Life-long learning in laboratory animal science and ethics for veterinary and para-veterinary professionals in South Africa.

Veterinary and para-veterinary professionals working in the animal research sector are critical to ensure scientific quality and the humane care and use of animals. However, there are few focused education and training opportunities available for these professionals in South Africa. A survey of veterinarians working in animal research, undertaken by the South African Association for Laboratory Animal Science, identified the need for more advanced education and training opportunities beyond the routine Day 1 Skills currently provided for in undergraduate education. These could be broadly categorised into knowledge and skills relating to species-specific husbandry, procedures and clinical approaches, research-related biosecurity and biosafety, and study-specific ethical and animal welfare considerations. A subsequent workshop, attended by 85 veterinary and para-veterinary professionals in the animal research sector, identified 53 life-long learning needs, each with an associated learning outcome, for this professional community. These were grouped into five overarching themes: Personal development (9); Leadership and management skills (12); Education and training skills (5); Welfare, ethics and clinical skills (20); and Regulations and quality-assurance (7). Of the 53 learning outcomes, 14 were knowledge-based, ten were competencies, and 29 both knowledge and competence. These life-long learning opportunities, if available and implemented, will address important needs of veterinary and paraveterinary professionals in the animal research sector in South Africa. This would empower these professionals, assist in improving animal and human wellbeing, support high-quality ethical science, and maintain public confidence in the sector, thus enabling a more satisfactory career environment.

Single-centre comparison of a novel single-step balloon inflation device and Amplatz sheath dilatation during percutaneous nephrolithotomy: a pilot study.

OBJECTIVE: A new second-generation balloon dilatation device for percutaneous nephrolithotomy (PCNL) has been launched, promising to challenge the traditional Amplatz serial dilators (ASDs). This device allows for the polyurethane sheath to be deployed on balloon inflation. Our primary objective in this pilot study was to determine whether the use of this new device impacted on overall patient outcome when compared with the traditional ASD system. DESIGN: Retrospective chart review. SETTING: Department of Urology, Inkosi Albert Luthuli Central Hospital, Durban. Subject. Single-centre comparison of a novel single-step balloon inflation device and Amplatz sheath dilatation during percutaneous nephrolithotomy - a pilot study. Outcome measures. Single procedure success rates, retreatment rates, hospital stay, haemoglobin concentration, calculi volume, calculi configuration, patient demographics. RESULTS: The stone-free rates after a single procedure were 30% (3/10) in the Amplatz sheath dilatation arm (series 1) and 80% (8/10) in the single-step balloon inflation device arm (series 2). Correspondingly, 11 individual repeat procedures in 7 patients (4 relook PCNLs, 5 ureteroscopies and 2 extracorporeal shockwave lithotripsies) were required in series 1 to render the remaining 70% stone free. Mean hospital stay was 5.2 days (range 3 - 10 days) in series 1 and 3.8 days in series 2. The mean fall in haemoglobin concentration after treatment was 1.79 g/dl in the whole group, 2.1 g/dl in series 1, and 1.5 g/dl in series 2. CONCLUSION: The single-step balloon dilatation device is found to have an improved patient outcome compared with ASDs.

Association between low serum free testosterone and adverse prognostic factors in men diagnosed with prostate cancer in KwaZulu-Natal.

BACKGROUND: The association of serum free testosterone (FT) with prostate cancer is not fully understood. Studies on the results of the relationship between serum testosterone level and prostate cancer are conflicting. However, there is a reported association between lower serum testosterone levels and high-grade prostate cancer. OBJECTIVE: To investigate the relationship between serum FT and the clinico-pathological characteristics of prostate cancer in South African patients. MATERIALS AND METHODS: The clinical data of 109 consecutive patients diagnosed with prostate cancer on biopsy were evaluated prospectively. The variables were age, ethnic group, prostate specific antigen (PSA), digital rectal examination (DRE) findings, clinical tumour, nodes and metastases (TNM) stage, and Gleason score. Low serum FT was defined as <250ng/dl. Statistical analysis was performed using Stata V10 software (p<0.05 considered significant). RESULTS: There was a statistically significant association between low serum FT and high serum PSA, high Gleason score and clinically advanced stage prostate cancer. CONCLUSIONS: In this cohort of men with histologically diagnosed prostate cancer, low serum FT was associated with higher PSA, higher grade, and locally advanced or metastatic prostate cancer.

Spino-renal fistula due to gunshot injury.

A 22-year-old female patient was treated for spino-renal fistula as a result of a high-velocity gunshot injury to her abdomen. The patient presented with meningeal signs, a headache and right monoparesis. A CT scan of her abdomen revealed a leak of contrast from the right kidney into the perirenal space and tracking further into the thecal sac. An MRI scan showed a stable fracture of L3 with slight compression of the thecal sac and features of cord contusion caused by the shockwave of the bullet. To the best of our knowledge a spino-renal fistula of traumatic origin has not previously been reported in the English language literature.

An audit of obstetric fistulae in a teaching hospital in South Africa.

Obstetric fistulae are still common in the rural areas of South Africa. This study describes the demographic and clinical characteristics of 41 women with obstetric urinary fistulae. All were from poor socioeconomic backgrounds and had limited or no access to antenatal care.

Obstetric Urinary Fistulas in KwaZulu-Natal - What is the Extent of this Tragedy?

