Antioxidant status of type 2 diabetic patients in Port Harcourt, Nigeria.

CONTEXT: Oxidative stress has been implicated in the pathogenesis of type 2 diabetes mellitus (T2DM) and its complications. AIMS: This study was conducted to determine and compare total antioxidant status (TAS), vitamin C and E levels in T2DM patients and healthy control subjects. SETTINGS AND DESIGN: Fifty-five previously diagnosed DM patients aged between 34 years and 70 years and 50 control subjects aged between 35 years and 69 years were consecutively recruited into this study. MATERIALS AND METHODS: Blood pressure (mmHg), body mass index (kg/m 2 ), concentrations of plasma glucose (mmol/l), lipid profile (mmol/l), TAS (mmol/l), vitamins C (µmol/l), and E (µmol/l) were determined in all participants. STATISTICAL ANALYSIS USED: Statistical Package for Social Sciences (SPSS) version 11.0 was used for statistical analysis. RESULTS: The mean plasma TAS (1.18 ± 0.27 mmol/l), vitamin C (26.59 ± 7.39 µmol/L) and vitamin E (15.33 ± 4.05 µmol/l) of T2DM patients were significantly lower (P=0.0001 for all) than those of controls (1.58 ± 0.28 mmol/l, 43.56 ± 6.86 µmol/l, 31.22 ± 6.20 µmol/l respectively). TAS had a positive correlation with vitamin E (r=0.588; P=0.013) but no correlation with vitamin C (r=-0.387; P=0.139) among diabetics. CONCLUSIONS: TAS, vitamin C and E levels are reduced in T2DM patients compared with those of controls.

Antioxidant status of subjects with Metabolic Syndrome in Port Harcourt, Nigeria.

AIMS AND OBJECTIVES: Increased free radical production and thus oxidative stress have been implicated in the pathogenesis of metabolic syndrome. As a result there is depletion of defences against free radical damage which comprise antioxidant enzymes and vitamins like vitamins C and E, resulting in low plasma levels. This study was designed to determine if the plasma total antioxidant status and vitamins C and E levels are lower in metabolic syndrome subjects living in Port Harcourt, Nigeria compared to healthy controls. PATIENTS AND METHODS: One hundred subjects between 21 and 73 years of age who satisfied the National Cholesterol Education Program (NCEP) Adult Treatment Panel (ATP) III criteria for metabolic syndrome were recruited into the study. One hundred controls were age- and sex-matched. After determining their blood pressure (mmHg) and waist circumference (cm), the concentrations of plasma glucose (mmol/L), lipid profile (mmol/L), total antioxidant status (TAS, mmol/L), vitamin C (mol/L) and vitamin E (mol/L) were estimated in all participants. RESULTS: The mean plasma TAS (1.23 ± 0.28mmol/L), vitamin C (27.5 ± 7.4mol/L) and vitamin E (16.9 ± 4.9mol/L) of metabolic syndrome subjects were significantly lower (P=0.0001 for all) than that of controls (1.58 ± 0.28mmol/L, 44.3 ± 7.3mol/ L, 30.8 ± 6.1mol/L respectively). CONCLUSION: The TAS, vitamins C and E are reduced in metabolic syndrome subjects compared with that of controls. This may be due to increased oxidative stress resulting from an imbalance between antioxidant defences and increased free radical production.

Microalbuminuria in children with human immunodeficiency virus (HIV) infection in Port Harcourt, Nigeria.

BACKGROUND: Microalbuminuria is an early manifestation of HIV associated nephropathy (HIVAN). This study was to determine the prevalence and risk factors for microalbuminuria in children with HIV infection in Port Harcourt, Nigeria. METHODS: Urine specimen of 50 children with HIV infection seen over a 4 months period (October 2007-February 2008) was assayed for albumin and creatinine to determine urinary albumin to creatinine ratio (ACR). Microalbuminuria was defined as urinary albumin to creatinine ratio (ACR) of greater than 2.5-25 mg/mmol. The glomerular filtration rate (GFR) was calculated using the Schwartz formula. RESULTS: There were 28 (56%) males and 22 (44%) females with a male to female ratio of 1.3:1. They aged 1 month to 18 years with a mean age of 4.07 +/- 3.61 years. Microalbuminuria occurred in 6 (12%) patients; 3 males and 3 females, mean age of 5.5 +/- 4.6 years. Five (83.3%) of the patients with microalbuminuria had clinical AIDS and CD4+ cell count less than 200 cells/microL. All the patients with microalbuminuria were not receiving highly active antiretroviral therapy (HAART) at the time of study. One (16.7%) patient had overt HIV-associated nephropathy (HIVAN) with ACR greater than 2.5 mg/mmol, elevated serum creatinine 400 micrommo/L, urea of 20 mmol/L and a GFR of 69 ml/min/1.73m2. CONCLUSION: The prevalence of microalbuminuria in Nigerian children with HIV infection is high, and it occurs mainly in older children with clinical AIDS who are not on HARRT.

Inhibins, activins and follistatins: a review.

