African Female Research Articles

Pneumoperitoneum, pneumoretroperitoneum and pneumomediastinum: rare complications of perforation peritonitis: a case report

BackgroundGas extravasation complications arising from perforated diverticulitis are common but manifestations such as pneumoperitoneum, pneumoretroperitoneum, and pneumomediastinum happening at the same time are exceedingly rare. This case report explores the unique presentation of these 3 complications occurring simultaneously, their diagnosis and their management, emphasizing the importance of interdisciplinary collaboration for accurate diagnosis and effective management.Case presentationA 74-year-old North African female, with a medical history including hypertension, dyslipidemia, type 2 diabetes, goiter, prior cholecystectomy, and bilateral total knee replacement, presented with sudden-onset pelvic pain, chronic constipation, and rectal bleeding. Clinical examination revealed hemodynamic instability, hypoxemia, and diffuse tenderness. After appropriate fluid resuscitation with norepinephrine and saline serum, the patient was stable enough to undergo computed tomography scan. Emergency computed tomography scan confirmed perforated diverticulitis at the rectosigmoid junction, accompanied by the unprecedented presence of pneumoperitoneum, pneumoretroperitoneum, and pneumomediastinum. The patient underwent prompt surgical intervention with colo-rectal resection and a Hartmann colostomy. The postoperative course was favorable, leading to discharge one week after admission.ConclusionsThis case report highlights the clinical novelty of gas extravasation complications in perforated diverticulitis. The unique triad of pneumoperitoneum, pneumoretroperitoneum, and pneumomediastinum in a 74-year-old female underscores the diagnostic challenges and the importance of advanced imaging techniques. The successful collaboration between radiologists and surgeons facilitated a timely and accurate diagnosis, enabling a minimally invasive surgical approach. This case contributes to the understanding of atypical presentations of diverticulitis and emphasizes the significance of interdisciplinary teamwork in managing such rare manifestations.

Effect of impaction on third molar development and age estimation – A study in a female black South African population

The impact of impaction on the development of third molars remains a subject of debate within the scientific literature, given the lack of consensus. Simultaneously, there has been a call for dental age estimation studies to consider population-specific factors. This research was conducted with the objective of examining the influence of impaction on the formation of third molars in a cohort of female individuals of black South African descent. The study population comprised 428 panoramic radiographs, focusing on females within the age range of 15 to 23.9 years. Within this sample, mandibular third molars were categorized based on their positioning into two groups: non-impacted and impacted. Dental development stages were assessed and classified according to Demirjian’s 8-level staging system. Descriptive statistics were performed. The outcomes of the independent t-test revealed statistically significant differences in developmental stages, specifically stage G for tooth #38 and stage F for tooth #48, suggesting that impaction had an impact on dental development, albeit not consistently across all developmental stages. Nonetheless, it's noteworthy that the minimum and mean ages across all developmental stages were higher among impacted teeth. In summary, our findings support the conclusion that mineralization of impacted mandibular third molars in South African female subjects proceeds at a slower pace compared to their non-impacted counterparts. Consequently, when estimating dental age in the context of South African females, it is advisable to prioritize non-impacted third molars whenever feasible.

Influence of energy availability on metabolic hormonal profiles in east African female and male distance runners.

Energy availability (EA) and relative energy deficiency in sport (RED-S) are understudied in East African endurance athletes, both females (F) and males (M). This study assessed the metabolic hormonal profiles of such athletes relative to their EA status. Forty athletes (F=16, M=24) had their EA status, training, maximal oxygen uptake, and resting blood samples assessed using standard research practices. Subjects were stratified into two groups, high EA (HiEA) and low EA (LoEA) based on combined median value. Cortisol (P=0.034) and insulin (P=0.044) were significantly elevated in the LoEA group, while growth hormone (P=0.045) was significantly suppressed; and, prolactin (P=0.078) trended towards suppression, respectively compared to the HiEA group. All other hormonal comparison were non-significant. Metabolic hormonal profiles of female and male African distance runners are affected by their EA status. Aspects of these alterations agree in part with published findings based upon White populations, although some differences exist and need further investigation.

