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Biomedical subjects

S Grobler

Publications and source records attributed to S Grobler.

At least 19 recordsLinked to original sources
PubMed2002

The impact of a new educational strategy on acquiring neonatology skills.

OVERVIEW: A shortage of staff for teaching neonatology skills to large numbers of students, in small groups and following a new curriculum, necessitated an innovative educational strategy. This entailed the development and implementation of an interactive multimedia program (CD-ROM) to deliver information about skills and to demonstrate them. METHODS: Students had to study a specific skill using the CD-ROM and then practise in the Skills Laboratory, supported by lecturers who provided formative evaluation. OBJECTIVES: The aims of this study were to assess the students' perspectives on the new strategy, and to compare the skills of students following the new curriculum to those of students following the traditional curriculum, who do not follow structured programmes on practical skills but experience a practical neonatology rotation. RESULTS: The evaluation of the CD-ROM program was very favourable. The majority of students still preferred live demonstrations but found the CD-ROM useful for revision purposes. With the exception of one skill, endotracheal intubation, the new curriculum students were found to be as competent as the students following the traditional curriculum and performed mask ventilation and cardiac massage significantly better than them.

CD-ROM↗
PubMed2001

Students' perceptions on skills training in simulation.

The University of Pretoria implemented a problem-oriented undergraduate medical curriculum that emphasizes experiential learning and the mastering of practical skills. Students' experiences with acquiring practical skills in a skills laboratory and the impact that acquiring these skills has on their clinical practice were explored and described. A qualitative, investigative, descriptive and contextual design was used. Data were collected at focus-group discussions and analysed using Tesch's methodology. A literature control was conducted to identify similarities of and uniqueness in the research findings. Trustworthiness was established by utilizing Guba's model for the trustworthiness of qualitative research (Lincoln & Guba, 1981). The findings were that attitudes, knowledge and skills are interrelated and contribute to an enhanced process of learning. The interrelated learning process has a positive effect when students progress from the skills laboratory to clinical practice. Students made valuable recommendations that should contribute to the optimal use of the skills laboratory.

Journal Article↗
PubMed1999

A laboratory assessment of enamel hypoplasia of teeth with varying severities of dental fluorosis.

The effect of lifelong exposure to drinking-water containing fluoride on tooth enamel microhardness was investigated. Dental fluorosis of teeth from adult subjects, who lived continuously since birth in areas characterized by the hot climate of India, supplied by drinking-water containing between 0.5 and 8.7 parts/10 F, was estimated by the Dean score. Tooth enamel sections were examined from the enamel surface towards the dentino-enamel junction (DEJ) for microhardness. Separated enamel crowns were pulverized and analysed for fluoride. Regarding the distribution of the fluoride concentrations in the drinking-water, we selected a partition below and above 0.8 parts/10 F as a criterion for comparison between the results. Tooth enamel of humans from Israel living in a drinking-water area containing about 0.5 parts/10 F was also examined. Positive associations were evident between fluoride in drinking-water, fluoride concentrations in the bulk enamel and fluorosis selection. A significantly high inverse relationship was evident between the fluoride concentration of the drinking-water and the subsurface enamel microhardness. In similar fluoride-concentration drinking-water areas of India and Israel the microhardness of the subsurface enamel was less for the Indian teeth. The microhardness of the enamel near the DEJ for the three different water fluoride-concentration areas was not significantly different.

Adult↗
PubMed1999

The effect of propolis exposure on microhardness of human enamel in vitro.

Propolis is a resinous wax-like material that is used by bees as a glue-like matrix in their hives. The in vitro effect of propolis solutions was investigated on the microhardness of human dental enamel. The calcium concentration of the solution was 7.8 ppm, the pH values varied between 5 and 6. The fluoride concentration was negligible. The Vickers hardness number of exposed enamel showed a steady increase with the percentage of propolis in the solution. The microhardness increase may be attributed to particular components of mineralization activity in propolis.

Calcium↗
PubMed1999

Adolescent interpersonal communication patterns.

