Solid phase peptide synthesis: new resin and new protecting group.

Masters Degree. University of KwaZulu- Natal, Durban.Solid phase peptide synthesis is the common approach used today in synthesizing peptides in a research scale and production. Success in this approach are governed by several factors. These are; (1) the solid support on which synthesis is to be carried out, (2) linker/spacer on which the first amino acid is linked to the support to allow stepwise growth of the peptide chain, (3) protecting groups of amino acids to allow a clean synthesis without disruption of the growing peptide chain and (4) coupling reagents for improved amide bond formation yielding peptides in the shortest amount of time and with the highest quality. The following thesis shows work conducted on some of these aspects. Chapter two is based on the application of a novel resin Fmoc-Rink-Amide PEG Octagel surface resin. Chapter three describes the development of a novel protecting group for histidine amino acid. A new PEG-PS based resin called Octagel has been developed by Aapptec. Fmoc-Rink-Amide Octagel PEG surface resin is a unique highly uniform surface-active resin. To study the resin’s performance, two peptides Aib-enkephalin pentapeptide and Aib-ACP decapeptide were synthesized and results were compared to Polystyrene and ChemMatrix resins. Swelling and microscope imaging studies were also conducted on each of the resins to highlight their performance associated with Solid Phase Peptide Synthesis. Results have demonstrated that Octagel resin has the potential to synthesize peptide sequences with high purity and therefore to be a good alternative to those currently in the market. Histidine is an important amino acid used in SPPS. It contains a reactive imidazole side group that can cause side reactions in SPPS if left unprotected. Fmoc-based SPPS is the most commonly used strategy in synthesizing peptides today. A protecting group was created for Fmoc-Histidine. SPPS was carried out on the protected histidine and results show that the group is stable in acidic conditions

Kajal's story : a novel.

Thesis (M.A.)-University of KwaZulu-Natal, Durban, 2004.Abstract not available

Does whole-cell pertussis vaccine protect black South African infants? Assessment of post-vaccination events and antibody responses to pertussis toxin, filamentous haemagglutinin and agglutinogens 2 and 3

The whole-cell pertussis vaccine currently used in South Africa has not been adequately evaluated for post-vaccination events and immunogenicity. A trial of this vaccine combined with diphtheria and tetanus toxoids (DTP) was undertaken in 115 black babies who received primary vaccination at 2, 4 and 6 months of age. Serological IgG responses to the major antigens of Bordetella pertussis, filamentous haemagglutinin (FHA), pertussis toxin (PT) and fimbriae (agglutinogens 2 and 3 (AGG 2 + 3), were evaluated by enzyme-linked immunosorbent assay in sera obtained at birth, and before vaccination at 2,4 and 6 months and at 9 months. Surprisingly, after 3 doses of DTP, responses to PT and FHA were found merely to restore levels of IgG to PT and FHA to those found in cord blood. In contrast with the positive increases in these antibodies found in other series of whole-cell vaccination, the anti-PT seroconversion rate was only 19% and the anti-FHA rate only 24%. High levels of anti-AGG 2 + 3 were produced with 67,2% seroconversion.The frequency and nature of post-vaccination events were recorded. Incidences of all reactions to the vaccine were low (7,6%): Fever (3,2%) and excessive crying (2,4%) were the most frequency occurring minor events. The rate of neurological post-vaccination events (without sequelae) during the brief follow-up period was 2 hypotonic-hyporesponsive  episodes (8,03/1 000 doses) and 1 convulsion (4,02/1000 doses).Significant pertussis antibody levels were found in maternal and cord sera with levels in the latter frequently being higher. Three cases of pertussis occurred during the study period. Only 1 of the subjects had completed primary vaccination. In view of these findings, the need for a proper efficacy and safety study of the currently used DTP vaccine is urgently indicated in South Africa

Carbapenem resistance in <i>Enterobacterales</i> from agricultural, environmental and clinical origins: South Africa in a global context