Chronicles of an uncommon term abdominal pregnancy with successful outcome: a case report

BackgroundIntra-abdominal pregnancies, while rare, present with unique diagnostic and management challenges. We present a case of a 25-year-old para 2 + 1, black African woman, who was referred from a peripheral Health Centre level IV in the Northern part of Uganda to a Regional Referral Hospital due to an abnormal presentation with easily palpable fetal parts. This case emphasizes the significance of prompt diagnosis, interdisciplinary collaboration, surgical planning, and managing the placenta in advanced intra-abdominal pregnancies.Case presentationA 25 year African black female, para 2 + 1 upon arrival at Regional Referral Hospital, a University Teaching Hospital during a weekend, an ultrasound was sourced from a nearby private clinic revealing an extra-uterine intra-abdominal pregnancy at 38 weeks of gestation and she was promptly sent back to the University Teaching Hospital. Following this diagnosis, the patient, who hailed from a remote village over 30 km away, returned to her family for discussions. After three days, she was readmitted. Emergency laparotomy unveiled an omental gestation sac with extensive placental attachment. A live female infant was delivered successfully, placenta was left in situ. The postoperative course was uneventful, with initial concerns about inadequate breast milk flow which resolved after placental removal during the second exploratory laparotomy.ConclusionThis case highlights the uncommon occurrence of an advanced intra-abdominal pregnancies and emphasizes the importance of multi-disciplinary teamwork and placental management. The favorable outcome in the management was based on thorough assessment of the placental location, attachments and blood supply during surgery. It demonstrates the possibility of reduced risk of massive bleeding if there is a delayed removal of placenta with favorable attachment. This is particularly important for milk letdown as well as reducing the needs of blood transfusion in resource limited settings.

E56 A 16-year diagnosis delay of a patient with Pigmented Villonodular Synovitis

Abstract Introduction Pigmented villonodular synovitis (PVNS), a subtype of tenosynovial giant cell tumours, is a rare non-cancerous proliferative synovial disorder usually affecting the knee in adults(1). The incidence rate is 1.8 patients per million people of the general population, with few reports amongst the paediatric population, hence it is frequently misdiagnosed(2). It has a slow onset of symptoms and has been noted to take ∼18 months to make a definitive diagnosis(3). Objective To describe a case of pigmented villonodular synovitis in a seventeen-year-old African female. Methods A retrospective chart review was done to ascertain the clinical presentation and management of the patient. Case description We present a case of a 17-year-old African female who presented with bilateral knee pain and swelling from 10 months of age. She had been on follow-up at a peripheral facility for 14 years, where she was being managed with methotrexate 12.5 mg weekly and folic acid 5 mg OD for Juvenile Idiopathic Arthritis with no marked improvement in her symptoms. In view of her poor response to therapy, the mother stopped her treatment 3 months prior to presentation in our facility. She initially had intermittent bilateral swelling of the small joints of the hand that were tender which eventually evolved to involve both knee joints. The pain was worse in the morning and was associated with the inability to ambulate and occasional night awakening. The systemic inquiry was otherwise unremarkable. She had an unremarkable birth history, and normal developmental milestones. She was however shorter than her peers and had not attained menarche. The patient had been admitted 8–10 times per year during the span of her illness for similar complaints and had undergone multiple knee joint fluid aspirations to relieve the swelling and several laboratory tests and radiological studies were done. On assessment, she was noted to be of fair general condition with gross asymmetric swelling of both knees and a surgical scar over the right knee with no limitation in the range of movement. There was minimal effusion of bilateral elbows and ankles, and the MCP, ICP and wrist joints weren’t affected. The patient had thoracic scoliosis, a grade 3/6 systolic murmur on the left lower sternal border, no radiation, and hepatomegaly 4 cm below the costal margin. She was prepubertal on sexual maturation rating. There was no central nervous system, abdominal, or respiratory abnormalities. A series of lab investigations to exclude the possibility of juvenile idiopathic arthritis were conducted. This panel included a complete blood count, which showed hypochromic, microcytic anaemia, c-reactive protein was raised at 61 mg/l but normal biochemistry and unremarkable autoantibody profile. Imaging done included a bilateral knee X-Ray followed by a bilateral knee MRI which showed large volume bilateral knee joint effusions associated with synovial-based masses causing extrinsic periarticular bony erosions and intra-articular synovial proliferation forming a villonodular appearance. The patient was referred to orthopaedic surgery and bilateral arthrotomy, drainage and synovectomy of both knees were done. She continues to be followed up in our paediatric rheumatology and orthopaedic clinic with good mobility and no other co-morbidities. She is currently undergoing work up for a delayed puberty. Conclusion Pigmented villonodular synovitis is a rare disease in the paediatric population. In the absence of awareness of its existence and expertise on how to diagnose it, patients may be misdiagnosed and mismanaged over a long duration of time as seen in the presented case.

