Horizontal and Vertical Distribution of Heavy Metals in Farm Produce and Livestock around Lead-Contaminated Goldmine in Dareta and Abare, Zamfara State, Northern Nigeria.

Background. Hitherto studies in response to the June 2010 lead poisoning, Zamfara State, Nigeria, have focused on clinical interventions without information on livestock and other metals. Objective. This study has investigated the distribution of heavy metals in farm produce and livestock around lead-contaminated goldmine in Dareta and Abare, Zamfara State, Nigeria. Methods. Vegetables, soil, water, blood, and different meat samples were harvested from goat, sheep, cattle, and chicken from Dareta, Abare, and Gusau communities. The samples were digested with 10 mL of a mix of nitric and perchloric acids; the mixture was then heated to dryness. Lead, cadmium, zinc, chromium, copper, magnesium, and nickel were analysed using flame Atomic Absorption Spectrophotometer. The daily intake, bioaccumulation factor, and target hazard quotient (THQ) were calculated. Results. Chicken bone-muscles from Dareta had the highest concentrations of lead, zinc, and nickel (28.2750, 16.1650, and 4.2700 mg/kg, resp.), while chicken brain had the highest levels of cadmium, magnesium (0.3800 and 67.5400 mg/kg), and chromium (6.1650 mg/kg, kidney tissue inclusive). Conclusion. In addition to lead, cadmium may also be of concern in the contaminated mining communities of Zamfara State, Nigeria, given the high levels of cadmium in meat and vegetables samples from these areas.

Therapeutic and Safety Evaluation of Combined Aqueous Extracts of Azadirachta indica and Khaya senegalensis in Chickens Experimentally Infected with Eimeria Oocysts.

Coccidiosis is a disease of economic importance in poultry causing morbidity and mortality. Reports show that Azadirachta indica and Khaya senegalensis have been used individually in the treatment of avian coccidiosis. We thus investigated the efficacy and safety of the combined aqueous extracts of these plants for the treatment of experimentally induced coccidiosis in broiler chickens using oocyst count, oxidative stress biomarkers, serum biochemistry, histology, and haematological parameters. The phytochemical screening revealed the presence of tannins, saponins, cardiac glycosides, and steroids in both extracts. In addition, alkaloids and flavonoids were present in Azadirachta indica. There was significant (p < 0.05) dose dependent decrease in oocyst count across the treatment groups with 400 mg/kg of the combined extract being the most efficacious dose. Immunomodulatory and erythropoietic activity was observed. There were decreased intestinal lesions and enhanced antioxidant activity across the treatment groups compared to the negative control. Administration of the combined extract did not cause damage to the liver as ALT, AST, and ALP levels were significantly reduced in the uninfected chickens treated with the extracts compared to control suggesting safety at the doses used. The combined aqueous extracts of K. senegalensis stem bark and Azadirachta indica leaves were ameliorative in chickens infected with coccidiosis.

Hypoglycaemia in Children Aged 1 Month to 10 Years Admitted to the Children's Emergency Centre of Lagos University Teaching Hospital; Nigeria

Background. Hypoglycaemia occurs in many disease states common in the tropics; and may also complicate treatment of malaria. It may contribute significantly to morbidity and mortality. Objectives. To determine the prevalence of and clinical conditions associated with hypoglycaemia. Methods. A total of 430 patients aged 1 month to 10 years were recruited consecutively from the Children's Emergency Centre of Lagos University Teaching Hospital. Clinical and demographic data were entered into a predesigned study proforma. Blood glucose was determined in the laboratory using the glucose oxidase method. Hypoglycaemia was defined as plasma glucose 2.5 mmol/L. Results. The median age of the study subjects was 24 months; with a range of 1.5 - 120 months. A total of 248 patients (57.6) were 24 months old. The mean (standard deviation) blood glucose of all the study subjects was 5.19 (2.05) mmol/L (median 4.9 mmol/L). Twenty-four patients (5.6) were hypoglycaemic. The predominant disease conditions in which hypoglycaemia occurred were severe malaria; multisystemic infections; marasmus; malignancies and gastroenteritis. Mortality was higher in hypoglycaemic patients than in those without hypoglycaemia (33.3 v. 5.4; p0.01). Conclusion. Hypoglycaemia complicates many common childhood illnesses seen in the emergency room and is associated with significant mortality. Hypoglycaemia should be suspected in severely ill children with severe malaria; multisystemic infections; marasmus; malignancies and gastroenteritis

Diagnostic usefulness of N-terminal pro-brain natriuretic peptide among children with heart failure in a tertiary hospital in Lagos, Nigeria.

