School of Health Sciences

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An assessment of the level of knowledge of diabetics and primary health care providers in a primary health care setting : on diabetes mellitus.
(2006) Moodley, Lushendran Manikum.
The effect of an anti-inflammatory homeopathic product on cytokine status in venous blood following 90 minutes of downhill running.
(2008) Docrat, Aadil.; Peters-Futre, Edith Margret.
Background: Downhill running involves eccentric contractions of the gluteal, quadriceps, hamstring and calf muscles and the lengthening of muscle fibres as they contract. Several studies have demonstrated that this type of prolonged eccentrically biased exercise induces tissue damage and subsequent enhancement of an inflammatory response. Traumeel® S (Heel GmbH, Baden-Baden, Germany) is a homeopathic-complex used to treat trauma and inflammatory processes that is sold as an over the counter remedy in pharmacies. Although the antiinflammatory and analgesic effects of Traumeel® S have been demonstrated in selected clinical trials as well as in in vitro experimental models, little is known of its scientific mechanisms of action. Aim: The aim of this study was to establish whether administration of Traumeel® S five days before and three days after a 90-minute downhill treadmill run at 75% V02 peak significantly changes systemic markers of the inflammatory response. These are to include blood-borne concentrations of Cortisol and examples of selected T-helperrcell cytokines, T-helper2-cell cytokines, chemokines and pro-inflammatory cytokines during the three days following the 90-minute downhill run. Method: This study was designed as a double-blinded, placebo-controlled clinical trial in which matched subjects were randomised to Traumeel (TRAU) and Placebo (PLAC) pairs and exposed to two 90-minute downhill running trials. Twenty subjects (12 men, 8 women) aged between 20 and 50 years, fully complied with all inclusion criteria set for the study. Following baseline laboratory and field testing, they were matched according to gender, body mass index (BMI), training age, training status, peak running performance and foot-strike patterns and randomized into TRAU and PLAC groups. One Traumeel® S tablet was ingested three times per day for five days prior to and three days following a 90-minute downhill run on a treadmill at a -6% gradient and at a speed eliciting 75% V02 peak on a level gradient. Blood samples were obtained immediately before the 90-minute trial (PRE), immediately after the trial (IPE) and 24 hours (24 PE), 48 hours (48 PE) and 72 hours (72 PE) following the trial. Each subject was also requested to complete a training record prior to the trial and keep a record of the daily symptoms of delayed onset muscle soreness (DOMS) both at rest (general pain) and while walking (daily living). Full blood counts, serum creatine kinase (CK) and Cortisol concentrations were determined using standard haematological laboratory procedures. A sandwich ELISA was used to determine plasma interleukin-6 (IL-6) concentrations. A commercial bead-array kit was used to conduct flow cytometric analysis of Interleukin-8 (IL-8), Interleukin-10 (IL-10), Tumour Necrosis Factor alpha (TNFa), and Interleukin-12p70 (IL-12p70) concentrations. Results: Paired student Mests indicate that the mean ± SEM of the two groups was not significantly different (p < 0.05) in terms of age, BMI, percentage body fat, training age, foot strike patterns, running performance, FVC, FEV1; baseline heart rate and blood pressure, RERmax, V02 peak, VEmax, or training status. Although the TRAU group completed the 90-minute downhill running trial at a significantly faster speed (13.3 ± 2.1 vs. 12.8 ±0.3 km.hr; p = 0.02) and covered a greater distance (20.1 ± 0.3 vs. 19.34 ± 0.4; p = 0.03), mean and maximum heart rate and RPE did not differ between trials in the TRAU and PLAC groups. The downhill running protocol resulted in significant increases in neutrophil counts and creatine kinase, Cortisol, IL-6, IL-8 and IL-10 concentrations in the circulation (n = 20; p < 0.001). When comparing the TRAU (n = 10) and PLAC (n = 10) groups, blood neutrophil counts, creatine kinase, Cortisol, and IL-6 concentrations over the 5 time points and PRE, IPE and 24 PE plasma TNF, IL-8, EL-10 and EL-12p70 concentrations did not differ significantly (p > 0.05). Blood creatine kinase was, however, significantly higher in the TRAU group at 24PE (p < 0.05). The post-trial DOMS scores reported by the TRAU group over the 3-day post-exercise recovery period were also significantly lower in the TRAU group at 24PE (p = 0.03). Conclusion: Despite a faster running speed and higher post trial CK concentration in the TRAU group following the 90-minute downhill run, statistically significant differences in circulating stress hormone, and cytokine concentrations (IL-6, IL-8, IL-10, TNFa and IL-12p70) between the TRAU and PLAC groups, were not identified. Delayed onset muscle soreness was also significantly lower in the TRAU group at 24 hours post trial (p = 0.03). While these findings would support attenuation of the post-exercise inflammatory response by Traumeel® S, further work is required to verify this possibility.
Hypoglycaemic and renal effects of a bioactive plant extract in streptozotocin induced diabetic rats.
(2008) Mapanga, Rudo Fiona.