Adolescents are admitted to psychiatric wards presenting with psychiatric problems which are essentially secondary to problematic interpersonal relationships. Successful interpersonal relationships however depend on effective interpersonal communication. Therefore the aim of research on adolescent interpersonal communication was to explore and describe the interpersonal communication patterns of adolescents and to develop an interpersonal communication skills approach to facilitate adolescent interpersonal communication skills within a training programme for adolescents. In this article however attention will be given to the description of the interpersonal communication patterns of adolescents. The target population of the research was 17 year old adolescents. The research consisted of a pre-phase where two contextual scenarios were formulated within group discussions with adolescents. During phase one of the research these scenarios were used to obtain video taped role plays from pairs of adolescents of the target population which were transcribed for data gathering purposes. Written dialogues were also obtained from each pair of adolescents on the same scenarios used for triangulation purposes. During phase two of the research the data was analysed according to Tesch's method and a literature control was done to verify the results. Guba's model for the trustworthiness of qualitative research was used. Four recurrent interpersonal communication patterns were identified, namely: Recurrent patterns of defocusing and externalizing the topic under discussion; Recurrent patterns of struggling for power; Recurrent patterns of not listening; and Recurrent patterns of focusing only on cognitive contents of messages and not on feelings. The research showed that adolescents have ineffective interpersonal communication patterns. Recommendations were made to facilitate adolescent interpersonal communication within an interpersonal communication skills approach.

Adolescent↗
PubMed1999

The use of dexamethasone in women with preterm premature rupture of membranes--a multicentre, double-blind, placebo-controlled, randomised trial. Dexiprom Study Group.

OBJECTIVE: To assess whether administration of dexamethasone in women with preterm premature rupture of membranes (PPROM) has an effect on the prevalence of maternal sepsis, neonatal respiratory distress syndrome (RDS), perinatal mortality and neonatal sepsis in a developing country. SETTING: Six public hospitals in South Africa that deal mainly with indigent women. METHOD: A multicentre, double-blind, placebo-controlled, randomised trial was performed on women with PPROM and fetuses of 28-34 weeks' gestation or clinically estimated fetal weight between 1,000 and 2,000 g if the gestational age was unknown. Women were randomised to receive either dexamethasone 24 mg intramuscularly or placebo in two divided doses 24 hours apart. All women received amoxycillin and metronidazole and were managed expectantly. Hexoprenaline was administered if contractions occurred within the first 24 hours after admission to the trial. OUTCOME MEASURES: The maternal outcome measures were clinical chorio-amnionitis and postpartum sepsis. The outcome measures for infants were perinatal death, RDS, mechanical ventilation, necrotising enterocolitis, and neonatal infection within 72 hours. RESULTS: One hundred and two women who delivered 105 babies were randomised to the dexamethasone group and 102 women who delivered 103 babies, to the placebo group. The groups were well balanced with regard to clinical features. There was a trend towards fewer perinatal deaths in the dexamethasone group: 4 compared with 10 (P = 0.16, odds ratio 0.37, 95% confidence intervals 0.09-1.34). A subanalysis of mothers who delivered more than 24 hours after admission to the study and their infants revealed a significant reduction in perinatal deaths; 1 death in the dexamethasone group and 7 in the placebo group, P = 0.047 (Fisher's exact test). No woman in either group developed severe sepsis, and the incidence of sepsis in the women did not differ significantly. Eleven infants in each group developed sepsis. CONCLUSION: This is the first randomised trial in women with PPROM to compare the effects of the use of corticosteroids with placebo, where all women received prophylactic antibiotics concomitantly with the corticosteroids. A trend towards an improved perinatal outcome was demonstrated in the women who received dexamethasone. There was no increased risk of infection in the women or their infants where dexamethasone was administered. Administration of corticosteroids to women with PPROM has more advantages than disadvantages in developing countries.

Anti-Inflammatory Agents↗
PubMed1993

An audit of restorative proctocolectomy.

