A review of 367 triplet pregnancies

CITATION: Deale, C. J. C. & Cronje, H. S. 1984. A review of 367 triplet pregnancies. South African Medical Journal, 66:92-94.The original publication is available at http://www.samj.org.zaQuestionnaires were sent to 452 hospitals in the RSA and SWA/Namibia requesting information on triplet pregnancies over a 10-year period. Information on 367 sets of triplets from 150 hospitals was adequate for analysis. The incidence of triplets was 0,04% of all deliveries. As many as 45% of triplets were diagnosed during the first or second stage of labour. These infants had a significantly lower birth weight than those diagnosed at an antenatal clinic (P <0,01). The mean birth weights of babies that died in utero or neonatally (within 7 days) were significantly lower than those in survivors (P <0,0001). Caesarean section was the delivery method for 14% of 1002 infants and perinatal mortality was improved for the second and third babies in comparison with second and third babies delivered vaginally (P <0,003 and P <0,002 respectively). It is concluded that the diagnosis of triplets should be made at the earliest possible stage of pregnancy, and that following adequate antenatal care all triplets should be delivered by caesarean section, except under ideal uncomplicated conditions where vaginal delivery may be feasible.Publisher’s versio

Management of anterior vaginal prolapse in South Africa : national survey

LetterThe original publication is available at http://www.samj.org.zaTo the Editor: A national survey was done on the management of anterior vaginal prolapse (AVP) by registered gynaecologists and urologists in South Africa. Of 822 questionnaires posted, 30.2% were returned completed (23.2% from gynaecologists and 7.0% from urologists). The information supplied was anonymous and is probably a true reflection of current practice. Of concern were the 36.3% of respondents who did not use a recognised staging system, a low rate of pre-operative urodynamic investigation by gynaecologists (8.4%) and a high rate of synthetic mesh use by urologists (75.9%), even for primary procedures. This first survey among South African prolapse surgeons provides valuable insight into clinical practice.Publishers’ versio

Prediction of ‘Nules Clementine’ mandarin susceptibility to rind breakdown disorder using Vis/NIR spectroscopy

The use of diffuse reflectance visible and near infrared (Vis/NIR) spectroscopy was explored as a non-destructive technique to predict ‘Nules Clementine’ mandarin fruit susceptibility to rind breakdown (RBD) disorder by detecting rind physico-chemical properties of 80 intact fruit harvested from different canopy positions. Vis/NIR spectra were obtained using a LabSpec® spectrophotometer. Reference physico-chemical data of the fruit were obtained after 8 weeks of storage at 8 °C using conventional methods and included RBD, hue angle, colour index, mass loss, rind dry matter, as well as carbohydrates (sucrose, glucose, fructose, total carbohydrates), and total phenolic acid concentrations. Principal component analysis (PCA) was applied to analyse spectral data to identify clusters in the PCA score plots and outliers. Partial least squares (PLS) regression was applied to spectral data after PCA to develop prediction models for each quality attribute. The spectra were subjected to a test set validation by dividing the data into calibration (n = 48) and test validation (n = 32) sets. An extra set of 40 fruit harvested from a different part of the orchard was used for external validation. PLS-discriminant analysis (PLS-DA) models were developed to sort fruit based on canopy position and RBD susceptibility. Fruit position within the canopy had a significant influence on rind biochemical properties. Outside fruit had higher rind carbohydrates, phenolic acids and dry matter content and lower RBD index than inside fruit. The data distribution in the PCA and PLS-DA models displayed four clusters that could easily be identified. These clusters allowed distinction between fruit from different preharvest treatments. NIR calibration and validation results demonstrated that colour index, dry matter, total carbohydrates and mass loss were predicted with significant accuracy, with residual predictive deviation (RPD) for prediction of 3.83, 3.58, 3.15 and 2.61, respectively. The good correlation between spectral information and carbohydrate content demonstrated the potential of Vis/NIR as a non-destructive tool to predict fruit susceptibility to RBD

Utilisation of maternity services by black women in rural and urban areas of the Orange Free State

An epidemiological survey was undertaken to evaluate the utilisation of maternal services for black women in the Orange Free State. Two hundred and forty clusters were selected from the rural (farms) and urban (local authorities) black population and eight households were interviewed in each cluster. Information was gathered from 237 rural women (from 959 households) and 168 urban women (from 926 households) who had delivered a baby or aborted during the preceding year. Antenatal care was received by 71 % of the rural women and 87% of the urban women. Rural women delivered at home in 60% of cases while 37% delivered in hospitals. Only 23% of urban women delivered at home while 67% of their deliveries were conducted in hospitals. Nurses supervised deliveries in both instances in more than 60% of cases, but in rural areas traditional midwives managed 26% of the confinements. The conclusions are that the maternity service was largely provided by nurses and was predominantly limited to hospitals and homes. It is recommended that the quality of service be upgraded and more emphasis placed on midwife obstetric units

Maternal deaths in Bloemfontein, South Africa -1986 - 1992

Objective. Determination of the maternal mortality ratio and the main causes of maternal death.Setting. Pelonomi Hospital, a tertiary care and referral hospital in Bloemfontein.Methods. Review of prospectively completed structured questionnaires on all maternal deaths from 1986 to 1992.Results. The maternal mortality ratio at our institution was 171 per 100000 live births. Haemorrhage (25%), infection (24%) and hypertensive disease (18%) were the most important causes of death. Seventy-one per cent were direct obstetric deaths and 23% indirect; in the remaining 6%, the cause was uncertain. Of all deaths, 35% were considered preventable.Conclusions. The maternal mortality ratio has decreased since our previous report for the period 1980 - 1985, and haemorrhage has replaced infection as the leading cause of death

Статические нагрузки упругих зубьев зубчатых передач

Представим себе изготовленную из упругих материалов, статистически нагружен-ную зубчатую передачу, состоящую из двух зацепляющихся колес и обладающую не-точностями в нормальном шаге зацепления, характеризуемыми погрешностью α01 . В этом случае для соблюдения условий уравнения (1), сохранения постоянства угловых перемещений при вращении и обеспечения непрерывности зубьев, обладающих раз-личными размерами нормального шага зацепления, потребуется соответствующая сум-марная упругая деформация, вызванная передаваемым удельным крутящим моментом Mn1, будет эквивалентна величине углового перемещени

Daily or weekly? The role of treatment frequency in the effectiveness of grammar treatment for children with specific language impairment.

This study compared the effectiveness of a school-based treatment for expressive grammar in 5-year-olds with specific language impairment delivered in two different dose frequencies: eight sessions delivered daily over 8 consecutive school days or eight sessions delivered weekly over 8 consecutive weeks. Eighteen children received treatment daily and 13 children received treatment weekly. In both groups, treatment consisted of eight 1-hour sessions of small group activities in a classroom setting. Techniques included explicit instruction, focused stimulation, recasting, and imitation. Results were analysed at the group level and as a case series with each child as their own control in a single-subject design. The 8-weeks group showed significantly greater gain in test scores over the treatment period than in an equal time period prior to treatment, whereas the 8-days group did not (Cohen's d = 1.64 for 8-weeks group). Single-subject analyses indicated that 46% of children in the 8-week group and 17% of children in the 8-day group showed a significant treatment effect. It is concluded that expressive grammar treatment was most effective when dose frequency was weekly over 8 weeks rather than daily over 8 days for 5-year-old children with specific language impairment.13 page(s