Background: Evidence from our laboratories indicates that triterpene constituents of Syzygium cordatum (Hochst.) [Myrtaceae] crude leaf extracts can be used to treat diabetes mellitus. For the plant derived triterpenes to have further potential in diabetes management, they should, however, additionally alleviate or prevent some of the complications of diabetes mellitus such as impaired kidney function and cardiovascular disorders. Accordingly, this study was designed to isolate the triterpene, oleanolic acid (OA) from S. cordatum leaves and evaluate its effects on blood glucose, renal function and blood pressure in streptozotocin (STZ)-induced diabetic rats. OA was studied because it is the major constituent of many African plant species used in traditional medicine. Materials and Methods S. cordatum crude leaf ethyl acetate solubles (EAS) were obtained after defatting the leaves with hexane followed by dichloromethane before maceration with ethyl acetate. Preliminary experiments indicated that EAS contained triterpenes with hypoglycaemic properties. Solvent extraction and fractionation of EAS yielded mixtures of oleanolic acid/ursolic acid (OA/UA) and methyl maslinate/methyl corosolate. Recrystallisation of the OA/UA mixture using ethanol yielded OA, the structure of which was confirmed by NMR spectroscopy ('H & 13C). Oral glucose tolerance test (OGTT) responses to various doses of OA (40, 80 and 120 mg/kg) were monitored in separate groups of non-diabetic and STZ-induced diabetic rats given a glucose load (0.86 g/kg, p.o.) after an 18-h fast. Rats treated with deionized water (3 ml/kg p.o.), or standard drugs, (insulin, 200 Hg/kg, s.c; metformin, 500 mg/kg, p.o. and glibenclamide, 500 f^g/kg, p.o.) acted as untreated and treated positive controls, respectively. To investigate the possible interaction between OA and standard drugs in lowering blood glucose, OGTT responses were studied in separate groups of animals simultaneously treated with OA at either 40 or 80 mg/kg and insulin (100 or 200 ug/kg, s.c), metformin, (250 or 500 mg/kg, p.o.) or glibenclamide (250 or 500 mg/kg, p.o.). Blood glucose was monitored at 15-min intervals for the first hour, and hourly thereafter for 3 h. Plasma insulin concentrations were measured in separate parallel groups of rats prepared as for OGTT studies to examine whether there was an association between OA treatment and pancreatic insulin secretion. Acute effects of OA on kidney function and mean arterial blood pressure (MAP) were investigated in anaesthetized rats challenged with hypotonic saline after a 3'/2-h equilibration for 4 h consisting of 1 h control, 1XA h treatment and 1 Vi h recovery periods. OA was added to the infusate during the treatment period. Short-term effects of OA were studied in individually-caged rats treated twice daily with OA (80 mg/kg, p.o.) for 5 weeks. Results OA decreased blood glucose concentrations of both non-diabetic and diabetic rats, as did some standard drugs except glibenclamide which did not exhibit any effects in STZ-induced diabetic animals. The blood glucose lowering effects were most potent in STZ-induced rats treated with combined OA and insulin by comparison with all other treatments. Short-term treatment of non-diabetic and STZ-induced diabetic rats with OA alone for 5 weeks decreased blood glucose concentrations, but the reduction in non-diabetic rats was to values that did not achieve statistical significance. Except for non-diabetic rats treated with insulin alone or in combination with OA, plasma insulin concentrations were not altered by treatment in non-diabetic and STZ-induced diabetic animals. Hepatic glycogen concentrations of non-diabetic and STZ-induced diabetic rats were significantly increased by all treatments at the end of 5 weeks. Acute intravenous infusion of OA in anaesthetized rats significantly increased Na+ excretion outputs of non-diabetic and STZ-induced diabetic rats without affecting urine flow, K+ or CI" excretion rates. Similarly, daily OA treatment (80 mg/kg, p.o.) significantly increased Na+ excretion rates of non-diabetic and STZ-induced diabetic rats throughout the 5 week experimental period without affecting urine flow, K+ or CI" excretion rates. By comparison with respective control animals, Short-term administrations of OA significantly (p<0.05) increased GFR of non-diabetic (2.88±0.14 vs 3.71±0.30 ml/min) and STZ-diabetic rats (1.81± 0.32 vs 3.07±0.16 ml/min, n=6 in all groups) with concomitant reduction of plasma creatinine concentrations. Acute and Short-term administrations of OA non-diabetic and STZinduced diabetic rats reduced mean arterial blood pressure by comparison with respective control animals. Discussion The results suggest that S. cordatum leaf derived OA not only has the potential to lower blood glucose in diabetes, but also has beneficial effects on kidney function and blood pressure. We suggest that the hypoglycaemic effects of OA mimic those of metformin as evidenced by the fact that neither of these treatments altered plasma insulin concentration of non-diabetic rats. OA-evoked increases in urinary Na+ outputs of STZ-diabetic rats and elevation of GFR suggest up-regulation of renal function by the triterpene. The findings are of considerable importance because they suggest the hypoglycaemic, renal and hypotensive effects of OA in the management of diabetes mellitus. Conclusion The results demonstrated that the oleanolic acid extracted from S. cordatum leaf has blood glucose-lowering effects comparable to standard anti-diabetic drugs in STZ-induced diabetic rats. Furthermore, OA augmented the hypoglycaemic effects of insulin in STZ-induced diabetic rats. These findings suggest that OA may have beneficial effects on some of the processes that are associated with renal derangement in STZ-induced diabetic rats. The results introduce the first in vivo evidence that OA ameliorates kidney function in STZinduced diabetic rats. Keywords: Renal function; diabetes mellitus; triterpenoids; oleanolic acid, hypoglycaemia
HIV and the metabolic syndrome.
(2008) Bryant, Lynda P.
Abstract not available.
An analysis of perceived leadership styles and levels of job satisfaction of sport administrators employed at tertiary institutions in South Africa.
(2007) Naidoo, Padmini.; Coopoo, Yoganathan.
The leadership role of sport administrators in South Africa is of prime importance as the local sports industry in South Africa is worth in excess of R2 billion annually. The most important variable in explaining sport administrators' success becomes leadership style. Sport administrators' roles are vital to the sporting industry and therefore the degree of job satisfaction they experience is of prime importance. The key objectives of the study were to determine the different styles of leadership available in sport administration departments, to identify factors affecting the progress and status of transformation in sport administration departments, to examine the factors affecting the progress of gender equity at tertiary institutions, to identify factors which influence job satisfaction or lack of it among sport administrators and coaches employed at tertiary institutions and to determine the organizational effectiveness of tertiary institution sport departments. The questionnaire was administered to 300 coaches who had to rate their sport administrators' leadership style and 140 sport administrators. A response rate of 78% (n=109) was obtained from sport administrators and 76% (n=227) were received from coaches. The data were analysed using the computer package SPSS. From the research the following conclusions can be drawn with respect to job satisfaction and leadership among sport administrators and coaches. The overall majority of the tertiary institution sport administrators adopted a transformational style of leadership. There was a lack of transformation in the industry and gender equity in the industry. There were reasonable de grees of satisfaction in the profession, however certain variables were more pronounced than others. The study proposed the following recommendations: Those sport administrators that are still practising a more transactional and laissez-faire approach to leadership should start adopting a more transformational approach to leadership. More females need to be placed in leadership positions at tertiary institution sport departments. With regard to transformation higher management at tertiary institutions should strive to create diversity by employing individuals from other race groups to ensure transformation at institutions of higher learning. This will also serve to rectify the imbalances of our past. Management at tertiary institutions should also strike a balance with regard to gender equity. With regard to improving coaches and sport administrators' job satisfaction higher management needs to adopt a policy of open communication between staff employed at the tertiary institution sport departments and themselves.
