HIV infection and the kidney

There is a wide clinical spectrum of renal disease in the course of HIV infection, which includes potentially reversible acute renal failure (ARF) (more recently known as acute kidney injury), electrolyte and acid-base disturbances, and intrinsic renal disease unrelated to HIV itself (e.g. co-morbid diabetes mellitus and hypertension).1,2 In addition, there is the group of HIV-associated glomerulonephropathies that may present with acute or chronic renal failure. Histologically, this group is divided into the ‘classic\' HIV-associated nephropathy (HIVAN) with focal segmental glomerulosclerosis (HIV-FGS), HIV-associated immune complex disease (HIV-IC), and HIV-associated thrombotic thrombocytopenic purpura/ haemolytic uraemic syndrome (HIV-TTP/HUS).3 It is this group that is primarily implicated in the burden of chronic kidney disease (CKD) in the HIV-infected population. Southern African Journal of HIV Medicine Vol. 9 (1) 2008: pp. 12-1

Isolated tricuspid valve infective endocarditis - A report of 6 cases

Six cases of isolated tricuspid valve endocarditis in young women are described. Preceding genital sepsis was a predisposing factor in 4 patients. Cardiac signs are unusual at presentation, rendering the diagnosis difficult. Pleuropulmonary manifestations are the predominant findings, while overt signs of tricuspid insufficiency and right heart failure occur late in the disease. Staphylococcus aureus is the pathogen most commonly found and requires energetic treatment for a minimum of 4 weeks. The value of echocardiography in establishing an early diagnosis is stressed. Persistent sepsis constitutes a major indication for surgery.S Afr Med J 1990; 78: 34-3

Outcomes following aortic valve replacement for isolated aortic stenosis with left ventricular dysfunction

Background: Severe aortic stenosis (AS) is associated with a poor prognosis in patients with left ventricular dysfunction (LVD). Survival is estimated at less than 2 years without aortic valve replacement (AVR). Limited data are available on the effects and outcomes of AVR in such patients, especially in the absence of concomitant coronary artery disease (CAD). Methods: This was a retrospective study which identified 33 patients over an approximate 10 year period who underwent surgical AVR for severe isolated AS and LVD(LVEF ≤50%). Patients were excluded if they had a prior valve replacement, mixed valve disease, <18 years old or the presence of CAD. Overall survival was analysed using the Kaplan-Meier curve and Cox proportional hazards model. The changes in postoperative LVEF and NYHA functional class, following AVR, was assessed using the Friedman test and ANOVA.  Results: Operative mortality was 15% with 5 deaths.  Female sex and hyperlipidaemia were identifi ed as predictors of early mortality by univariate analysis. LVEF improved in survivors from a mean of 39 ± 10% - 49.8 ± 8.7% at a 1 year follow-up (p=0.04). Younger age was identifi ed as an independent predictor of LVEF recovery (p=0.04). There was no difference in outcomes in patients with low baseline transvalvular gradients compared to those with higher gradients. There was signifi cant symptomatic improvement noted in all survivors following AVR (p<0.01).  Conclusion: Left ventricular function has a slower rateof recovery, compared to an earlier improvement of NYHA functional class after AVR for severe isolated AS and pre-operative LVD. In this high-risk group thefi ndings support AVR in patients with LVD

Investigating Secure Agile Requirements Engineering Practices in Software Development

The aim of this research study was to assess Agile RE practices in the South African software development industry and investigate secure Agile RE initiatives towards developing secure products. This qualitative research study was contextualized in seventeen South African software development companies. The researchers used structured interviews and document reviews as the primary data collection instruments. Qualitative data was analyzed inductively using content analysis. Emanating from the research were recommendations to guide a regular software developer on good Agile RE practices. The study concluded that although Agile Software Development is practiced in the South African software industry, there needs to be stricter adherences to the Agile Manifesto and Agile Security Manifesto in requirements engineering

Nephrolithiasis (part 1): Epidemiology, causes and pathogenesis of recurrent nephrolithiasis

A recent increase in the incidence of recurrent renal calcium oxalate calculi has been demonstrated. Although a few advances have shown that the increase in incidence of these stones is due to genetic causes, it is mostly associated with a change in environmental factors. Global warming and weather changes, some medications administered to young children and eating habits play a pivotal role in increasing stone incidence. By far the most important single factor in stone incidence involves the increased ingestion of red meat and salt. So much so that it is anticipated that calcium oxalate stone occurrence will increase pari passu with dietary changes in the South African black community. The reasons for the difference in the incidence between males and females (12% v. 6%) remain controversial, and should be further studied

Development of an energy-dense biscuit suitable for primary school learners for the South African National School Nutrition Programme

