Plasma Levels of a Product of Free Radical Injury and Antioxidant Status of Patients with Different Grades of Plasmodium Falciparum Infection.

BACKGROUND: Plasmodium falciparum infection, like any other clinical condition, is prone to generating free radicals. This can worsen patients' clinical presentations. Antioxidants do help in ameliorating these free radical effects. These antioxidants, especially vitamins, are sometimes given routinely to patients with Plasmodium falciparum infection of which it can be given according to the severity of this free radical injury. METHODOLOGY: A total number of qualified 245 patients that came for malaria parasite test between March and October, 2020 were recruited into the study. Patients on arrival at the laboratory had their samples collected for malaria parasite test and for the proposed biochemical parameters (MDA, GPx, SOD and TAS). Malaria parasite test was used to categorize the severity of Plasmodium falciparum infection. RESULTS: There were statistically significant differences (p<0.0001) in MDA, GPx, SOD and TAS among patients with negative MP, 1+ and >2+ on blood film for malaria parasite. Patients with >2+ MP had highest levels (2.21±0.40) while patients with negative blood film had lowest levels(0.8194±0.33) of MDA. Patients with >2+ had lowest levels of GPx (2406.41±1272.10), SOD (104.54±30.62) and TAS (1.18±.35) as against patients with negative MP that had highest levels (5229.85±.2957.95)( 206.41±36.70)( 2.40±.53), respectively. CONCLUSION: There was evidence of free radical generation as evidenced with raised plasma malondialdehyde in patients with Plasmodium falciparum infection. This was associated with severity of this infection. There was also corresponding decrease in measured antioxidants (GPx, SOD and TAS).

CONTEXTE: L'infection à Plasmodium falciparum, comme toute autre affection clinique, est susceptible de générer des radicaux libres. Cela peut aggraver les présentations cliniques des patients. Les antioxydants aident à améliorer ces effets des radicaux libres. Ces antioxydants, notamment des vitamines, sont parfois administrés en routine aux patients infectés par Plasmodium falciparum dont il peut être administré en fonction de la gravité de cette lésion radicalaire. MÉTHODOLOGIE: Un nombre total de 245 patients qualifiés qui sont venus pour un test de dépistage du paludisme entre mars et octobre 2020 ont été recrutés dans l'étude. Les patients à leur arrivée au laboratoire ont eu leurs échantillons collectés pour le test du parasite du paludisme et pour les paramètres biochimiques proposés (MDA, GPx, SOD et TAS). Le test du parasite du paludisme a été utilisé pour catégoriser la gravité de l'infection à Plasmodium falciparum. RÉSULTATS: Il y avait des différences statistiquement significatives (p<0,0001) dans le MDA, GPx, SOD et TAS parmi les patients avec MP négatif, 1+ et >2+ sur frottis sanguin pour le parasite du paludisme. Les patients avec >2+ MP avaient les niveaux les plus élevés (2,21 ± 0,40) tandis que les patients avec un frottis sanguin négatif avaient les niveaux les plus bas (0,8194 ± 0,33) de MDA. Les patients avec >2+ avaient les niveaux les plus bas de GPx (2406,41 ± 1272,10), SOD (104,54 ± 30,62) et TAS (1,18 ± 0,35) par rapport aux patients avec MP négatif qui avaient les niveaux les plus bas (5229,85 ± 0,2957,95) (206,41 ± 36,70 )( 2,40 ± 0,53), respectivement. CONCLUSION: Il y avait des preuves de génération de radicaux libres comme en témoigne l'augmentation du malondialdéhyde plasmatique chez les patients infectés par Plasmodium falciparum. Ceci était associé à la gravité de cette infection. Il y avait également une diminution correspondante des antioxydants mesurés (GPx, SOD et TAS). Mots-clés: Radicaux libres, stress oxydatif, antioxydants, Plasmodium falciparum, paludisme.

Plasma Lipids and CD4 Count of Newly Diagnosed HIV Sero-Positive Patients at Ekiti State University Teaching Hospital, Ado Ekiti, Nigeria.