Recognizability of Demographically Altered Computerized Facial Approximations in an Automated Facial Recognition Context for Potential Application in Unidentified Persons Data Repositories.

This study examined the recognizability of demographically altered facial approximations for potential utility in unidentified persons tracking systems. Five computer-generated approximations were generated for each of 26 African male participants using the following demographic parameters: (i) African male (true demographics), (ii) African female, (iii) Caucasian male, (iv) Asian male, and (v) Hispanic male. Overall, 62% of the true demographic facial approximations for the 26 African male participants examined were matched to a corresponding life photo within the top 50 images of a candidate list generated from an automated blind search of an optimally standardized gallery of 6159 photographs. When the African male participants were processed as African females, the identification rate was 50%. In contrast, less congruent identification rates were observed when the African male participants were processed as Caucasian (42%), Asian (35%), and Hispanic (27%) males. The observed results suggest that approximations generated using the opposite sex may be operationally informative if sex is unknown. The performance of approximations generated using alternative ancestry assignments, however, was less congruent with the performance of the true demographic approximation (African male) and may not yield as operationally constructive data as sex-altered approximations.

Graves’ disease-induced immune thrombocytopenic purpura in an African female: a case report

BackgroundImmune thrombocytopenic purpura is a condition associated with an unusual, unexplained, and sometimes very severe reduction in the level of platelets in the blood. Though documented, its association with Graves’ disease is not very common and can easily be missed or misdiagnosed, leading to excessive bleeding and mortality. Treatment with steroids and antithyroid medications has been shown to be beneficial in correcting thrombocytopenia in these patients, although the response is varied. We report on a patient with Graves’ disease who presents with immune thrombocytopenic purpura.Case presentationA 37-year-old Ghanaian female presented to our hospital’s emergency department with a complaint of palpitations, difficulty breathing, easy fatigue, and headaches. She had been referred from a peripheral hospital as a case of thrombocytopenia, severe anemia, and anterior neck swelling. She was diagnosed with Graves’ disease 2 years ago, became euthyroid during treatment, but defaulted. On further examination and investigation, she was diagnosed with immune thrombocytopenic purpura and was also found to have elevated free T3 and T4, and suppressed thyroid stimulating hormone. She also had high thyroid autoantibodies. She was initially started on oral prednisolone but there was no stabilization of platelets until methimazole was introduced, which improved and normalized her platelet count.ConclusionThe association of Graves’ disease with immune thrombocytopenic purpura, though documented, is uncommon, and very few cases have been reported thus far. There have not been any reported cases in Ghana or Sub-Saharan Africa and hence, clinicians should be aware of this association when investigating immune thrombocytopenic purpura and should consider Graves’ disease as a possible cause. From this study, we observed that there was no improvement in platelet count following the use of corticosteroid therapy until methimazole was started.

Clinical signs and symptoms associated with acute HIV infection from an intensely monitored cohort on 2 continents.

Define the clinical presentation of acute human immunodeficiency virus infection (AHI) among men and women from 2 continents to create a clinical scoring algorithm.Comparison of incident sign and symptom between those with and without AHI.At-risk human immunodeficiency virus (HIV) negative men and women in Thailand, Kenya, Tanzania, and Uganda underwent twice-weekly testing for HIV. Newly diagnosed participants were evaluated twice weekly for 21 days after infection.Of the 3345 participants enrolled, 56 African females and 36 biological males from Thailand were diagnosed with AHI. Four hundred fifty-two of their encounters were compared to 18,281 HIV negative encounters. Due to a high degree of heterogeneity among incident symptoms, 2 unique subgroups based upon geography and sex were created. Among Thai males, the signs and symptoms with the greatest odds ratio (OR) between AHI and uninfected participants were nausea (OR 16.0, 95% confidence interval [CI] 3.9–60.2, P < .001) and lymphatic abnormalities (OR 11.8, 95% CI 4.2–49.0, P < .001); and among African females were pain behind the eyes (OR 44.4, 95% CI 12.0–158.0, P < .0001) and fatigue (OR 22.7, 95% CI 11.3–44.3, P < .001). The Thai male scoring algorithm had a 66% sensitivity and 84% specificity while the African female algorithm had a sensitivity of 27% and specificity of 98%.The different incident symptoms during AHI necessitated creating 2 different scoring algorithms that can guide diagnostic testing among a particular sex in the appropriate geographic setting. Further research on risk exposure, sex, and demographic specific models is warranted.

