Papers by Z. van der Spuy
International Journal of Gynecology & Obstetrics, 2009
International Journal of Gynecology & Obstetrics, 2009
Azol topical supplies are the most common treatment for candida vaginitis with a high failure rat... more Azol topical supplies are the most common treatment for candida vaginitis with a high failure rate which has made health care providers to use complementary substances in addition to the basic treatment. This study was conducted to compare the effectiveness of vinegar solution bath and soda solution bath in the treatment of candida vaginitis. Methods: This is a randomized clinical trial study carried out on 79 women with marked candida vaginitis and positive fungal culture who were assigned randomly in three groups including of vinegar bath, soda bath and a control group. Vaginal clotrimazole supplies were prescribed for all three groups. Vaginal signs and symptoms were assigned after one week from the end of the treatment. Results: The results suggested that patients symptoms and signs such as itching and candida secretions did improve one week after treatments, but there was no difference in the recovery rate of clinical symptoms among the three groups. Furthermore, one week after treatment, 48% of the control group, 52.4% of the vinegar and 57.9% of the soda bath group participants experienced negative fungal culture; but this difference was not statistically significant. Conclusion: This study revealed that both vinegar and soda solution bath, had to some extent, improved clinical and laboratory signs and symptoms of candida vaginitis in sabzevarian women. Health care providers would better to use a complementary treatment in addition to Azol combinations, for their patients. But, as there was no difference in the effectiveness of vinagar and soda solution bath, the patient preferential should be considered in the complementary treatment of candida vaginitis.
Human Reproduction, 1999
People's Republic of China, and 4 Department reassuring data on safety, many women are concerned ... more People's Republic of China, and 4 Department reassuring data on safety, many women are concerned about of Obstetrics and Gynaecology, University of Cape Town, South the long-term exposure to steroid hormones, believing the Africa daily ingestion of hormones to be 'unnatural' and unsafe 5 To whom correspondence should be addressed at: The Dean (Oddens et al., 1994). In 1991, a study was undertaken Terrace Centre, Edinburgh, Scotland of different cultures and with widely different experiences, would find this an attractive approach to contraception.
South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde, 2011
BACKGROUND. An aim of the Colleges of Medicine of South Africa (CMSA) project 'Strengthening ... more BACKGROUND. An aim of the Colleges of Medicine of South Africa (CMSA) project 'Strengthening Academic Medicine and Specialist Training' was to research the number and needs of specialists and subspecialists within South Africa. METHODS. Data were collected from several sources: Deans of the 8 Faculties of Health Sciences and the Presidents of the 27 constituent Colleges of the CMSA completed a survey; and the HPCSA's Register of Approved Registrar Posts for Faculties of Health Sciences was examined and the results tabulated. RESULTS. South Africa compares unfavourably with middle-income countries on the ratios of medical and dental professionals; many districts have limited access to specialists and subspecialists. The unacceptable ratio of doctors, dentists and other health professionals per capita needs to be remedied, given South Africa's impressive reputation for its output of health professionals, including the areas of medical training, clinical practice and cl...
South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde, 1996
To assess the feasibility of performing laparoscopically assisted vaginal hysterectomy (LAVH) on ... more To assess the feasibility of performing laparoscopically assisted vaginal hysterectomy (LAVH) on women referred for total abdominal hysterectomy (TAH). Prospective intervention study on women referred for TAH from a gynaecological outpatient clinic. Groote Schuur Hospital, Cape Town. This institution accepts patient referrals from community hospitals and family physicians for hospitalised care. Forty-one consecutive women referred for TAH were suitable for LAVH. Women able to undergo conventional vaginal hysterectomy, women with uterine fibroids exceeding 14 weeks in size and subjects with malignant disease were excluded. The most common indication for hysterectomy was persistent abnormal bleeding. Of the 41 women assessed pre-operatively as suitable for LAVH, the procedure was successfully performed in 40 by means of a bipolar desiccation and scissors transection technique with re-usable equipment. Assessment of intra-operative and postoperative morbidity, surgical complications, o...
Obstetrics and Gynaecology Forum
South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde, 2014
The South African Menopause Society (SAMS) consensus position statement on menopausal hormone the... more The South African Menopause Society (SAMS) consensus position statement on menopausal hormone therapy (HT) 2014 is a revision of the SAMS Council consensus statement on menopausal HT published in the SAMJ in May 2007. Information presented in the previous statement has been re-evaluated and new evidence has been incorporated. While the recommendations pertaining to HT remain similar to those in the previous statement, the 2014 revision includes a wider range of clinical benefits for HT, the inclusion of non-hormonal alternatives such as selective serotonin reuptake inhibitors and serotonin noradrenaline reuptake inhibitors for the management of vasomotor symptoms, and an appraisal of bioidentical hormones and complementary medicines used for treatment of menopausal symptoms. New preparations that are likely to be more commonly used in the future are also mentioned. The revised statement emphasises that commencing HT during the 'therapeutic window of opportunity' maximises th...