INTRODUCTION: The pathogenesis of HIV has been linked to the affectation of a number of CD4 positive T cells upon which the severity of the disease is graded. Patients who present with complications such as disorders of lipid metabolism may be missed if appropriate laboratory investigations are not done. Dyslipidemia is a common phenomenon in patients with HIV infection. Early consideration of this may prevent further associated complications. OBJECTIVES: To determine the baseline parameters in plasma lipid profile in HIV positive patients and how they are affected by the severity of infection as measured by CD4 count. METHODS: This is a retrospective study of which records of patients that attended Anti-Retroviral Therapy (ART) clinic of Ekiti State University Teaching Hospital (EKSUTH), Ado Ekiti, Ekiti State Nigeria were looked into. All patients who attended our treatment sites for HIV/AIDS Counselling and Testing Program from June 2008 and October 2013 for the first time were reviewed. Records of four hundred and sixty-one (461) patients were found suitable and used for the study. Information about the age. RESULTS: There are statistical significant differences among categories of patients in plasma Triglyceride (TG) mmol/L (p<0.001) and TC/HDL-Chol (p<0.001). The plasma TG (mmol/L) and TC/HDL-Chol are highest in patients with CD4 count <200 cells/µl. All compared categories in plasma TG (mmol/L) are statistically significant (p<0.001) except when CD4 count between 300 and 399 cells/µl and >400 cells/µl (p=1.000) categories were compared. Comparisons of TC/HDL-Chol in different study classifications show significant differences when CD4 count of <200 cells/µl category was compared with CD4 count of 300-399 cells/µl (p=0.021) and >400 cells/µl categories (p<0.001). CONCLUSION: Plasma TG and TC/HDL-Chol were observed to have an association with severity of HIV infection as measured by a corresponding reduction in CD4 count.

Malondialdehyde and antioxidant enzymes in second and third trimesters of pre-eclamptic Nigerian women.

AIM AND OBJECTIVE: To determine changes in malondialdehyde (product of lipid peroxidation) and antioxidant enzymes (Superoxide Dismutase, Glutathione Per-oxidase) levels in pre-eclamptic Nigerian women PATIENTS AND METHODS: A Total of 100 subjects each for pre-eclamptic,apparently normal and non pregnant women were recruited into the study.Venous blood samples were taken from the participants during second and third trimesters of pregnancy and at the point of contact for non pregnant women. Malondialdehyde, glutathione peroxidase and superoxide dismutase were measured accordingly from plasma and haemolysate prepared from whole blood.Variables were analysed using SPSS version 16, taking level of significance to be 0.05 RESULTS: Plasma malondialdehyde in the third trimester (3.13±0.61umol/l) of pre-eclamptic subjects was higher than in the second trimester (3.00±1.21umol/l).Plasma malondialdehyde in the third trimester of normal pregnancy (2.03±0.71umol/l) was also found to be significantly higher than in the second trimester (1.65±0.62umol/ l)(p<0.0001). Glutathione peroxidase in pre-eclamptic subjects was significantly higher in the third trimester (2804.11±1573.00U/L) as compared to the second trimester (2655.00±1751.30U/L), p= 0.0001.Glutathione peroxidase activity in the third trimester of normal pregnancy(3339.50±1733.80U/L) was also found to be higher than in the second trimester(3023.50±1115.90U/L)(p=0.131). Superoxide dismutase activity was significantly lower in the third trimester of pre-eclamptic pregnancy when compared to second trimester (110.40±59.47 Vs 118.01±64.41 U/ ml)(p<0.039) .Similarly,superoxide dismutase activity was significantly lower in the third trimester of normal pregnancy (110.40±59.47U/ml) than in the second trimester(153.01±71.85U/ml)(p<0.0001). CONCLUSION: There was an increased level of lipid peroxidation products,malondialdehyde in subjects with pre-eclampsia. This was more in the third trimester. There was an increased oxidative stress in pre-eclampsia as evidenced also by low serum level of superoxide dismutase in the third trimester.Diet rich in antioxidant enzyme might be beneficial.

Impact of alcohol consumption and cigarette smoke on renal function and select serum elements in female subjects using combined oral contraceptive.

