Plasma Levels of a Product of Free Radical Injury and Antioxidant Status of Patients with Different Grades of Plasmodium Falciparum Infection.

BACKGROUND: Plasmodium falciparum infection, like any other clinical condition, is prone to generating free radicals. This can worsen patients' clinical presentations. Antioxidants do help in ameliorating these free radical effects. These antioxidants, especially vitamins, are sometimes given routinely to patients with Plasmodium falciparum infection of which it can be given according to the severity of this free radical injury. METHODOLOGY: A total number of qualified 245 patients that came for malaria parasite test between March and October, 2020 were recruited into the study. Patients on arrival at the laboratory had their samples collected for malaria parasite test and for the proposed biochemical parameters (MDA, GPx, SOD and TAS). Malaria parasite test was used to categorize the severity of Plasmodium falciparum infection. RESULTS: There were statistically significant differences (p<0.0001) in MDA, GPx, SOD and TAS among patients with negative MP, 1+ and >2+ on blood film for malaria parasite. Patients with >2+ MP had highest levels (2.21±0.40) while patients with negative blood film had lowest levels(0.8194±0.33) of MDA. Patients with >2+ had lowest levels of GPx (2406.41±1272.10), SOD (104.54±30.62) and TAS (1.18±.35) as against patients with negative MP that had highest levels (5229.85±.2957.95)( 206.41±36.70)( 2.40±.53), respectively. CONCLUSION: There was evidence of free radical generation as evidenced with raised plasma malondialdehyde in patients with Plasmodium falciparum infection. This was associated with severity of this infection. There was also corresponding decrease in measured antioxidants (GPx, SOD and TAS).

CONTEXTE: L'infection à Plasmodium falciparum, comme toute autre affection clinique, est susceptible de générer des radicaux libres. Cela peut aggraver les présentations cliniques des patients. Les antioxydants aident à améliorer ces effets des radicaux libres. Ces antioxydants, notamment des vitamines, sont parfois administrés en routine aux patients infectés par Plasmodium falciparum dont il peut être administré en fonction de la gravité de cette lésion radicalaire. MÉTHODOLOGIE: Un nombre total de 245 patients qualifiés qui sont venus pour un test de dépistage du paludisme entre mars et octobre 2020 ont été recrutés dans l'étude. Les patients à leur arrivée au laboratoire ont eu leurs échantillons collectés pour le test du parasite du paludisme et pour les paramètres biochimiques proposés (MDA, GPx, SOD et TAS). Le test du parasite du paludisme a été utilisé pour catégoriser la gravité de l'infection à Plasmodium falciparum. RÉSULTATS: Il y avait des différences statistiquement significatives (p<0,0001) dans le MDA, GPx, SOD et TAS parmi les patients avec MP négatif, 1+ et >2+ sur frottis sanguin pour le parasite du paludisme. Les patients avec >2+ MP avaient les niveaux les plus élevés (2,21 ± 0,40) tandis que les patients avec un frottis sanguin négatif avaient les niveaux les plus bas (0,8194 ± 0,33) de MDA. Les patients avec >2+ avaient les niveaux les plus bas de GPx (2406,41 ± 1272,10), SOD (104,54 ± 30,62) et TAS (1,18 ± 0,35) par rapport aux patients avec MP négatif qui avaient les niveaux les plus bas (5229,85 ± 0,2957,95) (206,41 ± 36,70 )( 2,40 ± 0,53), respectivement. CONCLUSION: Il y avait des preuves de génération de radicaux libres comme en témoigne l'augmentation du malondialdéhyde plasmatique chez les patients infectés par Plasmodium falciparum. Ceci était associé à la gravité de cette infection. Il y avait également une diminution correspondante des antioxydants mesurés (GPx, SOD et TAS). Mots-clés: Radicaux libres, stress oxydatif, antioxydants, Plasmodium falciparum, paludisme.

Plasma Lipids and CD4 Count of Newly Diagnosed HIV Sero-Positive Patients at Ekiti State University Teaching Hospital, Ado Ekiti, Nigeria.

INTRODUCTION: The pathogenesis of HIV has been linked to the affectation of a number of CD4 positive T cells upon which the severity of the disease is graded. Patients who present with complications such as disorders of lipid metabolism may be missed if appropriate laboratory investigations are not done. Dyslipidemia is a common phenomenon in patients with HIV infection. Early consideration of this may prevent further associated complications. OBJECTIVES: To determine the baseline parameters in plasma lipid profile in HIV positive patients and how they are affected by the severity of infection as measured by CD4 count. METHODS: This is a retrospective study of which records of patients that attended Anti-Retroviral Therapy (ART) clinic of Ekiti State University Teaching Hospital (EKSUTH), Ado Ekiti, Ekiti State Nigeria were looked into. All patients who attended our treatment sites for HIV/AIDS Counselling and Testing Program from June 2008 and October 2013 for the first time were reviewed. Records of four hundred and sixty-one (461) patients were found suitable and used for the study. Information about the age. RESULTS: There are statistical significant differences among categories of patients in plasma Triglyceride (TG) mmol/L (p<0.001) and TC/HDL-Chol (p<0.001). The plasma TG (mmol/L) and TC/HDL-Chol are highest in patients with CD4 count <200 cells/µl. All compared categories in plasma TG (mmol/L) are statistically significant (p<0.001) except when CD4 count between 300 and 399 cells/µl and >400 cells/µl (p=1.000) categories were compared. Comparisons of TC/HDL-Chol in different study classifications show significant differences when CD4 count of <200 cells/µl category was compared with CD4 count of 300-399 cells/µl (p=0.021) and >400 cells/µl categories (p<0.001). CONCLUSION: Plasma TG and TC/HDL-Chol were observed to have an association with severity of HIV infection as measured by a corresponding reduction in CD4 count.