THE CHALLENGES FACED BY AFRICAN FEMALES IN THE CONSTRUCTION INDUSTRY. EVIDENCE FROM A SELECTED METROPOLIS OF THE EASTERN CAPE

The South African construction industry has successfully held a positive role in the transformation of the country over the years through economic development, infrastructure, and job creation. The purpose of the study was to probe the challenges that hinder the progress of black female professionals to become successful entrepreneurs in the construction industry. The study pursued a quantitative research approach. A questionnaire-based survey was utilized to gather data from participants at the selected location of the Buffalo City Metropole, Eastern Cape. The research findings revealed that although there are still challenges faced by African females, there is still considerable growth of women-owned SMME’s and the retention of African female professionals within the construction industry has significantly improved. It was also concluded that the many Government initiatives have also played a key role in these successes, though participants have also noted that there are some areas for improvement on these programs.

Celebration, preservation and promotion of struggle narratives with a focus on South African women of Indian heritage

The relevance and value of oral history practices and principles and its impact on community history gives credence to its relationship with the liberation struggle. The liberation struggle heroines that formed the cohort of interviewees for this research were members of the South African Indian community. This interview- research process provides a platform that allows the veteran South African female of Indian Heritage to reflect almost 50 years later and be a part of the celebration, preservation and promotion of struggle narratives. The women who were interviewed for this research shed light on celebrating political achievements, whilst remembering and recalling the educational, material and economic assistance from international sources. Furthermore, these women referred to the preservation of South Africa’s unique heritage as, South Africa is united in its diversity. Promoting the values of the liberation struggle by sharing her anecdotes, honouring the cadres, relating experiences, retelling tales and sometimes possibly reliving military camp days completed the oral history interview process and eventually added to the body of knowledge that already exists and partially filled the gaps that exist. Contribution: From a multidisplinary religious perspective, this article contributes to the historical and social-cultural discourse on liberation theology within a paradigm in which the intersection of social sciences and humanities generates a transdisciplinary contested discourse.

Delayed Hemolytic Transfusion Reaction in a Sickle Cell Disease Patient: A Case Report

Alloimmunization has been reported in patients with sickle cell disease (SCD). Delayed hemolytic transfusion reaction (DHTR) is one of the complications of alloimmunization. DHTR is of particular clinical significance in this patient population as it may pose a diagnostic and management challenge to most healthcare providers. Symptoms of DHTR are often misinterpreted as pain crisis or worsening of baseline anemia. Furthermore, DHTR may take a turn for the worse in patients with SCD, thereby leading to worsening anemia and hyper-hemolytic crisis.In this report, we discuss the case of a 33-year-old African female, with hemoglobin SS (Hb SS) SCD and a history of multiple blood transfusions in her home country of Nigeria, who presented to the emergency department with generalized body pain, which was typical of her prior vaso-occlusive crisis (VOC).The trigger of her crisis was an acute onset of sepsis secondary to Escherichia coli (E. coli)-associated pyelonephritis. Owing to a worsening of her VOC and a significant drop in her steady-state Hb levels, she required a blood transfusion of one unit of packed red blood cells (PRBC), which was later complicated by a delayed hemolytic reaction and worsening anemia.

