Ketamine and the obstetric patient

Ketamine anaesthesia was administered to 135 mothers undergoing Caesarean section. The incidence of awareness, dream recall, and psychic disturbance in this group was compared with that occurring in 126 subjects anaesthetised with thiopentone and nitrous oxide. Factual recall was rare in both groups. Dreaming, although more frequent in the ketamine series, was usually pleasant in nature. Psychic phenomena occurred after ketamine anaesthesia, but were infrequent if ketamine dosage was limited, or anaesthesia supplemented with diazepam. It is concluded that ketamine may be used to advantage in obstetric anaesthesia, without significant dreaming or psychic disturbances. S. Afr. Med. J., 48, 734 (1974)

General anaesthesia for caesarean section

Fifty mothers presenting for elective Caesarean section were anaesthetised using a technique previously recommended for obstetric anaesthesia. Clinically, most infants were in good condition after birth. Blood gas studies done on the mothers before induction and at delivery showed a mild respiratory alkalosis with a compensatory metabolic acidosis. Mean umbilical arterial blood gas/acid-base status revealed a mild acidaemia, both respiratory and metabolic in origin, which was well within accepted normal limits. Fetal oxygenation also appeared satisfactory (mean umbilical vein p02 33,9 torr and umbilical artery p02 18,9 torr). Two mothers (4%) were conscious during surgery, but felt no pain. Vomiting after anaesthesia occurred in 16% of cases. Evidence of postoperative chest infection was found in 5 mothers (10%). Thus, the anaesthetic technique advocated does not appear to adversely influence the mother or her infant.S. Afr. Med. J., 48, 1735 (1974)

Ketamine and the Obstetric Patient

Ketamine anaesthesia was administered to 135 mothers undergoing Caesarean section. The incidence of awareness, dream recall, and psychic disturbance in this group was compared with that occurring in 126 subjects anaesthetised with thiopentone and nitrous oxide. Factual recall was rare in both groups. Dreaming, although more frequent in the ketamine series, was usually pleasant in nature. Psychic phenomena occurred after ketamine anaesthesia, but were infrequent if ketamine dosage was limited, or anaesthesia supplemented with diazepam. It is concluded that ketamine may be used to advantage in obstetric anaesthesia, without significant dreaming or psychic disturbances.S. Afr. Med. J., 48, 734 (1974)

An examination fo the legal liabilities of insurance intermediaries and the insurance thereof

The insurance product is marketed by various distribution channels, most notably that of the insurance intermediary. The extent of the intermediary‟s role within the insurance transaction, exposes the intermediary to liability risks; these liabilities could arise either in contract, delict or statute or be sui generis. This dissertation sets out the extent of the legal liabilities exposure of insurance intermediaries within the South African market against an international background and the insurance thereof

Smoothed particle hydrodynamics (SPH) modelling of nearshore breaking waves.

Masters Degree. University of KwaZulu- Natal, Durban.Breaking waves drive sediment transport in the nearshore zone of coastal regions and directly govern beach transformation. Accurate coastal modelling of breaking waves is essential to predict sediment transport accurately. Efficient and sustainable management of natural coastal systems and urban coastal developments relies on accurate sediment transport predictions. This study proposes a mesh-free, Lagrangian, smoothed particle hydrodynamics (SPH) model to simulate nearshore breaking waves in two-dimensions. This study emphasises using SPH to evaluate the wave field parameters (local velocities, vorticities, and shear stresses) that can be used to predict coastal phenomena, namely sediment transport in nearshore, wave-driven environments. This study showed that a two-dimensional SPH model could replicate the free surface of nearshore breaking waves and accurately predict the flow characteristics beneath breaking waves. However, the accuracy of the results can vary depending on the position of the breaking wave in the surf zone. Furthermore, SPH applications must choose between accuracy and computational efficiency. The key SPH calibration parameters identified were the artificial viscosity coefficient (α), the dimensionless smoothing length ratio (hSPH/dp), and the particle resolution (H/dp). Extensive comparative analysis was performed between simulated results and measured data to obtain suitable parameter values for a plunging solitary wave. A suitable choice of α=0.1, hSPH/dp=3, and H/dp=90 were selected based on the results. Furthermore, the results suggested that a suitable choice of model parameters depends on the viscosity treatment method (artificial/sub-particle scale viscosity approach) and the type of wave breaking simulated (plunging/spilling). Thus, α=0.1, hSPH/dp=3, and H/dp=90 were only deemed suitable when the standard SPH artificial viscosity approach is used to simulate breaking plunging and spilling waves on beach slopes milder than 1/10. The model sensitivity to α, hSPH/dp, and H/dp was also investigated based on the numerical wave energy dissipation and simulated wave surface of a plunging solitary wave in the space and time domain. When α was above or below the ideal value of 0.1 for a given hSPH/dp and H/dp, the numerical wave energy dissipation and wave height at breaking did not match the measured data. The choice of α was strongly related to H/dp, and a reduced α became more appropriate for a lower H/dp. The results also showed that the model was less sensitive to hSPH than the choice of α and H/dp in terms of the model performance. However, when hSPH/dp was less than 1, for any given α and H/dp, the numerical wave energy dissipation and wave height at breaking were under-predicted. The choice of H/dp was of principal importance and influenced the choice of the other model parameters. When H/dp was below the ideal value of 90, for any given α and hSPH/dp, the numerical wave energy dissipation and wave height at breaking did not match the measured data. Additionally, the breaking wave shape was poorly simulated. However, H/dp=90 becomes computationally expensive when simulating breaking waves in large numerical domains or with relative wave heights significantly less than 0.6. Hence, the available computing power limits the choice of H/dp. The performance of a two-dimensional SPH model was assessed by analysing the simulated flow field under several breaking waves. The local velocities, vorticities, and bed shear stresses were evaluated beneath two plunging solitary waves and a spilling solitary wave. Generally, the characteristics of the simulated flow field were fairly accurate during wave shoaling and wave breaking, less accurate during wave run-up, and inaccurate during wave run-down. The results also hinted at obliquely descending eddies occurring under the breaking plunging waves. However, the three-dimensional eddy structure beneath the breaking waves could not be investigated due to the limited two-dimensional nature of the model setup used in this study. A well-calibrated SPH wave and hydrodynamic model is an important coastal engineering tool. Thus, this study can serve as a physically based framework for using a two-dimensional SPH model to investigate coastal engineering problems that include wave-structure interactions, wave-run up on beach slopes and sediment transport in the surf zone over a wide range of scales and wave conditions

