Use of exchange blood transfusion in the management of severe COVID-19 infection in pregnancy: experience from Lagos, Nigeria

Coronavirus disease 2019 (COVID-19) presents with symptoms that may be mild or severe. The individual with the severe form of the disease usually presents with a constellation of respiratory symptoms typical of acute respiratory distress syndrome. In this report, we present our experience of the successful management of an oxygen-dependent pregnant woman with severe COVID-19 infection who had 2 sessions of partial exchange blood transfusion. We discussed the principles that informed this intervention and the need to adopt this novel approach in the care of severe COVID-19 infection.

A preprogram appraisal of factors influencing research productivity among faculty at college of medicine, University of Lagos

A defining feature of any university is its dedication to scholarly activities, leading to the generation of knowledge and ideas Research productivity is a measure of achievement of a scholar. The number of research publications in peer-reviewed journals is an important criterion for assessing productivity and prestige in the academia. Aims and Objectives: This cross-sectional descriptive study assessed the level of research productivity (RP) among junior faculty at the College of Medicine, University of Lagos, and investigated factors affecting their research output prior to the implementation of a 5-year training grant funded by the National Institutes of Health. Methods: Seventy junior faculty members attended a pre-program training, and the self-reported number of peer-reviewed publications (PRPs) was used as an indicator. Intrinsic and extrinsic factors influencing RP among the attendees were assessed and ranked. Results: The majority (42/70, 60%) of the respondents had <10 PRPs. The median (interquartile range) number of PRPs was 7 (3­18). A desire for the development of their personal skills, contribution to society, and personal research interests topped the list of intrinsic factors influencing RP. Work flexibility, research autonomy, and scholarly pursuits were the bottom three. A desire for promotion, respect from peers, and increased social standing were the top three extrinsic factors, while monetary incentives, employment opportunities, and the need to attend conferences were the lowest three. The top barriers to RP were lack of resources and lack of mentoring. Perceived older age, lack of time, and motivation were the lowest three barriers. Older age and professional cadre were associated with increased RP (P < 0.05). Conclusion: Among the participants, research output appears to be motivated primarily by a desire for personal development,promotion, and respect from peers. Lack of access to resources was the main barrier to increased RP. These factors may need to be considered when developing programs designed to promote RP

Serum Ferritin and Blood Pressure modulation in first-time and regular blood donors

Background:The health benefits ofblood donation are well known. However, the overall effect of long term regular blood donation on body iron store and blood pressure need to be evaluated among voluntary blood donors.Objective:To determine the effect of long term, regular blood donation onbody iron store and blood pressure amongregular voluntary non-remunerated blood donors in Lagos, Nigeria.Methods:Consenting adult blood donors (n = 320), ranging from the first time to regular blood donors were studied over six months. Supine blood pressure (BP) readings were taken twice at 30 minutes interval with a mercury sphygmomanometer. Venous whole blood was drawn into EDTA anti-coagulated and plain tubes for haematological parameters and serum ferritin estimation using Enzyme-linked Immunosorbent Assay (ELISA) method. Results:The mean serum ferritin levels declined significantly from 95.5ng/mL amongfirst time donors to 68.9ng/mL among Category IIIdonors (p = 0.035). Male voluntary blood donors had increased risk of low serum ferritin level (OR = 5.02; 95%CI= 1.12-22.51; p = 0.035). Lower values of serum ferritin were recorded more frequently among donors within the 21-30 year age category (OR = 1.54; 95%CI = 1.0-2.71; p= 0.042). Long term regular voluntary blood donation was associated with significant reduction in mean systolic blood pressure (p = 0.01).Conclusion:Long term blood donation resulted in the reduction of blood pressure. Progressive increase in the duration of donation resulted in reduced iron stores even as haemoglobin concentration levels remained acceptable for blood donation

Psychoactive substance use among Nigerian cohort with HIV/AIDS: frequency, types and demographic correlates

Introduction: There are good pointers from literature to the detrimental impacts of psychoactive substance use in HIV/AIDS patients. This study aimed at investigating the prevalence, types and demographic correlates of psychoactive substance use among people living with HIV/AIDS.Methods: The study participants consisted of 295 adults with HIV/AIDS and were interviewed with a designed questionnaire that consisted of two parts. The first part contained questions to elicit socio-demographic and treatment related information of the participants, while the second part focused on psychoactive substance use.Results: The mean (SD) age of participants was 37.6 (±8.6) years, and majority (61.0%) of them were made up of females. Most of the subjects were married, 181 (61.4%) and employed 174 (59.0%). Of the total participants, 64 (21.7%) reported use of a form of psychoactive substance, among which the largest proportion (19.3%) reported use of alcohol, 1.4% use cannabis while 1% admitted to use of nicotine. Following regression analyses, being male (Odds Ratio =2.38; 95% Confidence Interval: 95% CI = 1.26 - 4.49; p=0.008) and increasing educational attainment (Odds Ratio = 1.62; 95% CI: 1.07 - 2.45; p=0.02) correlated positively with psychoactive substance use, while being single (Odds Ratio = 0.59; 95% CI: 0.35 - 0.99; p=0.047) correlated negatively.Conclusion: Proactive and targeted intervention strategies against psychoactive substance use among people living with HIV/AIDS using what is known about vulnerability are implied. Further research on the complex relationship between HIV/AIDS and psychoactive substance use is indicated

Red Cell Characteristics in Anaemic HIV Infected Patients.

Background: Anaemia is the most frequently encountered haematological complication in human immunodeficiency virus (HIV) infected patients and acquired immunodeficiency syndrome (AIDS) even in the era of highly active anti-retroviral therapy (HAART). Although HAART appears to be associated with a somewhat lower risk of anaemia, anaemia remains common in the HAART era. This study looks at the characteristics of red blood cells in anaemic HIV infected patients with emphasis on red cell indices. Materials and Methods: A total of 60 patients aged 18-66 years were recruited, comprising of 40 HIV infected, treatment naïve individuals who were also anaemic patients and 20 individuals who were non anaemic patients. Venous blood (5 mls) was collected by vacutainer from each patient who consented into an anti-coagulant K3 EDTA specimen bottle for haematological indices which included Haemoglobin (Hb), Packed cell volume (PCV), White blood cell (WBC) & differentials, Platelet count and red blood cell indices by automated counter, CD4+ cell count by semi-automated flow cytometer, and HIV viral load was quantitated using PCR- based diagnostic tests. Peripheral blood smear for morphology was done by routine manual methods and stained with Romanowsky stain. Results: Majority (72.5%) have normocytic anaemia, 10.0% have microcytic anaemia and 17.5% have macrocytic anaemia. Majority (55.0%) of the HIV infected anaemic subjects have normocytic/normochromic red blood cells on morphology. The mean WBC of HIV infected anaemic patients (7.20 x109/L±4.93) was significantly different from the mean WBC of HIV infected non-anaemic patients (5.66 x109/L±1.74) (p=0.008). The mean platelet count of HIV infected anaemic patients (277.27 x109/L±126.76) was significantly different from the mean platelet count of HIV infected non-anaemic patients (207.40 x109/L±61.86) (p=0.006). Conclusion: Anaemia in HIV infection was found to be normocytic normochromic anaemia.