Pharmacological effects of Hypoxis hemerocallidea Fisch. & C. A. Mey. (Hypoxidaceae) Corm ("African Potato") aqueous extract on some mammalian extra-vascular smooth muscles in vitro.
(2009) Nyinawumuntu, Agatha.; Ojewole, John Akanni Oluwole.
Extracts of Hypoxis hemerocallidea corm (African potato) are commonly used by some traditional health practitioners in KwaZulu-Natal Province of South Africa for an array of human ailments. This study was, therefore, undertaken to investigate the GIT spasmolytic, bronchospasmolytic, uterolytic and vasa deferentia relaxant effects of Hypoxis hemerocallidea corm aqueous extract. Respectively, these effects were determined on both naive and spasmogenevoked contractions of the guinea-pig and rat isolated ileum, trachea, uterine horns and the vas deferens in vitro. Healthy, young adult, male and female Dunkin-Hartley guinea-pigs (300-400g) and Wistar rats (250-350g) were used in this study. The isolated tissues were prepared and mounted in Ugo Basile organ-baths under normal physiological conditions. After an equilibration period of 30-45 minutes, the isolated smooth tissue segments were challenged with graded concentrations of Hypoxis hemerocallidea corm aqueous extract, and/or reference drugs. Changes in tension developed by the muscle preparations (relaxations and contractions) were recorded isometrically by means of Ugo Basile's force-displacement transducers and pen-writing 'Gemini' recorders. Relatively low to high concentrations of Hypoxis hemerocallidea corm aqueous extract (APE, 25-400 mg/ml) produced dose-dependent and significant (p<0.05) relaxations of the guinea-pig ileum, and the uterine horns taken from non-pregnant rats, as well as on spasmogenprovoked contractions of stilboesterol-primed, oestrogen-dominated, non-pregnant rats in a concentration-related manner. Potassium chloride (40 mM)-induced contractions of uterine horns, ACh (0.1-3.2 ug/ml)-induced increases in the amplitude of contractions of the guinea-pig ileum, as well as noradrenaline (0.2-1.6 ug/ml)-induced increases in the amplitude of contractions of the male rat isolated vasa diferentia, were significantly (p<0.05-0.001) reduced or abolished by bathapplied APE (25-400 mg/ml). Relatively low to high concentrations of the extract (25-400 mg/ml) caused concentration-dependent increases in the relaxations of the guinea-pig isolated tracheal smooth muscles. Inhibitions of ACh (0.1-3.2 ug/ml)-induced contractions of the guineapig isolated ileum probably suggests possession of antidiarrhoeal activity of APE. Results of this study show pronounced relaxant effects of Hypoxis hemerocallidea corm aqueous extract on guinea-pig vas deferens. The study also lends pharmacological credence to the folkloric, ethnomedical uses of APE as a natural antenatal remedy for threatening abortions, as an antidiarrhoeal remedy, and as a bronchorelaxant. The precise mechanisms of APE action on the smooth muscles could not be established in the present study. However, the uterolytic action of the corm's extract is unlikely to be mediated via ^-adrenoceptor stimulation, but probably mediated through a non-specific spasmolytic mechanism.
A retrospective analysis of subjects who have approved gastro-oesophageal reflux disease (GORD) from a private medical aid fund.
(2006) Suleman, Aisha Bebe.
Abstract not available.
The effect of an anti-inflammatory homeopathic product on systemic markers of inflammation following 90 minutes of downhill running.
(2008) Smith, Megan.; Peters-Futre, Edith Margret.
Background: The homeopathic preparation, Traumeel S, has been used as a valuable alternative to conventional non-steroidal anti-inflammatory drugs (NSAIDS) for over 30 years. This antihomotoxic, anti-phlogistic drug has been widely used by sportsmen and women in the treatment of lesions and inflammatory processes which result from exercise-induced skeletal muscle microtrauma. Although numerous randomised, double-blind placebo-controlled trials have confirmed the efficacy of Traumeel S as an anti-inflammatory agent, there are few in vivo studies which have specifically investigated the mechanism by which Traumeel S is effective in reducing inflammatory response to exercise-induced muscle cell damage. Aim: To establish whether the administration of Traumeel S during the five days before participation and three days following participation, significantly attenuates the systemic markers of the inflammatory response, following a 90-minute downhill running trial. Method: Twenty-four healthy athletes (14 men and 10 women), aged 20-50 years, were recruited for this study. Following baseline laboratory testing and familiarisation with the treadmill as well as a field test, subjects were matched according to gender, BMI, training age, training status, peak performance and foot strike patterns and randomised into Traumeel (TRS) and Control (PLAC) groups in a placebo-controlled, double-blind design. One Traumeel S or Placebo tablet was ingested three times per day for five days prior to and three days following a 90-minute exercise trial on a downhill (-6% gradient) at 75% V02 max- Blood samples were collected prior to the 90-minute trial (PRE), immediately after the trial (IPE) and 24 hours (24 PE), 48 hours (48 PE) and 72 hours (72 PE) following the trial. Each subject was also requested to complete a training record prior to the trial and keep a record of the daily symptoms of delayed onset muscle soreness (DOMS) both at rest (general pain) and during walking (daily living). Full blood counts (FBC), serum creatine kinase (CK), lactate dehydrogenase (LDH) and Cortisol concentrations were measured using standard haematological laboratory procedures and serum C-Reactive Protein (CRP) was determined by immunoturbidimetric assay. Sandwich ELISA's were used to determine myeloperoxidase (MPO) and plasma interleukin-6 (IL-6) concentrations. All results obtained were adjusted for changes in plasma volume as calculated from the red blood cell indices. Results: Mean ± SD characteristics of the gender-matched subjects in the experimental (TRS) and placebo-control (PLAC) groups did not differ significantly in terms of BMI, age, % body fat, FVC, FEVi, training age and status, foot strike pattern or peak running performance, maximal Heart Rate, VE, V02peak> RER, RPE during the maximal exercise test (p > 0.05). This indicated that the randomised pairs were well matched. The 90-minute downhill running protocol resulted in significant elevations in total circulating white blood cell count (WBC), neutrophil, CK, LDH, Cortisol, CPR, MPO and IL-6 concentrations (p < 0.001). When comparing the TRS and PLAC groups, mean ± SD total and differential WBC count, neutrophil count, CK, LDH, Cortisol, CPR, MPO and IL-6 concentrations did not differ (p > 0.05) over the 5 time points. At 24 PE, MPO concentrations were significantly higher in the TRS group than in the PLAC group (p = 0.03). The lower mean ± SD post-trial DOMS scores reported by the TRS group were not significantly different from those reported by the PLAC group (p > 0.05). Conclusion: Although the findings of this study did not identify differences in circulating CK, LDH, Cortisol, CPR and IL-6 concentrations between the TRS and PLAC groups, the elevated MPO concentration at 24 PE did provide preliminary novel evidence of enhanced activation of neutrophil oxidative burst activity following exercise-induced muscle damage which is hypothesized to accelerate the recovery process.
