The effect of a membrane dialyzer during hemodialysis on the antioxidant status and lipid peroxidation of patients with end-stage renal disease.

Renal failure is accompanied by oxidative stress, which is caused by enhanced production of reactive oxygen species (ROS) and an impaired antioxidant defense. We studied 73 hemodialysis (HD) patients (39 males and 34 females) aged 24-75 years; the patients were randomized into two subgroups according to the type of hemodialysis membrane (35 patients were dialyzed on cellulose and 38 patients on polysulfone F7/F9 membrane dialyzers) and we assessed their antioxidant and lipid peroxidation status levels. The total antioxidant status (TAS) levels including whole blood levels of malondialdehyde (MDA) and glutathione (GSH); glutathione peroxidase (GSH-Px), superoxide dismutase (SOD), and catalase (CAT) activities were measured, before and after hemodialysis. The MDA levels significantly increased 52.0% and 16.9% post dialysis among the cellulose and the polysulfone dialyzer users, respectively, (P<0.05). The TAS levels significantly decreased, 22.0 and 16.5% in the cellulose and polysulfone dialyzer users, respectively, (P<0.05). The erythrocyte SOD activity decreased 25.1 and 19.1% in the cellulose and the polysulfone dialyzer users, respectively, (P<0.05). The GSH concentrations, post dialysis, decreased 49.9 and 6.8% in the cellulose and polysulfone dialyzer users, respectively, (P<0.05). In contrast, the erythrocyte activity of CAT, post dialysis, increased 15.0 and 37.3% in the polysulfone and the cellulose dialyzer users, respectively, (P<0.05). We conclude that the type of the dialysis membrane affects the oxidative status after HD with possible consequences on patient morbidity and mortality.

Relevance of fibrinolytic protein (D-dimer) and fibrinopeptide A as markers of sickle cell anaemia vaso-occlusive crisis.

AIMS AND OBJECTIVES: To determine the plasma concentration of fibrinolytic protein (D-dimer) and Fibrinopeptide A(FPA) in sickle cell anaemia (SCA) patients in steady state and vaso-occlusive crisis(VOC) for the purpose of determining their clinical value in assessing/or predicting the onset of VOC Subjects and Methods: A total of 25 (14 Males: 11Females) HbSS subjects in VOC , 24 (13M:11F) HbSS subjects in steady state between the ages of 10-40 years old and 30 (17M:13F) healthy HbAA volunteers, of the same age and sex with the subjects were recruited for the study. Haematological parameters{Haemoglobin (Hb), Haematocrit(HCT), White blood cell count(WBC) and Platelets(Plt)}, prothrombin time(PT), activated partial thromboplastin time(APTT), plasma concentrations of D-dimer and FPA were determined. RESULTS: Haemoglobin concentration of 6.22±1.75 g/dl and HCT of 18.45±6.43% for SCA subjects in VOC; Hb of 7.42±1.36 g/dl and HCT of 22.83 ±4.68% in steady state were significantly decreased(p <0.01) compared with Hb(13.0±1.04 g/dl and HCT( 41.09±3.50%) for HbAA controls. However, plasma FPA of 680.99 ± 411.37 ng/ml, WBC of 19.44±14.88 x109/L, Plt of 292.72±148.57 x109/L, APTT of 52.24±5.34sec. for SCA subjects in VOC and Plasma FPA of 449.67 ± 310.01 ng/ml, WBC of 11.84±7.67 x109/L, Plt of 292.72±148.57 x109/L, APTT of 47.76±4.80secs in steady state were significantly increased when compared with FPA(163.52 ± 86.26ng/ml), WBC(5.15±1.24 x109/L), Plt(173.44±59.90 x109/ L), APTT( 37.75±1.41secs) for HbAA controls. CONCLUSION: Fibrinolysis is not significantly increased in SCA either in the steady state or during VOC. Fibrinopeptide A assay appears to be of value in the assessment of VOC in sickle cell anaemia.