Drugs and life style choices such as alcohol consumption and smoking are capable of independently altering levels of essential trace elements as well as tissue or organ function. The purpose of the study is to determine how differences in degree of exposure to cigarette smoke and alcohol consumption will alter serum magnesium (Mg), Cobalt (Co) and Manganese (Mn) levels in female subjects using combined oral contraceptives. Thirty female subjects who have used combined oral contraceptive for at least 5 years as well as 30 age-matched control women who are using rhythm method as birth control method were recruited from drinking joints/bars by random sampling technique. Serum trace element concentrations were determined using atomic absorption spectrometry and K+, Na+, albumin, globulin, total protein, urea and creatinine were also determined. Data obtained were analyzed using Student't' test, Pearson's correlation coefficient and Multivariate Analysis of Variance (MANOVA). Na+ was significantly higher in combined oral contraceptive users compared with controls (p<0.05), whereas Mg was decreased (p<0.05). Co, Mn, urea, creatinine, total protein, albumin, globulin, K+ were not significantly different in combined oral contraceptive users compared with the controls (p>0.05). MANOVA results revealed that binge drinkers/smokers group recorded a significant lower (p<0.05) magnesium level than the passive smokers/social drinkers group and controls. The results of this study suggest that subjects using combined oral contraceptive, consuming alcohol and exposed to cigarette smoke may be at greater risks of diseases linked with magnesium depletion.

Effects of contraceptives on serum trace elements, calcium and phosphorus levels.

BACKGROUND: Women on different contraceptive methods have been linked with the development of various diseases and possible changes in serum trace elements and vitamins of women on contraceptives have been postulated. Therefore, the relationship between contraceptive use and trace elements needs to be investigated. METHODS: This is a cross-sectional randomized study. After informed consent was obtained, blood samples were collected from a total of 100 women of child-bearing age on different contraceptive methods: 50 on oral contraceptives, 25 on injectables and another 25 on intra-uterine device. Blood samples were also collected from another 50 age-matched non-contraceptive users to serve as control. Serum was analysed using atomic absorption spectrophotometer for zinc, copper manganese, iron, selenium, cadmium, lead and magnesium while colorimetric method was used for phosphorus and calcium. Body mass index (BMI) was calculated as weight in kilogram/height in meter squared. Results obtained from laboratory analysis and anthropometric measurements were analysed using computer SPSS package. RESULTS: The mean serum zinc, selenium, phosphorus and magnesium levels obtained from subjects on contraceptives were significantly lower (p < 0.01, p < 0.05, p < 0.05 and p < 0.05 respectively) than those of the control group. However, the mean serum copper iron, calcium and cadmium levels were significantly higher (p < 0.05) in participants on contraceptive when compared with the control group. Manganese and lead levels were similar in participants and control groups. Correlation analysis shows significant association between some trace elements and the duration of contraception and body mass index of the participants. CONCLUSION: The study showed and confirmed reduced levels of trace elements in women on contraceptives. The reduction is proportional to the duration of contraceptive use.

Effects of methionine containing paracetamol formulation on serum vitamins and trace elements in male rats.

Methionine is an effective antidote in the treatment of paracetamol-induced toxicity but at large doses it has been reported to induce or aggravate a number of pathological conditions. It also alters plasma levels of many vital elements and molecules. This study was designed to identify if the alteration observed for antioxidant vitamins and minerals especially at sub-toxic and toxic levels of exposure in our earlier study of 24-hour exposure period may warrant trace elements supplementation. This was investigated by carrying out a 48-hour study to test the ability of a living organism to restore homeostasis of these vital molecules and elements. The levels of antioxidant minerals and vitamins were estimated in the serum samples obtained from adult male Wistar rats exposed to paracetamol tablets. At 100 mg\kg BW (body weight) vitamin A, niacin, riboflavin, selenium and manganese were not significantly different from the control group. Moreover at 350 mg\kg, all these indices except zinc were not significantly different in the exposed group compared with controls whereas at 1000 mg\kg level of exposure manganese, selenium and vitamin E were not significantly decreased at the end of 48 hours of exposure but copper, niacin and vitamin A were significantly increased in the exposed group compared with the controls. These results suggest that with time the body may be capable of bringing about restoration of the levels of some of these elements\vitamins. This was more evident at 350 mg\kg level of exposure than a higher dose of 1000 mg\kg level.

Widal agglutination titres in the diagnosis of typhoid fever.