Multipolymeric monolayered mucoadhesive films for drug therapy.
(2007) Perumal, Velisha Ann.; Govender, Thirumala.
The use of the oral cavity membranes as sites of drug administration has been a topic of increasing interest for the past decade. The buccal route, in particular, offers several advantages over the per oral route and may prove to be a viable alternative to other routes for drug delivery, as it bypasses hepatic first pass metabolism, thereby improving the systemic bioavailability of the administered drug. A controlled drug release formulation may further enhance the therapeutic efficacy of a buccal drug delivery system. Propranolol HCI (PHCI), a non-selective p-blocker, primarily advocated in the treatment of hypertension, has a short half-life (3 - 6 hours) and is also subjected to extensive hepatic first-pass metabolism following oral administration, resulting in a low oral bioavailability, therefore rendering it an ideal candidate for buccal drug delivery. For optimal controlled release and mucoadhesivity of a buccal delivery system containing PHCI, the blending of polymers and drug of opposing solubilities may be required for the formation of monolayered films. The aim of this study was therefore to formulate and characterise multipolymeric monolayered mucoadhesive films containing drug and polymer/s of opposing solubilities for the buccal delivery of PHCI. First, preparation parameters for the formation of monolayered multipolymeric films (MMFs) and homopolymeric PHCI films comprising drug and polymer/s of opposing solubilities, i.e. Chitosan (CHT) and Poly(D,L-lactide-co-glycolide) (PLGA) by an emulsification/casting/solvent evaporation method were investigated. MMFs could be prepared at all homogenisation speeds (6000, 9000, 12000, 15000 rpm) and times (1, 5, 15, 25 minutes). The films showed micromatrices embedded in the film matrix due to the inclusion of the PLGA polymer. Increased homogenisation speed and time resulted in a reduction in the size of the micromatrices. Phase separation occurred at temperatures below 20 °C. Emulsifiers employed in the study (Poly(vinylalcohol) (PVA) and Tween 80®) adversely affected the morphology and appearance of the film and were therefore not considered feasible for inclusion in the formulation. The preparation parameters identified for emulsification without phase separation and the subsequent generation of monolayered films, without phase separation during solvent evaporation and drying, were emulsification at 20 °C and homogenisation at 9500 rpm for 15 minutes. It was discovered through preliminary investigations and a comprehensive literature search that the conventional film casting method of film preparation suffered from poor drug content uniformity. To address this problem of non-uniformity, a specially designed silicone-molded tray (SMT) for film casting was prepared and evaluated in terms of enhancing drug content uniformity. These investigations confirmed that the SMT with teflon-coated perspex inserts provided a reproducible method for the preparation of both homopolymeric and multipolymeric (including drug and polymers of similar and opposing solubilities) films that met drug content uniformity requirements (assay values were within 92-107.5%) and also reduced the variability in mucoadhesivity (p=0.2922), drug release [fi values = 92.76, 90.99 and 86.06) and film thickness for all three trays. The final phase of this study involved the identification of a suitable polymeric blend for the preparation of MMFs comprising hydrophilic and hydrophobic polymers for the controlled buccal delivery of PHCI and subsequent characterisation of these films in terms of their physicochemical/mechanical properties. Initial investigations of different polymers for the formation of homopolymeric films showed that the combination of drug and polymer/s of opposing ionic states was not possible due to complexation. PHCI film formation as homopolymeric films was achievable with hydrophilic polymers, Hydroxypropylmethylcellulose (HPMC) and CHT, and hydrophobic polymers, Ethylcellulose (EC) and Eudragit® RSI00 (EUD100). It was also found that combining PHCI, a hydrophilic drug, with a hydrophilic polymer (CHT or HPMC) failed to retard drug release (> 80% at 1 hour), whilst the release of PHCI from a homopolymeric film comprising a hydrophobic polymer (EC or EUD100) was retarded. A PHCIiEUDlOO (1:10) film provided controlled release but was too retarded (< 67% at 8 hours) for the purposes of this study. Hence, the polymeric content of the formulation was altered by the addition of a hydrophilic polymer CHT, to obtain the desired controlled release profile. A PHCI:EUD100:CHT (1:10:0.5) polymeric blend (MMF) was found to be suitable for the controlled release of PHCI and was reproducible in terms of drug content uniformity (p=0.1964), drug release [h values = 83.18; 82.03 and 71.19) and mucoadhesivity (p=0.9971). Drug release followed Higuchi's square-root model (r2=0.9426). Scanning electron microscopy revealed that the addition of CHT to the PHCI:EUD100 (1:10) film formulation rendered it more textured, which contributed to the faster drug release observed with the PHCI:EUD100:CHT (1:10:0.5) MMF. Swelling and erosion studies indicated that maximal swelling of the films occurred after 1 hour and 28.26% of the film eroded during the 8 hour test period. The system also demonstrated acceptable mucoadhesivity and mechanical properties. The surface pH of the films also remained constant at neutral pH throughout the study. The data obtained in this study confirmed the potential of this multipolymeric monolayered film system as a promising candidate for the controlled buccal delivery of PHCI. Key words: Films; Buccal; Multipolymeric; Mucoadhesive; Controlled drug release; Propranolol HCI
Effects of acetylcholine on isolated urinary bladders of normal and streptozotocin-treated diabetic rats.
