Depression, anxiety, and stress and adverse pregnancy outcomes in pregnant women with history of recurrent pregnancy loss in Nigeria.

OBJECTIVE: The primary purpose of this study was to examine whether pregnant women with a history of recurrent pregnancy loss (RPL) are more likely to experience moderate-to-severe depression, anxiety, or stress symptoms than pregnant women without a history of RPL. The secondary purpose was to determine whether women with prior RPL experienced more unfavorable pregnancy outcomes if they had depression, anxiety, or stress. METHODS: A prospective case-control study was conducted that included 47 pregnant women with a history of RPL and 94 pregnant women without prior RPL. Participants 20 weeks of gestation or earlier were included. Both groups completed the Depression, Anxiety, and Stress Scale (DASS-21), and were followed up until delivery to determine the pregnancy outcomes. Multivariate logistic regression was used to compare adverse pregnancy outcomes. RESULT: Among the 47 women with prior RPL, 10 had primary RPL (two or more miscarriages without a successful pregnancy) and 37 secondary RPL (two or more miscarriages with a history of successful pregnancy). RPL was significantly associated with moderate-to-severe levels of depression (P < .001), anxiety (P < .001), and stress (P < .001). Among the RPL group, high stress level was significantly associated with repeat miscarriage (adjusted odds ratio (AOR) = 5.28, 95%CI = 1.25-100.0, P = .03) and preterm labor (AOR = 6.07, 95%CI = 1.61-100.0, P = .04). Depression and anxiety were not associated with adverse pregnancy outcomes. CONCLUSION: Pregnant women with a history of RPL had considerably higher rates of moderate-to-severe depression, anxiety, and stress. Repeat miscarriage and preterm labor were considerably higher among pregnant women with RPL who were experiencing high stress levels at baseline.

Evaluation of serum ferritin levels and blood counts in apparently normal individuals in Nnewi, South-east Nigeria.

INTRODUCTION: Serum ferritin levels as well as blood counts are variously affected in diverse disease conditions, particularly those characterized by inflammation. OBJECTIVE: To evaluate the relationship between serum ferritin levels and blood counts in apparently healthy Nigerian subjects. SUBJECTS AND METHODS: Five (5ml) of venous blood was collected for full blood count, malaria parasite, serum ferritin and C- reactive protein (CRP) estimation from 88 apparently healthy subjects. Those positive for malaria parasite (on blood film examination) or had elevated serum CRP were excluded. Statistical analysis was performed with SPSS version 16; (SPSS Inc., Chicago IL). Associations were tested between parameters using Pearson's correlation, set at a coefficient of p < 0.05. Ethical approval was obtained from the Institutional Review Board and all participants gave informed consent. RESULTS: The median, mean and modal ages of subjects were 23.50 years, 25.25 years and 16.00 years, respectively while the mean packed cell volume (PCV), total white blood cell (TWBC), platelet count and serum ferritin level were 0.37L/L, 7.10 x 10(9)/L, 246.39 x 10(9)/L and 18.35 ng/ml, respectively. Age of subjects varied significantly with serum ferritin, platelet count and TWBC (p > 0.05). The PCV, platelet count and TWBC varied significantly across the different age groups of the study population (p < 0.05), likewise the PCV in males, compared to females (p < 0.05). CONCLUSION: Serum ferritin level in our apparently healthy subjects is lower than previously reported but did not vary significantly with blood counts.

Normal pregnancy and coagulation profile: from the first through the third trimester.

BACKGROUND: Normal pregnancy is a hypercoagulable state; a physiological safety valve aimed at preventing excessive maternal blood loss at delivery. OBJECTIVE: To evaluate the influence of normal pregnancy on blood coagulation and to explore changes in activity from the first through the third trimester. SUBJECT AND METHODS: Sixty (60) apparently healthy pregnant women (20 from each trimester) and 20 healthy non-pregnant age-matched controls were recruited. Each participant had Prothrombin time (PT). Activated partial thromboplastin time (APTT) and platelet count done. Multiple comparisons were made between control values and coagulation profile at different stages of pregnancy using the Bonferroni statistics. Results were expressed as means and standard deviations, p < 0.01 was significant at 95 % CI. Ethical approval for the study was obtained from the Institutional review board. RESULTS: The means of the APTT were significantly lower in the first, second and third trimesters compared with controls (35.59 ± 4.95 seconds, 32.22 ± 5.79 seconds and 29.60 ± 3.66 seconds, respectively, vs. 40.55 ± 5.95 seconds; p = 0.01). Correspondingly, the platelet count was significantly lower in the 3 trimester of pregnancy compared with controls (178.35 ± 41.52 x 10(9)/L vs. 233.86 ± 55.34 x 10(9)/L; p < 0.01) and equally with level in the 2nd trimester (178.35 ± 41.52 x 10(9)/L vs. 232.10 ± 48.67 x 10(9)/L; p < 0.01). CONCLUSION: The APTT and platelet counts are significantly lower in the 3 trimester of normal pregnancy.