Serum Uric Acid Predicts Antihypertensive Medication Adherence in Nigeria: A Hospital Based Study.

BACKGROUND: Hypertension is a major risk factor for cardiovascular morbidity and mortality. Optimum adherence to medication is still a perplexing matter for hypertensive patients in Nigeria and serum markers use as predictor for medication adherence has not been conclusive. AIM: To define the level of antihypertensive medication adherence, its possible correlation with serum uric acid (SUA) levels and other predictors of antihypertensive medication adherence among Nigerian patients. METHODS: Patients were recruited from the University Teaching Hospital Cardiology Clinic. Blood was drawn for SUA levels. Validated 8-item MMAS-8 was administered to hypertensives to measure adherence, and correlations analysed between SUA levels and the MMAS-8 score, with SPSS-23. SUA is defined as elevated in men with concentrations of =430µmols/l, normal range 200-430µmols/l, and =360µmol/l in women, normal range140-360µmol/l. Linear regression analysis of the predictors of antihypertensive medication adherence was done. A statistical p value of <0.05 was considered significant. RESULTS: The total number and mean age of the cases were 271 and 60.8±12.3years respectively. MMAS-8 revealed that about half of the hypertensives (131 cases, 48.3%) had low adherence (MMAS-8 score 4), 81 cases (29.5%) had medium adherence (MMAS-8 score 2) while 59 cases (22.1%) showed high adherence (MMAS-8 score 0). Bivariate Correlation between SUA levels in hypertensives and antihypertensive medication adherence was of moderate degree and significant (r=0.396, p<0.001) suggesting that SUA levels increased with increasing non-adherence to antihypertensive medications. This correlation remained significant after adjusting for singular confounding variables like age (r=0.371 fair relationship, p=<0.001), DM (r=0.382 fair relationship, p<0.001); blood pressure (BP) duration and class r=0.356, 0.306, fair relationship p<0.001 respectively). The correlation between SUA levels and adherence to antihypertensive medications was weakened (r=0.209, p<0.001) after adjusting for combined confounding variables. Linear regression revealed that SUA levels is a predictor of antihypertensive medication adherence. CONCLUSION: Antihypertensive medication adherence was unsatisfactory, elevated SUA levels correlated with low antihypertensive adherence, and this correlation was influenced by several singular and combined confounding variables in our patient population. Hence SUA levels can be a predictor and a marker of antihypertensive medication adherence.

Malondialdehyde and antioxidant enzymes in second and third trimesters of pre-eclamptic Nigerian women.

AIM AND OBJECTIVE: To determine changes in malondialdehyde (product of lipid peroxidation) and antioxidant enzymes (Superoxide Dismutase, Glutathione Per-oxidase) levels in pre-eclamptic Nigerian women PATIENTS AND METHODS: A Total of 100 subjects each for pre-eclamptic,apparently normal and non pregnant women were recruited into the study.Venous blood samples were taken from the participants during second and third trimesters of pregnancy and at the point of contact for non pregnant women. Malondialdehyde, glutathione peroxidase and superoxide dismutase were measured accordingly from plasma and haemolysate prepared from whole blood.Variables were analysed using SPSS version 16, taking level of significance to be 0.05 RESULTS: Plasma malondialdehyde in the third trimester (3.13±0.61umol/l) of pre-eclamptic subjects was higher than in the second trimester (3.00±1.21umol/l).Plasma malondialdehyde in the third trimester of normal pregnancy (2.03±0.71umol/l) was also found to be significantly higher than in the second trimester (1.65±0.62umol/ l)(p<0.0001). Glutathione peroxidase in pre-eclamptic subjects was significantly higher in the third trimester (2804.11±1573.00U/L) as compared to the second trimester (2655.00±1751.30U/L), p= 0.0001.Glutathione peroxidase activity in the third trimester of normal pregnancy(3339.50±1733.80U/L) was also found to be higher than in the second trimester(3023.50±1115.90U/L)(p=0.131). Superoxide dismutase activity was significantly lower in the third trimester of pre-eclamptic pregnancy when compared to second trimester (110.40±59.47 Vs 118.01±64.41 U/ ml)(p<0.039) .Similarly,superoxide dismutase activity was significantly lower in the third trimester of normal pregnancy (110.40±59.47U/ml) than in the second trimester(153.01±71.85U/ml)(p<0.0001). CONCLUSION: There was an increased level of lipid peroxidation products,malondialdehyde in subjects with pre-eclampsia. This was more in the third trimester. There was an increased oxidative stress in pre-eclampsia as evidenced also by low serum level of superoxide dismutase in the third trimester.Diet rich in antioxidant enzyme might be beneficial.