(2006) Nsabimana, Abdon.; Ojewole, John Akanni Oluwole.
This study was prompted by the inconsistent reports and apparent controversies that exist in the biomedical literature on the responses of diabetic bladder strips to cholinergic nerve stimulation or exogenous administration of muscarinic agonists, especially acetylcholine (ACh), in vitro. In the present study, acetylcholine-induced contractions of urinary bladders isolated from normoglycaemic (normal) and streptozotocin-treated, diabetic Wistar rats were examined under physiological conditions. Mechanical contractile changes of the isolated urinary bladders of STZ-treated, diabetic rats in response to bath-applied acetylcholine were compared with those obtained from isolated urinary bladders of normal, age-matched, control rats. Results obtained show that urinary bladders from diabetic rats consistently weighed more, and were always more spontaneously active after mounting, than those of the age-matched normal, control rats. ft A Acetylcholine (ACh, 10" -10" M) provoked concentration-related, atropine-sensitive contractions of the isolated urinary bladders of both diabetic and age-matched normal, control rats. However, acetylcholine always induced more powerful and greater contractions of the diabetic bladders compared with bladders from the age-matched normal, control rats. The enhanced contractile responses of the diabetic bladder strips to bath-applied ACh were detected soon after induction of diabetes, and the magnitude and/or intensity of the enhanced contractile responses to ACh continued to increase as the diabetic state of the animals progressed. Although this preliminary study could not establish the mechanism of the increased contractile responsiveness of the diabetic bladders to the muscarinic agonist (ACh) used, the results tend to suggest that alterations in diabetic urinary bladder synaptosomal, vesicle-bound neurotransmitter (ACh) concentrations and the compensatory increase in the density of muscarinic M3-receptor population in diabetic bladders are two of the most attractive plausible mechanisms of the increased diabetic bladder responsiveness to bath-applied acetylcholine.
Physiological response to incremental stationary cycling using conventional, circular and variable-geared, elliptical Q-chain rings.
(2008) Jones, Andrew D.; Peters-Futre, Edith Margret.
Background: As variable-geared, elliptical Rotor Q-rings may improve pedal dynamics by reducing the effect of the "dead spot" in the pedaling action and altering the mechanical leverage, use of these chain rings is currently gaining popularity among competitive amateur and professional cyclists. There are, however, no randomized, controlled, published studies examining the physiological effect of using Rotor Q-rings vs. standard circular chain rings. In addition, no previous studies comparing circular and noncircular chain rings have included analysis of the markers of exercise induced muscle damage. Aim: This work was designed to compare physiological response to an incremental cycling protocol when using Rotor Q-rings (QR) with an eccentricity ratio of 1.10 and 74° default setting, to that obtained when normal, circular chain rings (NR) are used. Methods: Twelve trained amateur cyclists (age: 40.67 ± 7.53 years) performed two incremental tests to exhaustion on their own bicycles in a controlled laboratory environment. The subjects were randomized to QR and NR trials which took place seven days apart, within a cross-over design. The type of chain ring attached to the cycle (QR vs. NR) was blinded from the participant. After an eight-minute warm-up at 130 W, the power output was increased by 30 W on the minute. During each trial, heart rate, VE, V02 were measured continuously and RPE and blood lactate concentration were measured during the last 15 seconds of each workload. Ventilatory and blood lactate turn- points were determined from serial VE and blood lactate concentrations. Serum lactate dehydrogenase (LDH) concentration was measured before and immediately after each trial. A numerical pain rating scale was used to assess post exercise leg muscle and knee joint soreness 24hr post trial. Results: There was no statistically significant difference (p > 0.05) in mean peak power output (380 ± 29.0 W vs. 385 ± 31.8 W), mean power (194.9 ± 12.7 W vs. 197.2 ± 16.7 W), mean distance covered (9.02 ± 1.29 km vs. 8.89 ± 1.84 km) during the QR and NR trials, respectively. There were no statistically significant differences between trials in submaximal and maximal V02, VE or RPE, and ventilatory or lactate turnpoints (p > 0.05). Knee pain and leg muscle soreness as well as and increment in serum LDH levels did also not differ significantly following the two trials (p > 0.05). The difference in peak blood lactate concentrations (12.62 mmol. £"' ± 2.15 on QR vs. 13.84 mmol. £"' ± 1.68 on NR), however, reached borderline significance (p = 0.055). Conclusion: Despite the popularity of non-circular chain rings and the apparent mechanical advantage derived from their use, the findings of this study were unable to provide support for significant physiological advantages when using Rotor Q-rings with an eccentricity ratio of 1.10 and 74° default setting, during an incremental cycling test to exhaustion. While the borderline significance of the lower mean maximal blood lactate concentration following the Q-ring trial requires confirmation in a larger study, the possible roles of training, higher eccentricity ratios and different orientations of the crank to the chain ring in eliciting a physiological advantage, require further investigation.
The effects of exercise on the aged.
(2002) Ellapen, Terry Jeremy.; Coopoo, Yoganathan.; Ramiah, Pramila Devi.