BACKGROUND: N-terminal pro-brain natriuretic peptide (NTproBNP) is useful in the diagnosis and management of adult patients with heart failure. OBJECTIVE: The objective of the study was to determine the usefulness of NT-proBNP in diagnosing congestive heart failure (CHF) in children and its correlation with left ventricular ejection fraction (LVEF) and clinical heart failure score. METHODS: Plasma NT-proBNP was measured in 28 children with CHF and age matched controls. Heart failure assessment was done using modified Ross score and all had echocardiography done. RESULTS: Mean plasma NT-proBNP of children with CHF (377.86±1026.49pg/mL) was significantly higher than that of controls (353.61±328.50 pg/mL) (p<0.001). A plasma NT-pro BNP of 951pg/mL was used as the cut off value for heart failure. The sensitivity, specificity, negative and positive predictive values were 57%, 96%, 69% and 94% respectively. NT-pro BNP levels showed a high positive correlation with the modified Ross score (r= 0.502; p<0.001) but low correlation with LVEF (r= -0.137; p>0.3). CONCLUSION: Our findings indicate that measuring NT-pro BNP may be useful as a diagnostic tool in congestive cardiac failure in children. The fact that its levels also correlated positively with modified Ross score thereby objectively determining severity of heart failure suggests that this biomarker may also be useful as an evaluation tool in congestive cardiac failure in children.

Plasma homocysteine level and its relationship to clinical profile in Parkinson's disease patients at the Lagos University Teaching Hospital.

BACKGROUND: Hyperhomocysteinaemia (HHcy) is as a long-term sequelum of levodopa therapy in Parkinson's disease (PD). Information on its frequency and effects in Africans with PD is sparse. OBJECTIVE: To determine the frequency of HHcy and its relationship to clinical features of PD in African patients. METHODS: Using a case-control design, 40 consecutively attending PD patients and 40 age- and gender-matched healthy volunteering controls were studied. Parkinson's disease cases were evaluated for disease and treatment characteristics, using the Unified Parkinson Disease Rating Scale (UPDRS) motor and activities of daily living scores and disease stage (Hoehn and Yahr scale). Fasting total plasma homocysteine (Hcy) was determined in all subjects. Hyperhomocysteinaemia was defined as a Hcy level above the 90th percentile for the controls. RESULTS: Mean Hcy was 13.8 ± 5.4mmol/L in PD and 12.4±3mmol/L in controls (P>0.05). Hyperhomocysteinaemia (Hcy > 16.26umol/L) occurred in nine (22.5%) PD patients (all on levodopa) and 6 (15%) controls (P>0.05). Mean duration of levodopa use was 92 ± 105.3 months in PD with HHcy compared to PD patients with normal Hcy 33.9 ± 33.2 (p < 0.05). Disease severity and disability were similar regardless of Hcy levels. None of current age, disease duration, Hoehn and Yahr stage, UPDRS scores, total levodopa dose and duration was independent predictor of homocysteine level. CONCLUSION: There is increased occurrence of hyper-homocysteinaemia in Nigerian subjects with Parkinson's disease, receiving Levodopa. This hyperhomocysteinaemia is more common with prolonged use but appears to have no relationship with disease severity or disability.

Adenosine deaminase activity in subjects with normal pregnancy, pregnancy induced hypertension and pre-eclampsia.

BACKGROUND: Both pregnancy and adenosine deaminase (ADA) are associated with depressed cellular mediated immunity. There is little information on ADA activity in pregnant Africans. OBJECTIVE: To determine the serum levels of adenosine deaminase (ADA) in normal pregnancy and pregnancy complicated by hypertension in Nigerian women. METHODS: One hundred and twenty-five pregnant women comprising 35 normal non-pregnant women, 35 normal pregnant women, 35 pregnant women with pregnancy induced hypertension and 20 patients with pre-eclampsia were recruited for the study. Serum adenosine deaminase enzyme (ADA) activity was measured by the Giusti and Galanti spectrophotometric method in all study subjects. RESULTS: The mean serum ADA level in the non-pregnant women was higher than that in the normal pregnant women (23.21 +/- 6.3 v 14.69 +/- 3.2, p<0.001). Amongst the pregnant women, mean serum ADA in the hypertensive and pre-eclamptic women was significantly higher than that in the normal pregnant group (p<0.001). CONCLUSION: These findings indicate a probable decrease in cellular immunity in normal pregnancy and an enhanced cell mediated immunity in pre-eclampsia.

