Thyroid Dysfunction among Hypertensive Pregnant Women in Warri, Delta State, Nigeria.

The hypertensive pregnant woman is at a higher risk of complications either before, during or after birth and the baby can be adversely affected leading to preterm birth, low birth weight, placental separation (abruption) and other complications. The aim of the study was to evaluate thyroid dysfunction among pregnant women with hypertension. The study participants were 150 hypertensive pregnant women, 25 non-hypertensive pregnant women and 25 non-hypertensive non-pregnant women. Exactly 5mL of blood was collected and used for the assay of triiodothyronine (T3), thyroxine (T4) and thyroid-stimulating hormone (TSH) using the enzyme-linked immunosorbent assay technique. Data were analyzed using appropriate statistical tools. The results showed a significantly higher (p < 0.05) age among hypertensive pregnant women when compared with non-hypertensive pregnant women and non-hypertensive non-pregnant women. The serum TSH was significantly higher (p < 0.035) among hypertensive pregnant women when compared with non-hypertensive pregnant women. The triiodothyronine (T3) of hypertensive pregnant women was observed to be significantly higher (p < 0.05) when compared with both non-hypertensive pregnant women and non-hypertensive non-pregnant women. Some 15/150 (10%) of hypertensive pregnant women had subclinical hypothyroidism, 13/150 (8.7%) had overt hypothyroidism, while 122/150 (81.3%) were euthyroid. Among those with thyroid dysfunction, five and four of the subjects had subclinical hypothyroidism and overt hypothyroidism during the second trimester, while ten and nine had subclinical hypothyroidism and overt hypothyroidism during the third trimester, respectively. Evaluation of hypertensive pregnant women for thyroid function may be routinely performed to enable early diagnosis and treatment.

The patterns and occupational distribution of hormonal abnormalities among men investigated for infertility in some centers in the southwest, Nigeria.

BACKGROUND AND AIM: Male factor infertility results from dysfunction at various levels of spermatogenesis, sex hormone abnormalities, and occupation or workplace exposure to toxins are involved. This study was designed to determine the frequency of occupational distribution of men who were evaluated for infertility, the patterns of hormonal abnormalities, and to associate hormonal abnormalities with occupational categories in some centers in Osun State, Nigeria. METHODS: Semen and 5 mL of whole blood were collected from the infertile men (n=319) who were referred to the laboratories for fertility investigation after physical and medical examination. Semen analysis was performed microscopically according to the World Health Organization manual while serum gonadotrophin-releasing hormone (GnRH), follicle-stimulating hormone (FSH), luteinizing hormone (LH), testosterone, and prolactin were determined by Enzyme-linked Immunosorbent assay technique using reagents supplied by Biorex Diagnostics Limited, Antrim, United Kingdom. The subjects were grouped based on semen characteristics. RESULTS: More than half 164 (51.4%) of the subjects were within the age group of 31-40 years, followed by 70 (21.9%) in the age group of 21-30 years, while 67 (21.0%) was in the age group of 41-50 years. Some 133/319 (41.7%) of the subjects had normal sex hormone levels while 186/319 (58.3%) had abnormal hormone levels. The patterns of hormonal abnormalities observed were 96/186 (51.6%) normogonadotrophin-hypogonadism, 49/186 (26.3%) normogonadotrophin-hypergonadism, 14/186 (7.5%) elevated FSH levels, 15/186 (8.1%) elevated LH levels, 07/186 (3.8%) hypergonadotropic-hypergonadism, and 05/186 (2.7%) hyperprolactinemia. Artisans (OR 1.2252 95%CI 0.367-2.472), workers in chemical related industries (OR 1.667, 95%CI 0.594-4.676), and businessmen (OR 1.200, 95%CI 0.110-3.49) are more likely to be predisposed to hormonal abnormalities. CONCLUSION: The patterns of hormone abnormalities as well as their relative proportions are slightly different from those reported previously. Some occupations may predispose workers to hormonal disorder than the others. RELEVANCE FOR PATIENTS: This is a cross-sectional study of males investigated for infertility; the contribution and patterns of hormonal abnormalities were evaluated. The possible association between workplace and infertility that may assist in the management of patients with male infertility was evaluated.

