3. Electronic Theses and Dissertations (ETDs) - All submissions
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Item A retrospective analysis of time delays in patients presenting with Cerebrovascular Accident (Stroke)(2017) Khalema, DitebohoRetrospective record review of time intervals regarding symptom onset, ED presentation and time to CT scan were recorded in patients who presented to the ED with signs and symptoms of stroke in 2014. RESULTS: There were 232 patient records included in the study. The average time to presentation to the ED was 33 hours with only 13.7% presenting within 3 hours. The earliest presentation was within 30 minutes of the onset of symptoms and the most delayed presentation was 3 months. Factors associated with early presentation were female sex, smoking and loss of consciousness. Known diabetic patients presented later than non-diabetic patients. Seventy-five percent of stroke patients had an ischaemic stroke and 25% were haemorrhagic. CONCLUSIONS: Due to delays in presentation, despite the availability of thrombolysis, patients are still not receiving thrombolytic treatment.Item The use of framework analysis in the alignment of the laws of rugby to skeletal development of children and adolescents(2019) Sinnett, Faye VictoriaRugby, as a contact sport, has inherent risks of injury. Children and adolescents playing rugby at schoolboy level have a developing skeletal system and therefore injuries through this age of play may result in injuries to under-developed bones. This research study looked to identify whether the laws of rugby align to protect skeletal development of children and adolescents through law adaptations. Framework Analysis was used to develop a matrix which aligned the adapted laws of rugby with bone fusion ages. In future studies this can be used as a base for other areas of development and other sports. This matrix was further analysed to determine a severity rating scale and this scale identified some bones of the skull (occipital, sphenoid and zygomatic), upper limb (scapular, glenoid and clavicle) and lower limb (sacrum and pelvic girdle) as having a higher risk for severe injury. While these bones are at severe potential risk of injury it is important to note that only one measure of maturation was used and in future additional measures of maturation should be used. In conclusion, while the adapted laws of rugby do protect some bones of the developing skeletal system, they do not protect all of the developing bones of the skeletal system. The matrix could be used to guide future law makers in their endeavour of making the game of rugby safer for children and adolescentsItem A comparison of the radiological features of lung cancer in HIV-infected and HIV-uninfected individuals in a South African hospital(2018) Nel, AndrewINTRODUCTION: Lung Cancer (LC) is one of the most important causes of death worldwide. With the increase in non-AIDS defining cancers, like LC, this is concerning in South Africa, with the country’s high incidence of HIV. AIM: To correlate the CT features of LC with the histological / cytological diagnoses and compare these findings in HIV-infected and HIV-uninfected patients. METHOD: 54 patients with lung lesions on CT, who had image-guided, biopsy-proven malignancies were retrospectively reviewed. RESULTS: The study population had a M:F ratio of 31:23, with 31.5% HIV-infected and a mean age of 59 years (SD±11). 85% had constitutional symptoms of LC and 59% had a smoking history. The most prevalent subtypes were squamous cell carcinoma (37%), adenocarcinoma (24.1%) and large cell carcinoma (24.1%). CT features were a mean axial lesion size anteroposterior of 67mm and transverse of 70mm, with an upper lobe predominance (76%). Other features were an irregular (70.4%), lobulated (55.6%) margin with pleural tags (61.1%) and spiculation (51.9%). Associated findings were CT significant mediastinal lymphadenopathy (77.8%), involvement of vessels or bronchi (68.5%), convergence of surrounding structures (64.8%), pleural effusion (55.6%) and secondary pulmonary lesions (51.9%). The HIV-infected patients had a mean age of 51 (SD±11) years iv and a strong Tuberculosis history (60%). There was no statistical difference in the imaging features between the HIV-infected and HIV-uninfected patients. CONCLUSION: HIV-infected patients with LC present younger. Larger studies are needed to confirm whether this subgroup has more atypical lesions and need a different set of criteria for CT evaluation.Item Patient related factors influencing the quality of paediatric chest radiographs(2017) Strasheim, Eben AlbertINTRODUCTION: The chest radiograph is the most common radiographic examination performed worldwide due to its versatility. Improving the quality of chest radiographs and avoiding repeat radiographs can decrease the collective radiation dose to children. AIM: To identify patient related factors that influence the quality of paediatric chest radiographs by assessing the quality of chest radiographs and to compare the quality of chest radiographs in “radiologically” sick patients to those of “radiologically” normal patients. METHOD: A retrospective study was performed to determine the quality of paediatric chest radiographs forming part of an existing database. The sample size of 280 radiographs, included radiographs of children aged 3 days to 13 years. Radiographic errors were captured on an electronic tick-‐sheet, consisting of twelve specific radiographic errors commonly made in practice and included the presence or absence of respiratory pathology. Data was extracted with regards to each of the 12 errors, patient demographics and presence of respiratory pathology to identify associations. RESULTS: The mean patient age was 52.95 months. The most common errors were, in descending order, “rotation”, “under inspiration” and “trachea and bronchi not well seen.” The most common respiratory pathologic finding was “Airspace opacification”. There was a statistically significant, low correlation present between the radiographic error count and the presence of respiratory pathology (p<0.001). There was a statistically vi significant difference in the quality of chest radiographs of children aged 0-‐18 months and those aged 37-‐156 months (p<0.05). CONCLUSIONS: The results of this study have demonstrated that there is a correlation between the presence of respiratory disease on a paediatric chest radiograph and the quality of the chest radiograph. The numbers of errors detected were higher in patients with respiratory pathology on the chest radiograph.