Comparative Effects of Antidiabetic Drug, Metformin and Deferoxamine, on Serum Lipids, Serum Ferritin and Endocrine Indicators of Diabetes Mellitus Complications in Sreptozotocin Diabetic Rats.

Increasing evidence has indicated that iron overload not only increases risks of insulin resistance and diabetes, but also causes cardiovascular diseases in non-diabetic and diabetic subjects. The present study compared the effects of metformin (met) and deferoxamine (DFX) on the serum lipids, serum ferritin and endocrine indicators of diabetes mellitus complications in streptozotocin experimental diabetes in rats. Study Design: Experimental diabetes was induced in overnight fasted rats by a single dose i.p each of nicotinamide and, 15min after, STZ followed by administration of the antidiabetic drugs, met (os, 250mg/kg b.wt) and DFX (i.p,150mg/kg b.wt), daily for 14 days. Blood and histological samples were collected and prepared for biochemical and histopathological analysis of indicators of cytotoxic side effects. Results were analysed statistically by Student t-test and analysis of variance (ANOVA). Both drugs caused progressively increased hypoglycaemic effect with repeated doses. However, Metformin showed markedly higher potency in hypoglycaemic activity than DFX. STZ diabetes caused hyperlipidaemic effect with respect to lipid profile parameters except HDL and treatment with antidiabetic drugs metformin and deferoxamine reversed the hyperlipidaemic effect. On the other hand, STZ caused hypolipidaemic effect with respect to HDL but the antidiabetic drugs reversed it. However, DFX is more potent than metformin in reversing the effect of STZ diabetes on HDL. STZ diabetes induced elevation of serum ferritin while inducing reduction in serum insulin level. Metformin treatment reversed the adverse effects of STZ on insulin secretion only, whereas, DFX significantly reversed the adverse side effects of STZ on both serum ferritin and serum insulin. However, metformin-treatment and DFX-treatment exhibited comparable potency in their effects on insulin secretion. Conclusion: Evidence from histological study of the pancreas suggests that both metformin and DFX were sufficiently biologically significant to effectively reverse the disruptic effects on the pancreatic exocrine tissue of diabetic rats.

Sero-negative Antibody Status in HIV-Infected Children Initiated on Early Anti-Retroviral Therapy in Jos, Nigeria.

Aim: To determine the association between the age at initiation of anti-retroviral therapy (ART) and the 18 month antibody status of human immunodeficiency virus (HIV)-infected children in Jos, Nigeria. Study Design: This was a retrospective cohort study. Place and Duration of Study: AIDS Prevention Initiative in Nigeria (APIN)-supported HIV clinic at Jos University Teaching Hospital, Jos, Nigeria between July 2008 and June 2012. Methods: We reviewed the clinical records of all children confirmed to be HIV-infected with 2 positive HIV deoxyribonucleic acid polymerase chain reaction (DNA PCR) results who were initiated on ART before 12 months of age. We studied the association between the age at initiation of ART and their antibody status at 18months of age. We also studied the association between the viral load and the antibody status. Result: Seventy-three HIV-infected children were initiated on ART at <12 months of age, 66 of these had antibody tests at 18-21 months of age. Nineteen (29%) of the 66 children were negative for rapid antibody test. Those that were initiated on ART at <6 months of age had 5 times the odds ratio of being rapid antibody test negative compared to those who were initiated at ≥6 months of age (AOR=5.23 (1.82-19.66), P=0.002). All the children with negative rapid antibody tests were virally suppressed while all those with detectable viral load were positive for rapid antibody tests. Conclusion: Antibody tests alone cannot be used to determine whether ART should be stopped in children where a definitive diagnosis does not exist. Improved access to affordable, technically simple DNA PCR testing is essential for the appropriate management of HIV-exposed infants in resource limited settings.

Survey of the Iron Status of Patients with Type 2 Diabetes Mellitus Attending Hospitals in Jos.

Background and Objective: Epidemiological studies have shown that high body iron stores are associated with insulin resistance and type 2 diabetes. The aim of this study was to evaluate iron status of patients with type 2 diabetes mellitus (T2DM). Blood samples were collected from participants after overnight fast. Materials and Methods: Two hundred (200) subjects comprising 130 type 2 diabetics attending Hospitals in Jos and 70 normal subjects as controls were involved in the survey. Questionnaires were used in the recruitment of participants. Serum ferritin (SF) was assayed by ELISA method, while other parameters were determined colorimetrically. Results: Diabetics presented with higher mean age, BMI, and blood pressure than non diabetics. Also, diabetics had elevated serum ferritin, SI, TIBC, total cholesterol (TC), triglycerides, and TC/HDL ratio, lower serum HDL; elevated serum aminotransferases and creatinine than non diabetic subjectsl There was a strong and significant positive correlation between serumn ferritin levels and each of six diabetes mellitus risk factors: systolic blood pressure, diastolic blood pressure, serum total cholesterol (TC), serum triglyceride (TG), HDL and TC/HDL. Conclusion: This work has shown that type 2 diabetic subjects exhibited strong positive diagnostic features for the indices of iron status, dyslipidaemia, liver damage and kidney dysfunction compared to non diabetic subjects.

