Medical Technology SA - latest Issue
Volume 30, Issue 1, 2016
Pilot study of Intern Medical Technologists performances related to the National Board examinations : views from the laboratory trainers, supervisors, examiners and moderators for the period 2008-2012Source: Medical Technology SA 30, pp 5 –9 (2016)More Less
This study investigated the possible reasons for the high failure rates of Interns in the Gauteng region related to the National Board examinations from 2008-2012. According to the SMLTSA database, for this five year period, a total of 2012 students wrote the Clinical Pathology examination. Of these only 854 passed. This 42% pass rate for the years under review has raised concerns as to the reasons for the high failure rates. Trainers and supervisors of two private sector laboratories and one government sector laboratory in Gauteng involved in the work integrated learning (WIL) and Internship training of Biomedical Technologists accepted the invitation to participate in the study. Examiners and moderators involved in the four main disciplines were asked to complete an electronic survey. The survey consisted of both structured and open-ended questions. A multiple response analysis with frequency counts and cross-tabulations was used to analyse the data based on a Likert scale. Coded data was transferred to a file and analysed using SPSS (Statistical Package for the Social Sciences). It was clear that the quality of training and the preparation received by students and Interns was not always adequate. One of the findings highlighted, the insufficient number of laboratory training staff available for the evaluation, preparation and mentoring of both WIL students and Intern Biomedical Technologists. The study emphasised the necessity to implement improvement plans.
Heamoglobin response to routine iron and folate supplementation during pregnancy in an HIV-endemic rural area roma, LesothoSource: Medical Technology SA 30, pp 10 –14 (2016)More Less
Iron deficiency is the leading cause of anaemia during pregnancy in African settings. Pregnancy and HIV are important risk factors for iron deficiency anaemia. The study assessed the occurrence of anaemia during pregnancy, the response to iron and folate supplements and the associated factors. The assessment was based on quantitative retrospective data of 126 pregnant women who attended antenatal care (ANC) between February and April 2014 in Roma, Lesotho and had haemoglobin (Hb) values taken at first ANC visit (baseline) and at term of gestation. Forty (31.8%) women were HIV-positive and 23 (57.5%) of them were anaemic at baseline. In total, 50 (39.5%) women had anaemia at baseline. The mean Hb at term was significantly higher (p<0.001) than that at baseline. Overall, 26 (20.6%) women had sub-optimal Hb response to iron and folate supplements, fifty-percent of whom were HIV-positive. Notably, 3 (2.4%) women developed anaemia while on supplements. Late first ANC visit (p=0.01), anaemia atbaseline (p<0.001) and HIV-positive status (p=0.024) were significantly associated with sub-optimal Hb response. There is need to encourage early reporting for ANC and closely monitor women with HIV and/or anaemia at first ANC visit.
Author A. NicolaidesSource: Medical Technology SA 30, pp 15 –24 (2016)More Less
The Belmont Report on Ethical Principles and Guidelines for the Protection of Human Subjects of Research established ethical principles to shield human subjects in biomedical research from unjustifiable exploitation by researchers. This was a response to the "Tuskegee Study" in the United States, where the rights of participants were grossly violated. Today, researchers and physicians often make use of human beings as subjects in scientific investigations. One of the key issues is that of informed consent. The ethical principles stressed in the Belmont Report have significant implications for the matter of informed consent. Informed consent must be required for any legal research involving human subjects. Regulatory frameworks must ensure that human subjects in bioethical or other research are not exploited either physically or psychologically. The need for effective humanistic ethical guidelines for biomedical research is great, but how does this tie in with the Common Good Approach if at all?
Source: Medical Technology SA 30, pp 25 –29 (2016)More Less
Bilateral orchiectomy reduces serum testosterone, an androgen stimulating the growth and proliferation of both normal and malignant prostate cancer cells. Low testosterone concentrations are associated with obesity, insulin resistance and an adverse lipid profile in men. The aim of this study was to measure the influence of post-orchiectomy changes in serum androgen concentrations on markers for metabolic syndrome. Fasting venous blood samples were obtained at baseline, 3-hourly (1-12 hours) and weekly (1-4 weeks) intervals post-orchiectomy from 10 patients (mean age 73.45 ± 12.7 years) with prostate carcinoma and high serum prostate-specific antigen (PSA) concentrations. Serum testosterone, free testosterone, PSA, insulin, luteinising hormone (LH), follicle-stimulating hormone (FSH), sex hormone-binding globulin (SHBG), dehydroepiandrosterone sulfate (DHEA-S) and glucose concentrations were measured. Serum high molecular weight adiponectin (HMW-A) concentrations and insulin resistance were determined. Baseline waist circumference and weight were compared to values obtained after 4 weeks. For median difference of paired data, 95% confidence intervals (CI) were calculated to measure the significance of differences between baseline and postorchiectomy results. Compared to baseline, serum concentrations of testoterone, free testosterone, PSA and DHEA-S decreased, and LH, FSH, insulin and insulin resistance increased significantly at different times post-orchiectomy. HMW-A was significantly decreased at 9 and 12 hours and then gradually increased. Serum glucose concentrations remained unchanged. Median weight and waist circumference increased by 3.5 kg and 5 cm, respectively, within 4 weeks. Post-orchiectomy hormonal changes resemble those found in metabolic syndrome.