Antioxidant status and reproductive hormones in women during reproductive, perimenopausal and postmenopausal phase of life.

BACKGROUND: Reproductive aging resulting in menopause with permanent cessation of ovarian follicular activity. The progressive loss of estrogen and its protective effects, combined with deficient endogenous antioxidant results in oxidative stress. OBJECTIVE: To assess the level of oxidative stress and its relationship with reproductive hormones at various developmental phases of women. METHODS: A total of 186 (65 in Reproductive, 58 in Perimenopausal, and 63 in Postmenopausal phase) participants between the ages of 20-60 years were recruited for the study. Follicle-stimulating hormone (FSH), luteinizing hormone (LH), progesterone, estradiol, total antioxidant status (TAS), malondialdehyde (MDA) and reduced glutathione (GSH); activities of glutathione peroxidase (GSH-Px), superoxide dismutase (SOD) and catalase (CAT) levels were all determined. RESULTS: FSH, LH and MDA levels were significantly increased during perimenopausal and postmenopausal phases compared to reproductive phase; however, estradiol, progesterone, TAS and GSH levels were significantly decreased during perimenopausal and postmenopausal phases compared to reproductive phase. The erythrocyte activities of GSH-Px, SOD and CAT were significantly decreased during perimenopausal and postmenopausal phases compared to reproductive phase. It was observed that MDA showed positive correlation with LH and FSH while a negative correlation with estradiol and progesterone was observed; whereas, antioxidants showed negative correlation with LH and FSH while a positive correlation with estradiol and progesterone. CONCLUSION: The present study revealed that normal perimenopausal and postmenopausal phase are associated with oxidative stress. Therefore it may be of benefit when both phases are being managed in term of hormonal deficit if antioxidant is an adjunct.

Relationship between liver function tests and thyroid hormones in thyroid disorders.

AIMS AND OBJECTIVES: To evaluated the effect of thyroid dysfunction on liver function tests and if there is any correlation between them. MATERIALS AND METHODS: A total of 68 subjects (40 hyperthyroid and 28 hypothyroid) between the ages of 20-60 years old and 40 healthy euthyroid volunteers of the same age groups were studied. Plasma albumin, bilirubin (total and conjugated), thyroxine (T4), triiodothyronine (T3), thyroid stimulating hormone (TSH); activities of aspartate transaminase (AST), alanine transaminase (ALT), alkaline phosphatase (ALP) and gamma glutamyltransferase (GGT) were estimated in the plasma of the participants. RESULTS: Plasma concentration of Total .bilirubin and liver enzyme activities increased significantly in both hyperthyroid and hypothyroid subjects. The positive correlations between thyroid hormones and liver enzymes in hyperthyroid subjects were negative in hypothyroid subjects and vice-visa. CONCLUSION: It can be concluded that both hyperthyroidism and hypothyroidism altered liver function tests. It is thus recommended that liver function tests interpretation in thyroid dysfunction should be with caution.

Influence of ageing process on body composition of antioxidant and lipid peroxidation among healthy individuals in South West Nigeria.

AIMS AND OBJECTIVES: To evaluate the effect of ageing on the level of antioxidants and lipid peroxidation in healthy individual of various age groups. SUBJECTS AND METHODS: A total number of 162 healthy males and females volunteer between the ages of 18-80 years were divided into three groups. These volunteers were divided into group i(18-30 yr), group ii (31-60 yrs) and group iii (60-80 yr). Plasma concentration of total bilirubin, uric acid, ascorbic acid, a-tocopherol, retinol, total antioxidant status (TAS), malondialdehyde (MDA), glutathione (GSH) and ceruloplasmin measured. Erythrocyte antioxidant enzyme activities of superoxide dismutase (SOD), catalase (CAT), glutathione and peroxidase (GSHPx) were measured using standard methods. RESULTS: Erythrocyte antioxidant enzymes (GSH-Px and SOD) activities and GSH level were significantly reduced among group iii (p<0.01) and group ii (p<0.05) age group subjects compared to the younger age group i. Conversely, MDA showed a significant increase in group iii (p<0.01) and group ii (p<0.01) compared to younger age group i. CAT activity and TAS level were reduced significantly (p<0.05) in both groups iii and ii compared to younger age group i. Ascorbic acid, a-tocopherol and retinol levels were significantly reduced among group iii (p<0.05) compared to group i. CONCLUSION: Ageing was associated with increased lipid peroxidation and lower antioxidant defenses. Changes that occur during ageing cannot be avoided but may be delayed and controlled to some extent. To counter these changes, dietary supplementation of a variety of antioxidants might be beneficial.