Comparative Effects of Antidiabetic Drug, Metformin and Deferoxamine, on the Hepatotoxic and Nephrotoxic Side Effects of Streptozotocin-induced Diabetes Mellitus in Rats.

Aims: The present study compared the effects of metformin (met) and deferoxamine (DFX) on the hepatotoxic and nephrotoxic side effects of streptozotocin experimental diabetes in rats using serum biochemical and histopathological indicators. Study Design: Following induction of diabetes, animals were randomly and evenly distributed into four groups A, B, C and D of six rats each (n=6). Experimental diabetes was induced in overnight fasted rats by a single dose i.p each of nicotinamide and, 15min after, STZ followed by administration of the antidiabetic drug, met (os, 250mg/kgb.wt) and iron chelating drug, DFX (i.p,150mg/kgb.wt), daily for 14 days. Blood and histological samples were collected and prepared for biochemical and histopathological analysis of indicators of cytotoxic side effects. Results: STZ caused cytotoxic effects on the liver and kidney of experimental rats, indicative of cellular leakage and loss of the functional integrity of the cell membranes. Metformin and deferoxamine both effectively reversed the hepatotoxic side effects of STZ-induced diabetes as determined by serum activities of ALP, AST and ALT and histopathological presentation. However, whereas metformin effectively reversed the STZ induced side effects on the kidney as determined by serum creatinine level and histopathological indicators, DFX did not. Conclusion: It is concluded that metformin has a markedly higher potency than DFX in mitigation of hepatic and renal tissue derangement, as determined by both serum biomarkers and tissue histology.

Prevalence and Laboratory Profile of Hepatitis B Virus Co-infected Nigerian Children with Human Immunodeficiency Virus.

Aims: To determine the prevalence of HBV co-infection in HIV-infected children and compare the baseline laboratory profile of mono-infected and co-infected patients. Study Design: This was a retrospective cohort study. Place and Duration of Study: AIDS Prevention Initiative in Nigeria (APIN)-supported HIV clinic of Jos University Teaching Hospital, Jos, Nigeria between January 2008 and December 2012. Methodology: We reviewed the clinical records of 452 treatment-naïve children aged 2 months to 15 years confirmed to be HIV positive with Polymerase Chain Reaction (PCR) for children <18 months or Western blot for children ≥18 months. The baseline laboratory tests included: HBsAg, plasma viral load and alanine transaminase (ALT), CD4+T cell count for children ≥5years or CD4+T cell % for children <5years. Results: Three hundred and ninety-four (87.2%) were mono-infected with HIV while 58 (12.8%) were co-infected with HIV and HBV (HIV/HBV). At baseline, the median viral load was 4.6 log copies/mL for mono-infected compared to 4.7 log copies/mL for HIV/HBV (P=.48). The median CD4+T cell count was 366 cells/µL for mono-infected compared to 332 cells/µL for HIV/HBV (P=.64). The median CD4+T cell % was 19% for mono-infected compared to 17% for HIV/HBV (P =.29). The median ALT level for the whole cohort was 23 IU/L for mono-infected compared to 26 IU/L for HIV/HBV (P=.15). However the median ALT level for mono-infected children aged 11-15 years was 28IU/L compared to 43 IU/L for co-infected children of same age (P =.008). Conclusion: A high rate of hepatitis B co-infection was observed in HIV-infected children at our centre; however more severe HIV disease was not observed. Older children co-infected with HBV had significantly higher ALT levels compared to their mono-infected counterparts. Early detection is therefore necessary in order to develop an appropriate treatment plan for children co-infected with HIV and HBV.

Evaluation of the Nigerian National Antiretroviral (ARV) Treatment Training Programme

There is an understanding that greater availability of HIV treatment for the 40.3 million people currently infected with HIV is a humanitarian imperative that could prolong the lives of millions; restore economic productivity; and stabilise societies in some of the world's hardest-hit regions. The Nigerian government recognises that the country has the third highest burden of infection; with people living with HIV estimated to total 4.0 million; and so in 2002 commenced the implementation of one of Africa's largest antiretroviral (ARV) treatment programmes. A successful ARV programme requires that all components of a functional management system be put in place for effective and efficient functioning. This would include logistics; human resources; financial planning; and monitoring and evaluation systems; as well as sustainable institutional capacities. The Nigerian national ARV treatment training programme was conceived to meet the human resource needs in hospitals providing ARV therapy. This paper reports on the evaluation of the training programme. It examines knowledge and skills gained; and utilisation thereof. Recommendations are made for improved training effectiveness and for specific national policy on training; to meet the demand for scaling up therapy to the thousands who need ARV