Theses and Dissertations (Medical Sciences)http://hdl.handle.net/10386/582024-03-29T12:33:33Z2024-03-29T12:33:33ZPrevalence and associations of anaemia among patients on chronic haemodialysis at a tertiary hospital in Limpopo ProvinceMuponda, Blessing Kudakwashehttp://hdl.handle.net/10386/43122023-10-17T01:00:40Z2023-01-01T00:00:00ZPrevalence and associations of anaemia among patients on chronic haemodialysis at a tertiary hospital in Limpopo Province
Muponda, Blessing Kudakwashe
Background: Anaemia is a very common cause of morbidity and mortality in patients
with chronic kidney disease (CKD) on chronic haemodialysis7. The main aetiology of
anaemia in CKD among patients on chronic haemodialysis is erythropoietin deficiency
Aim: To determine the prevalence and associations of anaemia among patients on
chronic haemodialysis at the PKDC in Limpopo Province, South Africa.
Methods: A retrospective descriptive, cross-sectional quantitative study was
performed at a single dialysis centre (PKDC) and included all patients on chronic
haemodialysis over a one-year period (01/01/2019 to 31/12/2019). A standardized
data collection form created on Epi Info Version 7 was used to collect data from 121
study participants’ hospital files. There was no sampling performed as all patients
meeting the inclusion criteria were included in the study. The collected data was
analysed using the SPSS Version 25.
Results: A total of 121 patients were included in the study. In the final data analysis,
55.5%(n=66) were males and 45.4%(n=55) were females. The overall mean age was
41.9 ± 11.7 years. Using the WHO definition of anaemia (Hb< 13g/dl in males and
Hb<12g/dl in females), prevalence of anaemia was 89.3% and 85% in male and
female patients, respectively. All 121 (100%) patients were on erythropoietin (EPO).
According to the 2012 KDIGO guidelines, the target Hemoglobin (Hb) in haemodialysis
patients on EPO is between 10g/dl and 12g/dl. Using a Hb level < 10 g/dl to define
anaemia, the overall prevalence of anaemia was 23.1%(n=28). The Chi-square test
indicated that there were no associations between anaemia (Hb<10g/dl) and any of
the clinical characteristics that were analyzed (all p-values > 0.05). Comparison of the
means of two groups (Anaemia: No and Anaemia: Yes) using the t-test it was observed
that the p-values were <0.001 and 0.007 for Hb and Albumin respectively. The null
hypothesis was rejected, and we concluded that there was a difference between the
Hb and albumin levels of patients who have anaemia (Anaemia Yes) and patients who
do not have anaemia (Anaemia No), with a 5% significance level. There was no
significant mean difference for the other laboratory variables.
Conclusion: This study concludes that there was a low prevalence of anaemia
(Hb<10g/dl) among the study population (23%) due to the high rates of EPO use
(100%). There was no association between any of the clinical characteristics and
anaemia. There was a difference between the Hb and albumin levels of patients who
have anaemia (Anaemia Yes) and patients who do not have anaemia (Anaemia No),
with a 5% significance level. There was no significant mean difference for the other
laboratory variables.
Thesis (M.Med. (Internal Medicine)) -- University of Limpopo, 2023
2023-01-01T00:00:00ZSerum lipid levels and lipoprotein subclasses in obese women residing in a rural area, Limpopo ProvinceMampeule, Nakampe Stanleyhttp://hdl.handle.net/10386/42772023-08-11T01:00:17Z2017-01-01T00:00:00ZSerum lipid levels and lipoprotein subclasses in obese women residing in a rural area, Limpopo Province
Mampeule, Nakampe Stanley
Obesity has been associated with dyslipidaemia (increased levels of triglycerides,
total cholesterol and low levels of HDL-C together with small dense lipoprotein
particles) in the absence of metabolic disorders such as, type 2 diabetes mellitus and
inflammation. Since community based studies in South Africa reported that obesity is
more common in women, and rural Africans have a more favourable lipid profile
compared to their White counterparts, the current study investigated the association
of obesity in women without metabolic disorders with lipid levels and changes in
proportions of small and large LDL and HDL particles.
Methods
The present study was part of the project “Prevention, Control and Integrated
Management of Chronic Disease in a rural area, South Africa”. A total of 521 women
participated in the above project. After excluding people with diabetes mellitus,
insulin resistance and inflammation, 308 women were left and of these 67 were
obese. Sixty seven ages matched, randomly selected non-obese women served as
controls.
Anthropometry variables as well as systolic and diastolic blood pressures were
measured and the WHO steps questionnaire was administered to collect information
on medication, lifestyle and diseases. Fasting blood levels of total cholesterol, HDL C, triglyceride, adiponectin, CRP, glucose and insulin were measured. Proportions
of small and large HDL and LDL particles were determined.
Results
There was no significant difference in TC, TG and LDL-C levels (p=0.558, 0.087 and
0.948) between obese and non-obese women or between women with increased
waist circumference (WC) and those with normal WC.
The HDL-C concentration was significantly lower in obese women compared to
women with non- obese (p=0.001). The lipid ratios TC/HDL-C and Apo B-100/Apo
A-I were significantly higher in obese women than those with non- obese (p=0.013
and p=0.006) respectively. The same phenomenon was observed in women with
xv
increased waist circumference (p=0.001** and p=0.025* respectively). Adiponectin
levels were significantly lower in obese women compared to non-obese women
(p=0.004**) and in women with increased waist circumference compared to those
with normal waist circumference (p=0.016*).
