Walter Sisulu University
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Antihypertensive effects of the hydroethanol extract of Senecio serratuloides DC in rats
Get PDFSenecio serratuloides DC is used in folk medicine for treating hypertension, skin disorders, internal and external sores, rashes, burns and wounds. This study aimed at investigating the antihypertensive effects of the hydroethanol extract of S. serratuloides (HESS) in N-Nitro-L-arginine methyl ester (L-NAME) induced hypertension in rats. Methods: Acute toxicity of HESS was first determined to provide guidance on doses to be used in this study. Lorke’s method was used to determine safety of the extract in mice. Female Wistar rats were treated orally once daily with L-NAME (40 mg/kg) for 4 weeks and then concomitantly with L-NAME (20 mg/kg) and plant extract (150 and 300 mg/kg), captopril (20 mg/kg) or saline as per assigned group for 2 weeks followed by a 2-week period of assigned treatments only. Blood pressure was monitored weekly. Lipid profile, nitric oxide, renin and angiotensin II concentrations were determined in serum while mineralocorticoid receptor concentration was quantified in the kidney homogenate. Nitric oxide (NO) concentration was determined in serum and cardiac histology performed. Results HESS was found to be non-toxic, having a LD50 greater than 5000 mg/kg. Blood pressure increased progressively in all animals from the second week of L-NAME treatment. HESS treatment significantly and dose-dependently lowered systolic blood pressure (p less 0.001), diastolic blood pressure (p less 0.01), low density lipoprotein cholesterol (p less 0.01) and triglycerides (p less 0.01). It significantly prevented L-NAME induced decrease in serum angiotensin II (p less 0.01), high density lipoprotein cholesterol (p less 0.001) and serum nitric oxide concentrations (p less 0.001). HESS also significantly (p less 0.01) prevented collagen deposition in cardiac tissue. Conclusion The hydro-ethanol extract of Senecio serratuloides showed antihypertensive, antihyperlipidemic and cardioprotective effects in rats thus confirming its usefulness in traditional antihypertensive therapy and potential for antihypertensive drug development
Ellisras Longitudinal Study 2017: association of hypertension with increasing levels of adiposity in 10- to 14-year-old boys and girls in the Eastern Cape (ELS 31)
Get PDFEligibility for co-trimoxazole prophylaxis among adult HIV-infected patients in South Africa
Get PDFCo-trimoxazole (fixed-dose trimethoprim-sulfamethoxazole) is a broad-spectrum antibiotic used to prevent opportunistic infections in patients with HIV infection. Primary prophylaxis with co-trimoxazole has been shown to decrease hospitalisation, morbidity and mortality among people living with HIV, primarily by decreasing rates of malaria, pneumonia, diarrhoea, Pneumocystis pneumonia, toxoplasmosis and severe bacterial infections.[1-4] Co-trimoxazole is inexpensive and widely available. In standard adult treatment guidelines and essential medicine lists in South Africa (SA), the current recommendation is that co-trimoxazole should be provided for HIV-infected patients with a CD4+ count ˂200 cells/μL, HIV/tuberculosis (TB) co-infection and/or advanced HIV disease (World Health Organization (WHO) stage 3 or 4). Because of expanded access and progression towards initiation of antiretroviral treatment (ART), the WHO issued updated guidelines for co-trimoxazole prophylaxis in 2014.[5] These guidelines recommend co-trimoxazole prophylaxis for adults (including pregnant women) with severe or advanced HIV clinical disease (WHO stage 3 or 4) and/or with a CD4+ count ≤350 cells/μL. In settings with a high prevalence of malaria and/or severe bacterial infections, prophylaxis is recommended for all patients regardless of WHO clinical stage or CD4+ cell count. However, the timing of discontinuation of co-trimoxazole prophylaxis may vary and is dependent on the malarial/ bacterial infection burden in different settings.[5] Therefore, the current WHO guidance should be adapted in the context of a country-specific epidemiological profile and priorities. The impact and benefit of co-trimoxazole prophylaxis on morbidity and mortality among HIV-infected patients with a CD4+ count ≤350 cells/μL in regions with high infectious disease burdens (irrespective of CD4+ count) have been shown in a good-quality systematic review and meta-analysis that included both randomised controlled trials (RCTs) and observational cohort studies.[6] This extensive systematic review by Suthar et al.