EVALUATION OF MALE SEX HORMONES AND TRACE ELEMENTS IN MALE TYPE 2 DIABETIC PATIENTS ATTENDING NNAMDI AZIKIWE UNIVERSITY TEACHING HOSPITAL DIABETIC CLINICS.

BACKGROUND: There is accumulating evidence that the metabolism of male sex hormones and several trace elements are altered in type 2 diabetic mellitus and may have specific role in the pathogenesis and progression of the disease. AIM: To assess the levels of male sex hormones and trace elements in type 2 diabetic patients and to ascertain an association between male sex hormones and trace elements among diabetic subjects. METHODS: A descriptive cross sectional study was conducted among 125 diabetic and 50 non diabetic subjects. Venous blood samples were collected from all respondents and estimated for fasting blood glucose, male sex hormones and trace elements. The results were subjected to statistical analysis and comparison using Students' test and Pearson correlation analysis. RESULTS: The mean testosterone level was significantly lower in diabetics than in controls (3.9 ± 1.9ng/ml) in comparison with (5.1 ± 1.7ng/ml; P < 0.05). The mean value of Zinc, Manganese, Selenium and Chromium were significantly lower among the diabetics when compared with the controls (Zn;898.7 ± 131.0 µg/l; Mn:0.30 ± 0.06 µg/l;Se:51.3 ± 11.1 µg/l; Cr: 0.04 ± 0.03 µg/I) in comparison with (Zn: 1007.3 ± 85.2 µg/l; Mn: 0.05 ± 0.07µg/l; Se: 62.1 ± 11.1 µg/l; Cr: 0.06 ± 0.01 µg/l; P < 0.05).The mean Fasting Blood Glucose in diabetic subjects was significantly higher when compared with the controls (7.9 ± 3.7 mmol/l) in comparison with (4.6 ± 0.4 mmol/l; P < 0.05).The trace elements showed a positive correlation with testosterone in diabetic subjects (Zn r = 0.359, Ser = 0.443, Mn r = 0.350, P < 0.05). CONCLUSION: This study observed decreased levels of testosterone and trace elements in type 2 diabetics and a positive correlation between low testosterone and low trace elements levels in diabetic subjects. These trace elements are antioxidants and their low levels in diabetic patients may further increase the severity of the disease.

Iron status of some pregnant women in Orlu town--eastern Nigeria.

BACKGROUND: High prevalence of anaemia has been reported among pregnant women especially in developing nations. This paper considers maternal haemoglobin (Hb) level, serum total iron, iron binding capacity, and serum ferritn iin antenatal women in Orlu-Imo State Nigeria. PATIENTS AND METHODS: Haemoglobin level, serum iron, serum ferritin, and total iron binding capacity (TIBC) were measured in different trimesters among 90 pregnant women aged 20-45 years, on iron supplements attending antenatal clinic of Imo State University Teaching Hospital Orlu. First trimester comprised of 16.7% (n = 15), second trimester comprised of 50% (n = 45) while as third trimester comprised of 33.3% (n = 30). 30 non-pregnant women aged 26-40 years were used as controls. RESULT: The mean Hb level was 11.28 +/- 1.4 g/dl in first trimester, 9.51 +/- 1.9 g/dl in second trimester, 10.4 +/- 1.2 g/dl in third trimester, and 10.9 +/- 1.5 g/dl in controls. Mean serum iron level was 142 +/- 23 microg/ml in first trimester, 235 +/- 118 microg/ml in second trimester, 251 +/- 118 microg/ml in third trimester, and 99.7 +/- 19.4 microg/ml in controls. Mean serum ferritin was 57.7 +/- 30 ng/ml in first trimester, 37.6 +/- 17 ng/ml in second trimester, 37.3 +/- 20 ng/ml in third trimester, and 86.7 +/- 16.9 ng/ml in controls TIBC was 337 +/- 90 microg/dl in first trimester, 441 +/- 19 microg/dl in second trimester, 482 +/- 149 microg/dl in third trimester and 271.8 +/- 89.0 microg/ml in controls. Hb level was relatively stable in pregnancy, but was significantly (p < 0.05) lowest in the second trimester compared with controls Serum iron and TIBC progressively increased from first trimester to third trimester. Conversely, serum ferritin declined progressively from first trimester to third trimester. The increments in serum iron was statistically significant (p < 0.05) between first and second trimester, but not significant between second and third trimester. TIBC was significantly higher in third trimester compared with first trimester. Serum ferritin was significantly lower in second and third trimesters compared with controls. This implies a progressive mineral transfer from mother to fetus. TIBC and serum iron were significantly (p 0.05) lowest in non-pregnant controls compared with the three trimesters of pregnancy. Conversely ferritin was significantly (p < 0.05) higher among the non-pregnant controls compared with the three trimesters of pregnancy. This implies that the nonpregnant women had more iron store and had less iron need than their pregnant counterpart. The higher iron need in pregnancy necessitated its mobilization from its stores. CONCLUSION: This study encourages more critical antenatal care especially at second trimester of pregnancy with much emphasis on dietary supplementation of iron and minerals through adequate consumption of local vegetables and other food diets rich in iron. There was poorest antenatal attendance in the first trimester. Pregnant women in this environment should be encouraged to register early for antenatal care.

