Evaluation of prostate-specific antigen and total serum acid phosphatase in prostatic carcinoma

Background: The importance of prostatic carcinoma and its detection has increased manifold over the last few decades. Total serum acid phosphatase (ACP) was the world’s first emerged clinically useful tumor marker in the 1940s and 1950s in patients with prostatic diseases. With the introduction of the prostatic specific antigen (PSA) test in the 1980s, which performed significantly better in screening and treatment programs bringing disfavor to the advent of ACP. Aims and Objectives: To determine serum PSA and total serum ACP in patients with prostatic cancer and benign prostatic diseases, followed by evaluation of these tumor markers. Materials and Methods: This study was conducted on 30 patients with histologically proven cases of prostatic carcinoma and compared against 30 patients as control with benign prostatic pathology, residing in Punjab who were admitted and treated with symptoms complex of prostatism or retention urine or other urinary complaints as the primary symptoms. PSA and ACP in serum were determined using ELISA test kit and King and Kind method, respectively. Results: The mean level of serum PSA was 81.19 ± 49.02 for cancer prostate and 4.975 for benign prostatic diseases, while the mean level of serum ACP was 5.22 ± 1.70 and 2.52 ± 2.27, respectively, for the cancer prostate and benign prostatic diseases showing statistically difference between study and control groups was highly significant as P < 0.0001. Conclusion: Statistical analysis and results of the present study indicated that although serum ACP has better specificity to PSA, yet later is a very sensitive tumor marker in prostate diseases for screening, diagnosis, and post-treatment follow-up.

Prevalence of hyperemesis gravidarum and associated risk factors among pregnant women in a tertiary health facility in Northeast, Nigeria

Background: One of the commonest symptoms observed in pregnant women before the 20th week of gestation is nausea and vomiting, an exaggeration of these symptoms hyperemesis gravidarum (HEG) could result in maternal and fetal catastrophes and even death. The objective of this study was to determine the prevalence and associated risk factors for hyperemesis gravidarum among pregnant women at booking.Methods: A prospective institutional based study design was done among 452 pregnant women seen at booking in a tertiary hospital in Northeast Nigeria from the 1st February 2019 to 30th June 2019. Data was summarized using descriptive statistics. OR was used to measure significant risk.Results: The observed prevalence of hyperemesis gravidarum among pregnant women in the study is 44.9%. The Majority (81.4%) of these women were between the age range of 21 and 35 years. Mean age of 27 years. Multiparity (33.4%), previous (44.9%) and family history of HEG (31.6%) were identified as important risk factors for developing HEG. Grand multiparity (11.5%) and gestational age less than 13 weeks (6.64%) were however less likely observed to be risks for HEG.Conclusions: HEG is a common problem in pregnancy with almost half of the number of pregnant women at booking affected. Multiparity and past history of HEG are pointers to developing the condition and it should be looked out for among at risk group of pregnant women, so that early intervention can be instituted to avoid any possible adverse outcome.

Gastrointestinal symptoms in pregnancy among antenatal clinic attendees in Abubakar Tafawa Balewa University Teaching Hospital Bauchi, Northeast Nigeria

Background: Pregnant women are at increasing risk of GI symptoms such as nausea, vomiting and heartburns, most of these symptoms are as a result of the hormonal and physical changes associated with pregnancy. This study aimed to determine prevalence of gastrointestinal symptoms (GI) among pregnant women attending booking clinic at a Northeastern Nigerian Teaching Hospital.Methods: The study was a cross-sectional, questionnaire-based survey of four hundred and fifty-two pregnant women booking for antenatal care. Their sociodemographic variables as well as the presence or absence of gastrointestinal symptoms in index pregnancy were obtained at by the use of researcher-administered questionnaire. Data were analyzed and presented as frequencies and percentages. A 5% significance level (p <0.05) to test associations.Results: Two fifty-five women had heart burns (56.4%) while 235 (52.0%) had nausea in pregnancy, these were observed to be the most prevalent GI symptoms among the women. Diarrhea and hemorrhoids were the uncommon GI symptoms in the study population constituting 406 (89.5%), and 360 (79.6%) respectively. Easy fullness was noted in 39.8% of the women while vomiting was in 41.8% and constipation in 29% of the respondents. A significant association was observed (p value <0.05) between parity and development of anorexia and hemorrhoids in pregnancy (p values of 0.049 and 0.051 respectively) but not for the other symptoms.Conclusions: GI symptoms are common in pregnancy, the most prevalent symptoms are that of heart burns and nausea, while diarrhea is relatively uncommon.