Association between serum vitamin D status and uterine leiomyomas: a case-control study.

OBJECTIVE: Uterine leiomyoma is a common gynecological condition that negatively affects women's quality of life. Vitamin D plays an important role in tumor development and progression. However, clinical studies comparing serum vitamin D levels between women with and without uterine leiomyomas are limited and inconclusive. This study aimed to compare serum vitamin D levels in women with and without uterine leiomyomas. METHODS: This hospital-based case-control study included 150 women who visited a gynecological clinic. The cases included 75 women with uterine leiomyoma, whereas the controls included 75 age-and parity-matched participants without uterine leiomyoma. Serum vitamin D levels were measured in each participant and volumes of the uterine leiomyomas were determined using the water displacement method following myomectomy. The statistical significance was inferred at P<0.05. RESULTS: The mean serum vitamin D level was 15.26±4.96 ng/mL and 22.45±6.93 ng/mL for the case and control groups, respectively. The difference was statistically significant (t-value -7.302 and P<0.001). Within the fibroid group, nine (12.0%), 49 (65.33%), and 17 (22.67%) participants had vitamin D deficiency, insufficiency, and sufficiency, respectively; and in the control group, two (2.67%), 24 (45.33%), and 39 (52.0%) participants had vitamin D deficiency, insufficiency, and sufficiency, respectively. There was significant negative correlation between the fibroid volume and the serum vitamin D level (r=-0.591, P<0.001). CONCLUSION: Women with uterine leiomyoma had lower vitamin D levels than women in the control group. Lower vitamin D levels were associated with larger fibroid masses. Therefore, vitamin D supplementation may reduce fibroid growth and development.

Short-term energy drink consumption influences plasma glucose, apolipoprotein B, body mass index and pulse rate among students.

OBJECTIVE: Energy drinks are becoming more popular every year, particularly among young adults such as college students, despite evidence that they have harmful health effects. The effect of energy drink consumption on plasma glucose, serum apolipoproteins, and triglyceride levels in students was investigated. METHODS: In order to test this, we chose two representative types of energy drinks in Nigeria, namely fearless and predator. These energy drinks are brand names of non-alcoholic beverages aimed to provide energy. 30 students, apparently healthy male human subjects aged 18 to 30 years who gave informed consent to the research work were randomly selected and divided into two groups: Group A (fearless energy drink consumers, n=15) and Group B (predator energy drink consumers, n=15).   RESULTS: The results demonstrated significant reductions in pulse rate (86.00±41.32 vs. 78.87±27.72; p=0.03) and BMI (21.41±1.93 vs. 21.7±12.02; p=0.00) as compared to baseline values after one month of "fearless energy drink" consumption. Plasma glucose levels were significantly higher (97.53±10.62 vs. 88.80±11.33; p=0.01) and Apo B levels were significantly lower (21.41±1.93 vs. 21.71±2.02; p=0.00) following two weeks of fearless energy drink consumption than in baseline. In addition, BMI and Apo B levels were significantly lower after two weeks of predator energy drink consumption, but plasma glucose levels were significantly higher after two weeks and one month of predator energy drink consumption, respectively (p<0.05). SBP, DBP, TG and Apo A levels did not differ significantly in both fearless and predator energy drink consumers at baseline and after the study period respectively (p>0.05). CONCLUSION: This study has shown that the consumption of energy drinks causes significant alterations in BMI, pulse rate, plasma glucose and apolipoprotein B levels which may have important clinical consequences for energy drink consumers.

Adiponectin and Disease Severity in Sickle Cell Anemia Patients Attending a Tertiary Health Institution in Nnewi, Southeast Nigeria.

