ABSTRACT
About 20% of people with multiple myeloma (MM) produce only light kappa chains which is produced in 80% of cases. This population of MM patients may be missed where the laboratory could not effectively detect free light chains of immunoglobulins as it is the case in most developing countries. Many reports showed that individuals with lambda light chain disease have a three times worse prognosis than kappa light chain disease. It is therefore important to improve awareness on the need to look out for light chain disease and emphasize the usefulness of a well-equipped laboratory that will fully analyze immunoglobulins of suspected multiple myeloma cases. After reviewing the patient, main findings included paraplegia, constipation and incessant vomiting suggestive of amyloidosis, a positive urinary bence jones proteins (BJP), normal biochemical parameters, elevated lambda light chain level and reversed kappa/lambda ratio of <0.01, magnetic resonance immaging (MRI) proven osteolytic lesions restricted to the spine and histology of bone marrow sample from laminectomy, as well as bone marrow aspiration cytology showed abnormal plasmacytosis. This is an unusual and rare presentation of MM in this environment. Free light chain (FLC) identification and quantitation should be carried out in all cases of suspected MM; especially in those with no monoclonal bands on serum protein electrophoresis and or immunofixation.
ABSTRACT
Metabolic Syndrome (MS), which affects 33.1% of Nigerians, predisposing them to cardiovascular disease (CVD) risk, has been associated with the female gender. The cardioprotective effect of oestradiol against CVD is now controversial and was investigated in premenopausal with MS (PRMMS) and postmenopausal women with MS (POMMS). A total of 191 women (44 PRMMS, 126 POMMS and 21 premenopausal women without MS (PRM) (controls) with mean (s.d) age of 40.0 (6.9), 57.0 (8.8), 29.0 (6.8) years were participants of this study. Demography, blood pressure (BP), anthropometry, hormones, fasting plasma glucose (FPG) and lipids were obtained by standard methods. Data were significant at (P<.05). Age, parity, all anthropometric measures, FPG, leptin, ET ratio and FSH were significantly higher while HDLC, testosterone and prolactin were significantly lower in PRMMS compared with controls (P<.03). In comparison of POMMS with PRMMS, age, parity, WHR, systolic BP, TG, FSH and LH were significantly higher while body weight, HC, and leptin were lower in POMMS compared with PRMMS (P<.05). DBP positively predicted oestradiol in PRM only (P=.044) while oestradiol positively predicted testosterone in PRMMS only (P<.001). In POMMS only, DBP positively predicted testosterone; testosterone, ET ratio and FSH positively predicted oestradiol while LDLC and oestradiol positively predicted the ET ratio (P<.03). Metabolic syndrome may predispose both pre and postmenopausal women to the risk cardiovascular disease and type 2 diabetes mellitus. Oestradiol may protect against cardiovascular diseases in women without metabolic syndrome only.
ABSTRACT
Background: Sickle cell anaemia (SCA) patients are prone to require long-term frequent blood transfusion because of chronic haemolysis and overlapping hyper-haemolysis. Hence, they become vulnerable to iron overload and its complications. On the other hand, iron deficiency has been documented among un-transfused SCA cases. Thus, there is a need to effectively and efficiently determine iron status of SCA patients. Objective: We investigated whether adult SCA patients in steady state (SSt) or those with vaso-occlusive crisis (VOC) have significantly different iron status viz-a-viz Serum Iron (SI), Serum Ferritin (SF), Total Iron Binding Capacity (TIBC), Transferrin (TRF), percentage TFS and haematological parameters when compared with age and sex-matched controls. Materials and Methods: Ninety subjects, comprising 30 SCA patients in SSt, 30 SCA patients with VOC and 30 HbAA, ethnicity, age and sex-matched controls (NC), were consecutively recruited. Serum samples were analysed for SF, TRF and TIBC using ‘WATER’ HPLC 616 and 626; SI was determined using the Atomic Absorption Spectroscopic (AAS) method. Haematological parameters were determined using a Sysmex Kx21 auto-analyser. Results: The SCA groups (VOC and SSt) had significantly lower SI, SF, TRF and TIBC compared to the control group. The VOC group had a significantly lower mean ferritin level but higher SI, TRF and percentage TFS levels compared to SSt group. The MCV, MCH (in SSt group) were significantly lower while MCHC was significantly higher in the SCA groups compared to the NC group. Using the normal ranges for all parameters, all parameters were within normal for the controls while TIBC was below normal and percentage TFS was higher in SCA groups. Percentage TFS was significantly higher in VOC compared to SSt group. Conclusions: The study reported lower SI and TRF, lower MCV and MCH, below normal TIBC, within normal Ferritin but elevated WBC and platelet counts, elevated percentage TFS (more elevated in VOC than SSt) and higher MCHC in SCA patients. The use of percentage TFS as a marker of VOC is suggested.