Plasma total and ultrafiltrable calcium in normal pregnancy, hypertension in pregnancy and pre-eclampsia.

OBJECTIVE: To measure the ultrafiltrable and total plasma calcium in normal pregnancy and pregnancies complicated with hypertension and pre-eclampsia. PATIENTS AND METHODS: Total and ultrafiltrable calcium concentrations were measured in maternal plasma from non-pregnant (35), normal pregnant (35), Pregnancy induced hypertension (35) and pre-eclamptic (20) women. Plasma total calcium level was measured by the o'cresolphthalein method. Ultrafiltrate of plasma was obtained using the Amicon MPS-1 micro-partition device. RESULTS: There was no significant difference in the plasma total calcium level between the non- pregnant group and the pregnant group (normal, hypertensive and pre-eclamptic). However there was a significant reduction in the ultrafiltrable (protein free and complexed) calcium level in the pregnant group compared to the non-pregnant group (1.15mmol/L +/- 0.23 Vs 1.25mmol/L +/- 0.13) p<0.05. CONCLUSION: Measurement of the ultrafiltrable calcium in addition to total calcium assay may be more useful in assessing calcium status in normal and complicated pregnancies.

Plasma magnesium and calcium levels in children with epilepsy in lagos.

BACKGROUND: Magnesium and calcium have been found to have increasing roles in the patho-physiology of epilepsy. Hypomagnesaemia and hypocalcaemia cause hyper-exitability of neurons and have been associated strongly with seizures in adults and children. OBJECTIVES: To determine if hypomagnesaemia or hypocalcaemia is present in Nigerian children with epilepsy and to determine the relationship between serum magnesium and calcium levels and frequency and control of epilepsy. DESIGN: A prospective case control study at the Lagos University Teaching Hospital. PATIENTS AND METHODS: 45 children with epilepsy and 45 controls were recruited from the paediatric neurology unit of the Lagos University Teaching Hospital. Serum magnesium and calcium were measured by spectrophotometric methods. RESULTS: Serum magnesium and calcium was significantly lower in the patients compared to the controls; Magnesium - 0.98 (0.0005) Vs 1.2 (0.04) mmol/L, p< 0.0001 and Calcium - 2.29 (0.04) Vs 2.3 (0.02) mmol/L, p<0.05 respectively. No significant differences were noted in the plasma phosphorus and albumin concentrations. CONCLUSION: Magnesium and calcium levels are lower in the epileptic children compared to the controls during the seizure-free periods. More studies are needed to evaluate these electrolytes during seizures and the effect of the different anticonvulsant drugs on these electrolytes.

Serum magnesium, phosphate and calcium in Nigerian children with sickle cell disease.

BACKGROUND: Biochemical abnormalities have been associated with sickle cell disease. Studies on phosphorus and magnesium in sickle cell disease have been conflicting. There is paucity of information on the role of these ions in the pathogenesis and management of sickle cell disease. This study was set out to determine the serum levels of magnesium, phosphorus and calcium in Nigerian children with sickle cell disease. STUDY DESIGN: A case-control study carried out on children with HbSS genotype (cases) and age-matched controls with HbAA. Serum magnesium, calcium, phosphorus and albumin were measured using colorimetric methods. RESULTS: Eighty-six subjects and forty-five controls were studied. The mean serum magnesium was 0.99mmol/L (0.02) and 0.98mmol/L (0.02) in the cases and controls respectively. The difference was not significant. Mean serum calcium was significantly lower in the cases [2.1mmol/L (0.3)] compared with the controls [2.3mmol/ L (0.15)]; p<0.01. Serum phosphorus was significantly higher in the cases than in the controls [2.2mmol/L (0.7) versus (1.5mmol/L (0.6); p<0.001]. There was no statistical difference in the albumin binding of calcium in both groups. A positive correlation existed between serum phosphorus and magnesium and also between serum calcium and magnesium in the cases group but no correlation between these parameters and age was found. CONCLUSION: Children with sickle cell anaemia in this study had normo-magnesaemia, hyperphosphataemia and hypocalcaemia. Further studies on changes in intracellular concentrations of these ions in children with sickle cell disease are required. Such findings could be useful in designing better management in individuals with this abnormality.

Fractional excretion of magnesium of chronic renal failure patients in Lagos, Nigeria.