The proportions of small dense HDL and LDL lipoprotein particles were similar in
obese and non-obese women. Both obese and abdominally obese women had
significantly higher odds ratios of low levels of HDL-C and elevated Apo B-100/Apo
A-I. Adiponectin was a significant predictor of elevated TC and TG in both obese and
abdominally obese women while BMI was a significant predictor of low HDL-C in
obese women. Waist circumference was a significant predictor of low HDL-C in
abdominally obese women.
Conclusion
In the current study, obesity in women was significantly associated with lipid
abnormalities such as low HDL-C levels, raised lipid ratios (TC/HDL-C and Apo B 100/Apo A-I) and low levels of adiponectin, after excluding metabolic disorders
Thesis (MSc. Medical Science (Chemical Pathology)) -- University of Limpopo, 2017
2017-01-01T00:00:00ZDetermination of in vitro effects of aqueous extract of camellia sinensis on human sperm functionsSetumo, Mmaphulane Abigailhttp://hdl.handle.net/10386/42442023-05-26T01:00:12Z2021-01-01T00:00:00ZDetermination of in vitro effects of aqueous extract of camellia sinensis on human sperm functions
Setumo, Mmaphulane Abigail
Infertility, defined as the inability to conceive following one year of unprotected sexual intercourse, respectively affects 25% of couples globally. Oxidative stress (OS) has been greatly related to the idiopathic cause of infertility and Camellia sinensis contains antioxidants that may enhance reproductive functions. This study focussed on the effects of Camellia sinensis (green and black tea) on human sperm functions in both normal and abnormal samples. Semen samples (n= 59) collected from donors were liquefied, analysed, and classified as normal (n=40) and abnormal (n= 19) using the WHO criteria. Samples were washed and exposed to aqueous leaf extracts of green and black tea (0, 0.4, 4, 40, 405 μg/ml) for 1 hour. Human Tubular Fluid (HTF) served as the control. The respective sperm parameters were analysed (sperm motility, vitality, DNA fragmentation, mitochondrial membrane potential (MMP), capacitation and acrosome reaction (CTC) and reactive oxygen species (ROS). Green and black tea significantly increased vitality, and intact MMP, while it significantly reduced, CTC, and intracellular ROS as well as DNA fragmented spermatozoa in both normal and abnormal samples compared to the control (p<0.05). A significant increase in sperm CTC, ROS, with a decrease in sperm vitality, and intact MMP was observed in the abnormal compared to the normal samples (p<0.05). No significant change in motility was observed between normal and abnormal samples compared to their respective controls, in both green and black tea (p>0.05). Camellia sinensis improved human sperm function in vitro and may be attributed to its antioxidant activity.
Thesis (M.Sc. (Medical Sciences)) -- University of Limpopo, 2021
2021-01-01T00:00:00ZAetiology and outcome of pleural empyema in children admitted to Pietersburg Hospital Limpopo, South AfricaTshamiswe, Mbilaelohttp://hdl.handle.net/10386/42052023-05-05T01:00:09Z2022-01-01T00:00:00ZAetiology and outcome of pleural empyema in children admitted to Pietersburg Hospital Limpopo, South Africa
Tshamiswe, Mbilaelo
Introduction: Pleural empyema in children is associated with high morbidity and high
mortality. Staphylococcus aureus has been shown to be the most common causative
organism in developing countries.
Study design: This study applied a retrospective quantitative descriptive study
design.
Study population: The population of the study is comprised of children (between 1
years and 13 years) admitted to Pietersburg Provincial Hospital with pleural
empyema from January 2016 until December 2020.
Objectives: The study aimed to determine the causative organisms of pleural
empyema, the treatment outcomes, and the relationship between pleural empyema,
TB, and HIV infection.
Data collection: The National Health Laboratory Services database was used to
identify patients who had pleural empyema. A self-generated data collection tool was
used to obtain secondary data related to all patients who met the operational definition
of pleural empyema during the defined time period.
Results: Eleven participants met inclusion criteria. The mean age of participants was
42 months with 43.8 standard deviation and 64% were males and females were 36%
. Of these participants, 40% cultured S. Aureus in the pleural fluid, 10% Streptococcus
pneumoniae, 30% were sterile and 20% cultured other organisms such as Klebsiella
pneumoniae and Haemophilus influenzae. Cloxacillin was the most prescribed
antibiotic. Intercostal drainage was inserted in 91% of the participants of which 18%
were successful, no further surgical intervention needed,73% had thoracotomy and
VATS was offered to 91% of participants and it was followed by thoracotomy.
Fibrinolytics were not offered to the participants in this study. The majority of patients,
55%, were discharged back to their peripheral hospitals and 27% of them died. PCV
immunisation status of the children was not documented hence the relationship
between pleural empyema and PCV immunisation could not be established. There
was a positive correlation between age of patients with pleural empyema and ICU
length of stay (r=89%; p=0,01) while another strong correlation was depicted between
HIV status and hospital length of stay (r=88%, p=0,019). Results further show a
positive association between outcome and surgery intervention offered (Chi=7,00;
p=0,02).
Conclusion: Our study showed that S. aureus is the leading cause of pleural
empyema, with a predominance of thoracocentesis and thoracotomy offered as
surgical interventions.
Thesis (M.Med. (Paediatrics and Child Health)) -- University of Limpopo, 2022
2022-01-01T00:00:00Z