Carbapenem agents are regarded as last-resort antibiotics, however, bacterial resistance towards carbapenems has been reported in both clinical and agricultural settings worldwide. Carbapenem resistance, defined as the resistance of a bacteria towards one or more carbapenem drugs, can be mediated in either of, or a combination of, three mechanisms–although, the mechanism mediated through the production of carbapenemases (β-lactamases that are able to enzymatically degrade carbapenems) is of most significance. Of particular concern is the occurrence of carbapenemase producing Enterobacterales (CPE), with literature describing a dramatic increase in resistance globally. In South Africa, increases of carbapenemase activity occurring in Enterobacter species, Klebsiella pneumoniae, Acinetobacter baumannii and Pseudomonas aeruginosa have recently been reported. CPE can also be found in agricultural environments, as global studies have documented numerous instances of CPE presence in various animals such as pigs, cattle, seafood, horses and dogs. However, most reports of CPE occurrence in agricultural settings come from Northern America, Europe and some parts of Asia, where more extensive research has been conducted to understand the CPE phenomenon. In comparison to clinical data, there are limited studies investigating the spread of CPE in agricultural settings in Africa, highlighting the importance of monitoring CPE in livestock environments and the food chain. Further research is necessary to uncover the true extent of CPE dissemination in South Africa. This review will discuss the phenomenon of bacterial antibiotic resistance (ABR), the applications of the carbapenem drug and the occurrence of carbapenem resistance globally

DOES EARLY INTERVENTION FOR PSYCHOSIS WORK? An analysis of Outcomes of Early Intervention in Psychosis based on the Critical Period Hypothesis, Measured by Number of Admissions and Bed Days Used over a period of Six Years, the first three in an Early Intervention Service, The second Three in a Community Mental Health Team

Background: Early Intervention in Psychosis (EI) was introduced into the British NHS as a result of the NHS Plan, about eleven years ago. The intention was to provide thebest possible care or patients with a first episode of psychosis.Recently however, long term studies over five years have suggested that early gains may be lost. Methods and Aims: We wished to establish whether our own group of patients who had received Early Intervention continued over six years to have better outcomes than patients treated in Community Mental Health Teams. To do this we analysed statistically the data on the readmissions and bed days used by our patients over the first six years of illness. Results: We found that patients, both in the whole two groups and in different sub-groups appeared to demonstrate a number of advantages,not always statistically significant, in favour of the EI treated team. Discussion: In many cases, the small size of the samples may have impeded us observing statistically significant differences, however, in general, it appeared that there were a number of advantages in favour of the EI treated team. Conclusion: Our study, though small, does appear to support the view that Early Intervention Services do improve outcomes and that some of the improvement may endure after the patient leaves EI services. Much larger studies ae however required

Diabetes Ther

INTRODUCTION: Type 2 diabetes represents a significant public health issue, with increasing prevalence in developing countries while adherence to insulin treatment remains a challenge. No studies have evaluated the relationship between adherence to insulin, diabetes-related distress, and trust in physician among persons with diabetes. Our objectives were to evaluate treatment adherence to insulin, emotional distress (using the Problem Areas in Diabetes Questionnaire, PAID), trust in physician, and to examine associations between them among Lebanese patients with diabetes. METHODS: This cross-sectional study, conducted in all districts of Lebanon between August 2016 and April 2017, enrolled 135 adult patients. RESULTS: The mean percentage score of adherence to insulin was 79.7 +/- 19.94. A significantly higher mean adherence score was found in non-sedentary (81.96) compared to sedentary patients (67.41) (p = 0.017), with no difference between gender, employment, rural vs non-rural residence, or familial history of diabetes. In addition, no significant relationship was seen between adherence score and education level, smoking, or alcohol intake. A significant positive association was found between trust in physician and adherence scores, whereas a significant but negative one was found between PAID and adherence scores. The results of linear regressions showed that a secondary level of education (beta = - 13.48) significantly decreased the trust in physician score, whereas the total number of oral antidiabetics (beta = 0.93) increased it. Having a sedentary lifestyle (beta = - 12.73) and smoking < 3 waterpipes/week compared to no smoking (beta = - 16.82) significantly decreased the adherence score. Female gender (beta = 10.46), smoking < 3 waterpipes (beta = 27.42) and 3 + waterpipes/week (beta = 17.95) significantly increased the PAID score. CONCLUSION: Trust in physician is associated with an increased adherence and with decreased diabetes-related distress. This distress was also associated with poor adherence in our study

