Research

Researcher: Ms Nikita Naicker

Designation: PhD study

Study: Trigonella foenum-graecum seed extract, 4-hydroxyisoleucine and metformin stimulate proximal insulin signaling and increases expression of glycogenic enzymes and GLUT2 in HepG2 cells

Summary: Fenugreek (Trigonella foenum-graecum) is globally recognized for its medicinal properties and hypoglycaemic effects. The seed extract as well as its active compound, 4-hydroxyisoleucine (4-OH-lle), have been shown to reduce hyperglycaemia insulin resistance. The mechanism by which this occurs has not been investigated in human liver cells (HepG2) in comparison to the anti-hyperglycaemic drug, metformin. We investigated the effect of fenugreek aqueous seed extract (FSE), 4-OH-lle and metformin in human hepatoma HepG2 cells relative to insulin as a positive control. Cells were treated with FSE and 4-OH-lle at 10ng/ml and 100ng/ml under normoglycaemic (5mM glucose) and hyperglycaemic (30mM glucose) conditions for 72h. Tyrosine phosphorylation of insulin receptor-β (IR-β), protein kinase B (Akt) and glycogen synthase kinase-3α/β (GSK-3α/β) was determined by western blotting. Gene expression of sterol regulatory element binding protein 1c (SREBP1c), glucose transporter 2 (GLUT2), glycogen synthase (GS) and glucokinase (GK) was evaluated by qPCR and supernatant glucose levels were measured using the Picollo Biochemistry Analyser. Under normo- and hyperglycaemic conditions, FSE, 4-OH-lle, insulin (100ng/ml) and metformin (2mM) caused a significant increase in tyrosine phosphorylation of IR-β, Akt and GSK-3α/β. Glucose uptake, however, was most significantly increased in FSE treated cells during normo-and hyperglycaemic conditions. FSE induced the most significant changes in downstream insulin signaling, GS, GK, SREBP1c and GLUT2 expression as compared to 4-OH-lle, metformin and insulin. Also, FSE significantly increased glucose uptake. Collectively, these findings provide a mechanism by which FSE exerts anti-hyperglycaemic effects similar to metformin and insulin occurs via enhanced insulin signaling, gene expression and increasing glucose uptake.


Researcher: Ms Olayide Arodola

Designation: PhD candidate

Study: Could the FDA-approved anti-HIV PR inhibitors be promising anticancer agents? An answer from enhanced docking and molecular dynamics analyses

Summary: Based on experimental data, the anticancer activity of nelfinavir, an FDA-approved HIV-1 protease inhibitor, was reported. Nevertheless, the mechanism of action of NFV is yet to be verified.  This promoted us to conduct the first account of investigation the anti-cancer activity of all currently FDA-approved HIV PR inhibitors using cutting-edge molecular modelling and drug design approaches. Results showed that nelfinavir has better binding affinity (∆G = -9.2 kcal/mol) when compared to other protease inhibitors – this is in a great accordance with the experimental data. Indinavir, saquinavir and ritonavir have close binding affinity to nelfinavir (∆G = -9.0, -8.6 and -8.5 kcal/mol, respectively). Information gained from this study should also provide a route map towards the design, optimization and further experimental investigation of potential derivatives of HIV PIs to treat cancer.

Researcher: Mr Soumendranath Bhakat

Designation: PhD candidate

Study: An integrated molecular dynamics, principal component analysis and residue interaction network approach reveals the impact of M184V mutation on HIV reverse transcriptase resistance to lamivudine

Summary: The study reported the first account of the molecular impact of M184V mutation on HIV reverse transcriptase resistance to lamivudine – the drug prescribed for the treatment of HIV infection and hepatitis B infection – using a combination of molecular dynamics simulation, binding free energy analysis, principle component analysis and residue interaction networks. Results from the study confirmed that M184V mutation leads to steric conflict between lamivudine and the beta-branched side chain of valine (amino acid), decreases the ligand lamivudine binding affinity when compared to the wild type, changes the overall conformational landscape of the protein and distorts the native enzyme residue-residue interaction network.


Researcher: Dr Tufayl Muslim

Designation: Lecturer

Study: Final-year Dental Therapy Student’s Perceptions of their Service-Learning Experience at a Selected University

Summary: Participants in the study reported an increased sense of social responsibility, and an increased understanding of the populations that they would serve after qualifying. Students were adequately prepared (academically and clinically) to undertake the service learning experience (SLE) and were aware of what was expected of them in terms of learning outcomes and service delivery. Additionally it was found that students were adequately supported in terms of clinical services rendered, and food and accommodation. The results indicated that certain improvements needed to be addressed in order to improve the students’ SLE, and contribute to the optimisation of the learning environment.