The objective of this study was to explore the usefulness of the fractional excretion of magnesium (FEMg2+) in Nigerian chronic renal failure patients (mild to moderate) in determining the severity of renal insufficiency. Plasma and twenty-four hour urine samples were analysed for magnesium and creatinine in thirty-five chronic renal failure patients and twenty-five healthy controls. The mean fractional excretion of magnesium (FEMg2+) was 15.3%(13.6) in the patients and 6.1%(2.3) in the controls and this correlated negatively with the creatinine clearance in both groups (r = -0.343, p < 0.05) in patients and (r = -0.665, p < 0.001) in controls. There was a positive correlation between plasma creatinine and fractional excretion of magnesium in the patients (r = 0.463, p < 0.05) and controls (0.455, p < 0.05). FEMg2+ may therefore be a more sensitive indicator of renal insufficiency and may also be a better indicator of the progression of renal failure.

Plasma magnesium in adult asthmatics at the Lagos University Teaching Hospital, Nigeria.

OBJECTIVE: To determine the plasma magnesium levels in adult asthmatics. DESIGN: Case control study. SETTING: Lagos University Teaching Hospital, Lagos, Nigeria. SUBJECTS: Forty stable asthmatics and thirty five apparently healthy controls. METHODS: Detailed history including drug history was obtained from patients and controls. Fasting venous blood was collected into heparinized tubes from both patients and controls. Plasma magnesium, albumin, calcium and phosphorus were measured using spectrophotometric end point methods. RESULTS: Mean (SD) plasma magnesium concentration of 0.93(0.24) mmol/L in the asthmatics was significantly lower compared to the controls which was 1.15(0.28) mmol/L, p<0.001. There was no significant difference in the plasma albumin, calcium and phosphorus levels between the patients and controls. Plasma magnesium levels correlated with the plasma albumin level (r=0.62) but did not correlate with the duration of disease, peak flow rate and age of patients. There was no gender difference in plasma magnesium levels in the asthmatics. CONCLUSION: Adult Nigerian asthmatics have lower plasma magnesium concentrations compared to healthy controls. This may be of use in future therapeutic management of asthma. A large scale multi-centre study needs to be carried out since this study was done in one hospital.

Laboratory assessment of three glucometers.

The study was designed to assess the technical performance of three common glucometers (Glucometer Elite, Accutrend Alpha, One Touch Basic) marketed in Nigeria. This is with a view to assessing their suitability for use in this environment and to provide an informed opinion on the selection option. Venous blood, capillary blood, serum and plasma were assayed during the study. Precision, accuracy, linearity and effect of haemolysis and haematocrit were carried out on each glucometer. Simultaneous analysis using the laboratory reference method was also carried out where necessary. Intra-assay precision was between 1.4% (Glucometer Elite)-11% (One Touch Basic) while the interassay precision was best for the Accutrend Alpha with a CV of 1.9%. All three glucometers correlated excellently with laboratory values and the %deviation from laboratory values was 0.2-10.5%. The Glucometer Elite was the most portable and used the least volume of blood (5 ul). One Touch Basic Glucometer was the least affected by haemolysis. Haematocrit values less than 50% did not have any effect on the three glucometer readings. The technical performance of these three glucometers were found to be acceptable and are recommended for use by diabetic patients, emergency and intensive care units and antenatal clinics, subject to periodic assessment and calibration.

Plasma magnesium in adult Nigerian patients with epilepsy.

UNLABELLED: The objective of this study was to determine the relationship between plasma magnesium levels and epilepsy. The study was carried out at the Lagos University Teaching Hospital. Plasma magnesium was estimated using the calmigite dye colorimetric method in 45 adults with epilepsy and 35 healthy controls. Plasma concentrations of calcium, phosphorus and albumin were also estimated. The mean plasma magnesium in the patients was 0.98 mm0l/L (0.05) while that in the controls was 1.15 mmol/L (0.28). The mean plasma magnesium in the epileptics was significantly lower than that obtained in the controls (p < 0.001). Age of onset of seizures, seizure frequency and duration of treatment did not influence the plasma magnesium levels. Low plasma magnesium is associated with epilepsy, further studies may determine the influence of anti-epileptic drug therapy on plasma magnesium levels. KEYWORDS: magnesium, seizures, Nigeria.

The usefulness of serum albumin and urinary creatinine as biochemical indices for monitoring the nutritional status of Nigerians with pulmonary tuberculosis.