Diabetes distress and related factors in South African adults with type 2 diabetes

Background: In South Africa, the prevalence rate of diabetes is 9.27%, with an estimated 2.6 million people living with the disease. Diabetes-related distress has been described as encompassing the patient’s concerns about the self-management of diabetes, perception of support, emotional burden and access to quality health care. There has been little or no research done in South Africa regarding diabetes-related distress.Objectives: The aim of this paper was: (1) to identify the level of diabetes-related distress in a cohort of diabetes type 2 patients in KwaZulu-Natal and (2) to identify the factors that contribute to diabetes-related distress.Methods: This cross-sectional study was conducted at two public facilities and five private medical practices on the north coast of KwaZulu-Natal, South Africa. The Diabetes Distress Scale was administered, together with a demographic questionnaire, to 401 participants.Results: In total, 44% of the sample reported having moderate to high levels of distress. The mean scores of the Emotional Burden dimension (M = 2.6; SD = 1.42) and the Regimen Distress dimension (M = 2.33; SD = 1.29) suggested moderate levels of distress. Factors that significantly contributed to high levels of distress were younger age, high HbA1C levels, female gender, attending the public health sector, unemployment and being a person of colour.Conclusion: Healthcare providers need to pay particular attention to the psychological needs of the patient, which impact on the medical outcomes of the disease.Keywords: adults, depression, diabetes-related distress, glycaemic index, South Africa, type 2 diabete

THE SUITABILITY OF THE ROBERTS APPERCEPTION TEST FOR CHILDREN (RATC), THE HOUSE-TREE-PERSON (H-T-P) AND DRAW-A-PERSON (D-A-P) SCALES IN THE IDENTIFICATION OF CHILD SEXUAL ABUSE IN THE INDIAN COMMUNITY: AN EXPLORATORY STUDY

Determining whether a child has been sexually abused is both a challenging and daunting task, since errors in this regard could have far-reaching implications. Adding to the dilemma of distinguishing between the abused and non-abused child is the fact that there is no single psychological measuring instrument to aid the forensic evaluator in this task. However, recently there have been attempts to either develop certain measures for specific use in child sexual abuse investigations or to determine the suitability of existing measures in this regard. The aim of this study was to determine the suitability of the Roberts Apperception Test for Children (RATC), the House-Tree-Person (H-T-P) test and the Draw-A-Person (D-A-P) test as measures of sexual abuse assessment in South African children. As there is particularly a lack of information in certain subcultures, this study focused on the Indian community. The research participants included 23 sexually abused girls and 17 non-sexually abused girls mostly from foster homes in KwaZulu-Natal. The results revealed that the two groups differed significantly on the four scales of the H-T-P/D-A-P, whereas there were no differences in the scale scores on the RATC. However, a larger proportion of girls who were sexually abused, gave responses of a sexual nature on the RATC. It was concluded that both these instruments seem to be suitable for inclusion in an assessment battery for sexual abuse investigations in Indian girls. It was also emphasised that none of the instruments can be used in isolation. However, they can provide an indication of possible sexual abuse which must be investigated further. Southern African Jnl Child and Adolescent Mental Health Vol.14(2) 2002:91-10

Psychosocial stress in South African patients with type 2 diabetes

Objective: Diabetes mellitus is considered an emotionally and behaviourally demanding condition which adds to the stress of a patient’s daily living. There is a paucity of literature in South Africa regarding stress and diabetes. This study therefore aims to identify the areas and contributory factors of psychosocial stress in South African patients with diabetes. Method: A cross-sectional study was conducted at two public facilities and five private medical practices on the north coast of KwaZulu-Natal, South Africa. The Questionnaire on Stress in Diabetes – Revised was administered to 401 participants. Results: Eighteen percent of the sample reported having extreme psychosocial stress. Depression, physical complaints and self-medication/diet were the main areas which contributed to high psychosocial stress. Factors that also contributed to high levels of psychosocial stress were low educational level, unemployment, female gender, attending the public sector and high HbA1c levels. Conclusion: Psychosocial stress affects metabolic control in patients with diabetes, thereby increasing the risks of long-term complications