Detection of mutations in mtrR gene in quinolone resistant strains of N.gonorrhoeae isolated from India.

Background and Objectives: Emergence of multi‑drug resistant Neisseria gonorrhoeae resulting from new genetic mutation is a serious threat in controlling gonorrhea. This study was undertaken to identify and characterise mutations in the mtrR genes in N.gonorrhoeae isolates resistant to six different antibiotics in the quinolone group. Materials and Methods: The Minimum inhibitory concentrations (MIC) of five quinolones for 64 N.gonorrhoeae isolates isolated during Jan 2007–Jun 2009 were determined by E‑test method. Mutations in MtrR loci were examined by deoxyribonucleic acid (DNA) sequencing. Results: The proportion of N.gonorrhoeae strains resistant to anti‑microbials was 98.4% for norfloxacin and ofloxacin, 96.8% for enoxacin and ciprofloxacin, 95.3% for lomefloxacin. Thirty‑one (48.4%) strains showed mutation (single/multiple) in mtrR gene. Ten different mutations were observed and Gly‑45 → Asp, Tyr‑105 → His being the most common observed mutation. Conclusion: This is the first report from India on quinolone resistance mutations in MtrRCDE efflux system in N.gonorrhoeae. In conclusion, the high level of resistance to quinolone and single or multiple mutations in mtrR gene could limit the drug choices for gonorrhoea.

An analysis of underlying factors for seasonal variation in gonorrhoea in India: A 6-year statistical assessment.

Purpose: A statistical assessment of a disease is often necessary before resources can be allocated to any control programme. No literature on seasonal trends of gonorrhoea is available from India. Objectives: The objectives were (1) to determine, if any, seasonal trends were present in India (2) to describe factors contributing to seasonality of gonorrhoea (3) to formulate approaches for gonorrhoea control at the national level. Materials and Methods: Seasonal indices for gonorrhoea were calculated quarterly in terms of a seasonal index between 2005 and 2010. Ratio-to-moving average method was used to determine the seasonal variation. The original data values in the time-series were expressed as percentages of moving averages. Results were also analyzed by second statistical method i.e. seasonal subseries plot. Results: The seasonally adjusted average for culture-positive gonorrhoea cases was highest in the second quarter (128.61%) followed by third quarter (108.48%) while a trough was observed in the first (96.05%) and last quarter (64.85%). The second quarter peak was representative of summer vacations in schools and colleges. Moreover, April is the harvesting month followed by celebrations and social gatherings. Both these factors are associated with increased sexual activity and partner change. A trough in first and last quarter was indicative of festival season and winter leading to less patients reporting to the hospital. Conclusion: The findings highlight the immediate need to strengthen sexual health education among young people in schools and colleges and education on risk-reduction practices especially at crucial points in the calendar year for effective gonorrhoea control.

Assessment of reactivity of three treponemal tests in non-treponemal non-reactive cases from sexually transmitted diseases clinic, antenatal clinic, integrated counselling and testing centre, other different outdoor patient departments/indoor patients of a tertiary care centre and peripheral health clinic attendees.

In India, many state reference centres for sexually transmitted infections perform only a single screening assay for syphilis diagnosis. In this study, Treponema pallidum haemagglutination (TPHA) was performed on 1115 Venereal Disease Research Laboratory (VDRL)/rapid plasma regain (RPR) non-reactive and 107 reactive sera out of 10,489 tested by VDRL/RPR according to the National AIDS Control Organisation syphilis testing protocol. A total of 47 Specimens reactive in TPHA and non-reactive with VDRL test were subjected to fluorescent treponemal antibody absorption and enzyme-immunoassay. Seroprevalence considering both VDRL and TPHA positivity was highest (4.4%) in sexually transmitted diseases clinic attendees than in other subject groups. Positivity by two treponemal tests in 24 (2.2%) cases non-reactive by VDRL/RPR was representative of the fully treated patients or latent or late syphilis cases. The findings highlight that a suitable treponemal confirmatory test should be performed in all the diagnostic laboratories.

