Towards the synthesis of lipopolysaccharide fragments and development of new alkylating agents

This document details the efforts towards the automated solution phase synthesis of fragments of the Xcc bacteria\u27s lipopolysaccharide. The target fragment is a trisaccharide consisting of two glucosamine monomers with a 1-6 beta linkage connected to a 2-6 alpha link to 3-Deoxy-d-manno-Octulosonic Acid (KDO). First, the field of glycobiology is introduced and the challenges associated with the advancement of oligosaccharide synthesis highlighted. Then the synthesis of the glucosamine building block is described. Different approaches to the same general building block are investigated for the best possible route to the building block. Approaches that require less reaction steps, cheaper reagents, easier intermediates to handle, easier purification methods and safer reagents are sought and reported. From the quest to produce easier intermediates, a different type of glycosyl donor, N-aryl trifluoroacetimidate donor is explored. Due to the change in stability observed with changing the substituent on the aryl group, stability studies of different methyl N-aryl trifluoroacetimidates are further studied. From the stability studies, the mechanism of acetimidate activation can be confirmed. Some acetimidates exhibit favorable characteristics and these are further studied for their role and ability as alkylating agents. Since some are crystalline at room temperature some acetimidates are reported for their appropriateness in commercialization. The other part of the target LPS fragment is KDO and this rare and expensive sugar is synthesized through biosynthesis. Major problems with purification resulted in the chemical synthesis of KDO from oxaloacetic acid and this method also presents the same major problem. Future directions include better purification protocols for KDO and more runs of glucosamine building blocks on the automated solution phase workstation developed in the lab

Periprocedural myocardial infarction following percutaneous coronary intervention at Charlotte Maxeke Johannesburg Academic Hospital

Original published work submitted to the Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, in fulfilment of the requirements for the degree of Master of Medicine (Internal Medicine) 18 October, 2017.The very first coronary artery balloon angioplasty is reported to have been performed by Gruntzig in 1977.1 Subsequently to this, over the past 40 years, there have been significant advances in coronary angiography and intervention. Coronary artery interventional techniques have evolved and improved significantly. There have been considerable device developments, new generation stents and novel antiplatelet therapy which have all proved to reduce the incidence of the primary periprocedural complications associated with percutaneous coronary intervention (PCI). [No abstract provided. Information taken from introduction]LG201

A study of gender equality in one of Swaziland's secondary schools: A case study

Bibliography: leaves 89-92.The purpose of my investigation was to study gender equality in one of Swaziland's secondary schools. This was a case study. The aim was to determine the extent to which gender equality was being practised, if at all. The study was based on socialization theories presented by some feminists. The theories discussed in this thesis are the Liberal feminist theory, the Socialist feminist theory, the Radical feminist theory, the Psychoanalytic feminist theory, the Postmodern feminist theory and the Third World feminist theory. Feminists believe that early socialization and sex-stereotyped attitudes about boys and girls have a fundamental effect on the processes of education in relation to teaching style and methodology and the way in which learning is negotiated by boys and girls. Feminists believe that the teachers as well as their fellow male students usually marginalize girls at school. In this case study a school in urban Swaziland was selected

The geographies of slow learners in a government high school under Mliba zone in the Manzini Region of Swaziland.

Masters Degree. University of KwaZulu-Natal, Durban.The focus of this study was to explore the geographies of slow learners in a government high school under Mliba zone in the Manzini region of Swaziland. The children’s geographies and new sociology of childhood studies was adopted. These theories were used in order to understand the space and place that is occupied by slow learner’s children at school. The aim of the study was to understand the experiences of slow learners and how they sail across in their daily lives within the school. A qualitative research methodology within the custom of a narrative inquiry was used for the study. Different methods of collecting information were used in this study and it includes the following: individual and focus group interviews with the use of a participatory learning activity, which is photo voice. Content and thematic analysis was used for data analysis. The study was conducted in a government school, with the focus on slow learners from form 1 to form 5.Three girls and three boys between the ages thirteen to nineteen years were selected to participate in the study. Purposive sampling was used for the study. The study found that slow learners were challenged within their navigation of spaces and places in the school. Findings revealed that slow learners were not understood, their state of being by teachers as well as their classmates, for there are normal children with no physical disability yet failing to cope with school work. The study recommended that teachers need to be work shopped on inclusion in order for them to be able to deal with every kind of learner especially the slow learners. There was also a need for the school to educate learners within the school to create a friendly culture amongst students