A total of 168 restorative proctocolectomies have been performed without mortality during the past nine years. Morbidity from pelvic sepsis (12%), ileoanal stricture (15%), and pouch related fistulas (16%) have become less with increasing experience of the operation. Pouch excision, which occurred in 30% of the first 50 patients was undertaken in only 4% in the last 68 patients. Despite this, intestinal obstruction (18%) continues to complicate the operation. We have abandoned restorative proctocolectomy after failed ileorectal anastomosis in patients with slow transit constipation as half have now requested pouch excision because of poor results. Failure to identify Crohn's disease continues to influence the outcome: in 10 patients now known to have Crohn's disease six developed post operative fistulas, three have required pouch excision. Sexual impairment has occurred in three male patients (4%). Ten women had children after operation, eight uncomplicated vaginal deliveries occurred without impaired continence. Seven of nine patients over 60 years of age have had a successful outcome. Our data also indicate that the operation may be justified in distal disease if urgency is socially inconvenient. Frequency of defecation is usually less than three per 24 hours in patients with familial adenomatous polyposis but remains variable in those with ulcerative colitis.

Adolescent↗
PubMed1992

Cost-effectiveness of gamete intrafallopian transfer in comparison with induction of ovulation with gonadotropins in the treatment of female infertility: a clinical trial.

OBJECTIVE: To compare the cost-effectiveness of gamete intrafallopian transfer (GIFT) with that of conventional infertility treatment in couples with female infertility, excluding tubal factors. DESIGN: Patients were randomly divided in two groups: receiving GIFT or conventional infertility treatment. For a period of 2 years, GIFT was compared with conventional infertility treatment in couples with endometriosis, anovulation, idiopathic infertility, cervical mucus factor, female immunologic factor, or multifactorial causes of infertility in a randomized clinical trial. SETTING: The study was performed in the Unit for Human Reproduction, Department of Obstetrics and Gynaecology, Faculty of Medicine, University of the Orange Free State, Bloemfontein, Republic of South Africa. PATIENTS: One hundred seventy-four successive couples with female infertility were selected for the study. All couples were from the higher socioeconomic bracket. INTERVENTIONS: One group received GIFT and the other received conventional infertility treatment consisting of induction of ovulation with gonadotropins followed by intrauterine artificial insemination or normal intercourse. MAIN OUTCOME MEASURES: The results were stratified according to the specific cause of infertility. Outcome was measured by the success rate per treatment cycle, as well as the cost per pregnancy. RESULTS: Overall, GIFT proved to be successful in 26.7% of treatment cycles compared with 9.7% with conventional therapy. CONCLUSIONS: After careful analysis, the authors came to the conclusion that GIFT is more cost-effective than conventional infertility treatment in patients with endometriosis and anovulation. In patients with idiopathic infertility, immunologic infertility, a cervical mucus factor, and multifactorial infertility, induction of ovulation followed by intrauterine artificial insemination or normal intercourse proved to be more cost-effective.

Coitus↗
PubMed1992

Ileal mucosal absorption of bile acid in man: validation of a miniature flux chamber technique.

A method that allows the quantitative assessment of ileal mucosal cell uptake and transport of bile acids in mucosal biopsy specimens has been validated. Viability of the tissue was confirmed by maintenance of normal cell morphology, wet weight, extracellular space, porosity to polyethylene glycol-900, lactate dehydrogenase release, and transmucosal potential difference. Using 14C-taurocholic acid, absorption was shown to be directional, capable of working against a concentration gradient, reduced by metabolic inhibitors, and sodium dependent. The system showed saturation kinetics with an estimated Km of 10 mumol/l. At a standard substrate concentration of 10 mumol/l ileal mucosal bile acid absorption was compared in patients with colorectal cancer (n = 6), ulcerative colitis (n = 10), and slow transit constipation (n = 8). There was no significant difference in tissue uptake or transport between the three groups.

Bile Acids and Salts↗
PubMed1988

The SCMC test: a reliable monitor for antispermatozoal antibodies.

Seventeen couples (13%) were selected from a group of 129 infertile patients according to the following criteria: (i) unexplained infertility for 3 years and (ii) greater than 50% shaking spermatozoa during SCMC testing. The couples were tested for sperm antibodies after a complete diagnostic work-up schedule. Post-coital tests were performed during the first menstrual cycle of the wife, followed by SCMC and sperm antibody titre testing. Ten males and seven females were thus treated with 96 mg methylprednisolone. Nine (52%) of the 17 with sperm antibodies achieved a pregnancy. The results of the SCMC test were in all the cases indicative of the actual sperm antibody titre. Reduction of the antibody titre and a decrease in the percentage of shaking spermatozoa as detected by the SCMC test correlated well with the pregnancy rate amongst the patients.