Guidelines to minimise human error in South African laboratories with regard to therapeutic drug monitoringSource: Medical Technology SA 30, pp 30 –35 (2016)More Less
Therapeutic drug monitoring (TDM) fulfils an important function in patient health in both the public and private healthcare systems. TDM is based on pharmacokinetic principles within the clinical laboratory and several health professionals, from different disciplines, take part in the management and implementation of the whole TDM process. Communication and collaboration between these professionals are extremely important to ensure beneficial TDM and patient care, however, human error plays a major role in the compromising of the TDM process. In this article, we discuss the most common human errors during the TDM process and give guidelines to prevent them. These guidelines must be implemented during all the TDM phases to ensure the patient receives optimal and reliable healthcare.
Exploratory study into the culturability and viability of three strains of Escherichia coli after exposure to simulated gastric fluid of sub-lethal pHsSource: Medical Technology SA 30, pp 36 –44 (2016)More Less
It has long been established that the acidic nature of gastric juice constitutes an important line of defence against invasion of the gut by microorganisms. Survival of the gastric barrier was traditionally tested using microbiological techniques (culturability), however, advances in viability studies have highlighted the viable but non-culturable (VBNC) state. The purpose of this study was to assess culturability and viability in the survival response of strains of Escherichia coli (E. coli) exposed to simulated gastric fluid (SGF) of varying pH. Bacteria were subjected to acid-stress conditions by incubation in SGF at various pH over 180 minutes. Survival was evaluated by assessing culturability, and viability via membrane integrity. The results showed that all strains of E. coli studied were able to remain viable in an injured state after exposure to various acidic SGF environments for the duration of incubation. These viable cells persisted in either a live or injured state. The Enterotoxigenic E. coli (ETEC) strain was both viable and culturable at all pHs, showing a high level of acid tolerance. The Enteropathogenic E. coli (EPEC) strain was not culturable at the lower pH of 1.5 and 2.5, however, showed a high viability percentage. This could show that the bacteria had entered a VBNC state at these low pHs. This exploratory study indicates that certain strains of pathogenic E. coli are able to endure the stomach pH and may enter into a VBNC state. This might prove to be a major public health concern due to the fact that these organisms can survive the harshacidic environment of the stomach and may possibly return to the infectious state once in the favourable conditions of the intestines.
Trace metals in blood and urine of pregnant women practicing geophagia at Dr. George Mukhari Academic Hospital, Pretoria, South AfricaSource: Medical Technology SA 30, pp 45 –48 (2016)More Less
Geophagia is a common practice among pregnant women in Africa. The present study investigated the haemoglobin levels and concentration of trace metals in blood and urine of those practicing geophagia at Dr George Mukhari Academic Hospital, Pretoria, South Africa. Haemoglobin levels of both consumers and non-consumers were measured using the HemoCue Hb 201+ haemoglobinometer. Blood and urine samples were collected and analysed for trace metal contents using inductively coupled plasma membrane spectrophotometry (ICP-MS). The trace metal concentrations were compared to World Health Organisation (WHO) standards. The result showed that hemoglobin levels of consumers were found to be lower than those of non-consumers, with a mean of 10.7 ± 0.67g/dl. Levels of chromium, lead and manganese in the blood of consumers showed mean values of 5.78 ± 4.40 µg/l, 2.90 ± 1.40 µg/l and 22.42 ± 14.11 µg/l respectively. From the urine of those eating soil, the mean levels of lead, copper, nickel, arsenic, mercury and zinc were 8.88 ± 7.57 µg/g creatinine, 31.67 ± 12.95 µg/g creatinine, 3.58 ± 2.26 µg/g creatinine, 17.66 + 28.66 µg/g creatinine, 2.40 + 3.57 µg/g creatinine, 452.40 + 286.48 µg/g creatinine respectively. The levels of trace metals were found to be higher than recommended limits (WHO) from those practicing geophagia, indicating that should the practice be continued, cumulative effects of toxic metals and respective health complications may occur. Much education needs to be done in order to make consumers aware of the health dangers involved in the practice.
Source: Medical Technology SA 30, pp 49 –51 (2016)More Less
This study compared phenotypic and genotypic identification methods of Campylobacter spp. against the polymerase chain reaction (PCR) in terms of sensitivity, specificity, positive-predictive value and negative-predictive value. Thermophilic Campylobacter isolates were identified using conventional biochemical tests, specifically hippurate hydrolysis, matrix assisted laser desorption ionization- time of flight (MALDI-ToF) mass spectrometry and PCR with primers unique to C. jejuni and C. coli. MALDI-ToF was shown to be superior to biochemical tests for identification of C. coli but equivalent to biochemical tests for C. jejuni.