Evaluation of irrigation adequacy in sugarcane systems in Eswatini

The adoption of objective irrigation scheduling approaches in the sugarcane industry has been very slow leading to over-irrigation, low water use efficiency and consequently, low returns. With the widespread use of subjective scheduling, there is also a perception that there are no significant benefits derived from objective scheduling. A study was, therefore, conducted in Eswatini to determine the performance of irrigation systems that were using subjective irrigation scheduling. More specifically, the objective of the study was to determine the irrigation adequacy for a sugarcane crop that was under two overhead systems viz. centre pivot and sprinkler irrigation. Adequacy was determined in terms of relative irrigation supply (RIS) for the 2015/16 season. The CROPWAT 8.0 model was used to estimate crop demand in terms of net irrigation requirement, whilst the amount of water applied during the period was the supply. Seasonal RIS results indicated that the area under the centre pivot was slightly over-irrigated (RIS= 1.13), whilst irrigation in the area under the sprinkler system was found to be adequate (RIS= 0.94). Monthly RIS values, however, revealed that the crop was over-irrigated most of the time. The crop under the centre pivot was over-irrigated for the months of January, June, July, September, November, and December as indicated by the RIS values of 1.17, 1.33, 1.20, 1.77, 3.35, and 15.09, respectively. Over-irrigation under the sprinkler system was observed in June, July, September, October, and November where the RIS was 1.36, 2.19, 2.91, 1.77, and 1.67, respectively. In both irrigation systems, over-irrigation was experienced at the germination and establishment phases of development. In contrast, all of the months with acceptable RIS values were found to be within the grand growth phase. It was, therefore, concluded that the scheduling approach used in the area was biased towards the grand growth phase. Hence, it was recommended that the irrigation schedule be modified to accommodate each of the different phases of sugarcane development

Association between malnutrition and diagnosed drug susceptible tuberculosis amongst children aged zero to fifteen years old in Swaziland

Background: In 2015, Swaziland had a tuberculosis (TB) prevalence of 733 per 100 000 population and HIV prevalence of 27.5%. Baylor College of Medicine Children’s Foundation Swaziland (BCMCFSD) reported 83% prevalence of malnutrition amongst children in 2014. No study has described the association between malnutrition and childhood TB in Swaziland. Purpose: To examine the association between malnutrition and diagnosed drug susceptible tuberculosis (TB) amongst children aged zero to fifteen years old in Swaziland. Method: The Mixed Method approach was used to conduct the study. A total of 306 children’s electronic records were extracted, then 12 children’s caregivers interviewed. Extracted data were cleaned and exported to an excel database, then analysed using STATA version 14 by a statistician. Qualitative data were analysed using NVIVO version 11 post the analysis of the quantitative data. Triangulation of quantitative and qualitative results was conducted to obtain a comprehensive picture of the study. Validity, reliability, trustworthiness and adherence to ethical considerations were maintained. Results: History of previous TB treatment, HIV status and age were strongly associated with poor TB outcome (<0.001) and severe malnutrition (<0.002). Sex, regions and TB type were statistically insignificant. Nutritional situation at home and nutritional support from the health care facility, emerged as themes. Conclusion: TB and Malnutrition are significant predictors of children mortality, thus the children caregivers need consistent health education and support.Health StudiesM. P.

Mural endocarditis - by default

We report on a case of a 33-year-old female patient with known adult congenital heart disease in the form of a coronary cameral fistula who, on prior presentation, had refused treatment and subsequently defaulted follow-up, but unfortunately developed a serious and rare complication. She presented with non-specific neurological symptoms of transient visual loss and headaches. Clinical examination revealed aortic regurgitation with peripheral features of infective endocarditis. This was confirmed with transthoracic echocardiogram, but additionally, we found mural endocarditis of the right atrial posterior wall. An initial CT brain scan and ophthalmology assessments were negative, blood cultures were positive and confirmed infective endocarditis, and she was referred for urgent cardiothoracic surgery. Unfortunately, she had further complications with a large intracranial haemorrhage which ultimately led to her death. This case illustrates a rare entity with disastrous complications