Researcher: Dr Tufayl Muslim

Designation: Lecturer

Study: The development of a proposed conceptual framework for conducting cross-national comparative policy analysis of oral health policy development and implementation

Summary: The study sought to develop and present a proposed conceptual framework that could be applied to cross-national policy analysis. This developed conceptual framework would need to allow policy analysts to undertake a comprehensive policy analysis that could lead to an understanding and contextualisation of the complex policy environments found in developed and developing countries such as Australia and South Africa.


Researcher: Ms Tashmin Rampersad

Designation: Masters candidate

Study: A novel high throughput methodology for Mycobacterium tuberculosis drug susceptibility testing, using multipoint inoculation. Why was it significant to conduct such a study?

Summary: Drug susceptibility testing using multipoint inoculation was done for 12 anti-TB drugs for 30 Mycobacterium tuberculosis isolates and the results were analyzed and compared to the gold standard (agar proportion method). Susceptibility testing of one more drug is left to do using multipoint inoculation and the gold standard. The expected outcome is to conduct a third susceptibility test and compare this to multipoint inoculation and the gold standard.


Researcher: Mrs Moganavelli Reddy

Designation: Lecturer

Study: A situational analysis of the viability in delivering oral health promotion within the health promoting school initiative in KwaZulu-Natal

Summary: Dental caries, or tooth decay, which is influenced by multi factorial factors such as diet, socio-economic status and the availability of oral health services, is a common condition affecting children in South Africa. Currently services offered at public health facilities are mainly curative. School Health Services do not reach all learners especially in the rural areas and there is also a lack of funds and oral health personnel for the delivery of oral health services. Dental caries is expensive to treat but very preventable. Results from this study indicated that although policies included statements on oral health promotion, this was not translated into practice at school level. Barriers and challenges identified in the study for the successful implementation of an oral health promotion programme included lack of funds, human resources, knowledge and ownership, high workloads and time constraints. Policy formulation and strategic planning must include educators and health care workers at grass root level for the successful implementation and sustainability of oral health promotion programmes, the study found. 


Researcher: Mr Ezra

Designation: Masters candidate

Study: Knowledge, attitudes and practices on malaria among women in Mgedula Village, Jozini Local Municipality, UMkhanyakude District

Summary:  The study was a public health research project, conducted in order to provide the National Malaria Control Program (NMCP) with up-to-date information that will guide the development and implementation of effective and comprehensive interventions among women at a community level.  It was found, in line with the key measures implemented by the NMCP, that the study population possessing basic malaria-related knowledge had had visits from a community health worker, history of previous malaria infection and high literacy levels. Positive malaria attitudes and good practice were reportedly associated with high malaria knowledge and high literacy levels, also observing that high levels of basic malaria knowledge positively influenced the health-seeking behaviour among study participants. The population’s limited knowledge of malaria needed to be addressed in order to positively modify their attitudes, practices and health seeking behaviour.


Researcher: Ms Naimah Ebrahim Khan

Designation: PhD candidate

Study: Prevalence of dry eye amongst black and Indian university students aged 18–30 years

Summary: Background: The overall prevalence of dry eye in South Africa seems to be increasing. University students work under conditions predisposing them to dry eye, which may affect some tasks. The predominant race groups at the University of KwaZulu-Natal (UKZN) are black and Indian, which suggested a study in this student population to assist the diagnosis and management of such subjects.

Aim and setting: To compare the prevalence of dry eye amongst black and Indian students at the UKZN’s Westville campus.

Methods: One hundred participants, equally divided by gender and race, between 18 and 30 years old were enrolled. Dry eye symptoms were investigated by the ocular surface disease index (OSDI), tear thinning time (TTT), tear breakup time (TBUT) and Schirmer’s 2 in that sequence on both eyes of each participant.

Results: The OSDI revealed that 41% of participants had some dry eye symptoms whilst 59% had no symptoms. Clinical testing showed that 81% of participants had dry eye. Half of the black participants had dry eye symptoms and 82% had clinical signs of dry eye. Of the 50 Indian participants, 32% had dry eye symptoms and 80% had clinical signs. Of the 50 male participants, 34% were symptomatic and 86% had clinical signs. Of the 50 female participants, 48% had dry eye symptoms and 76% had clinical signs. Participants were asymptomatic even in the presence of clinical dry eye signs.

Conclusion: For both races and genders, clinical signs of dry eye were more common than symptoms. Black participants were more likely to report symptoms than Indians, and more women than men reported having symptoms. Male participants were more likely than female to have clinical signs of dry eye.