This study aimed to document the effects of regular exercise and physical activity on the aged. Subjects (n=S8) over the age of sixty-five participated in the study. All subjects were patrons from various retirement centers of the DAFTA organization (Durban Association for the Aged). The subjects completed a PAR-Q and informed consent form, which allowed the eligible to participate in the study. A pre and post-test battery was administered to measure the following parameters; body mass, height, girth measurement, agility and dynamic balance, muscle strength and endurance, flexibility, co-ordination, dynamic grip strength and aerobic capacity. During the experimental period the subjects engaged in a structured intervention exercise programme of 30 weeks. The intervention programme composed of games, walking, stretching, flexibility and resistance training exercises aimed at improving the following fitness components; agility and dynamic balance, strength, flexibility, co-ordination and aerobic capacity. Inferential and differential statistical methods were employed in order to analyzethe data. The study indicated that regular exercise and physical activity positively impacted the senior citizens' functional capacity and improved their quality of life (p
A study to investigate the relationship between obstetric brachial plexus palsies and cephalopelvic disproporation (including fetal macrosomia)
(2002) Pillay, Kalaimani.; Naidoo, Krishnasmay Soobiah.
In view of the lifelong impact of Obstetrical Brachial Plexus Palsies (OBPP), prevention of OBPP would be of great significance. Despite contemporary advances in antenatal planning and assessment, OBPP remains an unfortunate consequence after difficult childbirth. Permanent brachial plexus palsy is a leading cause of litigation related to birth trauma. Objectives: To determine the incidence of Obstetrical Brachial Plexus Palsy (OBPP), Cephalopelvic Disproportion (CPD) and macrosomia in KwaZulu-Natal. As well as to investigate the relationship between OBPP and CPD, and the relationship between OBPP and macrosomia. The study also aimed to determine whether antenatal risk factors could identify those prone to OBPP. Study design: This was a case control study that included all deliveries from 1997 to 2000 from four provincial hospitals (Addington, King Edward VIII, Prince Mshiyeni Memorial and RK Khan hospital). The outcome variable was OBPP. Results were analyzed using Statistical Program for Social Sciences (SPSS). Results: A total of 60 infants of 76 352 deliveries sustained OBPP. The incidence of OBPP was found to be 0.72 per 1000 deliveries. The incidence of CPD was found to be 33.5 per 1000 deliveries and the incidence of macrosomia was found to be 16.7 per 1000 deliveries. Race, Maternal height> 150 cm, gravida >3, parity >4, history of a previous big baby, normal vaginal delivery, delivery by a midwife, difficult labour, inadequate or doubtful pelvic capacity, birth weight of >3700 g and gestation period> 34 weeks were significant risk factors. Logistic regression analysis showed that race, parity> 4, normal vaginal delivery and gestation period> 35 weeks were the variables most associated with OBPP. Using linear regression model was obtained for the calculation of predictive risk scores. Conclusion: Using standard statistical formulae the probability of OBPP can be calculated in women with significant risk factors from the logistic regression formula. This would need to be validated and could provide a useful tool for screening for OBPP thus contributing to preventing this devastating complication of birth trauma. The risk assessment profile would contribute greatly to the prediction of OBPP and the subsequent prevention of this debilitating birth injury.
An economic impact analysis of the Comrades Marathon on the city of Durban.
(2009) Maharajh, Ashok.; Coopoo, Yoganathan.
Sport has become a major industry as well as a key cultural preoccupation in contemporary society. Cities are increasingly using major sporting events and activities to re-image themselves, promote urban development and fund economic growth and regeneration. Major sport events are often recognised for their ability to generate significant economic benefits for the host destination. The major difference between this study and other economic impact studies is that the event is tracked over a two-year period. This afforded the author the opportunity to compare and note the variations in the data over the two years. Initially, the study purports to analyse the economic impact of the Comrades Marathon on the City of Durban. A secondary objective is to demonstrate the value of such a major sporting event to the regional and provincial governments as well as the formal and informal businesses in the city. Durban like other key cities in the world is and will increasingly be confronted by two main and related challenges. Firstly, there is need to successfully compete in a universal economy characterised by increased competition and globalization. Secondly, there is need to eliminate poverty and address issues of inequality and marginalization. Thus, the Comrades Marathon, as a major sporting event, can be seen as a primary driver to create jobs and contribute to competitiveness. As stated the research was conducted over two years viz. 2004 and 2005 thus representing an "up" and a "down" run. The questionnaire method and interviews were employed for this study and were administered to accommodate the alternate runs. The questionnaire requested data on the age, gender, occupations, income levels, spending patterns and the types of activities that the population found attractive. The population consisted of foreign runners and supporters, runners and supporters that reside in other provinces of South Africa, stall holders at the Comrades Expo that is normally held over three days prior to the race, representatives of the sponsors of the event and vendors. The sample was selected randomly from the population. Face-to-face interviews were conducted with representatives from the hotel industry in Durban, the Acting-Chief Executive Officer and committee members of the Comrades Marathon Association and the Marketing Managers/Public Relations Officers of three major shopping malls located in Durban. Turco, Swart, Bob and Moodley (2003) reported that the leverage ratio that is public sector input against private sector response indicated that the 2001 Comrades Marathon together with other major sporting events held in the city were successful and contributed significantly to the Durban economy. The leverage ratio is illustrative of the amount of money that was accrued to the private sector with every Rand spend by the public sector. Consideration was given to the total revenue generated by peoples' average spending at the events and the total amount accruing to the accommodation industry. Cognisance must be taken that the leverage ratio does not consider overall spending in Durban as well as other general multipliers such as revenue generated from transport, other financial transactions, product suppliers, guided tours, established businesses and informal traders. The findings showed that the leverage ratio for 2004 was computed to be 1:216.38 that is for every Rand spent by the public sector on the event R216.38 was generated by the private sector. In addition, the leverage ratio for 2005 was computed to be 1:434.49 that is for every Rand spend by the public sector on the event R434.49 was generated by the private sector. Thus, the expenditure was considerably higher in 2005 with an upsurge of R31 819 272 that is an increase of 33%. The fundamental idea behind the economic impact of sporting events is that it injects a significant increase in the demand of goods and services into the economy. This effect is not simply the direct effect of consumer spending but also the indirect effects caused by the stimulus to the economic activities induced by the direct effects.
Beta-lactamase mediated resistance in Escherichia Coli isolated from state hospitals in KwaZulu-Natal.
