Search PubMed⌕ Search

Biomedical subjects

M Nel

Publications and source records attributed to M Nel.

18 recordsLinked to original sources
PubMed2006

Patients' satisfaction with government health care and services in the Taung district, North West Province.

This was a descriptive study that determined patients' satisfaction with health care in the Taung district state health institutions, North West Province. One hospital, three health centres and five clinics were randomly selected, and consecutive patients were recruited at outpatients during 17 May 2000 - 17 June 2000. The patients completed a questionnaire regarding the service or care provided. Five hundred and sixty seven patients participated in the study. The median age was 30 years, and most patients were female (76.7%). More than half of patients (56.8%) were not satisfied with the availability of medicines and other supplies. Approximately two thirds of patients (65.2%) did not know about the quality of telephone services rendered. There was a high level of dissatisfaction (63.1%) among patients regarding accessing doctors after hours. Most patients were satisfied with the general attitude of health workers (62.1%) but 21.2% were dissatisfied. Few (11.7%) patients felt rushed during consultation. Most patients felt they received good health education when their illness was discussed (74.6%). Words and explanations used were easy to understand (76.7%); and they were not discouraged from asking questions (69.9%, n=539). Generally the level of satisfaction among the patients was high except for difficulty in accessing doctors after hours and lack of medicines.

Adolescent↗
PubMed2005

Posterior intravaginal slingplasty for vaginal prolapse.

OBJECTIVE: To evaluate the results of the posterior intravaginal slingplasty (IVS). PATIENTS AND METHODS: From a urogynecology database, 42 patients who had undergone posterior IVS procedures were analyzed. All the selected patients had also had a posterior colporrhaphy (88% with mesh inserted into the rectovaginal space). RESULTS: Intraoperatively, there was one complication, a rectum perforation. All patients were followed-up, with a median of 13 months. Recurrent prolapse, grade 3 or 4, developed in 12 patients (29%) which included ten cystoenteroceles (24%), four rectoenteroceles (10%), and three cases of utero/vault prolapse (7%). Repeat surgery was performed in six patients (14%). For utero/vault prolapse, eight patients presented preoperatively with grades 3 and 4 prolapse. On follow-up, three patients had utero/vault prolapse, one of whom did not have utero/vault prolapse on presentation. Therefore, of the eight patients presenting with utero/vault prolapse, only two had repeat prolapse on follow-up, which reflected an improvement of 75%. CONCLUSION: The posterior IVS delivered satisfactory results for vault and posterior compartment prolapse, with a 75% improvement in vault prolapse. It was not possible, however, to separate the effect of posterior IVS and posterior colporrhaphy on the prevention of recurrent prolapse nor on the improvement of difficulty in defecation. Due to the utilization of the now-abandoned vaginal anterior colposuspension procedure for the treatment of anterior compartment prolapse, no conclusions regarding the impact of the posterior IVS on the anterior compartment can be made.

Adult↗
PubMed2005

Lesotho midwives' utilization of non-pharmacological pain management methods during the first of stage labour.

The purpose of this study was to determine the use of non-pharmacologic methods of pain management used by midwives in Lesotho. The research design was non-experimental and of a descriptive nature. The data was obtained by means of a structured questionnaire which was compiled after a thorough literature analysis was done. Midwives, working in the Maternity wards of the Christian Hospital Association of Lesotho as well as the government Hospitals completed the questionnaires. All data was analysed on a nominal descriptive level. According to the results, the midwives indicated that they were taught non-pharmacologic methods of pain management, however they expressed that they inadequately use these methods during the first stage of labour due to shortage of staff, lack of privacy and space, a high midwife-mother ratio, culture and hospital policies. In the light of these findings, recommendations were made of maximizing the use of non-pharmacologic methods during the first stage of labour.

Adaptation, Psychological↗
PubMed2004

Uterine artery embolization for symptomatic fibroids.