[6] showed that co-trimoxazole prophylaxis reduced the rate of death when initiated at CD4+ counts ≤350 cells/μL with ART in populations in Africa and Asia. Co-trimoxazole prophylaxis in ART-naive patients with CD4+ counts >350 cells/μL reduced the rate of death and malaria, and continuation of prophylaxis after ART-induced recovery with CD4+ counts >350 cells/μL reduced hospital admission, pneumonia, malaria and diarrhoea in African populations (SA, Zimbabwe, Uganda, Malawi, Mozambique and Ethiopia).[6] While this review largely informed the 2014 WHO guideline update, the findings need to be interpreted in the context of studies included and the varied epidemiological profile across middle- and low-income countries. There were only 2 relatively small RCTs with very few events of key endpoints; therefore, the finding of non-significance was likely (e.g. total of ~5 deaths in both arms from both trials).[7,8] One of the 2 studies was unblinded, and the follow-up in the other study was only 4 months. Ongoing co-trimoxazole prophylaxis was better than discontinuation of the drug at CD4+ counts >200 cells/μL for 3 endpoints with an adequate number of events (pneumonia, diarrhoea and malaria). Furthermore, 8 of 9 studies were conducted in countries with a high burden of malaria and bacterial and parasitic diseases, which is generalisable to the SA context.[9] Although seasonal malaria occurs in the north-eastern parts of SA, the incidence of malaria mortality and morbidity has declined remarkably over time (˂10 000 cases annually for the past 10 years).[10] In contrast, in Uganda, >9 million confirmed cases of malaria were reported in the public health sector in 2015.[9] In this review, further stratification of the impact of co-trimoxazole prophylaxis at CD4+ counts ˂200 cells/μL v. 200 - 350 cells/μL was not available. Lower bacterial resistance to co-trimoxazole is possible among populations included in this review, while resistance to co-trimoxazole in SA is common in patients with community-acquired bacterial infections.[11-13] This potential risk of resistance compounded by the lack of long-term toxicity data needs to be weighed against recommending prophylaxis in populations where benefit has not been established. Local observational studies suggest no benefit of co-trimoxazole prophylaxis with a CD4+ count >200 cells/μL or in patients who were not WHO clinical stage 3 or 4.[14,15] In an observational cohort of patients attending the adult HIV clinics at the University of Cape Town, SA, the effect of prophylactic low-dose co-trimoxazole on survival and morbidity was examined over a 5-year follow-up period. Co-trimoxazole reduced the hazards of mortality by ~44% and the incidence of severe HIV-related illnesses by ~48% in patients with evidence of advanced immunosuppression (WHO stage 3 or 4) or laboratory measurement of total lymphocyte count ˂1 250 × 106/L or CD4+ count ˂200 cells/μL. However, no beneficial effect was seen in patients with WHO clinical stage 2 or CD4+ count 200 - 500 cells/μL. A potential limitation of this study was that the sample size of patients with a CD4+ count 200 - 500 cells/μL receiving co-trimoxazole was small and may have been underpowered to observe a significant benefit. In this study, patients on ART were excluded.[14] In another SA cohort study by Hoffmann et al.,[15] examining co-trimoxazole effectiveness in reducing mortality risk during ART among persons with a CD4+ count >200 cells/μL and varying WHO clinical stages, overall co-trimoxazole prophylaxis reduced mortality by 36% across all CD4+ count strata. Analysis stratified by baseline CD4+ count showed a similar reduction in mortality risk among persons with a CD4+ count ˂200 cells/μL, but no statistically significant association was found between co-trimoxazole prophylaxis and survival in the subgroup of persons with a CD4+ count >200 - 350 cells/μL, CD4+ count >350 cells/μL and WHO stage 1 or 2 disease. However, the findings of this study need to be interpreted cautiously for the following reasons: the group with a CD4+ count >350 cells/μL was small (n=917) and might not have had enough events to draw inferences; the study population was a cohort of miners and might not have been potentially representative of the SA population; and, being a non-randomised study, residual confounding might have been a potential limitation. An earlier Cochrane review established the benefit of initiating prophylaxis at a CD4+ count ˂200 cells/μL in those with stage 2, 3 or 4 HIV disease (including TB), and discontinuation once the CD4+ count was >200 cells/μL for >6 months.