Association between a marker of sperm DNA damage and sperm indices in infertile males in Benin City, Nigeria: A cross-sectional study.

BACKGROUND: Studies have shown oxidative DNA damage is associated with male infertility. OBJECTIVE: This study determines the levels of 8-hydroxy-2'-deoxyguanosine (8-OHdG) and some markers of oxidative stress in seminal fluid of males investigated for infertility and men of proven fertility in Benin City, Nigeria. MATERIALS AND METHODS: Semen samples produced by self or assisted masturbation were analyzed by microscopic technique according to the World Health Organization guidelines. Thereafter, samples were centrifuged and seminal fluid plasma separated and stored at -20°C prior to assay for 8-OHdG and oxidative stress biomarkers. Based on the sperm concentration/count, the overall samples were grouped into the following categories: normospermia (n = 20), oligozoospermia (n = 30), and azoospermia (n = 20). The control group comprised of 30 age-matched males of proven fertility. The seminal fluid 8-OHdG, total antioxidant status, superoxide dismutase and malondialdehyde (MDA) were assayed through ELISA and spectrophotometric methods, respectively. RESULTS: Seminal plasma level of 8-OHdG and MDA were significantly higher (p = 0.01) in infertile subjects than controls. The mean levels of 8-OHdG and MDA in infertile subjects were higher in azoospermia than oligospermia than normospermia and so, was least in the normospermia. Conversely, the mean levels of total antioxidant status and superoxide dismutase were significantly lower (p = 0.01) in infertile than fertile the control male subjects with levels higher in normospermia than oligospermia and least in azoospermia. Moreover, the seminal 8-OHdG correlated negatively with sperm count (r = -0.359, p = 0.01), percent motility (r = -0.388, p = 0.04), and percent morphology (r = -0.327, p = 0.02). CONCLUSION: The assessment of sperm DNA damage in addition to routine seminal fluid analysis may play an important role in specific diagnosis and management of male infertility.

Effects of lifestyle factors on fertility: practical recommendations for modification.

The role that lifestyle factors play in fertility issues has generated some amount of interest and questions among stakeholders. This review aims to highlight the impact of lifestyle behaviors on the fertility potential of an individual and what can be done to prevent or improve reproductive outcomes. Relevant published articles on the effect of lifestyle behaviors were obtained from Medline, Pubmed and Google scholar search engines for the study. The review of the literature indicates a negative impact of modifiable lifestyle factors such as fat-rich diets, delayed childbearing/age of starting family, smoking, alcohol misuse, sexual behavior, anxiety/depression and perception/beliefs were associated with fertility. The ensuing stress precipitates social behaviors such as excessive alcohol and caffeine consumption, tobacco smoking, misuse of recreational drugs/medications, which increases the risk of sexually transmitted diseases and infection leading to infertility. Practical recommendations to modify lifestyle behaviors and the impact of misconception of Assisted Reproductive Technology in the treatment of infertility are discussed. The need to make appropriate behavioral changes to stem the tide of infertility in Nigeria is imperative. More reproductive health education is needed to create the necessary awareness of the etiologies of infertility and the importance of in vitro fertilization treatment as a means of conceiving 'natural' babies is suggested. LAY SUMMARY: Scientific evidence has suggested that modifiable lifestyle factors (consumption fat-rich diets, delayed childbearing/age of starting family, smoking, alcohol misuse, sexual behavior, anxiety/depression and perception/beliefs) play important roles in the general health and wellbeing of individuals including fertility. Evidence exists of an association between lifestyle behaviors and infertility in both men and women. Understanding the various processes through which modifiable lifestyle behaviors impair fertility will help to assist in the management of affected individuals. We conducted a comprehensive review of published studies to assess how lifestyle factors inhibit fertility and practical ways to ameliorate them. This review also deals with the misconception of Assisted Reproductive Technology in the treatment of infertility. The need to make appropriate behavioral changes to stem the tide of infertility in Nigeria is imperative. More reproductive health education is needed to create the necessary awareness of the causes of infertility and the importance of in vitro fertilization in the treatment of infertility.