(2008) Mocktar, Chunderika.; Essack, Sabiha Yusuf.; Sturm, Adriaan Willem.
Escherichia coli, one of the most common pathogens causing urinary tract infections, has shown increased resistance to commonly used antibiotics. In this study we analyzed the β-lactamase profiles of 38 inhibitor-resistant E. coli isolates obtained from public hospitals at three different levels of healthcare in KwaZulu-Natal, selected on the basis of their resistance profiles to the three antibiotic/inhibitor combinations, viz., amoxicillin/clavulanate, ampicillin/ sulbactam and piperacillin/ tazobactam. The isolates were subjected to MIC determinations, IEF analysis, plasmid profile analysis, PCR of the different β-lactamase genes and sequencing thereof to detect the possible mechanism/s of resistance. A range of β-lactamases including two novel inhibitor-resistant TEM β-lactamases, TEM-145 and TEM-146 were detected in two isolates whilst a novel plasmid-mediated AmpC-type β-lactamase, CMY-20 was detected in three isolates. Other β-lactamases included OXA-1, TEM-55, SHV-2, CTX-M-l and TEM-1. Changes were detected in the chromosomal AmpC promoter/attenuator regions in one isolate. Diverse β-lactamase genes and plasmid profiles inferred extensive mobilization of β-lactamase genes causing the concern of limited therapeutic options in the face of increasing resistance.
Physiological and physical fitness profiles of elite South African surfers.
(2000) Patterson, Dean Kenneth.; Coopoo, Yoganathan.
The present study profiled the fitness characteristics of elite South African surfers. Sixty-one surfers volunteered to participate in the study. Each subject underwent a maximal tests in order to measure peak maximum oxygen uptake, anthropometery, co-ordination, agility, balance, Wingate test, and isokinetic strength assessments of the knee and shoulder in extension and flexion, including shoulder internal and external rotation. Lung function measurements were also measured to assess the lung capacity of the subjects. The cardiovascular demands of surfing was high showing a peak VO2 of 54.9 (+SD=9.73) ml.kg-1.min-t, and a peak VE of 98.3 (+SD=17.8) l.min-1. Actual lung function results obtained by the subjects were greater than predicted scores for age and weight. Anaerobic scores were excellent for surfers as compared to other sportpersons. Balance and agility scores were excellent. Good strength ratios and values were obtained through isokinetic testing, both for the shoulders and the knees. The subjects showed an above level of fitness in all the measurements as compared to other water-based athletes. As a result the research showed that surfing can be best enhanced through the principle of specificity, and that the subjects engaged in this sport can be regarded as elite athletes.
A comparison of the fitness levels of Indian high school boys in two cohorts : 1977 and 1997.
(2000) Naidoo, Krishnaveni.; Coopoo, Yoganathan.
The main aim of this study was to compare fitness levels of Indian high school boys in two cohorts: 1977 and 1997. A secondary aim was to identify if the same problem areas or strengths still exist in 1997 as in 1977 or if the levels of fitness have further deteriorated or improved, as well as the establishment of norms for boys 14 - 18 years. Ten different Secondary schools from the Durban Metropolitan area participated in this study. The test battery included eight tests measuring four components of motor fitness based on the Fleishman study. The tests that were used consisted of fifty metre shuttle run, fifty metre dash, sit-ups, pull-ups, medicine ball put, shot-put, 250m shuttle run and 12 minute run/walk test. Data from 500 hundred boys were included in the research analysis and these were categorized into 5 different age groups, 13,6 - 14,6 years; 14,7 - 15,6 years; 15,7 - 16,6 years; 16,7 - 17,6 years and 17,7 - 18,6 years. Basic statistical procedures were used to determine the normality of the samples for height and weight in each age group. Standard score tables were drawn for each age group. A paired t-test was used to determine if a significant difference between the means existed. The level of significance was set at 0,05. The means of both studies were compared to ascertain the difference in fitness levels in the two cohorts. The analysis of the data revealed that the fitness status of adolescent boys have deteriorated over two decades.
Antimicrobial and chemical analyses of selected bulbine species.
(2000) Mocktar, Chunderika.; Essack, Sabiha Yusuf.; Rogers, B. C.; Dangor, Cassim Mahomed.
The use of plant materials for the treatment of various diseases is very common in African countries. As traditional medicine used by the rural people does not always have a proper scientific basis, research programmes have to be undertaken to evaluate their therapeutic efficacy and safety. In traditional African medicine various Bulbine species are used to treat a number of conditions including sexually transmitted diseases, wound infections, dysentery and urinary tract infections. The Bulbine species belong to the family Asphodelaceae. There are over fifty South African Bulbine species and they are mostly herbs. Their leaves are evergreen and succulent in appearance. Bulbine species have thick fleshy tuberous roots, are easy to grow, are able to withstand drought and heat and are able to grow in poor soil. There is very little documented information on the antimicrobial activity and chemical properties of the Bulbine species. Therefore research programmes of this nature have to be undertaken. Various Bulbine species, viz., B. natalensis Bak, B. frutescens Willd (yellow flowers), B. narcissifalia Salm Dyck, B. abyssinica A Rich and B. frutescens Willd (orange flowers) were collected. The plants were washed with tap water, air dried and separated into the different components. Each component was cut into small pieces and immersed in methanol: dichloromethane (1:1, v/v) for extraction. The organic solvent was decanted from the plant material and evaporated under reduced pressure. The resultant crude extracts were stored in glass vials in the freezer. In addition, the roots, stems and leaves of B. natalensis and B. frutescens (yellow flowers) were extracted aqueously. The crude organic and aqueous were subjected to various tests to evaluate their antimicrobial and cytotoxic potential. To evaluate their antibacterial activities, the Disk Diffusion and Bore Well Methods were employed. The crude extracts were tested against various pathogens implicated in wound and urinary tract infections and dysentery. In these experiments the Disk Diffusion Method produced better results than the Bore Well Method. The crude organic and aqueous extracts were found to be effective against many of the bacteria used in this study including K. pneumoniae, S. aureus, S. typhi and S. flexneri which are considered to be troublesome pathogens. The TLC bioassay was employed to evaluate the antifungal potential of the various crude extracts against Aspergillus and Penicillium and the Disk Diffusion and Bore Well methods were used to evaluate the antifungal potential of C. albicans. The Bulbine species displayed no antifungal activity against Penicillium and limited antifungal activity against Aspergillus. The two method used to evaluate the antifungal activity of. C albicans was chosen because C. albicans grows in a similar manner to bacteria on solid and liquid culture media. Only the root extracts of the two B. frutescens varieties were inhibitory to C. albicans. The Brine Shrimp Bioassay was used to ascertain the cytotoxic potential of the crude extracts. The majority of the extracts were cytotoxic at the most concentrated dilution (i.e., dilution 1) but not cytotoxic at the lower dilutions. The only extracts that were not cytotoxic at the most concentrated dilution were the organic extract of the root of B. frutescens (yellow flowers), the organic extract of the root of B. narcissifolia and the organic extract of the leaf of B. abyssinica. TLC and column chromatography was carried out to evaluate the chemical composition of the Bulbine species. The TLC indicate that this technique could be a valuable tool in identifying the different species in the genus Bulbine. Column chromatogram was carried out on the extract which displayed a significant amount of antibacterial activity against the bacteria used in this study. The stem extract of B. natalensis was chosen for further analysis. The stem extract was fractitioned into different fractions but unfortunately none of the chemical component could be identified. According to the results obtained in this study, there is considerable scope for further studies of this genus.