[16] There was a reduction of ~31% in mortality, 27% in morbid events and 55% in hospitalisation. Significant reductions were also detected for bacterial and parasitic infections and for Pneumocystis jirovecii pneumonia. Considering the above-mentioned evidence gaps and lack of generalisability of studies to SA, the current National Essential Medicines List Committee and Adult Hospital-Level Technical Sub-committee do not support the implementation of the updated guidance by the WHO for co-trimoxazole prophylaxis among adult HIV-infected patients. Efforts should be directed towards exploring several research gaps. The impact of co-trimoxazole prophylaxis on morbidity and mortality at higher CD4+ counts in low-malariaburden areas needs to be investigated further. More data are needed on timing of co-trimoxazole cessation in HIV and TB co-infection in our context
Parents’ and teachers’ perspectives towards teaching and learning of intellectually impaired learners at the Foundation Phase in Mthatha Education Sub-District
Get PDFThe purpose of this study was to investigate parents’ and teachers’ perspectives towards the teaching and learning of intellectually impaired learners at Foundation Phase in Mthatha Education Sub-District. This study explored the lived experiences of parents and teachers of intellectually impaired learners in this special school. It determined parents’ and teachers’ understanding of intellectual disability, the challenges they face in working with such children and strategies they use to deal with intellectually challenged learners. The research was limited to one special school in Mthatha, which is the only special school in this sub-district. The study used the qualitative research approach in the form of case study research design. The sample consisted of twelve participants, four parents of learners who are intellectually impaired and eight Foundation Phase teachers in this special school. These are some of the findings: The Education White Paper 6 on building an inclusive education and training is effective even though it is moving slowly. There has been no preparation on how it should be implemented in terms of human and other resources, knowledge and skills on special needs education. The challenges teachers face in teaching learners who are intellectually impaired include: learner-teacher ratio that is not followed, hence overcrowded classes; classroom management; lack of learner support materials; no special curriculum designed for intellectually impaired learners; confining subject matter and teachers not participating in skills development. The mechanism that were suggested to assist learners who are intellectually impaired included: equipping teachers with skills necessary for learning and teaching of intellectually impaired learners, establishing institutional level support teams, making more learning and teaching resources available, providing qualified human resources, mobilizing public support, government understanding impairment and therapists being employed (psychologists, physicians, nurses, doctors and social workers). Some of the recommendations are: conducting workshops on effective coping strategies for teachers, public awareness campaigns in communities about intellectual disability, school governing bodies working with the government to supply the school with adequate learner support materials, proper infrastructure, School Based Support Teams support service, the District taking responsibility for establishing networks that promote effective communication between learners, teachers and parents as well as with non-governmental organizations and welfare, health and justice departments and Supporting teachers on site.Thesis (M.Ed) -- Faculty of Education Sciences, 201
Inequality in uptake of isoniazid prevention therapy and Mantoux test among pregnant women with HIV in the Eastern Cape, South Africa
No full textRisk factors and outcomes of acute kidney injury in South African critically ill adults: a prospective cohort study
Get PDFHereditary spherocytosis with successful splenectomy in a pregnant black South African lady: a case report
Get PDFREADINESS OF UNIVERSITIES FOR THE 21 ST CENTURY DIGITAL ECONOMIES A LOOK AT SELECTED LEC TURERS FROM U NIVERSITIES IN B UFFALO C ITY M ETROPOLITAN IN E AS TERN C APE P ROVINCE S OUTH A FRICA
Get PDFCOMMERCIALISATION OF SUBSISTENCE AGRICULTURE AS A STRATEGY FOR POVERTY ALLEVIATION IN THE KING SABATHA DALINDYEBO LOCAL MUNICIPALITY