265 Genome-wide association study of hidradenitis suppurativa in a multi-ethnic cohort

Hidradenitis suppurativa (HS) is a prevalent inflammatory skin disease. HS patients suffer from deep, painful, recurrent abscesses that drain malodorous fluid and lead to disfiguring scars that can limit mobility. African Americans and females are at an increased risk. A lack of effective therapies and limited knowledge about HS pathogenesis contribute to unmet needs. Unlike other common inflammatory skin diseases, there has never been a genome-wide association study (GWAS) conducted for HS. Here, we performed a first GWAS for HS using data from the eMERGE network of electronic health record linked biorepositories (project NT227). We used HS diagnosis codes to identify cases and controls. We estimated ancestry with principal component analysis using a set of 40,156 SNPs. Our final cohort consisted of 600 HS cases and 82,611 controls with comparable multi-ethnic ancestry (λ=1.005). Our cohort recapitulated HS race and gender predilictions with genetically African female participants accounting for 35% of cases, but only 10% of controls. Genotype data for 40 million variants was tested for association, adjusting for five principle components. No locus exceeded our threshold for statistical significance. There was no evidence for HLA association supporting classification of HS as inflammatory rather than autoimmune. Several loci approached the significance threshold, suggesting that a moderate expansion in cohort size may provide adequate power to detect associations. Interestingly, the lead SNP at one of the most significant loci (rs11075745; p=8x10-7) is an eQTL for NFAT5, a mediator of NOTCH signaling whose expression is downregulated in HS lesional skin relative to patient-matched nonlesional skin. The risk allele influences expression in tissue specific manner. Our group is constructing multi-ethnic replication cohorts that will allow us to expand this study in the near future.

CHARGE syndrome: genetic aspects and dental challenges, a review and case presentation

BackgroundCHARGE syndrome (CS) is a rare genetic condition (OMIM #214800). The condition has a variable phenotypic expression. Historically, the diagnosis of CHARGE syndrome was based on the presence of specific clinical criteria. The genetic aetiology of CS has since been elucidated and attributed to pathogenic variation in the CHD7 gene (OMIM 608892) at chromosome locus 8q12.Case presentationA South African female of mixed ancestry heritage, aged 4 years, was referred for dental assessment to the Faculty of Dentistry, University of the Western Cape, in 2018. She had a diagnosis of CHARGE syndrome confirmed by a Medical Geneticist from the Division of Molecular Biology and Human Genetics at the University of Stellenbosch.The patient had a long prior history of health and developmental problems, with the correct diagnosis becoming apparent over time. She presented with many oral and craniofacial features warranting consideration by the dentist including micrognathia, hypoplastic nasal bones, cranial nerve dysfunction, bruxism, craniofacial anomalies and compromised sensory perception. The treatment was mainly preventive and, although she fed through a percutaneous endoscopic gastrostomy tube (PEG), maintenance of her oral hygiene was necessitated.Conclusion: CS is a multisystem condition and the optimal care for an individual is with a specialist multidisciplinary team. The numerous systemic problems affecting these individuals take precedence in their care, and often there is neglect of their dental concerns. Given the abnormalities frequently present in the oral and craniofacial region, the authors recommend that a team of dental and other medical specialists be involved in the management of individuals with CS.

Abstract 38: New Mutations Linked to Cerebral Autosomal Recessive Arteriopathy With Subcortical Infarcts and Leukoencephalopathy in Africa and North America

Introduction: Cerebral autosomal recessive arteriopathy with subcortical infarcts and leukoencephalopathy (CARASIL) is a rare hereditary disease. It is linked to mutations in the high-temperature requirement A serine peptidase 1 gene ( HTRA1 ). The clinical presentation is characterized by cerebral small vessel disease, alopecia, and spondylosis. CARASIL was initially thought to be a recessive disorder and exclusively exist in Asian populations. The paradigm of CARASIL has recently expanded. Genetically confirmed heterozygous mutations and manifestation in other ethnicities were reported. A few cases were reported in Hispanic and Caucasian populations but none in the African population. Here we report a new homozygous mutation in a Hispanic male and a known heterozygous mutation in an African female. Methods: Patients underwent routine ischemic stroke work up and risk factor management. MRI brain results were consistent with severe small vessel disease out of proportion to age. Genetic testing for vascular dementia for NOTCH-3 and HTRA1 in Patient 1 and only HTRA1 in Patient 2 were performed through Mayo Clinic. Results: Table 1. Patient Characteristics and HTRA1 Mutations Discussion: The prevalence of CARASIL is unknown but probably underestimated. Since the recognition of heterozygous HTRA1 mutation in CARASIL, more cases of heterozygous HTRA1 mutations have been reported. One of the clinical CARASIL triad -alopecia was not reported or observed in our cases. Cases of CARASIL without alopecia have been reported. Thus, CARASIL should still be suspected in the appropriate clinical presentation even if there is no classic triad or in non-Asian populations. Our cases expanded CARASIL mutations and affected populations. Being more aware of the broad clinical presentation of CARASIL can lead to early diagnosis.