Metabolic syndrome in newly diagnosed type 2 diabetes mellitus using NCEP-ATP III, the Nnewi experience.

BACKGROUND AND OBJECTIVES: Type 2 diabetes is becoming epidemic and several studies have shown that diabetes is associated with increased co-morbidities and impaired functional health in the general adult population. Type 2 diabetes is one of the co-morbidities associated with metabolic syndrome that carries with it increased risk of cardiovascular disease and death. The purpose of this study is therefore to determine the prevalence of metabolic syndrome in newly diagnosed type 2 diabetes mellitus subjects seen at Nnewi South East Nigeria. DESIGN AND SETTING: This is a cross-sectional study in newly diagnosed diabetics attending a private hospital-Hope Specialist Hospital, Nnewi. MATERIALS AND METHODS: One hundred and eighteen (118) newly diagnosed diabetic patients were recruited into the study consisting of those who on routine screening were found to have elevated blood glucose or were symptomatic of the disease and presented for treatment. STATISTICAL ANALYSIS: Statistical analysis was carried out using SPSS version 13. Student's t-test was used for continuous variables, and a χ2 test was used for categorical variables. In the analyses a P- value of <0.05 was considered statistically significant. RESULTS: Of the 118 subjects, 25 were removed from the study because their samples were lost as a result of prolonged power outage leaving 93 subjects consisting of 47 males and 46 females. The mean (SD) and the range of age was 55.27 (12.55) years, 24-84 years; SBP 153.52 (29.83) mmHg,100-230 mmHg; DBP 94.23 (15.42) mmHg, 60-140 mmHg; TC 5.17 (1.4) mmol/L, 2.0-11.12 mmol/L; LDL-C 2.06 (1.55) mmol/L, 0.1-9.4 mmol/L; HDL-C 1.28 (0.48) mmol/L, 0.15-2.8 mmol/L; TG 1.75 (0.85) mmol/L, 0.50-5.0 mmol/L; BMI 30.30 (6.23) kg/m 2 , 17.84-49.12 kg/m 2 ; and WC of the general population mean (SD) 96.86 (7.16) cm, range 84-112 cm; for men 101.40 (3.88) cm, range 85-108 cm and for women 92.22 (6.77) cm, 84-112 cm. Metabolic syndrome was found in 62 (66.7%) subjects of which 26 (41.9%) were males and 36 (58.1%) were females (P < 0.019). The prevalence of different components of metabolic syndrome was as follows: hypertension was found in 75 (80.6%): 37 males and 38 females (P = 0.635), dyslipidemia in 31 (60.8%): 19 males and 12 females (P = 0.572). Obesity was found in 23 (45.1%): 8 males and 15 females (P < 0.014). Of the study subjects 33 had hypertension prior to the diagnosis of diabetes mellitus (DM). Seventeen males had hypertriglyceridemia against 11 females (P = 0.357). Equal number of males and females (11 each) had low HDL--C (-C (P = 0.603). CONCLUSION: The study shows that metabolic syndrome is highly prevalent in newly diagnosed type 2 diabetes patients and the most common risk factor is hypertension.