Investigation of the Stress-Induced Nuclear Localisation of Retinoblastoma Binding Protein 6 (Rbbp6) and its Role in Ubiquitination Of Y-Box Binding Protein-1 (Yb-1)

Magister Scientiae - MSc (Biotechnology)Retinoblastoma Binding Protein 6 (RBBP6) is a 200 kDa RING finger-containing human protein known to serve as an E3 ubiquitin ligase, and to play a role in ubiquitination and suppression of the tumour suppressor p53. It also regulates the stability of mRNA transcripts by modulating 3'-polyadenylation

Persistence of attention deficit/ hyperactivity disorder into adulthood: a study conducted on parents of children diagnosed with attention deficit/hyperactivity disorder

No Abstract.South African Psychiatry Review Vol. 10 (2) 2007: pp.93-9

Reflecting on Evictions and Unlawful Occupation of Land in South Africa: Where Do Some Gaps Still Remain?

The issue of unlawful occupation and homelessness has been a very prominent topic for many decades. While our approach to evictions and unlawful occupation has clearly shifted from a draconian approach under the Prevention of Illegal Squatting Act 51 of 1951 (hereafter PISA) to an approach that focusses on human rights under the Prevention of Illegal Eviction from and Unlawful Occupation of Land Act 19 of 1998 (hereafter PIE), there are still various aspects that potentially fall short in protecting the rights of the various stakeholders involved in these disputes. In particular, this paper focusses on three areas where PIE potentially falls short. In this regard we examine cases of the impossibility of eviction orders, our current understanding of the notion of "home", and whether or not PIE applies to both occupied and unoccupied structures. We also briefly explore issues relating to the non-implementation of PIE, especially in relation to the government's goal of preventing unlawful occupation. Central to these discussions is whether our current approach is sufficient and in line with constitutional obligations or whether we need to rethink our approaches to ensure that we do not undo the progress made since apartheid

Baseline patient profiling and three-year outcome data after metabolic surgery at a South African centre of excellence

The bariatric team at Waterfall City Hospital in Gauteng has performed 820 metabolic surgeries under the guidance of an extended team, and with comprehensive recordkeeping. Baseline profiling on more than 50 variables afforded insight into patients undergoing surgery. The available outcome data over three years were comparable with those in the documented literature. The attempted weight loss period prior to agreeing to surgery was 16–18 years. Weight loss in the overall cohort was 29% at three years, with a two-year outcome as follows: diabetes mellitus remission of 81.6% in males and 83.1% in females, full and part-hypertension resolution of 84.8% in males and 74.6% in females, hyperlipidaemia on no treatment of 76.8% in males and 72.1% in females, and sleep apnoea of 75.5% in males and 76.8% in females. Separating out the diabetic group indicated a diabetes mellitus remission of 73.9% in males and 75.1% in females at one year. Improvement in the components of metabolic syndrome was demonstrated in the total cohort. There was an worse profile and higher risk in the male patients. Similarly, higher risk was recorded in the biliopancreatic diversion-duodenal switch cohort, and there was a higher percentage of elected diabetic patients. A wide range of revision surgery was performed, with a higher complication rate (20%) experienced compared to that recorded with the primary surgeries. The morbidity data were separated into medical and surgical morbidity. Major medical morbidity was documented at 5.6% and surgical morbidity at 3.9%. Surgical morbidity in the first 250 cases was reported to be 6% vs. 2.7% in the last 570 cases. Mortality for the cohort was noted to be 0.1%.Keywords: bariatric surgery, outcome data, profiling, South Afric

