Sideropenic dysphagia

No Abstract

Multiple Myeloma

The results of the use of melphalan in 52 patients with multiple myeloma have been analysed.  The median survival of the whole group of patients was 30 months, and of those with renal insufficiency only 12,5 months. Bence-lones proteinuria was also a poor prognostic finding,. but only because of its association with renal failure. Patients with Bence-Jones proteinuria and normal renal function had a median survival of 41 months. Responsiveness to therapy by criteria based on those of the Chronic Leukemial Multiple Myeloma Task Force could be assessed in 25 patients. Dramatic symptomatic relief occurred in all but one of the responsive patients, but in only one-fifth of those who did not respond to therapy.S. Afr. Med. J., 48, 1026 (1974)

Local experience in the treatment of acute non-lymphoblastic leukaemia

Seventy-six patients suffering from various forms of acute non-lymphoblastic leukaemia were seen at the Johannesburg Hospital over an 8-year period. During this time various forms of therapy were used. Results with 6-mercaptopurine and prednisone were very poor, with less than 10% of patients achieving complete remission. Daunorubicin, when used alone, proved too toxic, but when given in a smaller dose with other agents, was more effective. The best results were obtained in 22 patients in whom a combination of daunorubicin and cytosine arabinoside was used. Complete remissions occurred in 9 patients and partial remissions in 2. The median survival of these 11 patients was 42 weeks. It is noteworthy that 3 of these patients were still alive one-and-a-half years from the time of diagnosis, and 1 of them is still in complete remission, two years after she was first treated.S. Afr. Med. J., 48, 963 (1974)

Relationship between pica and iron nutrition in Johannesburg black adults

On direct questioning by a Black staff nurse, 23% of 348 consecutive unselected adult outpatients attending the Johannesburg Non-European Hospital said that they regularly ate earth or ash. The prevalence was higher in the women (33%) than in the men (11 %), and in 50 women with minor gynaecological complaints who were interviewed by a Black psychologist, it was 72%. The quantity eaten varied from an occasional tablespoonful to several handfuls a day. In an attempt to define the reasons for the habit a thematic apperception test was used. A strong association with pregnancy was identified, but the explanation for this was not established. Some subjects claimed that the material was eaten for medicinal purposes, while others merely liked the taste. The effect on iron nutrition appeared to be variable, depending on the ironbinding capacity of the soluble iron content of the material consumed.S. Afr. Med. J., 48. 1655 (1974

Haemochromatosis in a young female

No Abstract

Liver iron stores in different population groups in South Africa

The hepatic non-haem iron concentrations of 1 143 subjects dying in Durban, Pretoria and Cape Town were determined. The effects of certain disease processes upon liver iron stores were confirmed, and data from subjects dying from such diseases were excluded. No significant differences were revealed between comparable groups from the 3 cities. In Whites and Bantu, the median values were higher in adult males than in postmenopausal females, and lowest in premenopausal females, reflecting the greater iron requirements imposed by menstruation and pregnancy. The figures in the Bantu were significantly higher than those in the corresponding members of each of the other population groups. In addition, suggestive evidence was obtained that a significant proportion of Coloured males have iron stores that are lower than normal. In contrast to the situation in adults, significantly lower concentrations were found in Bantu children than in White children. The probable explanation for these observations is that the Bantu children are not exposed to the majorsource of superfluous dietary iron, namely the homebrewed beers