Spirituality in nursing: an analysis of the concept.

There is scientific evidence that the spiritual well being of a person can affect quality of life and the response to illness, pain, suffering and even death. In spite of this evidence, spirituality in nursing has not been examined within a South African context. The purpose of this study was to describe the phenomenon of spirituality from the perspective of nurses and patients/clients with the aim of generating a middle range theory of spiritual care in nursing.

Anaesthesia for electroconvulsive therapy: a comparison of sevoflurane with propofol.

This study was a prospective audit of patients receiving either intravenous induction of anaesthesia with propofol 2 mg/kg or inhalational induction using 8% sevoflurane for patients undergoing electroconvulsive therapy (ECT). All patients received inhaled 50% nitrous oxide. The anaesthetic agent was determined by psychiatrist preference.

Blind transpyloric nasojejunal versus nasogastric tube intubation in severe head injuries: a preliminary report.

Aim: To compare the efficacy of blind transpyloric placement using a specifically designed nasojejunal tube (NJT) versus a standard nasogastric tube (NGT) in severe head injury (SHI).

Methods: This was a randomised trial conducted in a neurosurgical intensive care unit. Fourteen patients were enrolled with a Glasgow Coma Score (GCS) less than 8 (mean 6.

Advancing human rights through constitutional protection for gays and lesbians in South Africa.

As a consequence of the 1994 adoption of a justiciable Bill of Rights in South Africa, with an equality provision prohibiting discrimination on the ground of sexual orientation, a coalition of gay and lesbian organisations set about implementing a progressive agenda of gay and lesbian rights litigation. In striking down the offence of sodomy, the Constitutional Court established a jurisprudence of gay and lesbian rights to equality, dignity and privacy that proved to be the foundation for significant litigation around family law issues. Subsequent to the sodomy judgement, the Court has ruled that same-sex couples who are in permanent life partnerships should be entitled to the same rights as married couples to immigration, employment benefits, custody and adoption of children.

Changing patterns of under- and over-nutrition in South African children-future risks of non-communicable diseases.

Under- and over-nutrition in children in KwaZulu-Natal, South Africa was investigated comparing data collected from primary school children in a rural district (643 children aged 8-11 years in 1994) with secondary data from the National Schools Study (16,179 children, 4-11 years in 1994), the Vitamin A Consultative Group Study (408 children, 2-5 years in 1994) and the Income Dynamics Study (1,593 children, 2-11 years in 1998). Stunting and wasting (WHO/NCHS guidelines) and overweight and obesity (International Obesity Task Force guidelines) were retrospectively analysed from these studies and compared in the children aged 4-5 and 8-11 years. There was moderate stunting in 10-25%, wasting in 1-6%, 5-24% were overweight and 1-10% obese.

Challenges in the provision of ICU services to HIV infected children in resource poor settings: a South African case study.

The HIV/AIDS epidemic has placed increasing demands on limited paediatric intensive care services in developing countries. The decision to admit HIV infected children with Pneumocystis carinii pneumonia (PCP) into the paediatric intensive care unit (PICU) has to be made on the best available evidence of outcome and the ethical principles guiding appropriate use of scarce resources. The difficulty in confirming the diagnosis of HIV infection and PCP in infancy, issues around HIV counselling, and the variance in the outcome of HIV infected children with PCP admitted to the PICU in African studies compound this process.

Expression of cell adhesion molecules in oesophageal carcinoma and its prognostic value.

Oesophageal carcinoma remains a disease of poor prognosis. Surgical cure rates are compromised by the fact that most patients are diagnosed at a late stage of disease because of the delayed onset of symptoms, by which time metastases and organ infiltration may have already occurred. Thus, invasion and metastases play a key role in influencing patient survival, and the search for novel treatments may therefore hinge on gaining insight into the mechanisms controlling these processes.

Ventriculitis due to a hetero strain of vancomycin intermediate Staphylococcus aureus (hVISA): successful treatment with linezolid in combination with intraventricular vancomycin.

A 67-year male presented with relapse 14 days after treatment with vancomycin for a MRSA ventriculitis. CSF samples taken at the time of relapse grew MRSA with a MIC for vancomycin of 4 mg/L by E-test and therapy with linezolid (600 mg bd) and intraventricular vancomycin (20 mg od) was initiated. Using the macrodilution E-test, the isolate was found to have sub-populations with a MIC for vancomycin of 8 mg/L and teicoplanin of 12 mg/L and a population analysis profile almost identical to the hVISA strain MU3, indicative of a hVISA strain.

Pathways to mental health care in KwaZulu--Natal.

The understanding of popular beliefs about mental health care and the pathways clients take prior to admission to a mental health institution is vital in planning to reduce delays in seeking treatment. The objectives of this exploratory survey were to determine pathways of care the clients with mental illness take, which ultimately lead to the mental health institution, the effects of socio-cultural and economic factor on the pathways to mental health care and the satisfaction with different service providers consulted. Data was gathered through semi-structured interviews.

Recalcitrant cutaneous sarcoidosis: an evidence-based sequential approach.

Background: Cutaneous sarcoidosis in black-skinned people is more severe and, in a subset, recalcitrant to therapy. Management of these patients is a challenge.

Aim: To document the clinical features of recalcitrant cutaneous sarcoidosis (RCS) and its response to sequential therapy.

