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Biomedical subjects

D Moodley

Publications and source records attributed to D Moodley.

46 records · Page 3Linked to original sources
PubMed1996

Maternal mortality in Kwazulu/Natal: need for an information database system and confidential enquiry into maternal deaths in developing countries.

In a 2-year retrospective analysis of 147 maternal deaths in South African urban and rural hospitals, the maternal mortality rate (MMR) was estimated to be 144 per 100,000 live births. MMR was significantly higher (P = 0.025) in urban hospitals (160 per 100,000) and the main causes of death were hypertensive disease in pregnancy (33%), of which eclampsia contributed to 70% of deaths and haemorrhage (18%). Only 49.7% of women who died, attended an antenatal clinic. The MMR in South Africa is lower than sub-Saharan countries but unacceptably high for a country with a mix of private and public medicine. Disparities have been noted in maternal mortality rates within the country due to different study rates within the country due to different study designs and poor documentation, Structural changes in the health care system would only be possible if a common information database system were established and confidential enquiries held into maternal deaths.

Adult↗
PubMed1995

Free alpha-subunits of human chorionic gonadotropin in preeclampsia.

OBJECTIVE: To investigate free alpha-human chorionic gonadotropin (hCG) as a marker of preeclampsia. METHODS: Four groups of patients were studied: normal pregnancies, preeclampsia, eclampsia and normal pregnant women <20 weeks' gestation. Patients were further divided according to parity and gestational age (< or =20, 21-30, 31-40 weeks). An immunoradiometric assay employing monoclonal antibodies specific for free alpha-hCG was used. RESULTS: A total of 313 patients were analyzed. Thirty-four patients < or =20 weeks' gestation were followed until delivery: five (14.7%) developed preeclampsia; none had abnormal alpha-hCG levels before onset of preeclampsia. Patients with preeclampsia (21-30 weeks' gestation) demonstrated a mean alpha-hCG level greater than that of normotensive controls but this was not statistically significant. Between 31 and 40 weeks' gestation, mean alpha-hCG levels in the hypertensive and control groups were 210.8 ng/ml and 115.8 ng/ml, respectively (P < 0.001). A stronger association was observed between alpha-hCG and preeclampsia with increasing gestational age (relative risk [RR] 2.07, 21-30 weeks; RR 3.02, 31-40 weeks) and severity (RR 4.51, mild; RR 12.15, severe; RR 16.88, eclampsia). CONCLUSION: There is a strong association between alpha-hCG and preeclampsia, nevertheless this test is unsuitable for predicting preeclampsia.

Biomarkers↗
PubMed1995

Predicting perinatal human immunodeficiency virus infection by antibody patterns.

The evolution of human immunodeficiency virus type 1 (HIV-1) antibody titers determined by enzyme-linked immunosorbent assay between birth and 18 months of age was investigated in 118 babies born to HIV-1-seropositive South African mothers. By 18 months 41 (34.7%) children were diagnosed as HIV-1-infected by standard criteria. All 77 uninfected babies cleared maternal antibodies by 15 months; 94.5% of these babies seroreverted by 12 months. By 9 months of age a significant difference (P < 0.05) was noted between antibody decay rates in infected and uninfected children. Of the children subsequently shown to be uninfected, 95.8% demonstrated > or = 50% decay in antibody titers between 6 and 9 months; only 1 in the infected group showed a similar pattern (sensitivity, 97.8%; specificity, 93.8%). The approach of assessing the progression of antibody decay in infected and uninfected babies makes it a feasible and useful tool for estimating vertical transmission rates and diagnosis of perinatal HIV-1 infection earlier than standard practice.

AIDS Serodiagnosis↗
PubMed1993

Hepatitis B 's' and 'e' antigen carriage in childhood nephrotic syndrome predicts membranous glomerulonephritis.

Among 178 African children with nephrotic syndrome, membranous nephropathy was the commonest histological lesion (60 children; 34%). Fifty-seven (95%) of these 60 were hepatitis B surface antigen (HBsAg)-positive, and 52 (86%) of these 57 were hepatitis B 'e' antigen (HBeAg)-positive. HBsAg was detected in only six (5%) and HBeAg in one (0.8%) of the 118 patients with non-membranous lesions. The risk of membranous nephropathy was 35 and 15 times higher in the 178 African children with nephrotic syndrome who had serological evidence of HBsAg and HBeAg, respectively, than in those who did not. Sensitivity was 95% for HBsAg and 87% for HBeAg; specificity, and positive and negative predictive values were above 90% for each antigen. The strength of such an association in this particular community permits reliable prediction of membranous nephropathy from serological tests for HBsAg and HBeAg, thereby avoiding renal biopsy.

Algorithms↗
PubMed1992

Oxidation of exogenous carbohydrate during prolonged exercise: the effects of the carbohydrate type and its concentration.

We studied rates of exogenous carbohydrate (CHO) oxidation during 90 min of cycling exercise in trained cyclists exercising at 70% of maximal oxygen consumption (VO2max) when they ingested glucose, sucrose, or glucose polymer solutions at concentrations of 7.5%, 10% or 15%. Drinks were labelled with [U-14C]glucose or sucrose and were ingested at a rate of 100 ml.10 min-1. Rates of oxidation of the ingested CHO were calculated from the specific radio-activity of the labelled CHO, expired 14CO2 and carbon dioxide output (VCO2). Total CHO oxidation, determined from oxygen consumption and VCO2 was not influenced by CHO type or concentration. Gastric emptying (P = 0.01) and the rate of exogenous CHO oxidation (P = 0.028) was greatest for the glucose polymer solutions, and least for glucose. Although gastric emptying (P = 0.006) decreased with increasing CHO concentration, CHO delivery to the intestine and exogenous CHO oxidation increased linearly with increasing CHO concentration. The percentage of the CHO delivered to the intestine that was oxidized ranged from 30.0% for 7.5% CHO to 38.1% for 15% CHO. Our results indicated that the rate of gastric emptying for CHO was not controlled to provide a constant rate of energy delivery as is commonly believed and that factors subsequent to gastric emptying limit the rate of exogenous CHO oxidation from the ingested solution.

Adult↗
PubMed1991

A comparative assessment of commonly employed staining procedures for the diagnosis of cryptosporidiosis.

Following an increase in the number of reports of Cryptosporidium infections and the problems encountered in detecting these organisms in faecal smears, a comparative assessment of a modification of the Sheather's flotation technique and other commonly employed staining procedures proved the modified Sheather's technique to be most useful in identifying Cryptosporidium oocysts in diarrhoeal stools. This technique not only detected the parasite in the highest number of stools but also proved to be cost-effective and the least time-consuming. Other staining techniques assessed were the modified Ziehl-Neelsen, safranin-methylene blue and auramine-phenol fluorescence. Both the modified Ziehl-Neelsen and the auramine-phenol fluorescence procedures produced nonspecific staining, while the safranin-methylene blue method was found to be the least sensitive technique.

Animals↗
PubMed1991

Cryptosporidium infections in children in Durban. Seasonal variation, age distribution and disease status.

One hundred and eleven of 1,229 children (9%) aged less than 10 years admitted to King Edward VIII Hospital, Durban, with gastro-enteritis over a period of 1 year were found to harbour Cryptosporidium. Of these, 96 (89.7%) were less than 2 years of age. Cryptosporidium was the only potential pathogen identified in 80 of these patients (6.5%). The prevalence in paediatric patients without gastro-enteritis was 2.4% (3/124). During the study period Cryptosporidium infections were significantly more prevalent during the high rainfall season (P = 0.03).

Age Factors↗