Blood pressure indices and disease severity in patients with sickle cell anaemia.

Background: Individuals with sickle cell anaemia (SCA) have lower systemic blood pressures compared to individuals with haemoglobin Hb AA phenotype. Objective: Seventy-nine (79) individuals with SCA (subjects) in steady state and 50 age-matched individuals with Hb AA (controls) were prospectively studied. Height, blood pressure (BP), weight, creatinine clearance (by 24-hour urine collection), full blood count (FBC) and reticulocyte count were obtained from all subjects and controls. Body mass index (BMI), corrected reticulocyte count, mean arterial pressure (MAP) and pulse pressure (PP) were calculated using standard protocols.The frequency of vaso-occlusive crises in the last one year and number of blood transfusions in the last two years were obtained from subjects. Data was analyzed using descriptive and inferential statistics and p ≤0.05 was used to define the level of statistical significance. Methodology: Seventy-nine (79) individuals with SCA (subjects) in steady state and 50 age-matched individuals with Hb AA (controls) were prospectively studied. Height, blood pressure (BP), weight, creatinine clearance (by 24-hour urine collection), full blood count (FBC) and reticulocyte count were obtained from all subjects and controls. Body mass index (BMI), corrected reticulocyte count, mean arterial pressure (MAP) and pulse pressure (PP) were calculated using standard protocols.The frequency of vaso-occlusive crises in the last one year and number of blood transfusions in the last two years were obtained from subjects. Data was analyzed using descriptive and inferential statistics and p ≤0.05 was used to define the level of statistical significance. Results: The systolic (105.52±11.75mmHg and 113.20±7.94mmHg respectively; P = 0.01), diastolic (62.59±9.33mmHg and 75.40±5.70mmHg respectively; P=0.03) and mean arterial pressures (76.90±8.81mmHg and 88.00±5.51mmHg respectively; P =0.04) were significantly lower in subjects when compared with controls. ; pulse pressure (PP) was however significantly higher in subjects than controls (42.92±10.91mmHg and 37.80±7.43mmHg respectively (P = 0.03). In female subjects, the white cell count was negatively correlated with systolic BP (r = -0.39;P = 0.01) and PP (r = -0.33; P = 0.03). Conclusion: Lower systolic and pulse pressures may predict worsening disease severity in individuals with sickle cell anaemia.

Degrees of kidney disease in nigerian adults with sickle-cell disease.

OBJECTIVE: To study degrees of chronic kidney disease (CKD) using creatinine clearance in adult Nigerian patients with sickle-cell disease (SCD). METHODS: One hundred SCD patients, made up of 79 HbSS (homozygous haemoglobin S) patients and 21 HbSC (heterozygous haemoglobins S and C) patients, were investigated prospectively, along with 50 normal controls. Their sociodemographic data, weight and drug history were documented. Each participant underwent dipstick urinalysis, and creatinine clearance was calculated following a 24-hour urine collection and serum creatinine measurement. They were categorized into stages of CKD based on the creatinine clearance. RESULTS: Of the 79 HbSS patients, 14 (18%), 28 (35%), 33 (42%) and 4 (5%) had stage 1, 2, 3 and 4 CKD, respectively. In the HbSC group, 3 (14%), 9 (43%) and 9 (43%) patients had stage 1, 2 and 3 CKD, respectively. Proteinuria was noted in 16 (20%) HbSS patients but not in any of the HbSC patients. Of the subjects aged ≤24 years (n = 49), 9 (18%), 18 (37%), 21 (43%) and 1 (2%) had stage 1, 2, 3 and 4 CKD, respectively. Of those aged >24 years (n = 51), 8 (16%), 19 (37%), 21 (41%) and 3 (6%) had stage 1, 2, 3 and 4 CKD, respectively. None of the subjects had stage 5 CKD. CONCLUSION: In this study, the adult subjects with SCD had various degrees of CKD. Adequate follow-up and active intervention are advocated to delay the onset of end-stage nephropathy.

The dynamics of bacteria population on the skin, throat, and gastrointestinal tract of HIV-seropositive patients

Background: The study determined bacteria population on the skin; throat; and gastrointestinal tract of human immunodeficiency virus (HIV)-seropositive patients and HIV seronegative controls at the baseline; 3 months; and 6 months; respectively; at Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC); Ile-Ife; Osun State; Nigeria and State Specialist Hospital; Akure; Ondo State; Nigeria between May and November; 2012. Materials and Methods: Seventy HIV-seropositive subjects and 51 HIV seronegative controls who attended the HIV clinics were recruited. Skin; throat; and rectal swabs were obtained from the participants using sterile cotton-tipped applicators introduced into thioglycollate broth and incubated at 37oC overnight. When growth was noticed; the broth culture was streaked on different bacteriologic media and the isolates were characterized by the standard methods and disc diffusion for antibiotic sensitivity. Results: The number of isolates cultured from the HIV-seropositive subjects was 934; with the distribution being 397; 326; and 211 at the baseline; 3 months; and 6 months; respectively. The distribution of 1;138 isolates cultured from 51 HIV-seronegative controls was 433; 354; and 351 at the baseline; 3 months; and 6 months; respectively. At the baseline among HIV-seropositive patients; the predominant isolates were Arcanobacterium haemolyticum; Pseudomonas aeruginosa (P. aeruginosa); and Bacillus cereus (B. cereus). However; Corynebacterium haemolyticum; Enterococcus faecalis; and Escherichia coli (E. coli) were predominant at 3 months while at 6 months; Corynebacterium haemolyticum and Corynebacterium diphtheriae had the highest frequency followed by Pseudomonas fluorescens (P. fluorescens). In the controls; Corynebacterium diphtheriae; Listeria monocytogenes; and Staphylococcus xylosus (S. xylosus) predominated at the baseline and at 3 months while at 6 months; B. cereus; S. xylosus; and Staphylococcus aureus (S. aureus) were prevalent. Multiple resistances were widespread among the isolates. Conclusion: A preponderance of opportunists was observed in the HIV-seronegatives but higher multiresistant strains in the HIV-seropositives; suggesting both groups live in an antibiotic pressurized environment