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ABSTRACT: An audit was undertaken of a 'colposcopy and treatment' clinic between April 2003 and December 2006, to determine: (i) the frequency of overtreatment with Papanicolaou smear on its own, colposcopy on its own or a combination of the two methods; (ii) differences in overtreatment between patients who are HIV positive and those who are HIV negative; and (iii) the short-term complications of Lletz (large loop excision of the transformation zone) at this clinic.
An analysis of the data from the colposcopy clinic database of patients, who were referred according to national guidelines.
Patients who are referred to Chris Hani Baragwanath Hospital.
Normal histology was found in 1.3% of patients, and cervical intraepithelial neoplasia (CIN)1 or human papillomavirus (HPV) in 8.4%. The overall complication rate was 3%.
The high loss to follow-up and the low early complication rate together with an acceptable overtreatment rate make this a justifiable approach in our situation. HIV-negative women were more likely to be overtreated than HIV-positive patients(p=0.03).
South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde 03/2008; 98(2):119-22. · 2.04 Impact Factor
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ABSTRACT: The objective of the study was to investigate if a single dose of Hexoprenaline administered to patients diagnosed as having fetal distress improves neonatal outcome and whether there are any side effects and complications related to hexoprenaline injection. Patients with fetal distress diagnosed by electronic fetal heart rate monitoring with a gestational age of 35 weeks or more in active labor were eligible. Once the decision to deliver the patient by Cesarean section was made, patients were approached and randomised by sealed opaque envelopes to hexoprenaline or control groups. Ten micrograms of hexoprenaline were administered intravenously to study patients. Main outcomes were cord blood gas values, Apgar scores, the need for resuscitation and admission to intensive care. There were no statistically significant differences in the main outcome measures between the two groups. Fewer babies in the hexoprenaline group had a pH of < 7.2 and a base excess of < -10, but this was not statistically significant. The fetal heart rate pattern was improved in significantly more patients after hexoprenaline administration than controls. In conclusion, despite the statistically significant improvement in fetal heart rate tracings, Apgar scores and blood gas values showed only a trend towards improvement in the hexoprenaline group.
Journal of Perinatal Medicine 02/1997; 25(1):97-100. · 1.70 Impact Factor
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ABSTRACT: Antiovarian autoantibodies localized to the granulosa cells were detected in 50% of a group of eight patients diagnosed with polycystic ovarian syndrome. An analogy is drawn to other endocrinopathies characterized by hypersecretion of hormones, notably thyroid and adrenal, and a pathogenetic mechanism involving stimulating antibody is postulated.
The Journal of reproductive medicine 06/1993; 38(5):381-6. · 0.87 Impact Factor
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ABSTRACT: The association between amaurosis and preeclampsia has been extensively documented of late. In four women with amaurosis, the major etiologic factor appeared to be dramatic fluctuations in blood pressure associated with an excessive peripartum blood loss. One patient was found to have an area of cortical infarction, as evidenced by computed tomography. All four patients made a full recovery.
The Journal of reproductive medicine 04/1989; 34(3):253-7. · 0.87 Impact Factor
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ABSTRACT: Prior to artificial rupture of membranes, 498 women were questioned about obstetric and social factors including self-medication during pregnancy. Caesarean section (P less than 0,01) and low Apgar scores (P less than 0,001) were significantly more common in pregnancies complicated by fetal meconium passage. Meconium passage was more common in women who had recently taken castor oil (P less than 0,01) and possibly herbal substances called 'sihlambezo' (trend P less than 0,2). Use of laxatives or enemas and other obstetric risk factors were not associated with meconium passage.
South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde 05/1987; 71(7):431-3. · 2.04 Impact Factor
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ABSTRACT: Fifty-two patients who had had a single previous caesarean section were submitted to a trial of scar. Labour was monitored by internal tocography and direct fetal heart rate monitoring. Oxytocin infusion was employed when uterine work proved to be inadequate. The oxytocin-augmented and unstimulated groups were compared. Oxytocin augmentation improved uterine work and did not result in significant fetal or maternal morbidity or mortality. Internal tocography was found to be of value, but fetal heart rate monitoring was essential.
South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde 11/1986; 70(9):529-32. · 2.04 Impact Factor
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ABSTRACT: The obstetric management of 3 women with stable hydrocephalus is presented. The few obstetric complications were unrelated to the maternal hydrocephalus, and specific management of the maternal condition was not necessary. Better management of hydrocephalus in infancy, as well as of the other forms of non-tumoral hydrocephalus, has led to more adults in a stable state with the condition and pregnancy will occur in some of these. A plea is made for all female patients with hydrocephalus to have a ventriculoperitoneal shunt rather than a ventriculoatrial one, with a view to reduction of complications in later pregnancies.
South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde 10/1986; 70(6):358-60. · 2.04 Impact Factor
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C J van Gelderen
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ABSTRACT: Acute pelvic inflammatory disease is a very common gynaecological disorder, and more often than not it is caused by a mixed infection of aerobic and anaerobic organisms. Routine bacteriological investigation is consequently of little practical value in determining the therapeutic approach. In an open comparative trial, 60 patients were divided into two treatment groups of 30 patients each. Both groups received a combination of penicillins, probenecid, a sulphonamide and an imidazole derivative active against protozoa and anaerobes. Both regimens resulted in virtually the same therapeutic response in patients hospitalized for 6 days. The regimen consisting of ornidazole (as opposed to metronidazole) and the ultralong-acting sulphonamide, sulphadoxine (as opposed to sulphadimidine), can be given in a once-only administration, thereby greatly reducing the possibility of non-compliance in patients treated, as is customary, on an outpatient basis.
South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde 09/1980; 58(6):246-8. · 2.04 Impact Factor
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South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde 06/1978; 53(20):780. · 2.04 Impact Factor
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C J Van Gelderen
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ABSTRACT: Two hundred Black women who required trial labour for suspected disproportion were adminstered continuous lumbar epidural analgesia by an obstetrician. The effects, side-effects, and results are described and discussed. Epidural block provides safe, effective analgesia for trial labour, and does not adversely affect the delivery or fetal condition.
South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde 12/1975; 49(48):1993-6. · 2.04 Impact Factor