South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde, 1993
We assessed the possible role of CA 125 in the monitoring of gonadotrophin-releasing hormone (GnR... more We assessed the possible role of CA 125 in the monitoring of gonadotrophin-releasing hormone (GnRH) agonist analogue therapy in women with endometriosis and uterine fibroids. Serum concentrations of this cell surface antigen did not correlate with uterine volume and appeared to have no value in the assessment of shrinkage of uterine fibroids during GnRH agonist treatment. While CA 125 levels were not always elevated in subjects with endometriosis, they fell during treatment in all patients. The change accurately reflected therapeutic progress in these women and was of particular value in those patients who had commenced therapy with elevated levels. It is suggested that CA 125 may be useful in the monitoring of therapeutic progress in selected patients with endometriosis treated with GnRH agonists; the need for surgical follow-up may be obviated.
South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde, 1993
The so-called antiphospholipid syndrome may be responsible for repeated spontaneous abortion and ... more The so-called antiphospholipid syndrome may be responsible for repeated spontaneous abortion and fetal loss. We examined the plasma of 61 women with either reproductive failure or abruptio placentae for the presence of lupus anticoagulant and anticardiolipin antibodies in an attempt to assess the prevalence of this condition. No patient had haematological abnormalities consistent with the presence of lupus anticoagulant. However, 6 women had anticardiolipin antibodies with normal coagulation tests. The clinical profile together with this laboratory finding allows us to diagnose the antiphospholipid syndrome in these patients. Our incidence is considerably lower than that reported in many other studies but does suggest a place for screening for this condition in patients with recurrent complications of pregnancy.
Fertility and sterility, 1995
To investigate the effect of marathon training on hormonal and semen profiles in male athletes. P... more To investigate the effect of marathon training on hormonal and semen profiles in male athletes. Prospective longitudinal study over 1 year. Department of Obstetrics and Gynaecology, University of Cape Town, South Africa. Twenty-four healthy male marathon runners, 25 to 54 years of age. Hormonal evaluation included determination of plasma concentrations of total T, LH, FSH, PRL, E2, and P. Semen analyses included an evaluation of count, motility, morphology, and volume. These profiles were correlated with training intensity. The intensity of training increased significantly in the first 5 months of the study. This was accompanied by a significant rise in serum PRL levels and a fall in P levels. No other significant hormonal changes were identified. The semen volume and sperm motility and morphology fell significantly during training, but there was no significant alteration in the sperm count. This longitudinal study demonstrates that endurance training can modify significantly hormon...
LHRH and Its Analogs, 1987
Archives of Disease in Childhood - Fetal and Neonatal Edition, 2012
Journal of Obstetrics and Gynaecology, 1993
Gynecological Endocrinology, 2002
Infection with the human immunodeficiency virus (HIV) results in a chronic systemic illness with ... more Infection with the human immunodeficiency virus (HIV) results in a chronic systemic illness with multi-organ involvement, severe immunosuppression and profound cachexia. It has had a major impact on women's health. Endocrine abnormalities may contribute to the clinical presentation and therefore appropriate treatment would theoretically improve the patient's condition. This pilot study was undertaken to assess the endocrine status in a group of HIV seropositive women with the view to developing recommendations for future investigations. Thirteen women were recruited from a clinic for HIV-infected patients. All women had a comprehensive general and gynecological examination. Basal endocrine status was assessed and combined pituitary testing with gonadotropin-releasing hormone, thyrotropin-releasing hormone, growth hormone-releasing hormone and corticotropin-releasing hormone was performed. None of the participating women presented with gynecological complaints or had symptoms suggestive of an endocrinopathy. On questioning, seven women complained of menstrual abnormalities. Three had a body mass index of less than 20 kg/m2. Genital tract infections were common. Endocrine assessment demonstrated abnormalities of the pituitary-adrenal, pituitary-thyroid and pituitary-ovarian axes in seven women. One woman had panhypopituitarism. In six of the seven affected women CD4 counts were below 200 cells/mm3. Alterations in endocrine function were observed in seven of the women tested. While routine endocrine testing may not be indicated in all HIV-seropositive women, we should be aware of possible subtle presentations of endocrine abnormalities which may require treatment, especially in stress situations.