Immunodiagnosis of bovine trypanosomiasis in Anambra and Imo states, Nigeria, using enzyme-linked immunosorbent assay: zoonotic implications to human health.

BACKGROUND & OBJECTIVES: The prevalence of trypanosomiasis was studied in cattle, being a major source of animal protein in Nigeria, thus, a very likely means of spread of Human African Trypanosomosis (HAT). METHODS: Enzyme-linked immunosorbent assay (ELISA) was used to diagnose bovine trypanosomiasis in 264 samples collected from adult cattle of mixed breeds, age and sex, in Anambra and Imo states, Nigeria. RESULTS: Out of 264 samples analysed, 21 (7.96%) were seropositive for Trypanosoma congolense while 20 (7.58%) were seropositive for T. vivax and 8 (3.03%) were seropositive for T. brucei infections in both the states. INTERPRETATION & CONCLUSION: The predominant species was found to be T. congolense. Mixed infection of three species, T. vivax, T. congolense and T. brucei was found to dominate other mixed infections in both the states. ELISA detected the infection of the three species of trypanosomes in the same group of animals. The usefulness of antigen capture ELISA in the diagnosis of human or animal trypanosomiasis was established, and the possibility of the spread of HAT caused by T. brucei gambiense and T.b. rhodesiense through cattle was expressed.

Some pharmacological properties of Synclisia scabrida II.

The effect of the aqueous extract of S. scabrida on behaviour, and as an analgesic and antiulcer agent were studied. The extracts did not produce significant central nervous system action, or analgesia but had significant antiulcer activity against aspirin induced ulcer. The extract showed anticholinergic and antihistaminergic properties.

Low-dose mercury induces testicular damage protected by zinc in mice.

OBJECTIVES: This investigation was set out to determine whether mercury at a very low dose (4ppm) induces testicular damage on murine testis, and if so whether the toxic effects of mercury could be prevented by zinc. STUDY DESIGN: One of the following solutions was administered in the drinking water of CD-1 male mice: (1) 4ppm HgCl(2); (2) 800ppm ZnCl(2); (3) 4ppm HgCl(2)+800ppm ZnCl(2); or (4) deionised water; for 12 weeks. At the expiration of the treatment period, animals were sacrificed, testes excised and weighed, and epididymal sperm number taken. The testes were processed for histological examination. RESULTS: Both zinc and mercury significantly (p<0.05) decreased the absolute and relative testicular weights, with mercury producing the highest reduction in weight. Mercury reduced significantly (p<0.05) the epididymal sperm number, while zinc and mercury/zinc produced statistically same effect with control on the sperm number. Histological study showed that mercury at the concentration employed produced remarkable degenerative lesions on the testes, as the zinc-treated group showed a normal morphology. Majority of the animals in the mercury/zinc-treated group exhibited complete or partial protection as evidenced by the morphology of the seminiferous tubules. CONCLUSION: Zinc prevents mercury-induced testicular damage in mouse. These findings highlight the risks exposure to inorganic mercury might pose to male reproduction of mice, and suggests possible therapy with zinc. Study in humans is therefore advocated.

Effects of high doses of magnesium in drinking water and voluntary wheel running on magnesium and calcium concentrations in rats.