Study of the distribution of Malassezia species in patients with pityriasis versicolor and healthy individuals in Tertiary Care Hospital, Punjab.

Purpose: Pityriasis versicolor (PV) is a chronic superficial fungal disease caused by Malassezia species. Our aim was to identify Malassezia species from PV patients and healthy individuals in Punjab. Materials and Methods: Modified Dixon agar was used as isolation culture medium. Identification was based on morphological observation and biochemical evaluation. The biochemical evaluation consisted of culture onto Sabouraud dextrose agar, catalase reaction, Tween assimilation, Cremophor EL assimilation, splitting of esculin and growth at 38 0 C. Results: Out of 58 microscopically diagnosed cases of PV, growth was obtained from 54 (93.10%) cases. The most frequently isolated species were M. globosa, M. sympodialis and M. furfur which made up 51.79%, 31.42% and 18.51% of the isolated etiological agents respectively. However, the major isolate from the back of healthy individuals was M. sympodialis (47.61%), followed by M.obtusa (19.04%), M. globosa (14.20%), M. furfur (9.52%), M. pachydermatis (4.76%) and M. slooffiae (4.76%). Conclusions: M. globosa in its mycelial phase was the main etiological agent, but as normal flora from the back of healthy subjects, it was found in significantly less number (P = 0.01), suggesting that the higher pathogenicity of M. globosa in terms of enzymatic endowment, might be the cause of its predominance in PV lesions.

Prevalence of intestinal parasitic infections in HIV-infected individuals and their relationship with immune status.

Background and Objectives: Intestinal parasitic infection is a common entity in patients infected with human immunodeficiency virus (HIV). These infections may lead to fatal complications in the immuno suppressed individuals. The aim of the present study was to determine the prevalence of intestinal parasitic infections in HIV sero-positive patients and their relationship with the immune status of individuals. Materials and Method s: Fecal samples from 100 HIV sero-positive and an equal number of HIV sero-negative individuals were collected and examined for enteric parasites by direct microscopy. CD4 counts were carried out in only HIV sero-positive patients. Prevalence of intestinal parasites in patients with CD4 count <200 cells/μl, 200-499 cells/μl, and ≥500 cells/μl in HIV-infected patients were compared. Results: Enteric parasites were detected in 59.3% HIV-infected patients with CD4 count <200 cells/μl as compared with 23.5% in patients with CD4 count >200 cells/μl (P < 0.01). Prevalence of coccidian parasites was significantly (P < 0.01) higher (14%) in HIV sero-positive subjects compared with HIV sero-negative subjects (2%). Isospora belli (25%) was the most common parasite with CD4 count <200 cells/μl, followed by Cryptosporidium parvum (12.5%). Prevalence of intestinal parasitic infections was significantly higher in patients with diarrhea, 73.6% than without diarrhea, 25.9%, (P < 0.05). The mean CD4 count of HIV sero-positive patients presenting with diarrhea was significantly (P < 0.01) lower (181.26 ± 135.14) than without diarrhea (352.02 ± 204.03). Conclusion: This study emphasizes the need for routine screening of parasites especially in patients with lower CD4 count so as to decrease the morbidity by ensuring the early treatment of the cases.

