advertisements, which had been placed in various advertising media. The persons who responded to the advertisements were requested to complete Questionnaires one and two and of those who met the criteria, which clearly indicated that they were sufferers of Restless leg syndrome, a maximum of 30 volunteers were accepted for the study. An independent party randomly divided the participants into three groups and the study was conducted over a period ofthree months. During this period 10 of the participants received placebo treatment, 10 received the Homoeopathic simplex Zincum metallicum in a D6 potency and 10 received the Homoeopathic complex Spascupreel. Being a double-blind study neither the researcher nor the participants knew what type of treatment they received until the end of the research. The participants who fell into the placebo group were given the opportunity after the study to be treated with Homoeopathic simplex or complex treatment depending on the effectiveness.

Dr. C. Yelverton

Breast cancer in South Africa has become one of the most prominent cancers affecting women. Worldwide, breast cancer results in more deaths amongst women than any other cancer (Vorobiof, 2001). Chemotherapy has become one of the most effective and commonly used adjuvant forms of treatment in breast cancer. However, despite its effectiveness, it has a variety of side effects ranging from nausea, fatigue, vomiting, alopecia to many others. Due to the significant levels of discomfort and disability associated with chemotherapy, patients often seek additional treatment to assist with these side effects. Many individuals combine complementary and alternative therapies with conventional treatment of their cancer (Breasthealth, 2005). Homoeopathy is often used to alleviate the side-effects resulting from the chemotherapy treatments (Diamond and Crowden, 1997). This research involved the individualized treatment of patients experiencing side effects from chemotherapy, employing homeopathic medicine. The study involved ten participants who had been diagnosed with breast cancer and who were scheduled for at least four chemotherapy treatments. The participants did not receive any homoeopathic remedies to assist with the side effects following the first chemotherapy treatment. The results from the first chemotherapy treatment were utilized to establish each individual’s control results against which, future results would be compared. Participants received their homoeopathic similimum remedies to assist with their second, third and fourth chemotherapies. The appropriate homoeopathic remedy was determined using each patient’s distinguishing, mental, emotional and physical symptoms following each chemotherapy treatment. Each participant completed the Researcher’s Questionnaires (Appendix B) following their chemotherapy treatments and recorded the severity of their nausea, fatigue, vomiting and general symptoms experienced after each of the four chemotherapies. These were handed to the researcher at each follow-up consultation. These results, together with the holistic progress as noted by the researcher at every consultation, were used to determine the efficacy of homoeopathy on the side effects of chemotherapy treatment. This study aimed to reduce the severity and duration of side effects resulting from chemotherapy treatment using individual homoeopathic remedies prescribed. The severity of side effects was graded and monitored for each patient following each chemotherapy session. Of the ten participants involved in this study, eight participants completed all their scheduled chemotherapy sessions. Two of the participants completed only three chemotherapies as their conditions had improved drastically and were not compelled to complete their remaining chemotherapies. Compliance with the homoeopathic treatments was thus effectively 100%. The results of this study indicated that all of the participants reported a statistically significant decrease in side effects after taking the similimum homoeopathic remedies and they also experienced a shorter duration of side effects. All patients in this study were better able to cope with the side effects of chemotherapy whilst taking the similimum Homoeopathic remedies. / Dr. N. Wolf Dr. C.A. Benn Dr. K. Peck