S-nitrosothiol and S-nitrosoalbumin levels in pre-eclampsia plasma.

The aetiology of pre-eclampsia still eludes researchers. Recently, the development of laboratory techniques to measure the levels of serum nitrosothiols, compounds that appear to play a role in signal transduction and stress responses, could be the driving force in the search for the exact cause of pre-eclampsia. We attempted to verify a new technique of estimating the levels of S-nitrosothiols and S-nitrosoalbumin in pre-eclampsia.

Hematological recovery in male ultramarathon runners: the effect of variations in training load and running time.

Aim: Haematological response to the 2001 downhill Comrades Marathon was compared in high (>120 km/w in training; 3 weeks of pre-race taper) and low (<80 km/w in training; 2 weeks of pre-race taper) training status groups.

Methods: Full blood counts, differential lymphocyte counts (CD3, CD4, CD8, CD19, CD56), serum cortisol, C-reactive protein (CRP) and creatine kinase (CK) were measured in blood samples donated 21 hours before and 16 hours after a 90 km ultramarathon.

Results: Despite significantly faster mean race finishing time (8.

HIV vaccine trials: critical issues in informed consent.

Informed consent (IC), a fundamental principle of ethics in medical research, is recognized as a vital component of HIV vaccine trials. There are different notions of IC, some legally based and others based on ethics. It is argued that, though legal indemnity is necessary, vaccine trials should be founded on fully ethical considerations.

Traumatic innominate artery aneurysm 26 years after stab injury.

We report the case history of a 46-year-old African man with a false aneurysm of the innominate artery subsequent to a stab wound in the right supraclavicular area 26 years previously, presenting with stridor.

Isolated splenic tuberculosis.

Tuberculosis isolated to the spleen is a rare clinical entity particularly in the non-HIV-positive patient population. In the four patients described, two presented with thrombocytopenia; in two patients the condition was diagnosed serendipitously at laparotomy undertaken for abdominal trauma.

Quality of life issues for South Africans with acne vulgaris.

The adverse effects of acne on the psyche have been established in patients from 'first world' countries. There has been no in depth study in predominantly black patients from Africa addressing this issue. This was a prospective cross-sectional study of acne patients attending a dermatology unit in KwaZulu-Natal, South Africa.

Susceptible and protective human leukocyte antigen class II alleles and haplotypes in bahraini type 2 (non-insulin-dependent) diabetes mellitus patients.

Whereas the genetic risk for type 1 diabetes is linked to human leukocyte antigen (HLA) class II genes, the HLA association in type 2 (non-insulin-dependent) diabetes is less clear. The association between HLA class II genotypes and type 2 diabetes was examined in adult Bahrainis, an Arab population with a high prevalence of type 2 diabetes. HLA-DRB1* and -DQB1* genotyping of 86 unrelated type 2 diabetes patients (age, 51.

On conservativity and shattering for an equation of phytoplankton dynamics.

A model of phytoplankton dynamics introduced by Arino describes the evolution of aggregates of phytoplankton by a kinetic-type equation composed of terms describing the growth of the aggregates and their splitting, where the latter is modelled by a singular integral operator of the same form as in the classical fragmentation theory. In this paper we shall show that despite the presence of the growth term, the model displays the typical properties of the fragmentation models, in particular, if the fragmentation rate is unbounded as the size of aggregates tends to zero, then there occurs an unaccounted for loss of the phytoplankton though formally nothing is taken out of the system.

Serum cystatin C for assessment of glomerular filtration rate in hypertensive disorders of pregnancy.

Background: Assessment of renal function is important in the evaluation of the pregnant hypertensive patient. The aim of this study was to evaluate the diagnostic utility of cystatin C as a marker of glomerular filtration rate in hypertensive disorders of pregnancy and to correlate this with serum creatinine and creatinine clearance.

Methods: For our study, 198 women who presented with hypertension during pregnancy were recruited at the antenatal clinic of King Edward VIII Hospital in Durban, South Africa, a tertiary referral centre.

Cholecystectomy in a predominantly African population before and after the advent of the laparoscopic technique.

Objective: There is a paucity of information on gallbladder disease in an African population. We, therefore, conducted a study to compare the immediate pre-laparoscopic era with the laparoscopic period in the predominantly African population at the King Edward VIII Hospital.

Material And Methods: Data from a retrospective analysis of 144 patients undergoing open cholecystectomy (OC) between January 1990 and December 1992 were compared with a prospective analysis of 156 patients who underwent laparoscopic cholecystectomy (LC) between February 1992 and December 1994.

Pre-eclampsia - a problem of primipaternity not primigravidity?

Recent reports suggest that the incidence of pre-eclampsia may be associated with a change in paternity and the duration of cohabitation. In this study, we undertook to confirm the association between the duration of cohabitation and pre-eclampsia by performing a case-control study. There was no significant difference between women with pre-eclampsia and their controls in respect to the duration of cohabitation.

Cerebral magnetic resonance imaging in eclampsia: a series of 12 cases.

The object of this study was to assess the ability of magnetic resonance imaging (MRI) to detect the cerebral abnormalities associated with eclampsia and therefore to establish its place in our management of the condition. This study was of particular relevance to our institution because eclampsia is common in our patient population. This was a prospective study in which 13 patients with an initial diagnosis of eclampsia received MRI brain scans.