Background. This study describes the demographics and clinical characteristics of women with obstetric fistulas attending the urogynaecological unit at King Edward VIII Hospital (KEH); KwaZulu-Natal (KZN); South Africa. Method. A prospective clinical review of all women admitted with the diagnosis of an obstetric fistula at KEH from 1999 to 2003. Results. A total of 41 cases from the rural areas of KZN and the Eastern Cape were identified. The mean age was 29 years (range 15 - 51 years); and 21 were primi- gravidas; 14 of whom had unplanned pregnancies. All were from low socioeconomic backgrounds and had limited or no access to antenatal care; either due to their social cir- cumstances or to lack of health care facilities. The duration of labour was prolonged in all; there were 5 live births; and 2 neonatal deaths. Conclusion. Obstetric fistulas are still common in KZN and the Eastern Cape; and occur mainly in women from rural areas

Delayed bowel erosion by tension-free vaginal tape (TVT).

A 71-year-old woman who had had a previous abdominal hysterectomy and Burch operation presented with stress urinary incontinence due to intrinsic urethral sphincter deficiency. She underwent a technically difficult placement of a TVT tape in April 2002. After an uneventful recovery she was discharged after 72 hours but presented almost 5 months later with small bowel obstruction. At laparotomy she had a loop of ileum adherent to the left lower side wall of the pelvis, with the TVT tape penetrating and traversing this loop. The ileal segment was excised and an end-to-end anastomosis performed. Her recovery was uneventful and she is maintaining her urinary continence. Patients who have had previous combined pelvic intra- and extraperitoneal surgery should be operated on by experienced surgeons and be observed for 24 hours. The placement of a Uratape (Porges-Mentor) via a transobturator approach should also be considered in such cases.

Ventral pre-public herniation of bladder following incontinence surgery

Objective: Ventral pre-pubic herniation of the bladder through an incisional hernia is an uncommon condition and reports in the literature are confined to one or two cases. We describe nine patients who presented with this condition 1 to 5 years after undergoing Burch colposuspension operations for stress urinary incontinence [SUI]. Patients and Method: All patients developed the condition following Burch colposuspension operations for stress urinary incontinence. Their non-specific presenting symptom complex is described and emphasized. The incisional hernias were difficult to diagnose on initial clinical examination and easily missed; unless the patient was examined in the erect position with a full bladder. Lateral cystography was the definitive diagnostic imaging modality. CT findings were dramatic and informative but not essential for the diagnosis. On urodynamic investigation bladder pain and urgency on low volumes were found; but no abnormal contractions were seen. Cystoscopy was essential to exclude other intravesical pathology and the specific findings are described. As these patients had intractable bladder symptoms; surgical repair was performed. The anatomical defect in the anterior abdominal wall was always more extensive than anticipated and closure incorporating Prolene mesh and sutures was performed. Co-morbid vaginal prolapse was repaired 4 to 6 months later. Recurrent stress urinary incontinence in one patient was preferably treated with a transobturator suburethral tape. Results: Two patients developed recurrent incisional hernias within the first year. Our first patient who had a primary closure only; had a subsequent successful closure with Proline mesh. One other patient developed a recurrence in the upper part of the wound. The other patients were all symptomatically satisfied with their results at 6-month follow-up. The symptoms of bladder overactivity had reduced dramatically to satisfactory levels and clinically the repairs were secure. The subsequent vaginal repairs of their recurrent cystoceles and rectoceles in three patients seemed successful on short follow-up. The patient who had the transobturator suburethral tape placed is clinically continent. Conclusion: The condition is probably more common than realised and significantly under diagnosed. It should be considered and actively excluded in patients with symptoms of bladder irritability and pain after previous suprapubic incontinence or prolapse surgery. Surgical repair utilising Prolene mesh is recommended and co-morbid urogenital prolapse or recurrent stress urinary incontinence can be adequately treated 4-6 months later

The molluscicidal properties of Apodytes dimidiata subsp. dimidiata (Icacinaceae).

The molluscicidal and piscicidal activity of extracts from the leaves, berries and bark of the tree Apodytes dimidiata were evaluated experimentally. The leaves were highly toxic to both Bulinus africanus and Biomphalaria pfeifferi, the intermediate host snails of Schistosoma spp. B. pfeifferi profusely exuded mucus which appeared to render some protection against the toxic substance(s) of the plant but did not prevent their eventual demise. The LC10 after one-hour exposures of fish (Oreochromis mossambicus) was within molluscicidal levels.

Synthesis and biological activity of D3-trishomocubyl-4-amines.

The D3-trishomocubyl system was prepared from tertiary pentacyclo[5.4.0.0(2,6).0(3,10).0(5,9)]undecan-8-ols 5 in one step by using a modified Ritter reaction yielding only one of the possible two geometrical isomers of 4-amino-3-alkyl (or aryl)-D3-trishomocubane (8). Promising antagonism of reserpine-induced catalepsy was exhibited by these compounds which compared favorable with that of amantadine. Weak to mild anticholinergic properties were observed during the reduction of oxotremorine induced tremor and salivation procedure. Acute toxicities similar to that of amantadine were observed for some of these compounds. D3-Trishomocubyl-4-amines appeared as a promising new class of anti-Parkinson agents.

A pentacyclic triterpene with anti-inflammatory and analgesic activity from the roots of Commiphora merkeri.

A new pentacyclic triterpene [1] with anti-inflammatory activity was isolated from the roots of Commiphora merkeri. The structure was established on the basis of spectral data and conversion to its triacetate.

Synthesis and antimicrobial activity of a series of caespitin derivatives.

Chemical modification of the naturally occurring phlorophenone antimicrobial agent caespitin is described. These modifications include variations in the phenone side chain, substitution with prenyl, allyl, and benzyl in the 4-position of the phlorophenone nucleus, and ring cyclizations via etherification to give furan and chroman compounds. Several of these derivatives show enhanced in vitro potency over caespitin. Studies on the development of microbial resistance against these compounds show that no or very little resistance developed after several passes of these compounds in representative microbial strains.