Sero-Epidemiology of Human Immunodeficiency Virus (HIV) in Plateau State; Nigeria

Introduction: Previous sentinel surveys of HIV in Nigeria studied pregnant women attending antenatal care; thereby omitting other important high-risk groups. We therefore investigated the prevalence of HIV/AIDS in low- and high-risk populations in the state of Plateau; Nigeria. Methodology: Blood samples were collected by venepuncture from 5;021 adults aged ?15 years between August and October 2008. At least one major town and one rural community were selected in each Local Government Area (LGA). Samples were initially screened with a rapid HIV testing kit; reactive samples were further tested using Stat Pak. Discordant samples were confirmed using Genie-II. Results: Of 5;021 subjects screened; 245 (4.88) were seropositive. Local Government prevalence ranged from 0.68 in Bassa to 16.07 in Jos North. On average; LGAs in the Southern Senatorial Zone had higher rates. Most (over 80) positive cases were younger than 40 years. Females had a significantly higher (6.85) prevalence than males (2.72). Age-specific prevalence was higher among females aged 25 to 29 years (2.09). Risk factors identified for acquisition of HIV infection were previous history of STDs (6; 16.28); men having sex with men (2; 11.76); having multiple sexual partners (97; 10.49); intravenous drug use (10; 7.58); sharing of sharp objects (20; 4.82); and history of blood transfusion (21; 3.65). Conclusion: The seemingly higher prevalence recorded in this survey could be attributed to the inclusion of high- and low-risk groups in the general population; unlike previous reports which studied only antenatal care attendees. This survey provides useful baseline information for further studies

The role of a commercial enzyme immuno assay antigen detection system for diagnosis of C. trachomatis in genital swab samples.

In the present pilot study, endocervical and urethral swabs collected from 100 patients attending sexually transmitted disease (STD) clinics and regional centre for STD in two referral hospitals in New Delhi were analyzed by enzyme immune assay (EIA), polymerase chain reaction (PCR) and direct fluorescent antibody (DFA) for detection of C. trachomatis. It was found that EIA could detect a very low number of cases (3/100) as against DFA (11/100) and PCR (9/100). Thus, in spite of the widespread availability, lower cost and ease of performance of the enzyme-linked-immunosorbent serologic assay, the present study highlights the need to employ sophisticated diagnostic tools like DFA and PCR for detection of Chlamydia trachomatis in STD patients.

Is routine antenatal screening for syphilis in Nigeria still justified clinically and economically?

To determine the seroprevalence and cost effectiveness of antenatal syphilis screening at the University of Maiduguri Teaching Hospital [UMTH], Maiduguri, Nigeria. A retrospective chart analysis of venereal disease research laboratory [VDRL] results among pregnant women at the UMTH, Maiduguri, Nigeria, during a 10-year period [from 1st January 1999 to 31st December 2008] was undertaken. A total of 18,712 women registered for antenatal care during the study period. Of these, 18,101 had serological screening for syphilis. Only 12 of the 18,101 screened were seropositive by VDRL, 9 [75%] were confirmed by Treponema pallidum hemagglutination assay [TPHA], giving a seroprevalence rate of 0.05%. Three [25%] were biological false-positive. The peak age-specific incidence of 0.02% was in the 20-24 year-age group. There was zero prevalence in the age groups 15-19 and >40 years. There was no case of congenital syphilis seen. The cost for VDRL testing per patient in UMTH is US$2. The total amount of money spent on VDRL tests over the study period was US$37,424. The seroprevalence rate of syphilis is extremely low in this study. This calls for a review of the policy of routine antenatal serology screening for syphilis in Maiduguri, Nigeria

2-Deoxy-D-glucose induced modulation of DNA damage repair, survival, mutagenesis and recombinogenesis in 8-MOP+UVA treated yeast.

Cellular and genomic effects of post-treatment repair modulation by 2-deoxy-D-glucose (2-DG) and yeast extract were studied in 8-MOP + UVA treated cells of Saccharomyces cerevisiae. The type of lesions and their repair in phosphate buffer glucose (PBG) differed with UVA dose. At low UVA dose (1.4 kJ/m2), lesions were sublethal and mutagenic and did not repair by recombinogensis. The fraction of potentially lethal lesions and lesions repaired by recombinogenesis increased with UVA dose. Cellular repair in PBG was largely error-free and was inhibited by 2-DG. Yeast extract enhanced cellular repair and also recombinogensis; 2-DG in presence of yeast extract promoted error-prone repair. Pulsed-field gel electrophoresed chromosomal DNA bands did not show observable alterations immediately after 8-MOP + UVA treatment. On post-treatment incubation in PBG, the intensity ratio (rho n), of each band altered in a biphasic manner showing decrease first, followed by either increase or no change upto 24 hr depending upon UVA exposure dose. Presence of 2-DG in PBG inhibited decrease in rho n in a concentration dependent manner. Yeast extract reduced the time of first phase of DNA repair. 2-DG and yeast extract together reduced the time of first phase of repair and also inhibited the subsequent increase in rho n, which was observed in the case of yeast extract in PBG. It is proposed that (i) 2-DG in PBG inhibits excision of DNA damage and error-free repair; (ii) yeast extract stimulates the error-prone repair associated with cell cycle and recombinogenesis; (iii) 2-DG in presence of yeast extract allows excision of damage but inhibits build up through recombinogenesis inducing instead, cell cycle associated error-prone repair. A simple schematic model has been proposed to explain these events.

