Paediatric Human Immunodeficiency Virus (HIV) and Acquired Immunodeficiency Syndrome (AIDS) remain a significant health care challenge in South Africa. Oral health and coagulation are only two of the many problems experienced by HIV positive paediatric patients. This research report began with an observation that known HIV positive paediatric patients bled more than known HIV negative paediatric patients or those with unknown HIV status while undergoing dental extractions at Charlotte Maxeke Johannesburg Academic Hospital. The observation prompted a prospective, contextual, descriptive study looking at the coagulation profile (platelet count and thromboelastogram (TEG) profile (reaction time (r-time), clot formation time (Ktime), alpha angle (α-angle) and maximum amplitude (MA)), CD4 counts and percentages and observed clinical bleeding in HIV negative, HIV positive not on antiretroviral treatment (ARVs) and HIV positive on ARVs paediatric patients presenting for dental extraction. Over a two year period 47 HIV negative, 12 HIV positive not on ARVs and 17 HIV positive on ARVs paediatric patients were enrolled in the study using a consecutive, convenience sampling method. Each paediatric patient was given a standard inhalational general anaesthetic using sevoflurane and during intravenous cannulation the researcher drew blood from each child for analysis. A senior dentist from the Department of Paediatric Dentistry assessed bleeding in all cases. The data obtained for each of the three study groups was compared using a oneway analysis of variance followed by pair wise comparison using the Bonferroni adjustment to address multiplicity. To deal with the big standard deviations and skewed data a one-way analysis of variance for ranks tested for differences between the groups. No statistically significant differences were found when comparing the groups for platelet count (p = 0.2087), TEG r-time (p = 0.4738), TEG K-time (p = 0.6967), TEG α-angle (p = 0.7948) or TEG MA (p = 0.2982). There was a statistically significant difference between the HIV negative and HIV positive not on ARVs groups (p = 0.000 and 0.004) and HIV positive on ARVs and HIV positive not on ARVs groups (p = 0.000 and 0.001) when comparing CD4 count and percentage. Patient groups were compared with respect to bleeding complications using the Fisher’s exact test. There was no statistically significant difference in observed bleeding between the three groups of paediatric patients. The entire HIV positive group was then compared for bleeding, and using the Welch t-test, adjusting for unequal variances it was found that there was statistically, significantly more bleeding in the HIV positive children with lower CD4 counts regardless of treatment with ARVs (p = 0.0129). These results were also confirmed using the Wilcoxon rank-sum test (p = 0.0335). Although this study showed statistically significant bleeding in HIV positive paediatric patients with lower CD4 counts, the tests of coagulation used in the study were unable to define the underlying pathogenesis. Further research into coagulation in HIV positive paediatric patients is needed.

Thesis for Master of Science in Medicine at the School of Anatomical Sciences 5/11/2015 / In forensic anthropology, the estimation of sex is important for eliminating half of the possible identities the skeletal remains may have, as a result, sexing standards were set from fully dentate mandibles. Edentulous mandibles were excluded from studies that set these standards. Thus, this study intended to determine the effect of tooth loss on accurately estimating sex from the mandibular morphology of black South Africans. The mandibles sampled included 79 (31 males and 48 females) full dentition and 117 (57 males and 60 females) variable degrees of tooth loss mandibles from the Raymond A. Dart Collection of Human Skeletons. Outlines of the non-alveolar regions of the mandibles were digitised. The alveolar regions were rated according to the level of resorption that had occurred. A two block partial least square was performed to determine the effect of tooth loss on the mandibular morphology and a two sample permutation test was conducted to determine the sexing accuracies from all sampled mandibles. Tooth loss had a significant effect on the mandibular morphology. The overall accuracies determined were 85.5% from mandibles with tooth loss and 63.3% from full dentition mandibles. The overall mandible morphology is sexually dimorphic irrespective of the presence of tooth loss. The main factor that may affect the outcome was the mandibular mechanics in males and females. The results suggest that mandibles with high levels of tooth loss could be used in studies of identification. Further studies may want to set sexing standards from both dentate and edentate mandibles.

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Thesis (M.S.)--University of Michigan, Ann Arbor, 1979. / Typescript (photocopy). Includes bibliographical references (leaves 51-57). Also issued in print.

Thesis (M.S.)--University of Michigan, 1982.

Thesis (M.S.)--University of Michigan, Ann Arbor, 1965. / Typescript (photocopy). Includes bibliographical references (leave 40). Also issued in print.