M.Tech. / OBJECTIVE: The aim of this study was to determine the electromyographic effect of flexion distraction therapy of the lumbar spine on the Erector Spinae muscles in participants with lumbar facet dysfunction. STUDY DESIGN: Thirty participants with lumbar facet dysfunction underwent 6 flexion distraction therapy treatments on alternate days over a 2-week period (excluding weekends) to test the electromyographic effect on the Erector Spinae muscle. SETTING: University of Johannesburg Chiropractic Clinic, Johannesburg, South Africa. SUBJECTS: Thirty participants with lumbar facet dysfunction participated in this study. The participants were divided into two groups of fifteen participants each and matched according to age and gender. Group 1, the study group, received flexion distraction therapy to the restricted segments in the lumbar spine. Group 2, the control group, did not receive any flexion distraction therapy and rested during the duration of the treatment. METHODS: Lumbar Erector Spinae muscle electrical activity was tested before and after treatment one, three and six using surface electromyography (sEMG). One pair of bipolar electrodes was placed bilaterally over the Erector Spinae muscles at the level of L3. Participants were asked to lie down in a prone position with their arms next to their sides. They were then instructed to perform five maximum voluntary lower back extension exercises by lifting their chests and shoulders as high off the plinth as possible. Each contraction lasted five seconds, with a rest period of ten seconds between each contraction. The average rest and work surface electromyography readings were recorded, analysed and compared for reference. Information regarding the intensity of the pain experienced by the vii subjects was also collected at the start of treatment one, three and five using the Numerical Pain Rating Scale. RESULTS: Comparison of the results indicated a statistically significant difference between the two groups and their responses to the treatments. Subjectively, a statistically significant improvement was observed in Group 1 between the third and the sixth treatments and the first and the sixth treatments, with an overall 80% improvement in pain, thus demonstrating the medium to long term effects of flexion distraction therapy. Objectively, Group 1 demonstrated a statistically significant medium to long term improvement in the resting rate of the Erector Spinae muscles as observed between the first and sixth treatments. Statistically, the two groups responded differently over time with regards to the contraction ability of the Erector Spinae muscle. A statistically significant and immediate improvement was observed in the sixth treatment in Group 1, thus further supporting the long term effects and benefits of flexion distraction therapy. CONCLUSION: In light of these findings it can be concluded that flexion distraction therapy, as represented by Group 1, demonstrated favourable treatment results in terms of the pain experienced by the subjects, the resting rate and contraction ability of the Erector Spinae muscles. The trends observed in this study should be used and tested in future research studies of a similar nature incorporating larger sample groups.

M.Tech. (Chiropractic) / The purpose of the study was to compare the effectiveness of a cervical support pillow in conjunction with correcting abnormal cervical spine biomechanical function (by intervention of high-speed, low-amplitude spinal manipulation in the cervical spine) versus correcting abnormal cervical spine biomechanical function alone, to determine which is the most effective treatment protocol for cervicogenic headache. Thirty-two subjects suffering from frequent, chronic headaches who fulfilled the International Headache Society criteria for cervicogenic headache participated in the investigation. These subjects were recruited from 70 headache sufferers who responded to newspaper and poster advertisements. Patients were randomly assigned to one of two groups as they enrolled for participation. The sixteen patients in group one received cervical spine manipulation twice a week for three weeks. The other sixteen patients received cervical spine manipulation twice a week for three weeks and used a cervical support pillow for sleeping over the three-week period. The main outcome measures included the following: Patients completed a daily headache diary. This monitored the change from week one to week three in analgesic use per day, headache intensity per episode, headache frequency per week and number of headache hours experienced per day. Cervical active range of motion readings were taken at all consultations prior to treatment, using a goniometer. A Neck Pain and Disability Index (Vernon- Mior) Questionnaire and a Numerical Pain Rating Scale 101 were completed by each patient at the initial, second, fourth and sixth visits. In conclusion, it cannot be denied that the combination of a cervical support pillow and correction of cervical spine joint complex dysfunction using standard chiropractic manipulative techniques is a more effective treatment protocol for the management of cervicogenic headache, as it has a far greater benefit with regard to improving the ranges of motion of the cervical spine and a similar effect in improving patient's perception of pain intensity, headache frequency, headache duration and level of functional disability as related to cervicogenic headache, than manipulation of joint complex dysfunction in the cervical spine alone. The short-term symptomatic relief and long-term goals of chiropractic management for cervicogenic headache with specific chiropractic spinal manipulative therapy may be improved by combining the use of a cervical support pillow to this already beneficial and effective protocol.