Background: Hemoglobin polymerization in sickle cell anemia (SCA) leads to abnormally rigid and adhesive erythrocytes that obstruct blood vessels, leading to poor tissue perfusion, hence provoking inflammation and damage of surrounding tissues. Adiponectin, a protein hormone, presumptively has anti-inflammatory characteristics, hence may be an important therapeutic target in SCA. Aim: The aim of the study was to evaluate the status of adiponectin and its correlation with disease severity in SCA. Patients and Methods: A total of 84 subjects were recruited for the study comprising 34 homozygous sickle cell (HbSS) subjects (25 in the steady state and nine in the resolving crisis state) and 50 controls (25 heterozygous sickle cell [HbAS] and 25 hemoglobin phenotype AA subjects). The hemoglobin phenotype, adiponectin levels, and full blood counts were evaluated. Anthropometric measurements were also conducted. Results: A significant difference was observed in the mean body mass index between the different hemoglobin phenotype groups and also between the SCA in crisis resolution patients and the control group (p < 0.05). There was no significant difference in the median serum levels of adiponectin in the different hemoglobin phenotype groups and between SCA patients in the steady state compared with those in the crisis resolution state. Also, there was no correlation between disease severity and adiponectin in SCA patients in the steady state (p = 0.87). Conclusion: Our study seems to suggest that in our data set of sickle cell anemia patients in the steady state, adiponectin does not constitute part of the endocrinopathy that affects these patients.

Millettia aboensis ameliorates oxidative stress through synergic interaction of its active compounds.

Background M. aboensis has wide ethnopharmacological applications but very little has been done on the pharmacological basis for these indications. This study evaluated the antioxidant potentials of the leaf extracts of M. aboensis. Methods Total phenolic content of the extract and fractions was carried out using folin-ciocalteu method while in vivo site specific effect determined using carbon tetrachloride (CCl4)-induced liver oxidative damage. Chromatographic separations of the most active fraction led to the isolation of compounds 1 and 2 with their structures elucidated by a combination of 1D and 2D NMR and mass spectrometry. Inhibition of liver microsome lipid peroxidation was used to evaluate the antioxidant activities of these compounds while DPPH test was used to study their interaction. Results Ethyl acetate fraction had the highest phenolic content of 305.2 mgGAE/g with n-hexane fraction having the least (26.1 mgGAE/g). Structural elucidation revealed compound 1 as epicathechin-(2ß→O→7, 4ß→8)-cathechin and compound 2 as epicathechin-(2ß→O→7, 4ß→8)-epicathechin. Compounds 1 & 2 inhibited liver microsome lipid peroxidation with EC50 of 46 and 55 µg/mL respectively. Combination of the compounds produced synergic inhibition of DPPH radical with EC50 of 7 µg/mL against 9 µg/mL produced by ascorbic acid. Conclusion M. aboensis expressed strong antioxidant property which may explain its diverse ethnopharmacological uses.

Consumption of Soymilk Reduces Lipid Peroxidation But May Lower Micronutrient Status in Apparently Healthy Individuals.

Consumption of soy products is speculated to reduce the risk and progression of some disease conditions. The underlying mechanisms mediating this effect are uncertain, but the lowering of oxidative stress has been suggested. This study was aimed at investigating the effect of soymilk on antioxidant status and lipid peroxidation in apparently healthy individuals. Five hundred milliliters of soymilk was taken daily by each of 39 apparently healthy individuals for a period of 28 days. Two sets of blood samples (baseline and after 28 days of soymilk intake) were collected and assayed for total antioxidant capacity (TAC), malondialdehyde (MDA), superoxide dismutase (SOD), glutathione S-transferase (GST), manganese (Mn) and zinc (Zn) levels, using standard methods. Consumption of soymilk significantly increased serum TAC and reduced serum MDA when compared with baseline values (P < .001, P < .001 respectively). The decrease in MDA concentration was significantly contributed by the women (P < .001). Mean serum Mn was also significantly reduced (P = .03) when compared with baseline values. There were no changes in serum Zn concentration and the activity of SOD enzyme. The serum GST activity was significantly increased in men (P = .02) and significantly reduced in women (P < .001) in comparison with their corresponding baseline values. Daily consumption of soymilk enhanced antioxidant status and this led to reduced lipid peroxidation. It also resulted in a significant reduction of Mn. The dietary use of soymilk as an adjuvant to supplement meals seems beneficial health wise. However, soymilk should be taken with caution as it could result in micronutrient deficiency.

The levels of testosterone, zinc, manganese and selenium in type 2 diabetic patient in South-Eastern Nigeria.