The effect of high magnesium intake in addition to supplementation and voluntary wheel activity on magnesium and calcium homeostasis was investigated in rats. Thirty-six 5-week-old male Wistar rats were divided into four groups (n = 9). Groups 2 and 4 received five hundred ppm of elemental magnesium as MgCl2 provided in drinking water. After 1 week of acclimatization and 4 weeks of supplement and/or exercise, the animals were fasted and sacrificed. It appears that magnesium supplementation as well as exercise played some significant role in the homeostatic changes of magnesium and calcium. This could be of great significance in better understanding of mineral homeostasis particularly in sports medicine.

Hypoglycaemic shock: normal or abnormal response to injury?

We report a case of hypoglycaemic shock which occurred in a patient 18 h after injury. The patient was involved in a road traffic accident and sustained multiple rib fractures and bruising in the (R) lumbar region. Eleven hours after his last meal he developed sudden weakness, profuse sweating, air hunger, thirst, disorientation and suddenly lapsed into coma 18 h after admission. Administration of 50 ml of 50% dextrose resulted in immediate restoration of consciousness. This case shows that this complication can occur in trauma patients even though the metabolic response to trauma is usually assumed to be hyperglycaemic.

Effect of activated charcoal on rifampicin absorption in man.

The effect of activated charcoal (AC) on rifampicin excretion was investigated in six healthy volunteers. On three occasions, at weekly intervals, each subject received a 600 mg rifampicin with 350 ml of water; b+c one and two weeks later, 600 mg of rifampicin plus 7.5 and 15 g AC, respectively, in 350 ml of water as a charcoal slurry. Urinary levels of rifampicin were measured form 1-36 hr after ingestion. Treatment with AC led to 1.2 per cent urinary recovery of rifampicin; decreased excretion rate; and a much lower plateau indicative of reduced absorption.

Carbon black (N220): a possible role in poison management.

The adsorptive capacities of locally produced carbon black (N220) and activated charcoal in the management of poisoning due to some locally used drugs were investigated. Adsorption of metronidazole and tinidazole to carbon black (CB) and activated charcoal (AC) was completed within 30 min of incubation and was found to be dependent on the quantities used CB-B50 for metronidazole and tinidazole were 132.7 and 112.2 mg while AC-B50 for the two drugs were 254.7 and 125.9 mg, respectively. In the in-vivo study, 20 mg/kg of chloroquine given orally, then followed with 1.6 g/kg of either CB or AC by the same route, gave optimal protection against death in mice. The mortality rate decreased as the amount of adsorbents increased. We suggest that carbon black may be beneficial when properly handled and adequately administered during overdosage or accidental poisoning by metronidazole, tinidazole, or chloroquine.

Liver and renal function tests in artisans occupationally exposed to lead in mechanic village in Nnewi, Nigeria.

Additives in petroleum solvents have been reported to have adverse health implications. An evaluation study on some toxicological effects of occupational exposure to petroleum products (especially petrol which contains tetraethyl lead) amongst twenty five occupationally exposed artisans and twenty five graduate students of College of Health Sciences, Nnamdi Azikiwe University, Nnewi, Nigeria as controls, was carried out using the following biochemical markers: electrolytes, urea, uric acid, inorganic phosphorus, creatinine, zinc and blood lead, as well as the activities of alanine and aspartate aminotransferases, and alkaline phosphatase. The results showed that occupational exposure of human subjects to lead in petrol increases the concentrations of uric acid (357 +/- 123micro mol/L) and phosphate (1.5 +/- 0.5m mol/L) in exposed subjects compared with unexposed subjects (uric acid 228 +/- 105micro mol/L, phosphate 1.2 +/- 0.41m mol/L; p < 0.01 in both cases). Significantly lower activities were observed for alkaline phosphatase (66 +/- 18.9 iu/L). The activities of alanine aminotransferase (11.4 +/- 4.0 iu/L) and aspartate aminotransferase (15.8 +/- 4.4 iu/L) in occupationally exposed artisans were higher compared with unexposed subjects (alkaline phosphatase = 78 +/- 22.4 iu/L alanine aminotranferase = 6.8 +/- 2.7 iu/L, aspartate aminotranferase = 9.6 +/- 3.5i u+/-L; p < 0.01 in all cases). Occupational exposure of human subjects to lead significantly increased blood lead (59.6 +/- 15.9 microg/dL) and decreased plasma zinc (71.3 +/- 14.4 microg/L) in exposed compared with unexposed subjects (blood lead = 35 +/- 7 microg/dL, zinc = 108.4 +/- 16.9 microg/dL; p < 0.01). The results indicate that occupational exposure to lead in petrol may compromise liver and renal function.