European Journal of Obstetrics & Gynecology and Reproductive Biology, 1998
Objective. The presence of a supportive companion to women in labour has been found to reduce the... more Objective. The presence of a supportive companion to women in labour has been found to reduce the duration of labour and the incidence of oxytocin augmentation. The mechanism which produces this improvement is unknown but work in animals suggests that environmental disturbance produces changes in endogenous oxytocin secretion. This study was carried out to assess maternal oxytocin secretion in relation to the presence of a supportive companion in labour.
Current Opinion in Obstetrics and Gynecology, 1997
Contraception, 1990
The changes in the hypothalamic-pituitary-ovarian axis during the placebo week in oral contracept... more The changes in the hypothalamic-pituitary-ovarian axis during the placebo week in oral contraceptive pill users were assessed. Fifteen women using the combined oral contraceptive pill were studied for eight hours at the start and at the end of the placebo week and gonadotropin secretion and estradiol concentrations were compared with those in control women in the follicular phase of an unmedicated menstrual cycle. Both gonadotropin and estradiol concentrations were suppressed at the start of the placebo week. By day 7 of placebo, gonadotropin concentrations and pulse patterns were indistinguishable from those of the control subjects although estradiol concentrations were still significantly lower.
Clinical Science, 1998
1. Animal and human work has indicated that maternal oxytocin secretion is under the control of e... more 1. Animal and human work has indicated that maternal oxytocin secretion is under the control of endogenous opiates. Previous workers have described the fetal production of oxytocin in addition to maternal production. The study of the interaction between exogenously administered opiates and oxytocin secretion may give insight into the activity of any opiate-mediated regulatory mechanism of oxytocin secretion in the fetus. This study was designed to investigate the effect of an opiate (5 mg of morphine) given to the mother on the fetal production of oxytocin in labour. 2. Morphine was given by the attending clinicians for analgesic purposes to women in the first stage of labour. After delivery umbilical artery vein and maternal vein specimens were taken. 3. Four groups of patients were studied: women after normal vaginal delivery without analgesia in labour (n=10); women after normal vaginal delivery who had morphine administration in the first stage of labour (n=12); women who had an emergency Caesarean section in the first stage of labour (n=11); women who had an elective Caesarean section at term who were not in labour (n=11). 4. Oxytocin levels were measured by radioimmunoassay in the maternal vein, umbilical artery and umbilical vein specimens. Morphine was measured by radioimmunoassay in the umbilical vein specimens. 5. The umbilical artery minus vein concentration of oxytocin was calculated for each patient (A-V). There was no change in the umbilical (A-V) concentration of oxytocin if morphine had been given to the mother in labour; this applied to fetuses delivered vaginally or by Caesarean section. When the fetuses who were exposed to morphine were analysed separately, there was no correlation between the umbilical vein morphine concentration and the umbilical (A-V) oxytocin concentration either in Caesarean or vaginal deliveries. 6. Fetal oxytocin production was not affected by the maternal administration of morphine in the first stage of labour. This applies to the oxytocin production in the first and second stage of labour.
Clinical Endocrinology, 1996
Animal work suggests that maternal oxytocin secretion is influenced by the secretion of endogenou... more Animal work suggests that maternal oxytocin secretion is influenced by the secretion of endogenous opioids in pregnancy. Spontaneous labour and pre-labour uterine activity follow a 24-hour rhythm the origin of which has not been explained but may be related to diurnal changes in oxytocin secretion. This study was performed to document the changes over a 24-hour period in maternal oxytocin and beta-endorphin secretion. A 4-hourly blood profile was undertaken for a 24-hour period. Sixteen women with singleton pregnancies of more than 36 weeks gestation and 10 women with pregnancies in the mid trimester were studied. Blood was sampled 4-hourly for 24 hours beginning at 1200 h. Oxytocin was measured in all patients and beta-endorphin-like immunoreactivity was measured in 15 patients. A simple index was defined for comparing night-time levels to daytime levels for both oxytocin and beta-endorphin. In all cases more than 36 weeks gestation the index was positive for oxytocin (night-time levels were higher) and in all cases the index was negative for beta-endorphin (night-time levels were lower). In the mid trimester women all values of the index for oxytocin were positive but in the beta-endorphin group equal numbers demonstrated a positive or a negative index. Reciprocal 24-hour rhythms were demonstrated between oxytocin and beta-endorphin; however, it is not clear whether this relationship is causal.
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Papers by Z. van der Spuy