OBJECTIVES: The aim of this study was to introduce uterine artery embolization (UAE) as an effective and safe treatment option in patients with symptomatic fibroids. METHODS: Sixty-one patients underwent UAE with a 3- and 12-month follow-up. RESULTS: The procedure was well tolerated in all patients with the following symptoms improving: heavy bleeding [90% (95% CI 80.21%; 95.4%)]; dysmenorrhea [median -4 (95% CI -5; -4)]; feeling of a mass [74% (95% CI 57.9%; 85.8%)]; abdomino-pelvic discomfort [88% (95% CI 75.5%; 94.9%)]; and deep dyspareunia [90% (95% CI 71.1%; 97.3%)]. Uterine volume decreased by a median difference of 188 cm(3) (95% CI 146.5; 236), which related to a median % reduction of 37.7% (95% CI 32.4%; 45%) at 12-month follow-up. Most (91%) patients were satisfied with the procedure and only minor complications occurred. CONCLUSIONS: Uterine artery embolization can be performed effectively and safely at centers with the necessary expertise and can be used with success in Africa.

Adult↗
PubMed2004

Uterine artery embolisation for symptomatic fibroids: the effect of the large uterus on outcome.

OBJECTIVE: The aim of this study was to evaluate the efficacy of uterine artery embolisation (UAE) in myomatous uteri larger than 24 week's gestation (780 cm3). DESIGN: Prospective case control study. SETTING: Universitas Hospital, University of the Free State, Bloemfontein, South Africa. POPULATION: Sixty-one women, who underwent UAE, were included in the study. The study group comprised of 12 women with uteri > or =780 cm3 and the control group 49 women with uteri <780 cm3. METHODS: UAE was performed and the difference in outcome for the two groups was determined at 12 months. MAIN OUTCOME MEASURE: Symptomatic improvement with embolisation of the large uterus. RESULTS: Reduction of dysmenorrhoea, menorrhagia and pressure effects was similar for both groups. The median reduction in uterine volume (pre- to post-embolisation) was 188 cm3 (range 28-2038 cm3) with a 95% CI for the median difference for paired data of 146.5 and 236. Only 66% of the study group had, however, a reduction in volume to <780 cm3. The complication rates were similar for the two groups with regards to post-embolisation syndrome, fibroid slough, haematoma formation, infection, hysterectomy and failure to embolise. Satisfaction was similar between the two groups, with 91% of women satisfied with the procedure. CONCLUSION: The large uterus does not decrease UAE's efficacy. Although 33.3% of the study group still had a uterus of > or =780 cm3, symptom reduction was still similar for both groups. Women may thus still be left with a large uterine volume but without symptoms. This must be taken into consideration when counselling women with an extremely large uterus for UAE.

Adult↗
PubMed2003

The prevention of intrapartum HIV/AIDS transmission from mother to child.

The transmission of HIV/AIDS from mother to child is the main cause of HIV/AIDS in children and child mortality. Two-thirds of children with HIV/AIDS are infected in the intrapartum period (Farley, 2000:1-2). Midwives, through effective practices, can lower the transmission of HIV/AIDS from mother to child in the intrapartum period. The aim of the study was to determine which preventive practices registered midwives in provincial labour wards in Bloemfontein, implement to lower the risk of mother to child transmission of HIV/AIDS and in doing so to lower child mortality. A descriptive research design was used. Fifty-one midwives completed questionnaires to determine what preventive practices are used. The study showed that most of the midwives did not implement the interventions that could lower the chances of HIV/Aids transmission from mother to child during the intrapartum period. Midwives therefore may not have a positive impact on child mortality. The researchers concluded that midwives do not implement the interventions mentioned in the study because of a lack of knowledge and skills. Of the midwives who completed questionnaires, 67% completed their training between 1990 and 2000. This lack of knowledge may be due to a lack in the curriculum of training institutions and of an up-to-date policy concerning the transmission of HIV/Aids in provincial institutions in Bloemfontein. It is recommended that all affordable interventions should be incorporated in the policy.