Background: This study is aimed at evaluating the levels of some trace elements and testosterone, and to ascertain their possible association in type 2 diabetes mellitus. Methods: Ninety male type 2 diabetic subjects and forty five apparently healthy non-diabetic male individuals were recruited into this study. The control group was matched for age with the study subjects and they were all within the age range of 30-67 years. Fasting Plasma Glucose (FPG), testosterone, trace elements (zinc, selenium, manganese), Body Mass Index (BMI) were determined. Results: This study showed significant decreases in the levels of trace elements (Zn, Se, and Mn) with a concomitant decrease in the levels of testosterone in type 2 diabetic patients (P <0.001). This findings were further strengthened by the strong positive correlation between testosterone and these trace elements (P <0.05). Conclusion: This suggests that low testosterone level might be as a result of low trace elements considering their role in testosterone production. Therefore, trace elements supplementation is recommended.

Trace Elements Deficiency in Patients with Homozygous Sickle Cell Disease.

Aim: The serum trace elements statuses of sickle cell patients attending at General Hospital Owerri, Nigeria were investigated to determine whether or not the serum levels of these elements were normal. Materials and Methods: One hundred confirmed sickle cell patients (HbSS) age 5–30 years were selected. One hundred normal subjects (HbAA) age 5–30 years were used as control. Results: The levels of trace elements were significantly decreased in sickle cell anemia (p<0.05), except copper, when compared with the control. Conclusion: The result suggests, but not conclusively, that supplementation of sickle cell patients with food and drug containing trace elements might be helpful, particularly if diminished mineral levels predispose patients to crises.

Effect of moderate - vigorous intensity physical exercise on female sex hormones in premenopausal university students in Nnewi, Nigeri.

Background: Sedentary lifestyle and diseases associated with it is on the increase in our communities, state and country as a whole. The objective was to determine the effect of exercise on ovarian reserve status of the participants using day 3 FSH, LH and estrogen values and the ovulatory status of the participants using day 21 progesterone values. Methods: The study was a prospective comparative study. A total of 30 participants were recruited for this work. They were divided into 2 groups: 15 subjects that did exercise for 1 month and 15 controls that didn’t do any form of exercise. Baseline blood samples were collected from the two groups on day 3 and day 21 of the menstrual cycle. The subjects started exercise on day 1 of the next menstrual cycle. Blood samples were collected from the subjects and control on day 3 and day 21 of the next menstrual cycle. Results: There was significant reduction in weight and therefore BMI of the study group compared to control group and study group baseline after one month of exercise (P<0.05). There were no significant differences in the baseline levels of Estrogen, FSH, LH and progesterone between the subjects and control groups before the exercise, but after 1 month of exercise, there were significant differences in the levels of estrogen, FSH, LH and progesterone in these groups (P<0.01). Among the study group there were significant differences in the baseline and final levels of Estrogen, FSH, LH and Progesterone (P<0.01). Conclusions: The hormonal pattern shows that moderate-vigorous exercise may increase the responsiveness and sensitivity of the follicles to FSH and LH with attendant increase in ovulatory status of young females.

Evaluation of nephrotoxic effect of lead exposure among automobile repairers in Nnewi Metropolis.

Background: Lead toxicity is one of the most common occupational hazards that affect several organs of the body, kidney inclusive. Auto repairers are exposed to lead in petrol, radiator, leaded battery, lead soldering wire, and spray paints, thus this study was designed to evaluate lead-induced nephrotoxic effect among automobile repairers. Methods: A total of 80 male subjects within the age range of 20 and 65 years were recruited for this study. 50 subjects were occupationally exposed automobile repairers, of which 15 were electricians, 21 mechanics and 14 panel beaters/spray painters, whereas 30 were non-exposed students and staff from Nnamdi Azikiwe University, Nnewi campus. Blood sample was collected from these individuals and their blood lead levels were determined alongside creatinine, urea, uric acid, sodium, potassium, chloride and bicarbonate. Results: The results showed that the mean levels of blood lead is significantly higher in automobile repairers than in control group (P <0.05). The comparison of blood lead level among different categories of automobile repairers (electricians, mechanics, and panel beaters/spray painters) showed no significant difference (P >0.05). The evaluation of the renal function markers show that, there were significant increases in the mean serum concentration of creatinine, urea, and uric acid in the study group compare to the control subjects (P <0.05). However, there was no significance difference in the mean levels of sodium, potassium, chloride, and bicarbonate in study group when compared to the control group (P >0.05). Conclusion: Findings from this study show that blood lead level is high among automobile repairers above CDC recommended level for adults. This high blood lead level among automobile repairers may be responsible for raised levels of renal markers which may eventually lead to their renal damage.