BACKGROUND: Typhoid fever has continued to pose considerable health problems world-wide. This problem is made worse by misdiagnosis through the use of a single pretreatment Widal agglutination test in may developing countries. OBJECTIVE: This is to enable us establish the appropriate titres suitable for a reliable diagnosis of typhoid fever in our environment. METHODS: A total of 300 subjects were recruited into the study comprising 260 apparently healthy individuals aged 12 years and above and 40 patients with typhoid fever confirmed by isolation of S. typhi from blood and/or stool. The Widal slide agglutination test method was first used to screen subjects. Serum samples showing agglutination were then serially diluted with 0.85% saline from 1/40 to 1/1280 and subjected to tube dilution. RESULTS: Thirty-six (13.8%) of the healthy subjects had S. typhi 'O' agglutinin and 48(18.5%) had 'H' agglutinin in their serum while 37(92.5%) of patients with culture-confirmed typhoid fever had 'O' agglutinin and 38(95.0%) had 'H' agglutinin. At a cut-off titre of 'O' agglutinin = 80, the diagnostic sensitivity and specificity were 90% and 87.3%, and for 'H' agglutinin = 80, the sensitivity and specificity are 90% and 88.5% respectively. The predictive value of a positive test at 'O' = 80 is 52.2% and of a negative test is 98.3% while the positive predictive value of 'H' = 80 is 54.6% and negative predictive value is 98.3%. CONCLUSION: Because of the difficulties in isolating S. typhi from blood, stool or other body fluids in developing countries, a diagnostic Widal agglutination titre of 'O' and 'H' agglutinins = 80 will be considered useful in the diagnosis of typhoid fever in our environment.

Clinical laboratory in the biochemical evaluation of hypertension in Nigeria.

Hypertension is a worldwide problem. It is associated with severe complications that are worse in blacks! Effective management of hypertension requires that the pathophysiologic mechanism, underlining the condition be identified. The clinical laboratory can help in this regard by separating primary hypertension cases (high plasma rennin activity and low plasma rennin activity types) from those of secondary and mendelian types of hypertension. However most clinical laboratories in Nigeria do not provide some of the needed specialized tests-plasma renin activity level, urinary coritsol, plasma aldosterone and metanephrines, plasma natriuretic peptide and oral captopril tests, on routine bases. Importantly, clinicians in Nigeria should consider seriously, the role of the clinical laboratory in the management of hypertension, a condition that affects about 20% of the adult population. They should look beyond "basic or routine tests" in the management of patients with hypertension. Specific tests that will assist in the proper diagnoses of the type of hypertension in a patient should be carried out routinely on every case of hypertension. This will assist in justifying the addition of such investigations in laboratory tests repertoire, when laboratory budgets are prepared.

Role of hepatic enzymes in the biochemical assessment of the severity of sickle cell anemia.

BACKGROUND AND OBJECTIVES: Various clinical and hematological indices have been used to assess the severity of Sickle Cell Anemia (SCA), however biochemical indices are lacking. Hepatomegaly has been a frequent finding in SCA and its persistence has been associated with increased disease severity. The association between hepatic enzymes and disease severity in SCA is undefined. This study was therefore designed to look at the association between clinical severity and hepatic enzymes in SCA subjects with persistent hepatomegaly (that is, lasting more than six months) in order to determine a possible role for hepatic enzymes as a biochemical index of severity. MATERIALS AND METHODS: Serum levels of aspartate transaminase (AST), alanine transaminase (ALT), alkaline phosphatase (SAP) and gamma-glutamyl-transferase (GGT) were determined in two groups of SCA subjects and in hemoglobin genotype AA (HbAA) controls. SCA group comprised of 37 subjects with persistent hepatomegaly equal to or greater than 10 cm (below right coastal margin) while the second group comprised another 38 SCA subjects without palpable hepatomegaly. 40 individuals with hemoglobin genotype AA served as control for both groups. Clinical and hematological parameters of severity which included steady state haematocrit, number of transfusions per year, number of crises per year and percentage HbF level were determined and scored in a manner similar to the Glasgow coma scale. Results obtained were analyzed with the aid of statistical package on EPI-INFO version 6.02. RESULTS: There was a significant increase in serum ALT, ALP and GGT levels in SCA with persistent hepatomegaly over those without hepatomegaly (p < 0.05, p < 0.05 and p < 0.01 respectively). All the index scores and the final aggregate severity scores were also significantly higher in SCA subjects with persistent hepatomegaly. Only GGT demonstrated a fairly positive and significant correlation (r = 0.46, P < 0.05) with increased clinical severity among the hepatic enzymes. CONCLUSION: Elevated serum level of GGT in SCA during steady state is suggestive of increased disease severity.

High Risk Coronary Heart Disease, Lipid Fractions and Transferrin Saturation among Hypertensive Nigerians.