The study of the regulation of the reproductive process has largely focused on the interplay between endocrine organs, gonads and the brain. The discovery of inhibins, activins and follistatins and elucidation of their actions has emphasised their role in human reproduction. This review discusses various evidences provided for their role as well as their potential uses as clinical markers of reproductive function and pathologies.

Plasma Glucose in a Reference Population in Port Harcourt; Nigeria

Background: Reference intervals are important in the analysis of results obtained for patients in the Hospital. These intervals tend to change as population demographics change. Globally; there has been an increase in the prevalence of diabetes and a change in the criteria set in diagnosing this disease. Since we have used the same reference intervals since 1984; it became imperative to review the reference intervals in use in our Hospital; the University of Port Harcourt Teaching Hospital; Port Harcourt; Nigeria. Methods : A total of 605 patients from the Out-Patient department and the Hospital community randomly following informed consent. Five milliliters (5mls) of blood was collected into fluorides oxalate bottles between 9.00-11.00 a.m. after an overnight fast for the determination of plasma glucose. The samples were assayed daily within two hours of collection. Serum glucose was determined using the glucose oxidase method (Randox Laboratories-Antrim UK). Results: The reference interval covering the central 95th centile as determined by non-parametric methods was 3.0-5.7 mmol/L (95confidence interval-2.7-3.2 and 5.6-5.8 mmol/L) for the entire study population; while that for males was 2.9-6.3 mmol/L and that for females was 3.3-5.6 mmol/L. Conclusion : It is essential to review reference intervals periodically as changes may occur due to changes in population demographics

Pattern of abnormal liver enzymes in HIV patients presenting at a Nigerian Tertiary Hospital.

AIM: To demonstrate the pattern of abnormal liver enzymes in HIV patients presenting at the University of Port Harcourt Teaching Hospital, Port Harcourt. BACKGROUND: Abnormalities of liver function tests (LFT) have been shown to be common in HIV/AIDS in developed countries. Studies have shown that these abnormalities may be due to direct inflammation induced by the HIV virus on the liver cell. It may also be due to gall bladder disease and infection with bacterial, viral or other opportunistic agents. PATIENTS AND METHODS: We reviewed the clinical notes and biochemistry results of HIV positive patients presenting at the HIV clinic from January 2003 to October 2003. Efforts were made to elicit symptoms suggestive of hepatobiliary disease. Their hepatitis B surface antigen status and their hepatitis C status were obtained. Attempts were made to determine the pattern of liver injury in each patient seen. RESULTS: A total of one hundred and twenty -nine (129) cases were recruited. The mean age was 35.6 +/- 9.0 years with a male to female ratio of 1.1 : 1. One hundred and thirteen patients (87.6%) had abnormalities of their LFT'S. Sixteen of these (14.5%) were classified as cholestatic liver injury while ninety-four (85.5%) were classified as having hepatocellular injury. Three patients (2.3%) were HbSAg positive while one (0.8%) was hepatitis C antibody positive. None of the patients was on anti retroviral drugs at the time of recruitment. CONCLUSION: We therefore conclude that abnormalities of liver enzymes are common in patients with HIV in this environment. It is therefore important to characterise the nature of this abnormality and to institute appropriate management. However further studies are required in this field of HIV related liver disease in our locality.

Effect of organo- phosphorus compounds on plasma cholinesterase levels in industrial and non-industrial workers in Port Harcourt.

BACKGROUND: Port Harcourt is a city with a high concentration of companies (Industries) using organo-phosphorus compounds with workers who have been exposed to these compounds for varying lengths of time. This study looks at the effects of exposure to these compounds on the health of these workers relative to the control group by measuring the plasma cholinesterase activity of the workers and the control group. METHODS: In this prospective study, 200 subjects were selected from the companies in Port Harcourt (40 from each of five companies using organo-phosphorus compounds) and 50 controls selected from the state secretariat complex. The subjects in each of the five companies were again subdivided into "directly exposed" and "non-exposed". Among the "exposed" a group of workers who had worked in the organo-phosphorous unit for more than four years (prolonged exposure) were sorted out. The popular kinetic colorimetric method using Butyrylthiocholine with liquid reagents was used for measuring plasma cholinesterase activity. RESULTS: Results obtained showed significant reduction in the plasma cholinesterase activity of subjects exposed to organo-phosphorous compounds (5466+/-948) when compared with the control group (8042+/-1011) P<0.05. This reduction was more marked in those subjects who had been exposed to organo-phosphorus compounds for more than 4 years (4614+/-532) P<0.05. There was no significant difference in the mean plasma cholinesterase activity between the "non-exposed" company workers (8133+/-1635) and the control (8042+/-1011) P>0.05. CONCLUSION: Exposure to organo-phosphorus compounds causes reduction in the plasma cholinesterase activity and this reduction is directly related to the duration of exposure.

Comparison of red cell cholinesterase and plasma cholinesterase activities in early detection of organo-phosphorus toxicity in exposed industrial workers in Port Harcourt, Nigeria.

