Anticoagulation in pregnant women with mechanical heart valve prostheses: Case reports and a literature review.

The choice and regimen of anticoagulation therapy in pregnant women with mechanical valve prostheses have always been a daunting task. It is a delicate balance that takes into consideration the risk of thromboembolic complications in the mother and the risk of potential Warfarin embryopathy to the foetus. Medical practice in a low socioeconomic setting also has the peculiar challenge of financial constraints on the part of the patients and difficulties in monitoring the efficacy of anticoagulation therapy. We report our experience in managing two pregnant women with mechanical valve prostheses and review the existing literature on this complex but interesting subject.

Assessment of Plasma Sodium to Potassium Ratio, Renal Function, Markers of Oxidative Stress, Inflammation, and Endothelial Dysfunction in Nigerian Hypertensive Patients.

BACKGROUND: This study investigated plasma sodium/potassium ratio, markers of oxidative stress, renal function, and endothelial dysfunction in hypertensive Nigerians. MATERIALS AND METHODS: Five hundred forty-nine volunteers consisting of three hundred and twenty-four hypertensive and two hundred twenty-five controls participated in this study. Blood samples were collected from the participants and were analyzed for electrolytes, markers of oxidative stress, endothelial dysfunction, renal function, and inflammation, using ion-selective electrodes, spectrophotometric, and enzyme-linked immunosorbent assay methods, respectively. RESULTS: The mean systolic blood pressure, mean diastolic blood pressure, mean arterial blood pressure, and body mass index (BMI) were significantly elevated among the hypertensive group when compared with control (p < 0.001). The mean sodium increased, while potassium and bicarbonate (HCO3 -) decreased (p < 0.001) in hypertensive volunteers. The sodium-potassium ratio (Na+/K+) and urea were raised (p < 0.001) in the hypertensive group when compared with the control. Glutathione, superoxide dismutase, nitric oxide (NO), and catalase were significantly reduced (p < 0.001) while malondialdehyde (MDA), high-sensitivity C-reactive protein (hs-CRP), and ferritin were raised significantly (p < 0.001) in hypertensive participants. The odds of hypertension and its complications increased (p < 0.001) with an increase in BMI, Na+/K+, hs-CRP, MDA, and ferritin and a decrease in estimated glomerular filtration rate (eGFR), glutathione, superoxide dismutase, and catalase. CONCLUSION: An increase in Na+/K+, urea, hs-CRP, ferritin, MDA, and BMI and a decrease in eGFR, glutathione, and superoxide dismutase were associated with an increased risk of hypertension complication. Abnormal values of markers of oxidative stress, inflammation, and endothelial function could impact deleterious effects on the cardiovascular system among hypertensive Nigerians. A decreased bicarbonate possibly suggests an occult acid-base imbalance among hypertensive volunteers.

Full blood count pattern of pre-chemotherapy breast cancer patients in Lagos, Nigeria.

UNLABELLED: Background : Full blood count has been shown to predict disease severity and mortality risk in cancer patients. This study aimed to highlight the degree of derangements of full blood count parameters and provide mean values in pre-chemotherapy breast cancer patients compared with apparently normal control subjects. METHODS: This was an unmatched case-control study among breast cancer patients attending Oncology clinic of Lagos State University Teaching Hospital, Ikeja and the nurses of the institution as control. A total of 4.5 mls of blood was collected from each participant into EDTA bottle for full blood count analysis, done on the same day of collection. RESULTS: A total of 100 histologically diagnosed, consenting, pre-chemotherapy patients of the clinic (cases) and 50 nurses of the institution as controls were studied. Anemia was found in 58%, 43% and 20% of cases compared with 38%, 36% and 2% of controls using PCV< 36%, 30-36% and 30%, respectively. The mean MCV, MCH, MCHC (82.62±7.48 fl, 26.01±2.78 pg, 30.73±4.06 g/l respectively) of cases were lower than the controls (85.36±5.74 fl, 27.24±1.90 pg, 31.81±0.8 g/l, respectively and RDW of cases (15.61±3.53) was higher than the control (14.24±0.75). The mean WBC counts, neutrophil and lymphocyte percentages of cases (6.96±7.22, 54.75±13.1% and 38.19±12.70%, respectively) were higher than the controls (5.47±1.57, 44.39±8.78% and 8.82±15.97%, respectively). The mean platelet count of cases 291.51±103.38 was also higher than the controls (222.82±57.62). CONCLUSION: Breast cancer patients presented with deranged full blood count pattern, consequent to the disease compared with the controls.