Researcher: Dr Takshita Sookan

Designation: Lecturer

Study: Effect of a progressive resistance training program and whey protein intake on maximal strength in human immunodeficiency virus infected individual receiving antiretroviral therapy

Summary: Human immunodeficiency virus (HIV) infected patients on antiretroviral therapy (ART) may develop complications including sarcopenia and dynapenia. These conditions increase the risk of functional decline, comorbidities and mortality. Resistance training (RT) in combination with protein-supplementation is effective in decreasing both conditions. The aim of this study was to determine the effect of RT with or without whey protein intake on maximal muscle strength in HIV infected individuals receiving ART. Progressive resistance training increased maximal strength regardless of whey protein intake particularly in lower body compared to upper body exercises. A 12 week PRT program was able to increase maximal muscle strength in HIV infected individuals receiving ART.


Researcher: Dr Ashok Maharajh

Designation: PhD candidate

Study: A comparative socio-economic impact analysis of the comrades marathon on the cities of Pietermaritzburg and Durban

Summary: The study reported on a significant pool of benefits for Pietermaritzburg and the city of Durban which was one of nine hosting the World Cup game – the first of which was played eleven days after the Comrades Marathon was run.


Researcher: Ms Jessica Köhne

Designation: Masters candidate

Study:

Summary: Exercise-induced muscle damage (EIMD) can result in reduced muscle force, increased muscle soreness, increased intramuscular proteins in the blood, and reduced performance. Single ingredient supplementation protocols with whey protein isolate, branched-chain amino acids (BCAAs), creatine, and caffeine have been used to reduce the effects of EIMD. However, little is known about the effects of a multi-ingredient supplement on the reduction of muscle damage and repair after EIMD from downhill running. Moreover, there is little known about the effects of performance supplementation on endurance trained female athletes. The purpose of this study was to investigate the potential effects of the ingestion of a multi-ingredient supplement on markers of muscle damage and inflammation following a single 60 minute bout of downhill running (DHR) in trained female runners. Multi-ingredient supplementation did not reduce muscle damage and inflammation compared with an isocaloric placebo, although the bout of DHR did elicit changes in muscle damage and inflammatory markers in trained female runners that were returned to baseline by 72 hours.


Researcher: Ms Jaymie Donaldsons

Designation: Masters candidate

Study:

Summary: Introduction: Recent research has shown that the provision of dietary protein before sleep leads to enhanced dietary protein digestion and absorption, thereby increasing plasma amino acid availability. In addition it has been shown that the increase in plasma amino acid availability throughout the night stimulates protein synthesis and attenuates protein breakdown, thereby improving protein balance during overnight recovery from exercise. Currently there is limited information on whether the stimulation of protein synthesis results in improved performance and recovery the following day in physically active individuals. Aim: To investigate the effect of protein supplementation (PRO) and a placebo (PLA) before sleep, post a bout of resistance exercise, on performance and recovery the following day in athletes.

Methods: Fifteen male, resistance-trained athletes were recruited for this randomized, double - blind, placebo-controlled study (PRO: n=9; 24.9 ± 1.8 years; 180.2 ± 2.8 cm; 84.5 ± 3.3 kg) (PLA: n=6; 28.7 ± 4.3 years; 180.1 ± 3.7 cm; 87.6 ± 5.2 kg). Participants performed a strenuous 45-minute resistance exercise bout consisting of 8 sets of 8 repetitions of both squat and bench press at 75% of their calculated 1RM for each (19h15). Thirty minutes prior to sleep (21h00) they consumed either 40g casein protein or placebo. Venous blood samples were obtained pre exercise (T1) (18:30), immediately post (T2) (20h00), 1 hour post (T3) exercise at 21h00 and at 08h00 (T4) the next morning to measure creatine kinase (CK) and C-reactive protein (CRP). Peak muscle velocity and power output, maximal upper and lower body strength were measured at T1, T2 and the next morning at 08h30. Perceptions of recovery and hunger were measured the next morning using visual analogue scales. Results: There was a significant difference (p =.044) between the PRO (M = 7.52; SD = 1.86) and PLA (M = 5.27; SD = 2.01) group in terms of recovery with the PRO group reporting better recovery. No group x time interactions were observed for CK, CRP or muscle performance. Conclusion: Casein supplementation 30 minutes prior to sleep enhances the perception of recovery the next morning from a bout of strenuous resistance training in athletes.