Effect of senescence on some apoptosis and oxidative stress markers in infertile normozospermic and oligospermic men: A cross-sectional study.

BACKGROUND: Male senescence may affect testicular function, sperm indices and generation of high levels of oxidants and apoptosis. OBJECTIVE: This study evaluates the effect of male age on the expression of some apoptosis and oxidative stress markers in seminal fluid of males investigated for infertility in a tertiary health institution in Nigeria. MATERIALS AND METHODS: In this cross-sectional study, 122 men aged 20-60 yr who were investigated for infertility and were stratified according to age into four groups. Seminal plasma caspase 3, cytochrome C, and total antioxidant capacity (TAC) were assayed by ELISA technique, while manual semen analysis was performed according to WHO standard. RESULTS: Seminal caspase 3, and cytochrome C activity increased while TAC and sperm indices decreased with increasing age. Cytochrome C (r=0.288; p=0.002) and caspase 3 (r=0.250; p=0.05) correlated significantly with age in normospermia while cytochrome C (r=0.314; p=0.02), caspase 3 (r=0.268; p=0.05), TAC (r=-0.342; p=0.01) and morphology percentage (r=-0.414; p=0.002) correlated with age in oligospermic infertile males. CONCLUSION: The measured apoptotic markers increased with increasing age while TAC and sperm indices decreased with increasing age of subjects evaluated. Although the levels of measured apoptosis and oxidative stress markers correlated with age in normozospermia, the effect on sperm indices was severe among oligospermia compare to normozospermia. Therefore, these markers may be assayed in aged men attending fertility clinics.

Asymptomatic thyroid dysfunction in human immunodeficiency virus-1-infected subjects.

BACKGROUND: Thyroid hormone abnormalities have been reported elsewhere in human immunodeficiency virus-1 (HIV-1)-infected individuals, but such studies in Nigerians are scarce in literature. OBJECTIVE: To evaluate thyroid function in HIV-1-infected individuals and to correlate thyroid function parameters with cluster of differentiation (CD4+) cell count. MATERIALS AND METHODS: Total thyroxine (T4), total triiodothyronine (T3), thyroid-stimulating hormone (TSH), and CD4+ were estimated in 100 HIV-1-positive individuals on highly active antiretroviral therapy (HAART), 100 HIV-1-positive HAART naïve, and 100 HIV-1-negative controls. The mean values were compared between the groups, and CD4+ cell count was correlated with measured thyroid hormones. RESULTS: Thyroid function abnormalities were seen in 52 HIV-1-positive individuals on HAART and 56 individuals without HAART treatment. The pattern of thyroid hormone abnormalities is similar in both groups. Among the individuals on HAART, 10 had subclinical hypothyroid, 42 sick euthyroid, and 48 had normal thyroid hormones levels. Similarly, among those without HAART therapy, seven had subclinical hypothyroid, 49 sick euthyroid, and 44 had normal thyroid hormones levels. The HIV-1-positive individuals had significantly lower (P < 0.001) CD4+ cell count, TSH (P < 0.05), T3 (P < 0.01), and T4 (P < 0.001) when compared with controls. On the other hand, HIV-1-positive individuals on HAART had significantly higher (P < 0.01) CD4+ cell count and lower (P < 0.05) T4 levels than the HAART naïve group. CD4+ correlated positively with T4 in HIV-1-positive individuals on HAART (r = 0.26; P = 0.016) and HAART naïve (r = 0.218; P = 0.038). There was no significant correlation between CD4+ and measured thyroid hormones in the control individuals. CONCLUSION: Asymptomatic thyroid hormone abnormalities are common in HIV-infected individuals, and these abnormalities are independent of whether the individuals were on HAART or without HAART treatment.

The Association of Triiodothyronine-to-Thyroxine Ratio with Body Mass Index in Obese Nigerian Children and Adolescents.