BACKGROUND: The Niger Delta region of Nigeria has a high concentration of companies using organo-phosphorus compounds with workers who have been exposed to these compounds for varying lengths of time resulting in toxic manifestations in some of the workers. Studies have revealed that plasma cholinesterase and red cell cholinesterase levels are reduced following organo-phosphorus toxicity. This study looks at cholinesterase levels in plasma and red cell in the occupationally exposed groups and control with a view to determining which will be more useful in the early detection of organo-phosphorus toxicity. METHOD: Fourty seven subjects with early symptoms of organo-phosphorus toxicity who have worked for more than 4 years with organo-phosphorus compounds were selected from five companies localized around the same area in Port Harcourt. Fifty subjects who do not work directly with organo-phosporus compounds from the same companies as the 47 workers above but not working directly in the organo-phosphorus units were also studied while 50 persons working in the civil service were recruited as controls. The kinetic colorimetric method was used for measuring plasma and red cell cholinesterase activity Result: The results showed significant reduction in the mean plasma cholinesterase activity in the chronically exposed subjects (4614. +/- 532) who showed symptoms of toxicity when compared with that of the control group (8095 +/- 575). There was no statistical difference in the mean red cell cholinesterase activity of the chronically exposed group (7998. +/- 948) when compared with that of the control (8115. +/- 712) P > 0.05 CONCLUSION: The effect of organo-phosphorus poisoning occurs early and is more marked in plasma cholinesterase than in the red cell cholinesterase. Plasma cholinesterase is thus more useful in early detection of organo-phosphorus toxicity than red cell cholinesterase.

Sero-prevalence of hepatitis B surface antigen (HBsAg) in pregnant women in Port Harcourt, Nigeria.

BACKGROUND/OBJECTIVE: Hepatitis B Virus (HBV) infection is a global public health problem and is endemic in Asia and Sub-Saharan Africa, including Nigeria. Vertical transmission of HBV infection is thought to be a major mode of transmission in endemic areas. This study was therefore undertaken to determine the sero-prevalence of Hepatitis B surface antigen (HBsAg) on pregnant women in Port Harcourt, Nigeria, in an effort to obtain baseline information on disease burden in this locality, in order to institute public health measures to reduce transmission. PATIENTS AND METHODS: Serial recruitment of 600 women attending the ante-natal clinic at the University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria. HBsAg screening was done using a rapid ELISA Kit. RESULTS: 26(4.3%) of the 600 subjects tested positive to HBsAg. Blood transmission, dental manipulations, tattooing and circumcision were found not to be significant modes of transmission of HBV infection in Port Harcourt. CONCLUSION: There is an intermediate prevalence (4.3%) of HBV infection in pregnant women in Port Harcourt, Nigeria. The need to institute public health measures to reduce disease burden and transmission, including routine screening of all pregnant mothers for HBV infection and early passive/active immunisation of babies born to HBsAg--positive mothers is advocated.

Knowledge, attitude and practice of aspects of laboratory safety in Pathology Laboratories at the University of Port Harcourt Teaching Hospital, Nigeria.

OBJECTIVE: To assess current knowledge, attitudes and practice of aspects of laboratory safety in pathology laboratories at the University of Port Harcourt Teaching Hospital in view of perceived inadequacies in safety practices in clinical laboratories in developing countries. MATERIALS AND METHODS: Sixty (60) self- administered questionnaires were distributed to all cadres of staff in four (4) different laboratories (Chemical Pathology, Haematology, Blood bank and Medical Microbiology) at the Hospital. RESULT: Gross deficiencies were found in the knowledge, attitudes and practice of laboratory safety by laboratory staff in areas of use of personal protective equipment, specimen collection and processing, centrifuge--related hazards, infective hazards waste disposal and provision and use of First Aid Kits. CONCLUSION: Issues pertaining to laboratory safety are not yet given adequate attention by both employers and employees in developing countries in this ear of resurgence of diseases such as HIV/AIDS and Hepatitis Band C, is emphasized.

Health and safety in clinical laboratories in developing countries: safety considerations.

BACKGROUND: Clinical laboratories are potentially hazardous work areas. Health and safety in clinical laboratories is becoming an increasingly important subject as a result of the emergence of highly infectious diseases such as hepatitis and HIV. This is even more so in developing countries where health and safety have traditionally been regarded as low priority issues, considering the more important health problems confronting the health authorities in these countries. METHODS: We conducted a literature search using the medical subheadings titles on the INTERNET over a period of twenty years and summarized our findings. RESULTS: This article identifies hazards in the laboratories and highlights measures to make the laboratory a safer work place. It also emphasizes the mandatory obligations of employers and employees towards the attainment of acceptable safety standards in clinical laboratories in Third World countries in the face of the current HIV/AIDS epidemic in many of these developing countries especially in the sub-Saharan Africa while accommodating the increasing work load in these laboratories. CONCLUSION: Both the employer and the employee have major roles to play in the maintenance of a safe working environment. This can be achieved if measures discussed are incorporated into everyday laboratory practice.