Researcher: Dr Takshita Sookan

Designation: Lecturer

Study: The Effects of a structured group exercise program on functional fitness of older persons living in old age homes within the eThekwini Municipality

Summary: The study aimed to determine the effects of a structured group exercise program on functional fitness of older persons living in five old age homes within the eThekwini Municipality of South Africa. Comparisons of baseline and post-intervention measures showed greater improvements in upper and lower body strength and flexibility, as well as aerobic endurance capacity. But, no improvements were observed in participant’s agility and balance levels. With regards to training frequency, no significant difference in functional fitness measures was observed between both groups following the 12 week intervention program. The study concluded that twelve weeks of multifaceted group exercise training, at least two times per week can be used as an effective strategy to promote functional fitness in the elderly population.  


Researcher: Dr Elizabeth Bolanle Ojewole

Designation: Lecturer

Study: Exploring the buccal delivery potential of an antiretroviral drug

Summary: The study investigated the potential of the buccal mucosal as an alternate route for the delivery of ARVs using didanosine (ddI) as a model drug. The results in this study confirmed the potential of buccal delivery of ddI, identified permeability parameters of ddI across the buccal mucosa and its permeability enhancement by both AVgel and OA derivatives as novel permeation enhancers. The study showed that both OA1ANa at 2 %w/w and AVgel at 0.5 %w/v, or lower concentrations, can be used as buccal permeation enhancers to develop and optimize novel buccal delivery systems for ddI to improve ARV therapy. The novel enhancers are recommended for selection as buccal permeation enhancers, to design and optimize ddI buccal delivery systems, and application to other ARV drugs for improved therapy.


Researcher: Dr Tanuja Gengiah

Designation: PhD candidate

Study: Integrating human Immunodeficiency Virus (HIV) and Tuberculosis (TB) Drug Treatment

Summary: HIV and TB co-infection is associated with high mortality. Integration of drug treatment for the two diseases is essential to improve survival. However, success may be compromised by drug interactions. This PhD study demonstrated that rifampicin-based TB treatment unexpectedly increased concentrations of the first-line HIV drug efavirenz in the blood. This was the opposite of what was expected from previous studies in other populations. Genetic differences that influence the functioning of important drug metabolizing enzymes were found, in part, to explain these findings. The concentration of rifampicin, a critical anti-TB drug, was found to be far below the recommended target range. Recommendations are, firstly, a dosage reduction of efavirenz in African HIV/TB co-infected patients to minimize possible side effects and improve life-long treatment sustainability. Secondly the rifampicin dose should be increased to limit TB treatment failures and the development of drug resistant TB. The findings and recommendations will not only benefit co-infected patients but will also provide public health benefits for South Africa.


Researcher: Mr Soumendranath Bhakat

Designation: Masters candidate

Study: Molecular modelling studies on HIV drug targets: Reverse transcriptase and nef protein

Summary: The study reported the first account of the molecular impact of M184V mutation on HIV reverse transcriptase resistance to lamivudine – the drug prescribed for the treatment of HIV infection and hepatitis B infection – using a combination of molecular dynamics simulation, binding free energy analysis, principle component analysis and residue interaction networks. Results from the study confirmed that M184V mutation leads to steric conflict between lamivudine and the beta-branched side chain of valine (amino acid); decreases the ligand lamivudine binding affinity when compared to the wild type; changes the overall conformational landscape of the protein and distorts the native enzyme residue-residue interaction network. The study shed light on the molecular mechanism of M184V resistance on lamivudine and related changes in conformational landscape of drug binding as well as overall protein conformation. This insight acted as a cornerstone to design novel nucleoside analog reverse transcriptase inhibitors against drug-resistant strains.

 

Researcher: Ms Alicia Desmond

Designation: PhD candidate

Study: Evaluation of adherence measures in infants receiving daily Nevirapine suspension for prevention of mother-to-child transmission of HIV

Summary: The study aimed to ascertain the reliability of maternal verbal reports in measuring adherence to antiretroviral prophylaxis in infants in the first six weeks of the life and evaluating the unused returned medication as an alternative method of measuring adherence. The maternal verbal reports in this study were deemed a more reliable measure of adherence to infant antiretroviral prophylaxis in the first six weeks of life when compared to assessment of unused medication returned.


Researcher: Dr Samuel Boadi- Kusi

Designation: PhD candidate

Study: Ocular health of cocoa farmers in Ghana: An assessment and Intervention study

Summary: Eye disorders are prevalent among cocoa farmers in Ghana. Farmers are engaged in improper ocular health and safety practices on the farm. They also make insufficient use of appropriate protective eye devices and health services. The study demonstrated that, with an ocular health intervention, cocoa farmers can improve on their knowledge and awareness level on ocular health and safety practices which may be of benefit to the farmer, employers and the national economy. 