The interest in the relationship between thyroid dysfunction and obesity is on the increase. This study compares the triiodothyronine-to-thyroxine (T3/T4) ratio in obese and lean children and adolescents, and correlates thyroid hormones with body mass index (BMI) in obese Nigerian children. It is a retrospective study of records of 76 obese children and adolescents with a BMI of 31.7 ± 0.1 kg/m² (26 males aged 10.9 ± 0.35 years, and 50 females aged 10.8 ± 0.4 years) that were referred to the laboratory for thyroid hormone evaluation because of their obese status. The controls were 20 age-matched non-obese apparently healthy subjects, with a mean age of 11.0 ± 0.47 years and a BMI of 20.2 ± 0.2 kg/m². Serum T3, T4, and thyroid stimulating hormone (TSH) were determined using ELECSYS 1010 auto-analyzer (Roche Diagnostics, Penzberg, Germany). The BMI (p < 0.001), T3 (p < 0.01), TSH (p < 0.001) and T3/T4 ratio (p < 0.001) were significantly higher in obese than non-obese children and adolescents. Triiodothyronine (r = 0.230; p < 0.05), TSH (r = 0.272; p < 0.02), and T3/T4 ratio (r = 0.232; p < 0.05) correlated positively with BMI in obese children and adolescents. The T3/T4 ratio (p < 0.005) was significantly higher in obese boys than obese girls. Serum T3, TSH, and T3/T4 ratio correlated positive with BMI in obese Nigerian children and adolescents. Since thyroid dysfunction represents a continuum from asymptomatic to clinical symptomatic disease, it is suggested that obese children be counseled on the need to maintain ideal BMI in order to avoid the risks associated with obesity.

Serum Creatine Kinase-MB Isoenzyme Activity among Subjects with Uncomplicated Essential Hypertension: Any Sex Differences.

Hypertension (high blood pressure) is a major health challenge and more women than men are affected by the condition. Complications as a result of this condition often lead to disabilities and premature death. The objective of this study was to evaluate creatine kinase-MB (CK-MB) activity in uncomplicated hypertension and to know whether sex differences exist in the activity of the enzyme. Serum creatine kinase-MB isoenzyme activity, troponin I, and lipid profile were evaluated in 140 male and 100 female Nigerians with hypertension. The control group was comprised of 100 (50 males and 50 females) normotensive subjects. Measured parameters were assayed using Selectra Pros chemistry analyzer. The means were compared between males and females using Students't-test. The mean CK-MB activity of the female hypertensive subjects was significantly higher (p < 0.001) than the males. Similarly, the mean cardiac troponin I (cTnI) of the female hypertensive subjects was significantly higher (p < 0.001) than the males. Conversely, the mean CK-MB activity of the female normotensive subjects was significantly lower (p < 0.001) than the male counterparts. There was no difference in the levels of cTnI between male and female normotensive subjects. Serum CK-MB activity was higher in female than male hypertensive subjects. In the light of these results, cardiac markers should be routinely done in the evaluation of hypertensive subjects and sex-specific consideration may be recognized in the management of these patients.

Relationship between Neutrophil-to-Lymphocyte Ratio and Inflammatory Markers in Sickle Cell Anaemia Patients with Proteinuria.

The renal functions and structure in sickle cell anaemia (SCA) patients may be affected by chronic haemodynamic changes and consequences of vaso-occlusive events in the renal medulla. Few reports on neutrophil-to-lymphocyte (NLR) and platelet-to-lymphocyte (PLR) ratios in SCA patients in Africans exist in the literature. This study correlates the values of NLR and PLR with measured traditional inflammatory markers in SCA patients with and without proteinuria and impaired kidney function (defined in this study as estimated glomerular filtration rate (eGFR), less than 60 mL/min/1.73 m². Full blood count, C-reactive protein (CRP), and fibrinogen were assayed in 150 SCA patients and 50 control subjects using Coulter Haematology analyser (CELL DYE 37000) and ELISA method, respectively. The NLR and PLR were calculated by dividing absolute neutrophil or platelet counts by absolute lymphocyte count. Fibrinogen, CRP, NLR, and PLR increased progressively (p < 0.001) in SCA patients with or without proteinuria, with the highest values seen in those with impaired renal function. NLR correlated positively with CRP and fibrinogen in SCA patients without proteinuria (p < 0.001), with proteinuria (p < 0.001), and impaired renal function (p < 0.05). A positive relationship was also observed between NLR and fibrinogen in the control subjects. The need to determine cut-off values for these leukocyte ratios to be used in identifying those patients at risk and in the general management of SCA patients is suggested.

