No abstract available. / Thesis (Ph.D.)-University of Natal, Durban, 1980.

The following blood group phenotypes and antigens were studied: Abantu , Ax, Ay, Bm, Bm-like, B3-like, "Bombay" Oh Le(a+b-), "Bombay" Oh Le(a-b-), para-Bombay, Mi(a+), Vw+, S-s-U-, Dantu, Gerbich-, P1H, STEM+, Rh :-34, Rhnu11 , Le(a-b-c-d-), McC(e+) and Wd( a+) and a new form of polyagglutination associated with haemoglobin M - type Hyde Park. The effect of inheriting a y, D--, Dc- or R1Lisa haplotype was also investigated. The following blood group antibodies were studied: anti-N in a person with type MN red cells, anti-hrs, anti-Rh34, anti-Jsb and anti-T. Type M red cells were confirmed to absorb anti-N and type N red cells not to absorb anti-M. A new technique was described for separating the two red cell populations in twin chimeras. Three XX/XX female dispermic chimeras with blood of two genetic types, two with patchy skin pigmentation, were identified. Reduced I and enhanced i antigen expression helped confirm a case of congenital dyserythropoietic anaemia type II. Oval red cells accompanying an r (dce) haplotype were found, and anti-Tja-like haemolysins were not detected in women about to abort. Aspects of haemolytic disease of the newborn due to ABO and Rh antibodies were discussed. Two new tests in which 2-mercaptoethanol was used to distinguish between IgG (7S) and IgM (19S) immunoglobulins were described. Blood group phenotype and gene frequency studies were made in Black, White, Indian and Coloured blood donors and the results were presented in 32 tables. Thirty monoclonal anti-A and 96 monoclonal antibodies for antigens in the ABO, MNSs, Rh, Lutheran, Kell, Lewis and Kidd systems and for other antigens were investigated for their activity and specificity. / Thesis (Ph.D.)-University of Natal, Durban, 1991.

Hereditary Spherocytosis (HS) is a common inherited haemolytic anaemia with variable clinical expression. Fifty subjects with HS from KwaZulu-Natal were studied with the aim of providing further information on the protein abnormalities of the red blood cell (RBC) membrane and their relationship with clinical presentations. Haematological and biochemical tests were performed by routine procedures. Mean Corpuscular Haemoglobin Concentration ( MCHC) in the HS group was 35.1g /dl. This was significantly higher than in normal control subjects (33.6g /dl) (p value < 0.001); indicating its usefulness for the screening of HS. Mean Red Cell Distribution Width (RDW) was also significantly higher in subjects with HS (p<0.001); thus providing an additional screening tool. Erythrocyte membrane proteins from 21 subjects were analysed by SDS - polyacrylamide gel electrophoresis (SDS-PAGE) using the Laemmli and Fairbanks methods. The most common abnormality was a deficiency of band 3 (10 subjects), followed by a combined spectrin and ankyrin deficiency in five subjects. One subject had increased band 6 and in five cases no abnormality was detected. A decreased ratio of protein 4.1a / 4.1b on the Laemmli SDS PAGE correlated with an increased reticulocyte count. The degree of haemolysis and clinical findings did not correlate with the type of red cell membrane protein defect. In this study red cell membrane analysis did not contribute further to the initial laboratory diagnosis. In addition it did not influence clinical management. The presence of red cell membrane abnormalities, either single or multiple, did not correlate with disease severity. Red cell membrane analysis, however, will play an important role for future management such as gene therapy. Red cell membrane analysis is also useful as a research tool to determine the underlying molecular defect and to assess racial or ethnic differences. It is also of value as a differential diagnostic tool in cases where the clinical and laboratory findings are not conclusive for HS. / Thesis (M.Med.Sci)-University of KwaZulu-Natal, Durban, 2006.

