ABSTRACT
Background:Type 2 Diabetes Mellitus is a disease of epidemic proportions and many patients are at a great risk of premature mortality and complication of atherothrombotic disorders affecting coronary, cerebral and peripheral arterial trees. Increased Plasminogen Activator Inhibitor Type 1 inhibits fibrinolysis and predicts cardiovascular risk in those living with Type 2 Diabetes. This study aimed to determine the effect of antidiabetic treatment on haemostatic and fibrinolytic parameters among Type 2 Diabetic subjects in Ilorin.Methods:This was a comparative cross-sectional study involving 78 Type 2 diabetic patients, (39 treatment naïve, 39 treatment experienced). Full blood count was performed using Sysmex XP300 while Prothrombin time was determined using one stage test of Owren. Activated partial thromboplastin time was determined by method of Proctor and Rapaport. Fibrinogen and Plasminogen Activator Inhibitor type-1 were assayed using AssayMax Human Fibrinogen ELISAand AssayMax Human PAI-1 ELISAkit. Data Analysis was done using SPSS version 25.0.Results:Mean PAI-1 levels were significantly higher in treatment naïve diabetics when compared to treatment experienced diabetics (2.44 ±2.57 vs 2.51±1.47 ng/ml p=0.002) as were fibrinogen levels (434.65±366.15 vs 482.24± 299.64mg /dl; p = 0.048). PAI -1 levels were lowest among diabetics treated with Metformin + DPP4 inhibitors, while fibrinogen levels were lowest among those treated with Metformin + sulfonylurea combination.Conclusion:Oral hypoglycaemic treatment, combination therapy in particular, improves fibrinolysis in type 2 diabetics thereby reducing the risk of cardiovascular disease in type 2 diabetes mellitus patients
Subject(s)
Humans , Fibrinolysis , Fibrinolytic Agents , Therapeutics , Diabetes Mellitus , Hypoglycemic AgentsABSTRACT
Objective: The study was carried out to document the pattern of childhood malignant tumors which were diagnosed at the University of Ilorin Teaching Hospital, Ilorin, and compare with previous reports from other parts of Nigeria and elsewhere and also highlight the challenges and strategies for effective management of these diseases in our environment. Methods: A ten year retrospective analysis of all cancers diagnosed in children below the age of 18 years at the study centre between January 2000 and December 2009 was carried out. Case folders of all children diagnosed with malignant tumors within the study period were retrieved from the Cancer Registry Department of the Hospital and were analyzed with respect to age, gender, morphological or histological type of malignancy, extent of disease, treatment modality, and survival outcome. Results: Ninety nine (99) children were diagnosed with various malignancies during the study period. Sixty seven (67; 67.7%) were boys and 32 (32.3%) were girls giving a male to female ratio of 2:1. There were 22 cases (22.2%) recorded in children aged below 4 years and 72 cases (72.7%) were diagnosed in children between 4 -14 years. Lymphomas were the most prevalent malignancies encountered accounting for 54 cases (54.5%), Burkitt’s lymphoma constituted 43 (79.6%) of all lymphoma cases. The distribution of the five foremost malignancies recorded were as follows: Burkitt’s lymphoma (43 cases), Nephroblastoma (10 cases), Retinoblastoma (8 cases), Non Hodgkin’s lymphoma (7 cases) and Acute leukaemias (5 cases). Other malignancies included Osteogenic sarcoma (5), Hodgkin’s lymphoma (4), and 2 cases each of primary liver cell carcinoma, neuroblastoma, rhabdomyosarcoma and nasopharyngeal tumor. Conclusion: The distribution of the various childhood malignant tumors recorded in this study is similar to the pattern reported in previous studies from Nigeria and other countries. However, there appears to be a lower prevalence of leukemia recorded in this study compared to the earlier findings. The challenges which were identified in the diagnosis, management and overall outcome of our patients included limited number of diagnostic tools, late presentation in the hospital, high patient default rate, poverty, and shortage of chemotherapeutic drugs.
ABSTRACT
Background: Human immunodeficiency virus (HIV)and Hepatitis B virus (HBV) share similar routes of transmission; making it possible for an individual to have a co-infection. HBV infection is well known to be a major cause of chronic liver diseases worldwide. The aim of this study was to determine the prevalence of HBV infection among HIV infected HAART naive patients and investigate the effect of co-infection on CD4 count and liver function. Study design: This was a hospital based descriptive cross sectional study of one hundred consecutive therapy-naive HIV-infected individuals. The CD4 count; Hepatitis B surface antigen; Serum albumin; total Protein; and liver enzymes were determined using standard techniques. Results:The prevalence of HIV and HBV co-infection was 37. The mean serum ALT and ALP were significantly higher in the co- infected patients (Pvalues 0.05). The mean CD4 count of the mono infected patients was significantly higher (p-value of 0.014). The mean serum ALT; AST and ALP of mono and co-infected patients with CD4 count200/?l were significantly higher than those with count ? 200 cells/?l. (p-value of 0.01). The mean ALT and AST of the co -infected patients and all patients with CD4 count 200 cells/?l were higher than the normal reference range. Conclusion : Approximately one third of HIV positive patients had hepatitis B virus co-infection. Coinfection and CD4 count 200 cells/?l are likely to result in abnormal ALT and AST. We recommend that co-infected patients and those with CD4 count 200 cells/?l should be given non-hepatotoxic antiretroviral drug