The objective is to evaluate the relative roles of urinary creatinine and serum albumin as biochemical markers for monitoring the nutritional status of pulmonary tuberculosis patients during treatment. Thirty-one newly diagnosed pulmonary tuberculosis patients were placed on six months short course regimen. Their weight, body mass index, serum albumin and 24-hour urinary creatinine excretion were determined before treatment, at the end of the 1st, 2nd, 4th and 6th month of treatment. Subjecting the mean values of the weight, BMI and Urinary Creatinine excretion and serum albumin to Friedman test showed significant changes for all the four indices. Further analysis with paired student t-test of the pre-treatment values with end of 6th month values confirmed significant changes in the mean values of weight, BMI and serum albumin. Of these three indices serum albumin with chi-square value of 103.515 demonstrated the most significant changes, while the minimal change observed in urinary creatinine excretion could not be confirmed with paired t-test. We recommend serum albumin (as a more sensitive index) for monitoring the nutrition of patient with pulmonary tuberculosis.

The lactate dehydrogenases in malignant and non-malignant diseases.

The objective of this paper was to determine different patterns of Lactate Dehydrogenase(LD) isoenzymes in serum, pleural effusions and ascitic fluid collections and their usefulness in the differential diagnosis of malignant and non-malignant diseases. It was a case control study carried out at the Lagos University Teaching Hospital. Forty- six patients with pleural or ascitic fluid collection (male and female, age range between 18 and 65 years) made up of Twenty-two patients with malignant diseases and twenty-four with non- malignant diseases were recruited. Control group comprised 50 apparently healthy subjects of both sexes with age ranging between 18 and 65 years. Serum, pleural and ascitic fluid collections were assayed for total lactate dehydrogenase(LD) and it s isoenzymes. Total LD was estimated using the pyruvate to lactate reaction. LD isoenzyme analysis was estimated by cellulose acetate electrophoresis and stained with formazan. The mean total serum LD activity in the disease groups (malignant and non-malignant) was significantly higher than the mean total serum LD activity in the control group. The pleural fluid LD was highest in patients with empyema thoracis. Five isoenzymes of LD (LD1 - LD5) were present in both control and patient sera. The serum LD1 and LD2 isoenzymes were predominant in the controls. The serum LD4 and LD5 isoenzymes were predominant in the disease groups (malignant and non-malignant). LD4 and LD5 were the predominant isoenzymes in both pleural and ascitic fluids obtained in malignant and non-malignant diseases. Serum LD4 was significantly higher than serum LD5 in non-malignant disease while serum LD5 was significantly higher than serum LD4 in malignant disease. The types of malignancies could not be differentiated by serum and effusion fluid LD isoenzyme pattern. Pleural fluid total LD estimation is useful in monitoring patients on chest tubes and may be used to determine when to insert them. Serum LD4 and LD5 differentiates malignant from non-malignant disease but the effusion LD isoenzyme pattern does not.

Hypothalamic neuropeptide Y mRNA in pregnant, lactating and suckling rats.

Blood glucose, plasma insulin and luteinizing hormone levels were studied in pregnant wistra rats and those in early and late stages of lactation. NPY mRNA was also measured in whole hypothalamic tissue of these rats which were either fed ad libitum or food deprived to 80% of the relative controls. When fed ad libitum, hypothalamic NPY mRNA was not significantly elevated in the pregnant rats (111 +/- 2.1%). By the 5th and 4th days of lactation the mRNA had increased progressively (141 +/- 4.7% of control, p<0.01; 186 +/- 9%, p<0.001) respectively. Blood glucose levels were unchanged in pregnancy and lactation, however, insulin levels dropped significantly by the ]4th day of lactation (control 322.3 +/- 3.2; lactating 298.6 +/- 4.8 pmol/l; p<0.05). Luteinizing hormone was significantly reduced in the lactating rats (control 2.2 +/- 0.21, lactating 0.81 +/- 0.2 ng/ml;p<0.05). In food restriction, NPY mRNA was increased moderately in the non-pregnant state and enormously in late lactation (non-pregnant 157 +/- 21%, lactating 333 +/- 35%, p<0.001). In a lactation, blood glucose was unchanged while plasma insulin and LH were reduced to 20% and 50% of controls respectively (insulin: control 110.3 +/- 2.0; lactating 18.3 pmol/l; LH. control 1.3 +/- 0.1; lactating 0.59 +/- 0.4 ng/ml p<0.01). Orexigenic effect of hypothalamic NPY is possibly responsible for the hyperphagia in lactating. Food restriction and lactation had additive lowering effect on plasma insulin but an additive increase on hypothalamic NPYmRNA. NPY message may be partially responsible for the anovulatory effect of lactation.