Observation on the value of erythrocyte membrane fatty acids in the discrimination of hypothyroidism.

A computer-based 3-dimensional representation of two erythrocyte membrane saturated fatty acids (hexadecanoic acid, 16:0 and octadecanoic acid, 18:0), serum cholesterol and thyroid stimulating hormone (TSH) was performed in 26 hypothyroid patients and in 10 control subjects. The result indicates that a three-dimensional representation of grouped data discriminates normal people from individuals with hypothyroidism in a small population of highly selected cases.

Cholesterol concentrations in diabetic patients in Nnewi, Nigeria.

Twenty out-patient and twenty in-patient adult Nigerian type II diabetics and twenty healthy subjects matched for sex, age and weight, were studied at Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria. Mean total cholesterol and fasting blood glucose concentrations were higher in the diabetics. The out-patients had significantly higher total cholesterol and fasting blood glucose values than their in-patient counterparts. The possible cardiovascular risk of the raised cholesterol level in the diabetics was discussed. We recommend that for effective management of diabetic patients, periodic measurement of cholesterol level is necessary. An integrated enlightenment programme to acquaint the out-patients with the health benefits of dietary and drug compliance and occasional hospitalisation for better monitoring would be desirable.

Serum cholesterol level in a typical suburban commercial community in Nigeria.

Forty-one apparently healthy businessmen and -women and an equal number of government workers matched for age and sex underwent serum cholesterol determinations. The mean serum cholesterol levels of businessmen and -women were significantly higher than those of their government worker counterparts (p < 0.001). The marked increase in the serum cholesterol of the business subjects was attributed to their overindulgence and/or eating habits and lack of physical activity. The cardiovascular risk implications of the high cholesterol value and other risk co-factors such as obesity and alcoholism observed among the business subjects are highlighted. We advise that for communities similar to the one described here, public enlightenment programmes about the health benefits of periodic medical assessment and recreational physical activities are necessary. A further comprehensive study of lipid, lipoprotein and other risk factors in these subjects should be encouraged.

Prevalence of asymptomatic malaria parasitaemia amongst pregnant women.

Two hundred and forty-six apparently healthy pregnant women aged 19-40 years, without symptoms were recruited (147 recruited during the dry season and 99 recruited during the rainy season) for the present study. Blood examinations for malaria parasites, Plasmodium falciparum specific-IgG concentration and serological reactivity with P. falciparum-histidine rich protein-2 (HRP-2) antigens were conducted on all the pregnant women during the dry and rainy seasons of the year. During the dry season, 109 (74%) of the recruited pregnant women without symptoms had P. falciparum parasitaemia, while 79 (80%) of the recruited pregnant women without symptoms had P. falciparum parasitaemia during the rainy season. However, the P. falciparum malaria parasites density was significantly raised during the dry season compared with that of in the rainy season (p < 0.05). Serological analysis with P. falciparum histidine rich protein-2 antigen (HRP-2) showed 108 (73%) and 71 (77%) of the pregnant women without symptoms as seropositive during the dry and rainy seasons respectively. The P. falciparum specific-IgG concentration was similar during both seasons in the HRP-2 seropositive pregnant women without symptoms (p > 0.05). The results showed no seasonal tide in the incidences of asymptomatic P. falciparum parasitaemia; however, the significantly raised parasitaemia during the dry season may suggest possible increased parasites tolerance. The P. falciparum specific-IgG concentration during both seasons may not be the primary effector mechanism offering tolerance in asymptomatic parasitaemia in pregnant women.