Background Several case reports and studies have alluded to an increased prevalence of venous thrombosis in human immunodeficiency virus positive (HIV-positive) patients. Although a relationship between HIV infection and thrombotic disease has been suggested, the mechanisms predisposing to thrombosis have not been fully elucidated. Aim A prospective study, to determine possible coagulation factor abnormalities that could explain the predisposition to thrombosis in HIV-infected African (Black) patients, was undertaken. Method African (Black) patients, with acute upper segment deep vein thrombosis (DVT) confirmed by duplex ultrasound, were enrolled. Patients who had recognisable risk factors such as recent surgery, pregnancy or malignancy, were excluded. After informed consent, blood samples were taken for baseline tests as well as a thrombophilia screen. The control group comprised known HIV-positive African (Black) patients without DVT. Patients with DVT who were found to be HIV-negative were also analysed. Analysis was done in 2 parts: HIV-positive patients with and without thrombosis and HIV-positive and negative patients with thrombosis were compared. Results Part A: HIV-positive patients with and without thrombosis Of the 77 patients with DVT, 50 patients tested HIV-positive. These 50 patients (HIV-positive DVT-arm), as well as 56 controls (HIV-positive, no DVT), were enrolled into the study. The groups were well matched with regard to age, sex and cluster designation 4 (CD4) count. On univariate analysis, significant findings in the DVT-arm were a history of active tuberculosis on treatment, low protein C levels and a positive qualitative D-dimer, whereas on multivariate analysis, only tuberculosis and an elevated D-dimer proved to be significant. Part B: HIV-positive and negative patients with thrombosis There were 20 HIV-negative patients with DVT who met our inclusion criteria Limited assessment was done on this group owing to unavailability of some data. The mean age of the HIV positive DVT group was significantly lower than the HIV-negative group with DVT (31.78 vs. 41.45 years; p=0.005). There was no significant difference in the prevalence of tuberculosis between the HIV-positive and HIV-negative patients with thrombosis (p = 0.269). Mean protein C levels were reduced in the HIV-positive group and normal in the HIV-negative group. They were significantly lower in the HIV-positive patients compared to the negative group (p=0.02). Conclusion The findings of the study suggest a relationship between HIV, its complications and DVT. Although this study confirms HIV infection as a risk factor for thrombosis, clear pathogenetic mechanisms remain to be elucidated. In our population, tuberculosis appears to be an important risk factor predisposing patients to the development of DVT, both in the HIVpositive and negative population. Further studies will need to be done to confirm this hypothesis. / Thesis (MMed)-University of KwaZulu-Natal, Durban, 2006.

The thesis is comprised of a comparative study of iron metabolism with particular reference to iron deficiency in the Indian and the African; Europeans were included when naterlal was available. Fifty four patients with iron deficiency anaemia were studied. There ware 43 Indians as compared with 11 Africans although the overall proportion of Indians to Africans admitted to the same ward was 1 : 4. Amongst the Indians the commonest cause of anaemia from blood loss was peptic ulceration (6 patients); while 3 had cirrhosis of the liver, one had hookworm anaemia and one was a case of ulcerative colitis. Gynaecological lesions were found in 2 patients, one had a proliferative endometrium and the other had endometrial polypi. Idiopathic iron deficiency anaemia was found in 60.5% of the Indian patients (both male and female). Amongst the Africans on the other hand, there were 2 cases of hookworm anaemia and 2 of cirrhosis of the liver while peptic ulceration was suspected in one patient who alao had amoebic dysentery and urinary hllharsiesis. None of the Africans had Idiopathic iron deficiency anaemia with the possible exception of one who had 4 Caesarean sections in rapid succession. There were 175 Indians, 175 Africans and 139 Europeans who were studied haematologlcally during pregnancy. The Incidence of iron deficiency anaemia among them was 26.7%, 2% and 4% respectively. The third aspect of the thesis is confined to an analysis of necropsy materiel for iron stores. Two hundred Africans and 58 Indians were studied. It was found that the incidence of *siderosis" in the African was high. There was a significant difference in the iron concentrations in the stores of the 2 racial groups. It was concluded that iron deficiency anaemia is common in the Indian. Diet appears to play an important role in its production. / Thesis (M.D.)-University of Natal, Durban, 1963.