Aspiring surgeons, Mr Xolani Ntombela and Ms Nqobile Manzini, have impressed medical specialists and health scientists with their inspiring and high quality research studies presented at various educational forums.

Inspired by UKZN’s “Living Legend” and Head of the Department of Surgery, Professor Thandinkosi Madiba, both undergraduate students are making waves in the medical profession through their contribution to novel studies in the local context.

Ntombela, a third year medical student, has focused his research on the Clinicopathological Spectrum of Anal cancers in the province of KwaZulu-Natal.

In July this year, Ntombela and Manzini, had the honour to present at the Surgical Research Society of Southern Africa’s Congress in Stellenbosch. Ntombela, then went on to present his study at the South African Gastroenterology Society Congress in August and was the only undergraduate student to be given this honour.

At the congress, he walked away with the second prize for his poster. Again in August, he presented at the College of Health Sciences Student’s Clinical Conference and won second prize for his presentation.

Ntombela’s study was a retrospective analysis of 130 patients treated for anal cancer at the Inkosi Albert Luthuli Central Hospital from 2004. The study focused on adenocarcinomas and squamous carcinomas.

During the period, 2004-2012, Ntombela reported that 13 of the patients had died.

Anal cancers affect all populations with squamous carcinomas recorded as being three times as prevalent as adenocarcinomas. Ntombela’s study also found that anal margin cancers were more common than anal canal cancers. He found that the proportion of patients with anal adenocarcinoma as higher than that reported in the literature.

Problems encountered are that patients presented at an advanced stage of the disease. Often patients resort to seeing a doctor only when they see excessive bleeding, the detection of a mass or constipation. Unfortunately this is too late in the stage of the disease. The other problem is that patients are often misdiagnosed with haemorrhoids, constipation and anal warts. So apart from the fact that patients seek medical assistance quite late resulting in a later diagnosis, often their initial diagnosis is incorrect.

From his study, Ntombela emphasizes the importance of early referral of patients with bowel symptoms to a specialist unit where a biopsy will be taken. He also suggests that medical professionals should not shy away from doing rectal examinations at the point of the consultation.

Ntombela and Manzini’s studies are currently being prepared for publication in one of the internationally recognised, peer-reviewed surgical journals. Ntombela continues to conduct research in anal cancers and hopes to come back to UKZN after qualifying as a medical doctor to specialize in colorectal cancer or gastrointestinal surgery.

Ntombela applied for many years to study medicine at UKZN. He said: ‘Despite being rejected for so many years, my passion for the field never abated. I’ve always wanted to specialize as a surgeon and now I am on my way to achieving this.’

Manzini, a final year medical student, also presented at the Surgical Research Society of Southern Africa’s Congress in Stellenbosch; at the UKZN College of Health Sciences Research Symposium and at the Pfizer-College of Health Sciences Young Health Scientists Research Symposium where she won first prize for her clinical research presentation. As a result of this she represented UKZN at the Pfizer-National Young Health Scientists Research Symposium in October this year.

Manzini’s study is on the Traumatic Retroperitoneal Hematoma (RPH): Factors Affecting the Outcome and is a retrospective analysis of data from the trauma database at the King Edward VIII Hospital from 1998-2004.  Of the 488 patients treated for abdominal trauma at King Edward VIII Hospital, 145 had RPH which is the accumulation of blood in the abdominal cavity behind the peritoneum.

The study found that the proportion of males presenting with RPH was 15 times higher than in females. Injuries were due to firearms (109), stabs (24) and blunt trauma (12). She also found that the kidney was the most commonly injured organ.

Manzini’s study is particularly important in that there is paucity of local studies on RPH. Said Manzini: ‘The successful management of post-traumatic retroperitoneal hematomas depends on following the prescribed management protocols as exploring a haematoma that does not require exploration may lead to uncontrollable bleeding and death. Decision-making on surgical intervention must be prompt and expeditious.’

Whilst serving her internship next year in Stanger hospital, Manzini will begin her second study on colorectal cancer. She hopes to return to UKZN to specialize in cardio-thoracic surgery.

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