Attitude of Health Personnel↗
PubMed2001

Delusions of parasitosis in clients presenting pets for veterinary care.

The syndrome delusions of parasitosis (DP) constitutes a psychiatric disorder of humans in which patients falsely believe that they are infested with parasites. This report describes 2 cases of DP observed at the Onderstepoort Veterinary Academic Hospital (OVAH). The first case involved a 34-year old, single female, who believed that she and her three cats were being parasitised by insects of unknown origin. Before referral to the OVAH, she had taken her cats to 2 other veterinarians and had consulted 2 dermatologists herself. The second case was a single male who believed that he was being parasitised by insects originating from his cat. A full diagnostic evaluation performed on all 4 cats failed to reveal any dermatological abnormalities. No parasites were seen or cultured from any of the cats.

Adult↗
PubMed1999

Nutritional status of HIV-1 seropositive patients in the Free State Province of South Africa: anthropometric and dietary profile.

OBJECTIVE: To evaluate the nutritional intake and status of HIV-1 seropositive patients, as well as the relationship between malnutrition and disease stage. DESIGN: A cross-sectional study. SETTINGS: The Immunology Clinic at the Pelonomi Hospital in Bloemfontein, South Africa. SUBJECTS: Eighty-one HIV/AIDS patients in different stages of disease were recruited consecutively from January to May 1995. Eleven of these patients were followed in 1997. MAIN OUTCOME MEASURES: Anthropometric data including current weight, height, triceps skinfold thickness, mid-upper-arm circumference, body mass index and bone-free arm muscle area were collected. Nutrient intake was estimated using a diet history in combination with a standardised food frequency questionnaire. The patients were divided into 3 groups according to their CD4+ T cell counts. RESULTS: The men were leaner (BMI = 18.9) than the women (BMI = 22.7) and patients with a CD4+ T cell count < 200 (stage III) tended to have the lowest median values for all anthropometric measurements. More than half the patients had a low intake (< 67% of the recommended dietary allowances) of vitamin C, vitamin B6, vitamin D, vitamin A, calcium, iron and zinc. CONCLUSIONS: The results confirms that HIV/AIDS patients from this population are malnourished. There was, however, no association between disease stage and nutritional status. Nutritional supplementation of HIV/AIDS patients should be considered, as this might lead to improved immune function in these patients.

Acquired Immunodeficiency Syndrome↗
PubMed1998

Nutritional status of HIV-1 seropositive patients in the Free State Province of South Africa--laboratory parameters.

OBJECTIVE: To evaluate the nutritional status of HIV-1 seropositive patients with regards to laboratory parameters; the correlation between nutrient intake and actual values of nutrients, as well as the relationship between malnutrition and disease progression. DESIGN: A cross sectional study. SETTING: The Immunology Clinic at the Pelonomi Hospital in Bloemfontein, South Africa. SUBJECTS: 90 HIV/AIDS patients in different stages of disease were recruited consecutively from January to May 1995. Sixteen patients were followed up in 1997. MAIN OUTCOME MEASURES: The patients were divided into three groups according to their CD4+ T-cell counts, and blood levels of protein, albumin, cholesterol, ferritin, vitamin B12, magnesium, and phosphorus, as well as several micronutrients including vitamin E, vitamin C, beta-carotene and retinol which were determined using standard methods. These values were compared with the normal reference values used in the laboratory, and we tried to correlate these parameters with disease stage, as well as recorded nutrient intake in a subgroup of 35 patients. RESULTS: Abnormal values for several parameters, including plasma-retinol and serum-protein were found, but no correlation between more advanced disease and micronutrient deficiencies could be demonstrated. CONCLUSIONS: HIV/AIDS patients from this population are deficient in several micronutrients, and for some patients this is mirrored by a low intake. Multivitamin/anti-oxidant supplementation of HIV/AIDS patients should be considered, as this could lead to improved immune function in these patients.

Adolescent↗