COVID-19 and heart failure

Acute and chronic heart failure patients have a 2- to 3-fold increased risk of complicating with severe COVID-19, and these patients tend to have multiple comorbidities which are the primary aetiologies for the heart failure clinical syndrome. Furthermore, the incidence and prevalence of heart failure increases with advanced age, and advanced age is an independent risk factor for poor prognosis and mortality. The SARSCoV-2 infection also has multiple mechanisms that cause acute heart failure and precipitate acutely decompensated chronic heart failure. Additionally, the optimal management of these patients has been marred with the controversy around the use of the renin-angiotensin-aldosterone system blockers. This review provides an update on how heart failure patients should be managed during COVID-19 and summarises the existing evidence, focusing on heart failure

HbA1c control in type 2 diabetes mellitus patients with coronary artery disease: a retrospective study in a tertiary hospital in South Africa

BackgroundType 2 diabetes mellitus (T2DM) patients with coronary artery disease (CAD) have an increased risk of recurrent cardiovascular events. These patients require optimal glucose control to prevent the progression of atherosclerotic cardiovascular disease (ASCVD). Contemporary guidelines recommend an HbA1c ≤7% to mitigate this risk. The aim of this study was to evaluate HbA1c control in T2DM patients with angiographically proven ASCVD.MethodsWe conducted a cross-sectional, retrospective study on consecutive T2DM patients with acute and chronic coronary syndromes managed in a tertiary academic hospital in South Africa. Glycaemic control was assessed by evaluating the glycated haemoglobin (HbA1c) level measured at index presentation with acute and chronic coronary syndromes and during the most recent follow-up visit.ResultsThe study population comprised 262 T2DM patients with a mean age of 61.3 ± 10.4 years. At index presentation, 110 (42.0%) T2DM patients presented with ST-segment elevation myocardial infarction, 69 (26.3%) had non-ST-segment elevation myocardial infarction, 43 (16.4%) had unstable angina, and 40 (15.3%) had stable angina. After a median duration of 16.5 months (IQR: 7-29), 28.7% of the study participants had an HbA1c ≤7%. On multivariable logistic regression analysis, females were less likely to have poor glycaemic control (HbA1c above 7%) [odds ratio (OR): 0.42, 95% confidence interval (CI): 0.19-0.95, p=0.038]. Also, T2DM patients prescribed metformin monotherapy (OR: 0.34, 95% CI: 0.14-0.82, p=0.017) and patients with ST-segment depression on the electrocardiogram (OR: 0.39, 95% CI: 0.16-0.96, p=0.041) were less likely to have poor glycaemic control.ConclusionAfter a median duration of 16.5 months, only 28.7% of T2DM patients with CAD had an HbA1c ≤7%. This finding underscores the substantial unmet need for optimal diabetes control in this very high-risk group

Emotional intelligence predicting subject-specific academic success: EQ-i Youth in South Africa

Background: Academic performance has been perceived as an element, which can change the lives of youth, while emotional intelligence (EI) often relates to adolescents’ well-being and, in turn, can influence academic performance. Emotional intelligence development is related to multiple beneficial outcomes and deemed a valuable tool for educational and career planning. However, there is a need for more EI-related guidance in youth interventions. Objectives: To inform such guidance, this is the first study that aimed to confirm the relationship between the academic results of South African adolescents and EI (measured using an updated assessment and newer EI model). It also aimed to determine whether specific EI scales were dominant predictors of subject-specific academic results. Methods: A quantitative research study was conducted following a non-experimental, correlational research design and stratified random sampling method. The study was conducted in secondary schools across South Africa. Academic results and EI scores of 284 adolescents between 13 and 19 years were available for correlational and regression-based dominance analysis techniques. Results: Results confirmed a significant positive relationship between total EI scores and academic year averages. Prominent findings included the decision making composite, which had the strongest relationship with and was the most dominant predictor of most compulsory subject averages. Conclusion: The results point to the importance of considering learners’ EI as a contributing aspect to their school performance, by incorporating learner-tailored EI testing and development at a school level. Contribution: Findings contribute to the criterion validity of the EQ-i Youth assessment and can guide teaching and career guidance initiatives in incorporating tailored EI strategies for learner development