BACKGROUND AND OBJECTIVES: Hypertension and hypercholesterolemia are well established independent risk factors of coronary heart disease. Moreover, drug treatment of hypertension also affects lipid metabolism. Recently, body iron status has also been implicated as a risk factor of coronary heart disease. It is not however clear whether hypertension or hypercholesterolaemia directly or indirectly influences body iron status. This study was therefore decided to look at the association between transferrin saturation and hypercholesterolaemia in adult hypertensive Nigerians with high risk Coronary Heart Disease (CHD) lipid fraction. MATERIALS AND METHODS: The study group comprises eighty two adult Nigerians who are known hypertensives with high risk coronary heart disease lipid fraction: that is the ratio of high density lipoprotein cholesterol to total cholesterol (HDL-C/TC) <= 0.13 while the control subjects comprises eighty adult Nigerians who are also known hypertensives with normal HDL-C/TC ratio (>=0.30). RESULTS: The total iron binding capacity is not significantly different between the two groups. Also, serum iron and transferrin saturation were not significantly different in the two groups. Transferrin saturation does not show appreciable correlation with total cholesterol, LDL-cholesterol, HDL-cholesterol and triglyceride levels in any of the two groups. CONCLUSION: The association between transferrin saturation and hypercholesterolaemia in hypertensive is not strong enough to possibly suggest that one influences the other. However, the influence of antihypertensive drugs on lipid metabolism cannot be ruled out in this study because subjects and controls were not selected based on type or class of medication. KEYWORDS: transferrin saturation, high risk CHD lipid fraction, hypertensives.

Risk of nosocomial bacteria transmission: evaluation of cleaning methods of probes used for routine ultrasonography.

BACKGROUND: There exists a small but definite risk of nosocomial infection transmission attributable to ultrasonography probes and coupling gels. OBJECTIVE: Our objective was to ascertain whether the current method of probe disinfection in between patients is adequate to prevent cross infection, and to determine the best and safest method of probe disinfection applicable during routine ultrasonography in our institution. MATERIALS AND METHOD: Forty consecutive patients sent for routine ultrasonography at the Radiology Department of our institution in the month of January 2004 were studied. Each patient had a standardized ultrasound scan of the abdomen, after which swabs were taken from the surface of the unclean probe and after probe disinfection by single and double paper wipe cleaning method. The swabs were cultured on Blood agar to determine the characteristics of the colony forming units (CFU). RESULT: Forty four bacterial isolates were recovered from 37 patients who cultured positive, with MRSA constituting 36.4 %, MRCONS 22.7 %, MSSA 13.6 %, MSCONS 13.6%, Klebsiella spp 9.1% and Proteus mirabilis 4.6%. The average CFU transmitted by the unclean probe was significantly higher (P<0.05) than that transmitted by the probe after single or double paper wipe. Also, the average CFU transmitted following single and double paper wipe, in the inpatients was significantly higher (P<0.05) than in the outpatients. CONCLUSION: Single paper wipe is adequate for outpatients, but for inpatients, especially those with high risk of cross infection, double paper wipe is preferred with probe thoroughly wiped until visibly clean.

Prevalence of some risk factors of coronary heart disease in a rural Nigerian population.

OBJECTIVE: To determine the prevalence of some risk factors of coronary heart disease (CHD) in a rural Nigerian population. DESIGN: Prospective cross-sectional study. SETTING: Three villages around Maiduguri in the north eastern part of Nigeria. SUBJECTS: Five hundred randomly selected subjects, consisting of 278 males and 222 females. INTERVENTION: Anthropometric parameters such as weight, height, body mass index and blood pressure were measured. Also fasting blood concentration of glucose, total cholesterol (Tc) and high density cholesterol (HDL-c) were measured. MAIN OUTCOME MEASURES: The various parameters were compared between males and females. RESULTS: Prevalence of hypercholesterolaemia was zero because no subjects had values greater than 5.2 mmol/1. Overall prevalence of obesity was 2%, with 1.2% in males and 3.2% in females. High blood pressure was observed in 15.2% of the subjects, with it being more among males (19.1%) than females (10.3%). Mean fasting blood glucose was significantly higher (p < 0.01) in females (6.2 mmol/1) than males (4.2 mmol/1). Prevalence of diabetes mellitus was 2.6% and being higher among females. CONCLUSION: Our results demonstrated lower prevalence of obesity and hypertension when compared with earlier results from the southern part of Nigeria, but showed an increase in the prevalence of diabetes mellitus. We therefore recommend that a survey of CHD risk factors should be carried out in different ethnic groups.