Visual perceptual abilities in obstetric brachial plexus palsy : an investigation of the incidence and a comparative analysis.
(1998) Nukanna, Ornissa.; Naidoo, K. S.; Van Vuuren, Santie.; Joubert, Robin Wendy Elizabeth.
Obstetric brachial plexus palsy, a traumatic birth palsy, results in the paralysis of the upper limb/s. The birth injury is treated at the Brachial Plexus Clinic at King Edward VIII th Hospital, where the Candidate forms part of the Rehabilitation Team. In keeping with worldwide trends, the focus of treatment was on rehabilitation of the upper limb/s. During the course of treatment of these patients, it was observed that the performance of these children varied from excellent to poor. This observation, has not been recorded previously, hence a Research study was initiated to invesitigate this aspect of performance. The study comprised thirty children, between the ages of four and seventeen, whose paralysis was assessed in the conventional pattern. In addition, the visual perceptual abilities of these children were assessed in a variety of batteries, catering for the wide age range. These were: Developmental Test of Visual Motor Integration (1989), Motor Free Perception Test (1972), Developmental Test of Visual Perception (2nd edition), Test of Visual Perceptual Skills - Upper and Lower levels ( Gardner), Jordan's Left-Right Reversal Test (1974), Clinical (Ayres) and General Observations. Although traditionally viewed as a physical disorder, the results of the study indicate that children with obstetric brachial plexus injury present with a significant incidence of below average performance, against the normal population, on most of the assessment batteries. No significant relationship could be established between the severity of the lesion and visual perceptual abilities, owing to the disproportionate numbers of children amongst the different lesions. Further research is required to support and consolidate the findings of this study. It is also recommended that Occupational therapists screen for visual perceptual deficits in such injuries, thus facilitating holistic patient management.
Toward access, success and equity in health science education : a KwaZulu-Natal case study.
(1999) Stewart, Rene.; Brookes, David W.; Bhagwanjee, Anil Mohanlal.; Joubert, Robin Wendy Elizabeth.
Aim: This study aims to generate recommendations for enhancing the access and success of historically disadvantaged students to health science education at UDW, based on barriers identified within diverse schooling contexts and local conditions at UDW. Methodology: A case study approach was used to select five former DET schools within the DFR to constitute the sample of historically disadvantaged schools for this study. In order to capture the specific ecological milieu, social and cultural conditions pertaining to rural, urban and informal settlement contexts, three schools were strategically selected from each of these contexts (i.e. Sobonakhona, Ilanga and Inhlanhlayethu High schools respectively). In addition, two former DET schools that displayed relatively high achievement rates were also selected (i.e. Vukuzakhe and Zwelibanzi High schools), in order to contextually understand how barriers to positive educational outcomes might be overcome. A multistage sampling procedure was used to sample 40 standard seven and 40 standard ten scholars from each of the selected schools (n=400) and a purposive sampling procedure was used to obtain a sample of teaching staff involved in career counselling and/or science education in each school (n=16). In addition, saturation sampling was employed to obtain a sample of second year African students in the Faculties of Health Sciences and Dentistry at UDW (n=73). A combination of quantitative and qualitative data collection methods was employed, with questionnaires being administered to standard seven and ten scholars as well as to historically disadvantaged health science students. In addition, a total of five focus groups were conducted with teaching staff from each of the selected schools. Results and discussion: It was evident that a complex and interwoven web of factors impacted on the access and success of historically disadvantaged students in health science education at UDW, including, inter alia, inadequate school instructional resources; limited community economic resources; a paucity of educational opportunities and experiences in the home environment; poverty status; low levels of self-efficacy in academic skill; inadequate school career counselling; university selection procedures with a eurocentric bias; adjustment difficulties in the transition from secondary to tertiary education; financial difficulties; a paucity of 'in-group' academic role models; inadequate ADPs and negative conditions in campus student residences. These results are discussed and interpreted within the context of relevant empirical literature as well as a taxonomy derived from over 60 multivariate school-effects studies undertaken in developing countries, comprising four dimensions, viz. ecology, milieu, social system and culture. Conclusions: On the basis of the findings of this study, recommendations for enhancing the access and success of historically disadvantaged students to health science education at UDW are offered. While these recommendations pertain to a broad range of stakeholders, including the Education Ministry, the schooling sector and higher education institutions, particular attention is paid to the development of practical recruitment, selection and retention strategies to be employed by UDW and its Faculty of Health Sciences. Finally, the limitations of the study are discussed and recommendations for future research in this field are offered. KEY terms: access, success and equity; historically disadvantaged; health science education; educational outcomes.

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