ABSTRACT
Aim: To assess the prevalent components of metabolic syndrome (MSC) and their related determinants of lipid metabolism in the Nigerian for early diagnosis, prevention and management of the metabolic syndrome (MS) and its associated diseases. Study Design: Cohort study. Place and Duration of Study: Department of Chemical Pathology, College of Medicine, University of Ibadan, Ibadan between March and August 2010. Methodology: 534 apparently healthy Nigerian traders aged 18–105 years were participants of a cohort study. The IDF (2005) criteria was used for MS diagnosis. Anthropometric indices and blood pressure (BP) were obtained by standard methods. Fasting plasma glucose, total cholesterol (TC), triglycerides (TG) and high density lipoprotein cholesterol (HDLC) were determined by enzymatic methods while low density lipoprotein cholesterol (LDLC) was calculated. Data analysed were statistically significant at P<0.05. Results: 60.1% of traders had 2 and 3MSC. 0.6%, 1.1% and 9.6% of traders had all 5MSC, ≥3MSC without elevated waist circumference (WC) and zero MSC respectively. Elevated WC, reduced HDLC and high BP were more frequent MSC representing 70.2%, 63.1% and 47.9% while FPG and TG were less frequent representing 11.2% and 2.2% of traders respectively. This pattern was similar in MS and non-MS groups. 25.3% of males and only 2.2% of females had no MSC. Reduced HDLC and elevated WC were the most frequent MSC in males and females respectively. All metabolic risk factors (MRF) except TC were significantly different in comparison between MS and non-MS groups as well as among traders with 0-5 MSC. WHR was the only parameter that correlated significantly with all MRF. Conclusion: Elevated waist circumference, reduced high density lipoprotein cholesterol, and high blood pressure may be prevalent metabolic syndrome components and important in managing metabolic syndrome in Nigeria. Regional specific cut-offs for these components for the African population is needed.
ABSTRACT
Aims: To compare the mean levels of plasma total Homocysteine (tHct), Meth ylm alonic ac id ( MMA), vitamin B12, folate and haematological parameters(PCV, WBC, Platelet counts, MCV, MCH, MCHC) among adult SCA patients in steady state (SS), SCA in (VOC) and age and sex matched controls in order to determine significant differences. Study Design: Case-control study. Place and Duration of Study: Department of Haematology and Department of Chemical Pathology, University College Hospital, Ibadan, Nigeria between March 2012 and July 2012. Methodology: We included 60 SCA patients (30 in VOC, 30 in Steady State; and 30 age and sex matched controls. Plasma tHct, MMA, folate and vitamin B12 were assessed using HPLC and haematological parameters were determined using haematological autoanalyzer (Syxmex Kx21). Results: The mean plasma tHct, MMA, vitamin B12 of SCA patients (VOC and SS) were significantly lower (p=0.000) compared to control population but the mean folate levels were comparable (p=0.085). The SCA (in VOC) had significantly lower (p=0.000) MMA and folate levels compared to SS group but the SS group had significantly lower (p=0.001) tHct level compared to VOC group. While the PCV, Hgb, MCV, and MCH were significantly lower; the WBC, platelet count and the MCH were significantly elevated in SCA patients compared to controls. Conclusion: A larger, better controlled, multicenter study is required to confirm lower tHct and MMA found in SCA groups compared to control group and higher tHct in SCA (VOC) but higher MMA level in SCA (SS) when VOC and SS groups were compared. The haematological parameters in SCA groups were not in keeping with macrocytic anaemia but were indicative of chronic haemolytic and inflammatory process.
ABSTRACT
The incorporation of nutritional screening and comprehensive assessments of oxidative stress is increasingly recognised as imperative in the development of standards for quality care in oncology. This study evaluated the levels of nitric oxide (NO); some essential trace metals (Zn; Cu; Fe; and Se); superoxide dismutase (SOD) activity and malondialdehyde (MDA) in twenty five (25) patients with acute leukaemia and 25 apparently healthy controls. The mean levels of plasma Zinc (Zn); Iron (Fe) and Selenium (Se) were not significantly elevated (p 0.05) in leukaemia patients compared with controls. Also; slightly lower level of plasma Cu was observed in leukaemia patients compared with the controls. However; nitric oxide was significantly increased (p 0.05) in leukaemia patients compared with controls. The implication of the present finding is that intervention to increase antioxidant status in patients with Acute Lymphoblastic Leukaemia (ALL) should be considered