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Sounds of home: book one, compositions.
(2026) Mashiloane, Sibusiso Joseph.; Ntsele, Marlyn.
Pregestational prediabetes induces maternal Hypothalamic-Pituitary-Adrenal (HPA) Axis Dysregulation and results in adverse foetal outcomes.
(2024) Ngema, Mathuli.; Ngubane, Phikelelani Siphosethu.; Khathi, Andile.; Xulu, Nombuso Duduzile.
Background Foetal programming refers to the concept that maternal insults have the ability to disrupt the normal pattern of foetal development, permanently changing the body's structure, physiology and metabolism, thereby predisposing it to chronic diseases in later life. During pregnancy, maternal HPA (hypothalamic-pituitary-adrenal) axis activity increases due to placental corticotropin-releasing hormone (CRH), leading to higher glucocorticoid (GCs) levels, though within normal ranges. The maternal glucocorticoid influences foetal system development, yet the foetal HPA axis is sensitive to excess glucocorticoids, especially in cases of maternal stress, synthetic glucocorticoids or pregestational diabetes pregnancies. Excess glucocorticoids can irreversibly reprogram the foetal HPA axis, causing persistent changes such as increased bioavailability of GC in basal levels observed from juvenile to adulthood. Alterations such as the programmed HPA axis have been associated with increasing risks of metabolic disorders like hypertension, T2DM, obesity, cardiovascular diseases, and mental health disorders. Prediabetes, often a precursor to T2DM, is marked by asymptomatic hyperglycaemia and is linked to high-caloric diets. Research using high saturated fat, high refined carbohydrate diet-induced prediabetic models indicates that T2DM complications, including myocardial injury, renal dysfunction, hormonal dysregulation and dysregulation in the function of the HPA axis, begin during prediabetic stages. However, there is a lack of research in the existing body of literature that clarifies the influence of maternal prediabetes on the HPA axis during pregnancy and its effects on foetal outcomes. Hence, the present study aimed to investigate the effects of pregestational prediabetes on maternal HPA axis function and postnatal offspring development. Methods Female Sprague Dawley rats (n=12) were randomly assigned to one of the two groups (n=6, per group): pre-diabetic (PD) and non-pre-diabetic (NPD). Prediabetes was confirmed through fasting blood glucose and glucose tolerance tests. After PD induction, mating occurred, and pregnancy was confirmed. Post-gestation, 36 male pups from PD and NPD groups were collected. Blood from dams was collected on the weaning day to measure insulin, glycated haemoglobin (HbA1c), and the homeostatic model assessment for insulin resistance, insulin sensitivity and beta cell function as well as the adrenocorticotropic hormone (ACTH) and corticosterone concentrations. In addition, the pups were divided into three independent experimental weeks, week 3, week 6 and week 16, with 6 pups in each group assigned to either the NPD or PD on the day of weaning. Pups were evaluated at weeks 3, 6, and 16, with body weight, fasting glucose, and glucose tolerance tests conducted. Terminal investigations on each experimental week included measuring plasma ACTH, corticosterone, insulin via ELISA and gene expressions for glucocorticoid and mineralocorticoid receptors, in pups' hippocampus via polymerase chain reaction (PCR). Results and Discussion The high-fat, high-carbohydrate diet caused moderate hyperglycaemia, elevated plasma insulin, HbA1c, and insulin resistance in the PD group. Pregnant PD rats showed higher ACTH and corticosterone levels, indicating HPA axis dysregulation when compared to the NPD group. Pups from the PD group had elevated ACTH and corticosterone, altered GR and MR gene expressions, and increased adrenal gland weights compared to the NPD group. These findings suggest constant HPA axis activation without external stress, indicating alterations at the hypothalamus, pituitary, or adrenal gland levels, which may have been due to exposure to excess maternal corticosterone in utero. PD pups also had lower body weight, glucose intolerance, and insulin resistance, suggesting that maternal corticosterone affected foetal growth and glucose metabolism pathways when compared to the NPD group. Conclusion The findings suggest that pregestational prediabetes is associated with dysregulated HPA axis function, and it is positively associated with pregestational diabetes and maternal stress pregnancy complications. The foetal adverse outcomes such as HPA axis hyperactivity, reduced growth development and glucose handling disturbances relative to foetal programming might also begin in prediabetic pregnancy.
The role of traditional health practitioners and the effects of Salix mucronata on the treatment of negative symptoms of Schizophrenia in KwaZulu-Natal, South Africa.
(2024) Ngubane, Ntombifuthi Princess.; De Gama, Brenda Zola.; Mabandla, Musa Vuyisile.