2-DG induced modulation of chromosomal DNA profile, cell survival, mutagenesis and gene conversion in X-irradiated yeast.

Effects of post-irradiation modulation in presence of 2-deoxy-D-glucose and yeast extract, on chromosomal DNA profile, cell survival, reverse mutation (ILV+) and gene conversion (TRP+), were studied in X-irradiated stationary phase yeast cells (diploid strain D7 of Saccharomyces cerevisiae). The damage and repair in chromosomal DNA bands, resolved by using contour clamped homogeneous electric pulsed-field gel electrophoresis (PFGE) technique, was estimated by calculating intensity ratio, rho n (rho n I(n)/I(t); where I(n) is the intensity of nth band in a lane and I(t) is the sum of intensities of all bands and the well in the lane). The data indicate linear correlation between relative compactness (tau) of a chromosome [chromosome size (Kb)/length of synaptonemal complex (microns)] and DNA damage and repair. The chromosome repair kinetics were biphasic, showing initial decrease followed by an increase in rho n. Variations were observed among different chromosomes with respect to DNA damage, repair and post-irradiation repair modulation. 2-DG inhibited both components of chromosomal DNA repair and also repair of potentially lethal damage but enhanced frequencies of mutants. Relatively the effects on revertants were greater in cells irradiated with lower doses (50 Gy) of X-rays and post-irradiation incubation in presence of phosphate buffer having 2-DG (50 mM) and glucose (10 mM). Yeast extract increased frequencies of revertants and convertants thus promoting error-prone DNA repair. Yeast extract in combination with 2-DG showed complex effects on chromosomal DNA repair and enhanced mutagenesis further.

Modulation of repair and fixation of UV-induced damage and its effects on mutagenesis in yeast.

Modulation of repair of UVC-induced damage under different post-irradiation nutritional conditions and its effects on mutagenesis were studied in stationary phase cells of diploid strain D7 of Saccharomyces cerevisiae. Reverse mutation and gene conversion frequencies at ILV and TRP locus were measured in the respective omission media. It was observed that post-irradiation (150 x 10(-3) J/m2) repair in presence of (i) 2-deoxy-D-glucose (2-DG, 10 mM) resulted in decreased surviving fraction (56 +/- 5%) and increase in frequencies of revertants and gene convertants (122 +/- 10% & 132 +/- 14% respectively), (ii) yeast extract enhanced the frequency of revertants to a large extent (204 +/- 18%) and (iii) yeast extract and 2-DG together further increased the frequencies of revertants (304 +/- 15%) and gene convertants (151 +/- 12%); when compared with irradiated controls in phosphate buffer glucose; the observed changes being statistically significant (P < 0.05, Student's t test). These results indicate that (i) 2DG reduces the error-free DNA repair in yeast, (ii) yeast extract increases error-prone DNA repair and thus, in combination with 2-DG, further promotes mutagenesis.

Prevalence of R-plasmids and serotypes in intestinal Escherichia coli.

A total of 150 strains of E. coli isolated from faecal samples of normal population (Group I), hospital personnel (Group II) and hospitalised patients (Group III) were studied for the transfer of R-plasmids. Auto-transferable R-plasmids were observed in 72.0, 82.0 and 80.0 per cent of groups I, II and III respectively. 77.0 per cent strains were typable. 04 was the most common serotype found in groups I and II, 0134 in group III.