Is the Greulich and Pyle atlas applicable to all ethnicities? A systematic review and meta-analysis

ObjectiveTo determine whether the Greulich and Pyle (G&P) atlas is applicable when applied to populations of different ethnicity.MethodsA systematic review of studies published between 1959 and 15th February 2017 identified from the Embase, MEDLINE and Cochrane databases was undertaken. Quality of the studies was assessed using the National Institute for Health and Care Excellence tool. Meta-analysis used mean differences and standard deviations as summary statistics for the difference between bone age (BA) and chronological age (CA).ResultsA total of 49 studies were included of which 27 (55%) were related to Caucasian populations. Of the 49 eligible studies, 35 were appropriate for further meta-analysis. In African females, meta-analysis showed a significant mean difference between BA and CA of 0.37 years (95% CI 0.04, 0.69). In Asian males, meta-analysis showed significant differences between BA and CA of -1.08, -1.35, -1.07, -0.80 and 0.50 years for chronological ages of 6, 7, 8, 9 and 17 years, respectively. Meta-analysis showed no significant differences between BA and CA in African males, Asian females, Caucasians and Hispanics.ConclusionsThe G&P standard is imprecise and should be used with caution when applied to Asian male and African female populations, particularly when aiming to determine chronological age for forensic/legal purposes.Key Points• In African females, bone age is significantly advanced when compared to the G&P standard.• In Asian males, bone age is significantly delayed between 6 and 9 years old inclusive and significantly advanced at 17 years old when compared to the G&P standard.• The G&P atlas should be used with caution when applied to Asian and African populations, particularly when aiming to determine chronological age for forensic/legal purposes.

P013 Steps leading to discovery of a rare allele

Sanger sequencing-based typing (SBT, Life Technologies), and LABType Sequence specific oligonucleotide (SSO) Typing (One Lambda) are performed on all bone marrow/stem cell transplant recipients and prospective donors at Mayo Clinic, Rochester. SSO performed on an 11 yr-old African American male with Hemophagocytic Lymphohistiocytosis needing a stem cell transplant and his full-sibling donor, resulted in C*04/C*07 with group 1 results showing common allele possibilities. SBT of exons 2, 3, and 4 resulted in either a rare C*04 allele, a rare C*07 allele, or both C*04 and C*07 being rare alleles. (Fig. 1a). At base pair 862 in exon 4, a heterozygous A/G result was seen. At this base the G result was consistent with a C*07:18 while the A suggested C*04:165. (Fig. 1b). This nucleotide exchange from G → A in codon 264 resulted in an amino acid change from Glutamic Acid to Lysine GAG → AAG. Ambisolv Sequence Specific Primers (SSP, One Lambda) were performed to help differentiate the common alleles C*04:09 N, C*04:82, C*07:01, C*07:06, and C*07:18. Except for the C*07:18, all were negative and led to an initial interpretation of C*04:165 and C*07:18. Olerup C*04 and C*07 SSP trays were set up with C*04:01/C*07:18 results obtained. Included in the C*04 SSP tray was C*04:165 with negative results. To further confirm the presence of C*07:18, exons 5 and 6 were sequenced by SBT where results at position 1043 showed a T/C. (Fig. 1b). After SSO typing a maternal half-sibling showing a haplotype match at class I, SBT was performed showing a C*04:01 homozygous result. (Fig. 1c). To help resolve the typing, Next Generation Sequencing (NGS) using Omixon Holotype HLA was performed. This led to a conclusion of C*04:01/C*07:18 novel allele (Fig. 1d). The allele has been newly discovered and named C*07:607 in the IPD-IMGT/HLA Database. It was originally found in a Black East African female. NGS phasing proved extremely valuable in identifying the nucleotide change from G→A at position 862 (codon 264) belonging to the C*07 and not the C*04.

An Exploration of Experiences and Academic Challenges of African Female Student at University of Zululand, South Africa (UNIZULU)

Most African female students are weak in accounting. They feel that accounting is a male-dominated subject. Studies have shown that females consider accounting to be the masculine career. This study is an attempt to understand the academic challenges and experiences of African females at UNIZULU. With the aid of structured questionnaires, varied experiences and challenges of African female students at UNIZULU were captured and studied. Among the variety of experiences, few important ones are highlighted: academic support of lecturers, teaching and leadership style of lecturers, academic preparation of students, understanding of language and curriculum problems. In terms of challenges, students face problems related to language barriers, mathematical knowledge, time management, discipline and conduct, lack of female role model among others. The study suggested that UNIZULU should follow the gender-sensitive leadership and mentorship programs to improve female academic performance in the accounting modules.