South Africa has a well established National School Nutrition Programme (NSNP). Despite rescheduling the mealtime to two hours after the start of the school day to accommodate learners who come to school on an empty stomach, a gap still exists as many children start their learning day with low energy and concentration levels. A cost-effective, energy-dense snack served at the start of the school day can be a solution to sustain learners until the main meal is served. Cross-sectional surveys were used to determine the snack preferences of children and the product development process was used to develop a suitable snack. An energy-dense peanut butter biscuit was developed based on those surveys as well as a scoping review of previous snack studies. The energy-dense developed product provided 1388kJ (61.0%) of energy from fat, 688kJ (30.2%) of energy from carbohydrates and 201kJ (8.8%) of energy from protein per 100g. The biscuit conformed to microbial testing standards. Shelf-life analysis projected a shelf-life of five weeks fresh and five months in food grade packaging. Sensory results showed that there was no significant difference in sensory scores across gender (p=0.691) and age (p=0.706). More of the learners (n=56, 69.1%) found the biscuit to be ‘Super good’ than the other ratings (p<.0005). When compared with similar biscuit products currently on the market, it was found that the developed biscuit was the most reasonably priced. The developed biscuit has the potential to serve as a solution to hidden hunger for children that come to school on an empty stomach. This versatile snack solution has potential for continuity of use even during periods of national crisis as with COVID-19, when learners’ nutritional needs may be most vulnerable

Geothermal heat pump system operational data: high frequency monitoring of a large university building

This data was collected as part of a PhD project to analyze the performance of a large-scale non-domestic heat pump installation. The building in question was the Hugh Aston building at De Montfort University, Leicester, UK. High frequency data have been collected during the initial three years of operation of the system. This data has been collated to allow seasonal performance factors to be derived and also detailed analysis of heat pump, circulating pump and control system operation. The data set includes minutely ground loop and heating/cooling loop fluid temperatures and flow rates. The data set has been used to validate models and design procedures for vertical borehole ground heat exchanger arrays

The nutritional status of continuous ambulatory peritoneal dialysis patients at a Johannesburg hospital

Objectives: To assess the nutritional status of continuous ambulatory peritoneal dialysis (CAPD) patients in our hospital using different assessment tools, and to assess the correlation between nutritional status and other parameters such as solute clearance. Method: A cross-sectional study was performed on end-stage renal disease patients treated with CAPD at Charlotte Maxeke Academic Hospital, Johannesburg, South Africa. The nutritional status of each patient was assessed using subjective global assessment (SGA), anthropometric parameters including body mass index (BMI), mid-upper arm circumference (MUAC), triceps skin fold (TSF), arm muscle area (AMA) and arm fat area (AFA), and biochemical parameters including serum albumin and total cholesterol levels. Dialysis adequacy was assessed by solute clearance measurement. Results: The mean age of the patients was 37.9 ± 13.4 years, 54% were males and 74 % were black. The mean BMI was 24.8 ± 3.5 kg/m2, mean MUAC was 28.5 ± 3.9 cm, mean TSF 85.6 ± 41.5 cm, mean serum albumin was 37.1 ± 7.6 mg/dl, while mean serum cholesterol was 5.32 ± 1.7 mmol/l. Based on SGA scores, 42% were well nourished, 50% moderately undernourished, while 8% were severely malnourished. We noted significant correlation between the SGA score and anthropometric parameters (BMI, MUAC) and there was no significant correlation between the nutritional parameters and the solute clearance. Conclusion: Malnutrition is common among CAPD patients in our centre, without a significant correlation between the nutritional status and the solute clearance. There is thus a need for ongoing nutritional assessment and support among these patients.Keywords: nutritional status, peritoneal dialysis patients, Johannesburg, Afric

The effects of trade policy on intra-industry trade within the context of trade liberalization in South Africa.

Thesis (M.Com.)-University of Durban-Westville, 2001.Intra-industry trade is a new phenomenon in international trade theory and has attracted interest from economists, in the form of both empirical and theoretical work. The first attempt to measure the extent of intra-industry trade in South Africa was under taken by Simson (1987). In his study Simson (1987) found that the amount of intra-industry trade accounted for only one-third of total trade. This is low compared to many industrialized countries. This thesis aims to analyze the extent of intra-industry trade within the context of trade liberalization. Chapter two provides the evolution, background and an overview of the literature of the concept of intra-industry trade. This chapter is followed by a presentation of the different measurement of intra-industry trade. But, however the Grubel Lloyd (1975) index remains the most commonly used index in the literature. A fourth chapter estimated the level of intra-industry trade in South Africa for the period 1972 to 1993. This chapter concludes that intra-industry trade in South Africa is a real phenomenon and not just a statistical novelty as argued by Finger (1975). It was is concluded that intra-industry trade is low when compared to most of its trading partners and there remains much scope for the growth of intra-industry trade. The fifth chapter discusses the role of regional integration and intra-industry trade. It is concluded that the levels of intra-industry trade between South Africa and with the countries in the Southern African region is relatively low when compared to the intra-industry trade between South Africa and its major trading partners, nevertheless there remains scope for the growth of intra-industry trade within the region as the countries become more similar. Chapter six discusses the commercial and welfare effects of intra-industry trade, concluding that there are advantages to be gained from intra-industry trade. Chapter seven analyses the effect of tariff levels on intra-industry trade in South Africa. Weak support was found for the height of tariffs and intra-industry trade in South Africa. Given the reduction of tariff lines in terms of the GATT requirement, it is anticipated that levels of intra-industry trade in South Africa will increase and there is much to gain in terms of welfare than inter industry trade