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Doctoral Degrees (Haematology)

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    Profile and management of AIDS related lymphoma.
    (2022) Rapiti, Nadine.; Moosa, Mahomed Yunus Suleman.
    Worldwide, HIV-associated lymphoma (HAL) is a common HIV-related malignancy. Most are aggressive, high-grade B cell malignancies and are classified as AIDS Related Lymphomas (ARL). ARL include Diffuse large B cell lymphoma (DLBCL), Burkitt lymphoma (BL), and less commonly, plasmablastic lymphoma (PBL), primary effusion lymphomas (PEL) and primary central nervous system lymphoma (PCNSL). Prior to antiretroviral therapy (ART), the incidence of lymphoma was 60-200 fold higher than that seen in HIV-negative subjects, but this has decreased to 11-25 fold with the widespread use of ART. The prevalence of HIV in South Africa (SA) is estimated at 13.5% (8 million people), with the province of KwaZulu-Natal (KZN) leading other provinces at a seroprevalence rate of 18%. Most patients in SA access medical care through government health facilities. King Edward Vlll Hospital (KEH) is a government-funded, tertiary health care centre affiliated with the academic hospital of the Nelson R. Mandela School of Medicine of the University of KwaZulu located in Durban, KZN. Most ARL in the indigent population, other than BL, are treated at KEH. The aim of this original research was to describe the profile, outcome and prognostic variables of ARL treated in a government hospital at the epicentre of the HIV/AIDS pandemic in KZN, and compare this to data described elsewhere in South Africa and internationally. There is limited data from South Africa on ARL, and no data from KZN. Globally, conventional chemotherapy for ARL has been supplemented by rituximab, which is a monoclonal antibody targeting CD20. A shift in treatment midway through this study period, to include the use of rituximab locally for CD20-positive ARL, provided an opportunity to compare outcomes with and without rituximab. Plasmablastic lymphoma is a challenging ARL, in terms of diagnosis and management. As this is an unusual lymphoma, with a prevalence of 0.004% of all lymphomas, there viii are no large, prospective trials. We describe our experience with the profile and outcome of this cohort of ARL patients, treated with combination chemotherapy. Outcome in lymphoma is guided by prognostic scoring systems, the international prognostic index (IPI) or the age-adjusted IPI (aaIPI). As these prognostic scoring systems have not been validated in the local population in KZN, the utility of these scoring systems was assessed in this research.
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    Human blood groups and antibodies.
    (1991) Moores, Phyllis Patricia.
    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.
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    The blood groups of the Natal Indian people.
    (1980) Moores, Phyllis Patricia.; Bain, Peter G.
    No abstract available.
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    A comparative study of iron deficiency in the Indian and the African in Durban.
    (1963) Mayet, Fatima G. H.
    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.