Do Sex Differences in Respiratory Burst Enzyme Activities Exist in Human Immunodeficiency Virus-1 Infection?

Studies have shown that human immunodeficiency virus type 1 (HIV-1) disproportionally affects more females than males. Affected individuals are susceptible to infections due to depressed immunity, qualitative defects in phagocytic function and altered phagocytosis as well as lowered oxidative burst capacity. This study seeks to determine whether sex differences exist in serum activities of respiratory burst enzymes in HIV-1-infected female and male subjects. Serum myeloperoxidase, catalase and superoxide dismutase activities were assayed in 170 confirmed HIV-1 positive and 50 HIV-1 negative subjects using ELISA. Data were analyzed using Student's t-test and p values of less than 0.05 were considered significant. The measured enzyme activities were significantly higher (p < 0.001) in females than males in HIV-1 negative subjects while no sex differences were observed in HIV-1 positive subjects. The absence of sex differences in the activities of respiratory burst enzymes in HIV-1 infection may be due to immune activation as a result of active phagocytic leukocytes, immune reactivity and inflammation.

Increased Levels of Pancreatic Enzymes in Sickle Cell Anemia and the Effect of Proteinuria

Background/Objective: Sickle cell disease (SCD) is the most common hemoglobinopathy in Nigeria; and the condition can affect any part of the body including the pancreas. The study seeks to evaluate the levels of pancreatic enzymes in blood and urine of SCD patients in steady clinical state; and the effect of proteinuria on the enzyme levels as proteinuria was previously reported in SCD subjects. Materials and Methods: Urine and plasma amylase; serum lipase; and proteinuria were determined in 150 subjects comprising 100 SCD patients and 50 age/sex matched apparently healthy subjects with normal hemoglobin using commercially available reagent test kits. Results: Urine amylase (P = 0.029); serum amylase (P 0.001); lipase (P

Serum alpha-fetoprotein level is higher in hepatitis C than hepatitis B infected chronic liver disease patients.

BACKGROUND: The frequency of raised serum alpha-fetoprotein may vary in relation to hepatitis B or C infection in chronic liver disease (CLD). The study evaluated the frequency of hepatitis B and C in patients with chronic liver disease and correlated the levels of serum alpha-fetoprotein with hepatitis B and C infection in the patients. MATERIALS AND METHODS: Eighty-six patients with CLD were recruited for the study. Fifty subjects, with no CLD were used as control. Hepatitis B surface Antigen (HBsAg) and hepatitis C antibody were determined using enzyme-linked immunosorbent assay (ELISA) technique (Human diagnostics, Germany and HCV Murex 40 Anhet laboratories, USA) while liver function tests were evaluated using express plus chemistry auto analyzer. Alpha-fetoprotein was assayed using ELECSYS 1010 auto analyser. RESULTS: There were 60 males and 26 females, with a mean age of 46 + 6.5 years, while the controls were 25 males and 25 females with a mean age of 41 ± 2.5 years. Thirty-six subjects (41.7%) were seropositive for HBsAg while 24 (27.9%) were seropositive for Hepatitis C Virus (HCV) antibody. The mean alpha fetoprotein level was 359 ± 9.9 ng/mL while mean control value was 1.93 ± 0.24 ng/mL. Liver function test parameters were elevated compared with control subjects (P < 0.001). The increase in serum alpha-fetoprotein was higher (P < 0.001) in HCV than HBsAg positive patients. CONCLUSION: Serum alpha-fetoprotein level was highest in HCV compared to HBsAg positive and hepatitis negative patients with CLD.