Get PDFAbstract The study investigated whether commercialisation of subsistence agriculture can reduce poverty in the King Sabatha Dalindyebo Local Municipality. The study also sought to identify the constraints that hinder subsistence farmers in the commercialization of their agricultural produce, measured the degree of commercialisation among small scale crop farmers and made recommendations that will facilitate increased commercialisation among small holder crop producers in the study area. A cross-sectional study was conducted in the King Sabatha Dalindyebo Local Municipality. A quantitative research method was used in the study. To achieve these objectives data were collected using a structured questionnaire. This was followed by data analysis using the Statistical Package for Social Sciences Software (SPSS). The study made use of the Household Commercialisation Index (HCI) to measure the level of commercialisation among the farmers in the study area. An Ordinary least squares regression (OLS) analysis on the determinants of commercialisation was also conducted. Poverty was measured using income generated by farmers from the sale of their produce and bench-marked with the food poverty line of South Africa in 2017 year prices as stipulated by STATSSA. A binary logistic regression analysis was conducted to measure poverty against independent variables. It emerged from the study that 74% percent of the farmers fall below the halfway mark of the commercialisation treshhold. The regression analysis showed that three variables were significant for commercialisation. These were farming experience, access to credit and other sources of income. The farming experience was the variable with the strongest significance level, and hence affects the Household Commercialisation Index (dependent variable). The only variable that was not significant is the plot size. The analysis of results for poverty reduction revealed that the Household Commercialisation Index (HCI), access to credit and educational level were significant for poverty reduction and hence are said to be the necessary economic variables that improved the welfare of farmers. The variables that were not Significant were the size of the plot, access to extension services, access to irrigation and savings. The study also revealed that the constraints that are faced by the farmers in the King Sabatha Dalindyebo (KSD) are inadequate extension facilities, poor road and irrigation infrastructure, lack of access to credit, unfenced ploughing field, poor storage facilities and lack of access to the market. The recommendations of the research study were that there is a need for the government, both at a local and national level to intervene Walter Sisulu University ii by providing the necessary support to improve the welfare of the farmers in the region. It is further suggested that extension services should be improved to enhance agricultural skills and increase productivity
Factors influencing English reading competencies of Grade 4 learners in the Libode-Mega District of the Eastern Cape Province of South Africa
Get PDFReading has become the national and international centre of debate as learners persistently read below the required levels and matriculation results are due to learners‟ poor reading competencies. The concerns about poor reading competencies has mounted into inflammatory statements in articles and popular media nationally, continentally and internationally. Without the ability to read learners are deprived access to pertinent information and knowledge that can assist individuals in lifelong learning. Being a language teacher, the researcher in this study strongly believe that every learner can read appropriately and teachers can assist learners to improve their reading competencies. The purpose of the study was to identify the factors contributing to poor reading competencies of grade 4 learners and to provide recommendations to assist in dealing with poor reading competencies. Qualitative research approach was undertaken to deal with all aspects related to research methodology. The data were collected using research instruments such as observation of six learners from three selected primary schools. The observation was conducted during reading of text by learners in the presence of English teachers. The questionnaires were distributed to eleven teachers offering English in grade 4 as another means of data collection instrument. Major findings of the study revealed that factors affecting reading competencies are hugely emanated from schools, teachers, family background, departmental policy and learners themselves. Despite reading problems exist in schools, there are always positive solutions to bring hope and success to the learners