Masters Degrees (Neurosurgery)

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  • ItemOpen Access
    Prevalence of latex allergy in spina bifida patients in Universitas Academic Hospital
    (University of the Free State, 2020-08) Mpungana, Z.; Basson, J.; Sinclair, W.; Van Rooyen, F. C.
    Background: Latex allergy in spina bifida patients has attracted a great deal of interest around the world, especially in Europe and the United States, where it is estimated to be as high as 67%. It is one of the primary reasons for anaphylaxis in the operating theatre, which occurs in about 50% of patients with myelomeningocele. Epidemiology from South Africa is scarce, especially for the Free State province. Objective: To estimate the prevalence of latex sensitivity and latex allergy in a population of patients with spina bifida at Universitas Academic Hospital and to describe associated risk factors. Methods: A descriptive, cross-sectional observational study was undertaken. A questionnaire gathered information on family and personal history of allergy, number and types of surgeries undergone, history of symptoms caused by contact with latex, previous hospitalisation, and therapy given. Patients with spina bifida participated in the study after parents gave consent. Patients underwent blood tests for total serum immunoglobulin E and specific immunoglobulin E for latex. Patients with negative immunoglobulin were set to undergo skin-prick tests. Results: In total 39 patients diagnosed with spina bifida were assessed, 25 (64%) of whom were male; their ages ranged from 1 to 156 months. Not all patients completed skin-prick tests, due to staff shortages in the dermatology department. Of the 39 patients, 8 (21%) had latex allergy (positive specific IgE and personal history of allergy reaction in contact with latex); 24(61%) were not allergic, and 7 (17%) showed sensitivity, but not allergy. Of the 21% defined as latex allergic, 50% had been operated on more than five times. Conclusion: According to this study, the prevalence of latex allergy and sensitivity in patients with spina bifida at Universitas Academic Hospital is 21% and 17% respectively.
  • ItemOpen Access
    Retrospective audit of paediatric intracranial tumours treated in Universitas Hospital from 2000-2020
    (University of the Free State, 2021-08) Bango, Lelethu Bulelani; Van Aswegen, A.; Stones, D.
    The research involved a retrospective review of the number and types of paediatric tumours managed at Universitas Hospital, Bloemfontein, over 20 years. Universitas is the only referral hospital serving the Free State province and the surrounding areas, including the Northern Cape and Lesotho, in relation to paediatric tumours. The total population of the Free State, Northern Cape, and Lesotho numbers at least 6 million, and the area has only one hospital to manage paediatric tumours. Paediatric tumours are treated in cooperation by the neurosurgery and the paediatric oncology departments of Universitas Hospital. This collaboration is due to the multidisciplinary approach needed to treat this pathology adequately. The objective of this research was to review the different types of tumours encountered and managed by the hospital. An investigation was done into the demographics of patients presenting at the hospital from 2000 to June 2020. The data that was collected clarified the patient gender and age distribution, and also the outcomes achieved during the given period. A review of the management of the patients was done, and a comparison made of reviewed data and literature reporting on international statistics. The research was undertaken with the aim of optimising the management of pediatric oncology patients, and to streamline data collection. As Universitas is a teaching institution, achieving these aims may help upcoming registrars in both neurosurgery and paediatric oncology to have a better understanding of a disease that affects this fragile population. The research conducted is a retrospective review of paediatric intracranial tumours admitted to Universitas hospital during the period ranging from 2000 to 2020 (June). It looks at the different types of tumours admitted and the management thereof by the departments involved; neurosurgery and paediatric oncology. During this period 274 patients were managed with 60% of the patients dying after receiving surgery and or adjuvant treatment. Of the 274 patients, most tumours were glial in origin with medulloblastomas and ependymomas being second and third most, respectively. Patients received radiotherapy and oncotherapy according to paediatric protocols; after a biopsy or resection by neurosurgery. Patients would also get cerebrospinal fluid diversion if required. This diversion was seen as prophylactic management in patients that could not receive a complete resection of the tumour. This research revealed a need for better notekeeping and storage of patient data when it comes to tumours, ensuring that future research will be of greater quality. Research also revealed that a more thorough examination of tumours in teenagers will need to be conducted. This research will help in compiling a better template in admission of all tumours in Universitas and thereby facilitate an extensive tumour registry for the neurosurgery department.
  • ItemOpen Access
    An audit of central nervous system tumours as diagnosed at Universitas Academic Hospital in Bloemfontein, Free State from 2007 - 2017
    (University of the Free State, 2019-06) De Bruyn, Martha Magdalena; Van Aswegen, A.
    Tumours of the central nervous system are a common and challenging entity seen by Neurosurgery Departments worldwide. It is the cause of significant morbidity and mortality worldwide. Since the advent of Neurosurgery there has been an immense interest in classifying these tumours to enable prognostication and optimize the management of these tumours. Various classification systems have been used with the latest being the 2016 WHO classification of tumours of the central nervous system. The discovery of the molecular and genetic basis of these tumours and the development of these characteristics to aid in the diagnosis and management of these tumours, have had a great impact on the classification of these tumours. In developed countries, tumour registries exist to optimize the diagnosis and management of these tumours and to identify fields of possible further research and development. There is a lack of such registries in most developing countries and the need exist to establish such registries. The aim of this study is to implement a central nervous system tumour registry at the Universitas Academic Hospital in Bloemfontein to assist with the diagnosis, management and further resource implementation to optimize our management of these tumours and to enable us to compare our data with the international and national data bases.