The potential of meaningful engagement in realising socio-economic rights: Addressing quality concerns

Thesis (LLM)--Stellenbosch University, 2019.ENGLISH ABSTRACT : The advent of the Constitution of the Republic of South Africa, 1996 (“the Constitution”) was a major milestone for South Africa in terms of redressing the atrocities of apartheid. While this has resulted in major developments, remnants of apartheid are still present and can be seen in the continuation of vast socio-economic inequalities. Access to housing and education still remains elusive to many South Africans, as indicated by the recent service delivery and higher education protests. Developing effective mechanisms for realising these rights is thus a high priority, including in the context of socio-economic rights litigation and adjudication. The doctrine of meaningful engagement developed by the Constitutional Court in housing and education rights cases offers a potentially innovative method for government, communities and other stakeholders to pursue the realisation of socio-economic rights. However, the potential of this participatory approach to socio-economic rights realisation remains contested, and its efficacy in practice has not yet been determined. A key challenge to its efficacy in realising the normative commitments of socioeconomic rights concerns the quality of the engagement that occurs between organs of state and various stakeholders. In light of the above, this thesis investigates the role that the quality of meaningful engagement plays in enhancing its efficacy as a mechanism to realise socio-economic rights. The thesis examines the justifications posited for using meaningful engagement as well as the importance of quality in achieving these justifications. Evaluative criteria for assessing the quality of engagement are developed. In addition to evaluating the quality of meaningful engagement in South Africa’s housing and education rights jurisprudence, the thesis examines meaningful engagement in an extra-judicial context, focusing on the #FeesMustFall Movement. The thesis concludes by making recommendations on how the quality of meaningful engagement could be improved, drawing on diverse theoretical literature pertaining to participatory democracy and critical theory.AFRIKAANSE OPSOMMING : Die aanvang van die Grondwet van die Republiek van Suid-Afrika, 1996 (“die Grondwet”) was ’n groot mylpaal vir Suid-Afrika in die regstelling van die gruweldade wat tydens apartheid gepleeg is. Alhoewel hierdie gebeurtenis belangrike ontwikkelings tot gevolg gehad het, is die effek van apartheid steeds sigbaar deur die teenwoordigheid van voortgesette sosio-ekonomiese ongelykhede. Toegang tot behuising en onderwys bly ontwykend vir baie Suid-Afrikaners, soos aangedui deur die onlangse diensverskaffing en hoër onderwys betogings. Die ontwikkeling van effektiewe meganismes vir die verwesenliking van hierdie regte is dus 'n hoë prioriteit, insluitend in die konteks van sosio-ekonomiese regte-litigasie en beregting. Die leerstuk van betekenisvolle onderhandeling wat deur die Konstitusionele Hof in sake wat handel oor die reg op behuising en onderwys, ontwikkel is, bied 'n potensieel innoverende metode waardeur die regering, gemeenskappe en ander belanghebbendes die realisering van sosio-ekonomiese regte kan nastreef. Die potensiaal van hierdie deelnemende benadering tot sosio-ekonomiese regterealisering bly egter betwis, en die doeltreffendheid daarvan in die praktyk is nog nie bepaal nie. 'n Belangrike uitdaging vir die doeltreffendheid van die prosesse wat daarop gemik is om die normatiewe verpligtinge van sosio-ekonomiese regte te verwerklik, het betrekking tot die gehalte van die onderhandeling wat tussen staatsorgane en verskeie belanghebbendes plaasvind. In die lig hiervan, ondersoek hierdie tesis die rol wat gehalte speel om betekenisvolle onderhandeling ʼn meer doeltreffende meganisme te maak om sosioekonomiese regte te verwesenlik. Die tesis ondersoek die regverdigings wat vir die gebruik van betekenisvolle onderhandeling aangevoer word sowel as die belang van gehalte om hierdie regverdigings te bereik. Kriteria vir die beoordeling van die gehalte van onderhandeling word ontwikkel. Benewens die evaluering van die gehalte van betekenisvolle onderhandeling in Suid-Afrikaanse regspraak wat oor die reg op behuising en onderwys handel, ondersoek die tesis betekenisvolle onderhandeling in 'n buite-geregtelike konteks, met die fokus op die #FeesMustFall Movement. Die tesis sluit af deur aanbevelings te maak oor hoe die gehalte van betekenisvolle onderhandeling verbeter kan word, met verwysing na ʼn diverse teoretiese literatuur rakende deelnemende demokrasie en kritiese teorie