Comparison of vaginal and oral misoprostol, for the induction of labour in women with intra-uterine foetal death.

Objective: To compare the efficacy of vaginal and oral misoprostol for the induction of labour in women with intra-uterine foetal death (IUFD).

Design: A prospective randomised clinical trial, comparing 200 microg oral and 200 microg vaginal misoprostol, six hourly for a maximum of four doses for the induction of labour in women with IUFD.

Setting: Ga-Rankuwa hospital (Department of Obstetrics and Gynaecology), Pretoria, South Africa.

Arthrogryposis multiplex congenita: functional classification and the AMC disc-o-gram.

The arthrogryposis multiplex congenita (AMC) disc-o-gram is presented as a way to measure the effect of hand therapy, splinting and/or surgery on the AMC patient. It also allows comparative measurement of passive motion (in the baby), active motion (in the young child) and function (in the older child and adult). These measurements are related to a new classification system which, as movement and function improves, indicates the efficacy of management.

Nephroblastoma (Wilms' tumour) diagnosed in the Department of Anatomical Pathology Medunsa/Ga-Rankuwa Hospital for the period 1980 to 1997.

Objective: The aim of the analysis was to describe the clinicopathological features of Wilms' Tumour (WT) diagnosed in our Department and compare results to other WT Registers.

Design: All cases of WT for the period 1980 to 1997 were retrieved from the Register of Renal Tumours of Childhood.

Setting: The Medical University of Southern Africa, Department of Anatomical Pathology and Department of Paediatrics, Ga-Rankuwa Hospital.

HIV infection in general surgical patients at the Ga-Rankuwa/MEDUNSA complex South Africa.

Objective: To assess the possible impact of HIV infection on the management of general surgical patients at the Ga-Rankuwa Hospital.

Design: A prospective study.

Setting: Ga-Rankuwa Hospital/Medical University of Southern Africa (MEDUNSA) Academic Complex, Pretoria, South Africa.

Pasteurella gallinarum neonatal meningitis.

A 4-day-old baby weighing 1.7 kg was admitted to the neonatal intensive care unit of Ga-Rankuwa Hospital, Pretoria, with a history of apneic attacks. On examination there was an umbilical sepsis and the neonate was septicemic.

Biotechnology and the utilization of biowaste as a resource for bioproduct development.

There is widespread concern that increasing concentrations of carbon dioxide and other greenhouse gases in the earth's atmosphere will ultimately lead to climate changes. Recognizing the important role that fossil fuels have in the economies and lifestyles of people throughout the world, it is reasonable to ask if the global economy can be powered in ways that might have less impact on the environment because they discharge less carbon dioxide. A way of addressing this sensitive issue could be through the biodevelopment of biowaste as an alternative and renewable energy resource.

A national database for essential drugs in South Africa.

In the process of drafting standard treatment guidelines for adults and children at hospital level, the Secretariat of the National Essential Drugs List Committee made use of a database designed with technical support from the School of Pharmacy, MEDUNSA. The database links the current 697 drugs on the Essential Drugs List with Standard Treatment Guidelines for over 400 conditions. It served to streamline the inclusion of different drugs and dosage forms in the various guidelines, and provided concise, updated information to other departments involved in drug procurement.

The procedural skills of rural hospital doctors.

Objectives: To describe the spectrum of procedures performed by general medical officers in South African rural hospitals, and the attitudinal issues associated with these tasks.

Design: A descriptive study combining quantitative and qualitative methods: a quantitative audit of operating theatre records of 15 rural hospitals in KwaZulu-Natal and 4 rural hospitals in Northern Province, and a qualitative analysis of 8 focus group discussions in which rural hospital doctors discussed their procedural work.

Outcome Measures: Quantitative results included patient age, type of anaesthetic, type of procedure, and whether a separate anaesthetist was present or not for each recorded procedure performed in the operating theatre.

Carcinoma of the uterine cervix: results of Ka-Ngwane screening programme and comparison between the results obtained from urban and other unscreened rural communities.

Objective: The Ka-Ngwane screening programme was initiated by the Department of Anatomical Pathology and the Department of Community Health at Medunsa to establish the incidence of cervical intraepithelial neoplasia (CIN) and cervical carcinoma (CaCx) in previously unscreened rural population in our catchment area.

Study Design: Ten thousand consecutive PAP smears from Ka-Ngwane (Mpumalanga) area are the subject of the analysis. The incidence of CIN I-CIN III and CaCx is calculated in the screened material.

Effect of HLA-DR3 gene expression on cadaveric renal allograft survival in blacks.

The effect of HLA-DR3 gene expression was studied in black cadaveric renal allograft recipients of organs from the same donor race. From January 1984 to June 1992, 70 patients received cadaveric renal allografts at the Medical University of Southern Africa (MEDUNSA). The average age and F:M ratio was 30 years and 1: 1.

Incidence of toxigenic Campylobacter strains in South Africa.

Campylobacter strains can produce a heat-labile cytotonic toxin (CTON) and various cytotoxins (CTOX). Of 22 South African Campylobacter strains tested, 86% were toxigenic (77% produced CTON, 41% produced CTOX, and 32% produced both types) and 14% were toxin negative. Campylobacter jejuni strains were 67% CTON positive and 47% CTOX positive, whereas Campylobacter coli strains were 100 and 29% positive, respectively.

Carbamazepine clearance in paediatric epilepsy patients. Influence of body mass, dose, sex and co-medication.

Carbamazepine clearance was studied in Black paediatric epilepsy patients, 90 receiving monotherapy and 17 on combination therapy. For patients on monotherapy the following relationship are shown: clearance decreases with increasing body mass (r= 0.87); clearance increases with increasing dose (r = 0.

Ethnic differences in response to beta-blockade: fact or artefact? A study with bisoprolol and propranolol.

A randomized, double-blind, placebo-controlled study was performed in 8 white and 8 black volunteers matched for sex, age and mass. The effect of 3 intravenous doses of a new, cardioselective beta-adrenergic blocker, bisoprolol, on the heart rate increase after standardized exercise was compared to that of 3 doses of propranolol. As described previously for propranolol, black volunteers showed less response than whites to beta-blockade assessed in terms of the reduction in exercise-induced tachycardia.