“It's Hardly Fair to Bring a Child Into the World With the Way Things Look…”: Anomie, Mistrust, and the Impact of Race, SES, and Gender

This article examines the impact of race, socioeconomic status (SES), and gender on subjective outlook using anomie and general mistrust as indicators. Specifically, this study addresses the following questions: (1) How do African Americans and whites compare with respect to anomie and mistrust? (2) Do racial differences in anomie and mistrust vary by SES? (3) Do African American women have higher levels of anomie and mistrust than whites and African American men? and (4) Are African Americans becoming more or less trusting and anomic over time? Using data from the General Social Survey (GSS) (1972–2014), the analysis reveals significant racial differences in social outlook as measured by anomie and mistrust. African Americans indicate higher levels of both anomie and mistrust than whites even after controls for SES and the other variables. The racial gap in anomie and mistrust increases with increases in SES. Being African American and female is associated with higher levels of anomie but not mistrust. African American mistrust decreases relative to whites over time. More affluent African Americans’ anomie levels slightly increase relative to similar whites over time. Explanations using the “rage of a privileged class” and “intersectionality” ideas are evaluated.

Case Report Ramsay Hunt Syndrome presenting as “a window’’ to HIV diagnosis in 48 year old African female: A case report

Background: Ramsay Hunt Syndrome in adults is reported in a number of case reports as an uncommon presentation of Varicella zoster Virus infection. Ramsay Hunt Syndrome occurs when there is reactivation of the latent Varicella zoster virus present in the ganglia due to previous varicella infection. Following a breakdown of the immune system, latent Varicella zoster infection can be activated. HIV (Human Immunodeficiency Virus infection), causes immunosuppression and hence reactivation of Varicella zoster. The diagnosis of Ramsay Hunt Syndrome, gives a window of opportunity to investigate for HIV. Here we report our first case of Ramsay Hunt syndrome as a presenting feature of HIV disease in an apparently healthy looking 48 year old black African female who was unaware of her HIV status at the time of presentation.&#x0D; This case is reported in order to highlight the need to use Ramsay Hunt Syndrome as a window of opportunity to screen for underlying HIV.&#x0D; Case presentation: A 48 year old black African female who was unaware of her HIV status, presented to our outpatients department with a two day history of painful right ear pain, vesicles on the right pinna and inability to completely close her right eye, her mouth was deviated to the left, with a wrinkle free frown. She denied any alteration in taste sensation and hyperacusis. She had a grade IV House-Brackmann facial paralysis.A diagnosis of Ramsay Hunt Syndrome was made and an HIV test was offered, the test was positive for HIV.A subsequent HAART (Highly Active Antiretroviral Therapy) work up, revealed CKD 3B (Chronic Kidney Disease stage 3B) and a CD4 (cluster of differentiation 4) count of 217 cells/µl .She was started on antiretroviral therapy 2 weeks after completing a 10 day regimen of acyclovir. In addition to her drug treatment she received ocular care and physiotherapy. Four months on her facial nerve function has improved modestly.&#x0D; Conclusion: An HIV test should be an indispensable part of the Ramsay Hunt syndrome workup, as its diagnosis gives a window of opportunity to diagnose HIV and offer life- saving HAART.

Graphic family sculpting as a visual projective data-collection method: an example of South African female adolescents

ABSTRACTGraphic family sculpting is a drawing technique which is a modified form of family sculpting. Initially developed by Chris Venter, the technique was intended as a projective, therapeutic technique to enable family members to understand and make sense of their emotional experiences of family matters. The aim of this article is to describe graphic family sculpting as a visual projective data-collection technique by illustrating its use in research conducted with a group of African female adolescents regarding their experience of parent–adolescent relationships in a South African context. African adolescent females (n = 30) between the ages of 13 and 18 were sampled through the implementation of purposeful sampling. The sculptings were analyzed with the use of guidelines provided by Venter and were thematically analyzed. The findings illustrate the value of graphic family sculpting as a visual projective data-collection method and recommendations are made for the use of graphic family sculpting in research.