Antibodies↗
PubMed1987

The SCMC test: a accurate indicator for spermatozoal antibodies.

Eighteen couples (12.9%) were selected from a group of 138 infertile couples for a special study about the reliability of the SCMC test, when compared with spermantibody titres in the cervical mucus and or seminal plasma and corticosteroides as treatment for immunologic infertility. It can be demonstrated that there exists a reliability of the SCMC test as an immunologic assay for sperm antibody activity in the semen and the cervical mucus.

Adrenal Cortex Hormones↗
PubMed1986

Sperm/cervical mucus contact test for sperm antibodies.

Thirteen couples with a history of primary infertility for at least 3 years were selected according to the following criteria: a positive sperm/cervical mucus contact (SCMC) test, the presence of sperm-agglutinating antibodies in the cervical mucus, and/or seminal fluid of one of the partners. Nine of the males and 4 of the 13 females were accordingly treated with high dosages of corticosteroids for 6 months. Among 4 (44%) males and 2 (50%) females a pregnancy ensued. Four (80%) of the 6 patients in whom a pregnancy was reported showed not only a decline in their sperm antibody titer but also a decrease in the percent shaking spermatozoa during SCMC testing.

Antibodies↗
PubMed1985

[The treatment of sperm antibodies with corticosteroids].

Seven women whose infertility was thought to be due to sperm antibodies alone were treated with either high or low doses of corticosteroids. During the treatment period the significance of the sperm-cervical mucus contact test was evaluated as a monitor for sperm antibodies. Five women became pregnant after steroid therapy and it was considered to be an effective method of treating infertility due to sperm antibodies since none of the patients complained or suffered from any side-effects.

Antibodies↗
PubMed1985

Important semen parameters during postcoital testing.

One hundred and sixty-two females who attended our infertility clinic were selected according to the quality of their cervical mucus. Only mucus of extremely high quality was used in the study to determine the influence of different semen parameters on the postcoital test results. All mucus samples were evaluated 8 h following coitus. The results of the postcoital tests were divided into group I (less than 7 spermatozoa per 400 X magnification) and group II (greater than 7 spermatozoa per 400 X magnification). The results of the statistical analysis indicated the order of importance of the different semen parameters during postcoital testing. By using the stepwise discriminant analyses, it was calculated that the sperm concentration and forward progression rate of the spermatozoa are discriminating factors between the two groups.

Cervix Mucus↗
PubMed1984

Inflammatory fibroid polyp of the stomach. A case report.

A case of inflammatory fibroid polyp of the stomach is reported. The precise nature and aetiology of this condition remain undetermined. On pathological examination it is a sharply localized lesion in the gastro-intestinal tract, which most frequently involves the stomach. Most of these lesions are very vascular. Eosinophilia of the peripheral blood does not occur and malignant change is unknown. There seems little doubt that eosinophilic gastro-enteritis is a quite separate entity from the condition we have described.

Aged↗
PubMed1984

IgG-coated latex particles and the identification of sperm antibodies.

The identification of sperm surface antibodies forms an integral part of the investigation of male infertility. We tested 39 randomly selected men for the presence of sperm surface antibodies by using IgG-coated latex particles during mixed antiglobulin reaction (MAR) testing. The latex MAR test results were compared with the red blood cell MAR and the Friberg sperm agglutination test results. The latex MAR is a sensitive indicator and can be employed by physicians to identify the presence of sperm antibodies on the sperm surfaces.

Antibodies↗
PubMed1984

Second pregnancies among immunologically infertile women: a preliminary report.

Two females with sperm antibody activity in their blood serum and cervical mucus were treated with high dosages of methylprednisolone. Both patients became pregnant during therapy. Following the birth of their first offspring, one was treated with steroids and the other conceived without steroids in order to establish their second pregnancies. The sperm antibody activity showed a sharp decline in the blood serum and cervical mucus during therapy. The response of the females showed drastic modification in the antibody activity in that the females revealed a complete disappearance or a significant decrease in their initial sperm antibody reactions after treatment with high dosages of steroids.

Antibodies↗