Introduction: The negative symptoms of schizophrenia overlap with the symptoms presented in conditions associated with witchcraft, evil spirits and ancestors in the African healing setting. The cornerstone biomedical treatment for schizophrenia is antipsychotics which are associated with adverse side effects. Traditional healing employs a holistic approach when managing physical and mental ailments, and encompasses cultural and spiritual beliefs. Hence, its preferability in African communities. Thus, this study aimed to investigate the role of Traditional Health Practitioners (THPs) and traditional medicine in the treatment of negative symptoms of schizophrenia by investigating the THPs’ methods of diagnosis and treatment. The herbal plants used by THPs were investigated for phytochemistry and cytotoxicity, and S. mucronata was further investigated for its antipsychotic activity which was compared to the activity of the currently used antipsychotic drug, risperidone. Methodology: Self-developed questionnaires were administered to 100 randomly selected THPs from the Harry Gwala District Municipality and focus group discussions were conducted with 31 of the THPs with experience in treating mental illness. Phytochemistry and cytotoxicity of herbal plants recommended by the THPs were investigated using GC-MS and the MTT assay, respectively. S. mucronata, was further tested for antipsychotic potential on ketamine-induced Sprague-Dawley rats. The animal component of the study consisted of a total of 66 male adult rats (n=21 formed the experimental groups and n=45 formed the experimental groups which received 30 mg/kg of ketamine). During the treatment phase, the animals received either saline, risperidone (6 mg/kg) or the herbal extract of S. mucronata (5 mg/kg). This plant was selected since there is a paucity of studies reporting on its potential for the treatment of this disorder. Three-chambered sociability and sucrose preference tests were used to examine asociality and anhedonia, respectively. The concentrations of dopamine and acetylcholine were measured using ELISA as the dysfunction of these neurotransmitters is linked with the pathophysiology of schizophrenia. Results: Consultation with ancestors and the administration of a medicinal concoction were the common methods employed by the THPs to diagnose and treat schizophrenia. A variety of bioactive compounds were identified from herbal plants recommended by the THPs for treatment of schizophrenia and these plants showed no cytotoxic effects. S. mucronata reversed social withdrawal and promoted social novelty in ketamine-induced rats. Conclusion: THPs play a significant role in the treatment of schizophrenia and traditional medicine (TM) had a positive effect in the treatment of this disorder. The herbal plants used by THPs to treat mental disorders in KwaZulu-Natal can be considered safe for use as they have indicated non-cytotoxicity and may have a number of benefits as they possess a variety of beneficial bioactive compounds. S. mucronata showed antipsychotic activity similar to the effects of risperidone.
Quality of life of children treated for cleft lip and/or palate in a selected South African population.
(2025) Lembede, Siyabonga Welcome.; Lazarus, Lelika.; Madaree, Anil.
Background Cleft lip or palate are regarded as the most prevalent congenital anomalies of the head and neck, occurring on the lips and both the hard and soft palates. These clefts are associated with complications that affect patients’ quality of life (QoL) by impairing their eating, communication, hearing, and physical appearance in both adolescence and adulthood. Maxillofacial surgeons commonly perform surgical repairs for clefts, yet some challenges may persist even after treatment. These ongoing issues might go unnoticed without a QoL assessment. Thus, this study aimed to evaluate how surgical correction of cleft lip or palate impacts the QoL of patients with orofacial clefts. Methods Fifty patients who came for cleft lip or palate repair surgery at Inkosi Albert Luthuli Central Hospital’s Craniofacial Clinic were included in this study. A questionnaire was employed as the data collection instrument to evaluate the QoL of these patients. Results Participants with a cleft lip only exhibited low QoL scores specifically in the social health domain, at 63.5%. Those with unilateral cleft lip and palate had decreased scores in the psychological health domain, while patients with bilateral cleft lip and palate scored lower in the physical health domain, with percentages of 57.1% and 71.1%, respectively. In contrast, children with cleft palate only displayed higher QoL scores across all health domains. Female participants showed elevated scores in both the psychological domain (61.5%) and the physical domain (85%). Importantly, children aged 10 to 13 years recorded the lowest scores across all health domains. Conclusion QoL was higher in patients with cleft palates than in those with other cleft subtypes. Those within the 1-3 age group had much higher QoL scores than older age groups, and females had a higher QoL than males.
An exploration of the experiences of South African healthcare workers practicing in the COVID-19 context.
(2024) Redinger, Rayne Robyn.; Reuben, Shanya.; Frizelle, Kerry Lyn.
The coronavirus disease rapidly spread worldwide placing enormous pressure on healthcare systems and healthcare workers. As the COVID-19 pandemic has progressed, research concerning the impact of the COVID-19 pandemic on healthcare workers has rapidly expanded. However, the majority of these studies have been quantitative. Moreover, few studies that have been conducted within the South African context. The current study sought to address these gaps in the literature by qualitatively exploring the experiences of South African frontline healthcare workers during the COVID-19 pandemic. This study focused on the various intrapersonal and contextual factors that have contributed to the unique experiences and well-being of healthcare workers within the South African context. Semi-structured email facilitated qualitative interviews (EFQI) were used to explore the experiences of one general practitioner, two specialist physicians, and one nurse, who have directly cared for and treated patients with COVID-19, in KwaZulu-Natal, South Africa. Interview transcripts were analysed using theory-driven thematic analysis, with an ecological framework providing a lens through which to view the data. The findings indicate that practising during the COVID-19 pandemic impacted on the well-being of healthcare workers. Although healthcare workers experienced significant distress, they appear to have utilised various coping strategies to manage these negative emotions. Healthcare workers also report positive experiences during the COVID-19 pandemic, such as receiving social support and a strengthening in their relationships. Furthermore, the results of the study show that the experiences of participants were mediated by multiple factors at the various ecological levels. This study provides an in-depth understanding of the experiences of South African healthcare workers practicing during the COVID-19 pandemic. These findings contribute to the limited literature on this topic available in South Africa, and may be used to assist in the development of future crisis intervention and public policy in South Africa to protect the mental health of healthcare workers.