Researcher: Mr December Mpanza

Designation: Masters study

Study: Rural Health Realities Versus Substance Abuse Service Providers in South Africa.

Summary: Substance (drug) abuse was observed as a major challenge in the uMkhanyakude district and substance abuse-induced psychosis was rife, leading to further problems within the community. Not only were the common drugs readily available to the community but local traditions and culture also contributed to the problem as in some instances youngsters were expected to sip traditional brew as a way of respecting the ancestors during traditional ceremonies. Study findings were shared with relevant people and departments, including traditional leadership and the Department of Arts and Culture. 


Researcher: Mr Siyabonga Kunene

Designation: Masters Research

Study: Level of physical activity and dietary habits among health professionals in KwaZulu-Natal district hospital, South Africa

Summary: The purpose of the study was to determine the level of physical activity and dietary habits, and determine any association between them among health professionals in KwaZulu-Natal district hospital, South Africa. The findings revealed that an urgent health promotion intervention is required to address the risk of physical inactivity and poor dietary habits amongst health professionals. Employers should seek to eliminate the barriers that discourage physical activity and good dietary habits at the worksite.


Researcher: Dr Tufayl Muslim 

Designation: PhD Research

Study: The development of a proposed conceptual framework for conducting cross-national comparative policy analysis of oral health policy development and implementation

Summary: The development of a proposed conceptual framework for conducting cross-national comparative policy analysis of oral health policy development and implementation. This study sought to develop and present a proposed conceptual framework that could be applied to cross-national policy analysis. This developed conceptual framework would need to allow policy analysts to undertake a comprehensive policy analysis that could lead to an understanding and contextualisation of the complex policy environments found in developed and developing countries such as Australia and South Africa.  Undertaking cross-national policy analysis using the developed conceptual framework and modelling tool could result in an improved understanding of the complex policy processes and environments across developed and developing countries.


Researcher: Mrs Verusia Chetty

Designation: Lecturer

Study: A Rehabilitation Model as a Key to Comprehensive Care in the Era of HIV as a Chronic Disease in South Africa

Summary: Public health approaches to HIV need to include prevention, curative treatment, support and rehabilitation. In the context of HIV major mile stones have been achieved with regards to prevention and treatment. People living with HIV survive however this comes with new experiences of disablement and this poses new challenges to health and rehabilitation professionals. Well-resourced countries have developed rehabilitation approaches in the context of HIV to guide rehabilitation. Resource poor settings lack feasible approaches to sustained rehabilitative care. The current response to HIV in resource poor settings needs to integrate disability into its model of care in a viable and effective way. A learning in action approach was the protagonist in developing a novel model to guide rehabilitation within a resource poor setting. An interpretive phenomenological exploration of key stakeholders including people living with HIV, the multi-disciplinary healthcare team and community outreach partners at a semi-rural hospital in South Africa initiated the development of the proposed model. A workshop style focus group discussed barriers to and enablers of rehabilitation. It also discussed the potential of standard and alternative approaches to rehabilitation used in a variety of settings such as: hospital/clinic based rehabilitation, community based rehabilitation, home-based care, support groups and block therapy. The results of the workshop were used to develop a framework for a model to guide rehabilitation. The model was represented by four categories objectives, principles, enablers and settings which were also evidenced by working models in resource rich settings. The objectives included improving access to patient centred care, maintaining a multidisciplinary team approach, and responding to policy. Principles that were proposed to underlie the model were imperative communication between all stakeholders, collaboration of all stakeholders and leadership to implement the model enabled by education and training for service providers at all points of care, and task-shifting to empower lay personnel for continuum of care. Each of the settings i.e. acute hospital, intermediate clinic, home-based care, outreach and community based rehabilitation need to be harnessed and incorporate a gamut of rehabilitation services in a coordinated manner. The assumption is that the burden on the healthcare system will be curbed and the projected benefit for all stakeholders will promote a sort after service delivery in rehabilitation of people living with HIV.

 

Researcher: Mr Saul Cobbing

Designation: Lecturer

Study: The Design and Implementation of a Home Based Rehabilitation (HBR) Programme for People Living with HIV and Disability in KwaZulu-Natal, South Africa

Summary: The study aimed to describe and evaluate findings related to the design and implementation of a novel home based rehabilitation intervention for people living with HIV and disability in KwaZulu-Natal, South Africa. It demonstrated that a task-shifting approach was a valuable means of providing alternative rehabilitation options to PLHIV in a resource-poor community. By training care workers to conduct simple HBR, it may be possible to scale up the treatment of the ever-growing number of individuals living with HIV and disability. 




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