3. Electronic Theses and Dissertations (ETDs) - All submissions
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Item The assessment of lipid levels in type 2 diabetic patients in relation to lipid modifying therapy at the charlotte Maxeke Johannesburg academic hospital (CMJAH) diabetic clinic(2019) Naidoo, SagenAtherosclerotic cardiovascular disease is major contributor to morbidity and mortality in diabetic patients. Strict goal-directed lipid control is associated with better cardiovascular outcomes. Aim The main aim of this study is to describe the lipid profiles of a cohort of patients with type 2 diabetes mellitus in order to highlight the quality of lipid control by correlating the type and dose of lipid-modifying therapy used with lipid levels. Method A retrospective analysis was performed on 200 type 2 diabetic patients who attended the Charlotte Maxeke Johannesburg Academic Hospital diabetic clinic in March 2017. Their lipid profiles and the type and dose of lipid-modifying therapy prescribed to them were assessed. Results Although the majority of participants [146 (73%)] were at target for total cholesterol, fewer [133 (66.5%)] were at target for triglycerides, 112 (56%) participants were at target for HDL-cholesterol, only 53 (26.5%) participants were at target for LDL-cholesterol, and very few, only 25 (12.5%) participants were at target for all four lipid parameters. Conclusion The LDL-cholesterol levels of participants on statin therapy was significantly lower in statin-treated participants than in participants not treated with statins. However higher doses of statins or the use of more potent statins is recommended in order to achieve LDL-cholesterol target in the majority of diabetic patients.Item Impact of dexmedetomidine on postoperative biomarkers,length of hospitalisation and mortality in patients undergoing coronary artery bypass graft surgery(2019) Motshabi, Palesa Mamoseki VioletCoronary artery bypass graft surgery, a surgical procedure performed to alleviate the symptoms of ischaemic heart disease and improve prognosis on cardiopulmonary bypass, is beneficial in patients with ischaemic heart disease, however it is not without deleterious adverse clinical events and mortality due to its associated inflammatory and stress response. Dexmedetomidine, an a–2 adrenergic agonist, is a promising drug with a potential towards myocardial protection due to its favourable pharmacological profile. This study investigated the impact of dexmedetomidine compared to placebo on high sensitivity troponin in patients undergoing coronary artery bypass graft surgery on cardiopulmonary artery bypass in a randomised controlled trial. Secondary endpoints included mortality and the length of hospitalization. Subsequently, a systematic review and meta-analysis of randomised controlled trials on the effects of dexmedetomidine on conventional troponin (cTn) compared to control was conducted.Item The in-vitro effect of ridogrel on platelet function in normocholesterolaemic subjects and familial hypercholesterolaemic subjects(1996-03) Naran, Nitien, Hira.Familial hypercholesterolaemia IIa (F. H. IIA) is a congenital disorder characterized by a raised plasma level of low density lipoprotein (LDL). Platelets in this condition have been found to be hypersensitive to aggregating agents and to produce increased amounts of thromboxane A2.These modifications of platelet function and biochemistry may play an important role in the occurrence of premature atherosclerosis and myocardial infarction in adolescence and young adults.