Plasma level of atherogenic and anti-atherogenic factors among palm wine drinkers of rural southwest Nigeria.

BACKGROUND: Scientific evidence indicates that light to moderate drinking on a daily basis may significantly reduce the risks of coronary heart disease (CHD). In contrast, excessive alcohol intake and binge drinking are toxic to both the heart and overall health. There is dearth of knowledge whether palm wine exhibit any these properties. OBJECTIVES: The objective of this study is to evaluate the effect of level of palm wine consumption on the plasma atherogenic and anti-atherogenic factors among the rural dwellers. METHODS AND MATERIALS: Fifty-eight male volunteers between the ages of 28-69 yrs were recruited. They were divided into two groups; 28 moderate drinkers with intake of 20-70 grams/day and 30 heavy drinker with intake of >70 grams/day of palm wine at a sitting for 3 to 4days per week with a minimum duration of 5 years. Thirty controls of the same age groups with the same socioeconomic status were recruited. Plasma activities of liver enzymes, plasma concentration of Total Cholesterol (TC), Triglyceride (TG), High-Density Lipoprotein (HDL), Low-Density Lipoproteins (LDL) and apolipoprotiens (ApoA1 & Apo B) were determined. TC/HDL, LDL/HDL and ApoB/A1 ratios calculated. RESULTS: There was significant increase in plasma concentration of TG, LDL, ApoB and decrease in HDL and ApoA 1 among heavy drinkers. However, there was an increase in plasma level of ApoA1 and decrease in ApoB among moderate drinkers but not significant when compared to the controls. A positive correlation were observed between level of palm wine consumption (>70gram/day) and plasma levels of TG LDL, ApoB, TC/HDL ratio, ApoB/ApoA1 ratio; but negative correlation with HDL and ApoA1. CONCLUSION: Our finding revealed that heavy consumption of palm wine may promote atherogenic factors, but the benefits of moderate consumption recorded need further investigations. There is also the need to determine the level of polyphenolic substances if any in palm wine.

The effect of palm wine on lipid peroxidation and antioxidant status of rural dwellers in South West Nigeria.

AIMS AND OBJECTIVES: To evaluate the levels/activities of antioxidants and lipid peroxidation in the blood of subjects that consumed palm wine on regular bases. SUBJECTS AND METHODS: Sixty-four male volunteers between the ages of 30-70 years were recruited for the study. The subjects were those that visited palm wine vendor outlet on regular basis at least for a minimum duration of 5 years, with daily intake of 80-160 gm of palm wine at a sitting for a minimum of 3 to 4 days per week. Plasma activities of aspartate aminotransferase (AST), alanine aminotransferase (ALT) and gamma-glutamyltransferase (a-GT); plasma concentration of total antioxidant status (TAS), Malonyldialdehyde ((MDA), selenium (Se) and erythrocyte glutathione peroxidase (GSH-Px) activity were determined. RESULTS: The plasma activity of a-GT and marker of lipid peroxidation (MDA) were significantly increased in subjects compared to the controls p<0.01. However, the erythrocyte scavenging antioxidant activity of GSH-Px and plasma Se for the subjects were significantly reduced compared to the controls p<0.05. Positive correlation was observed between MDA/ level of palm wine consumption (r =+ 0.471, p<0.01), AST/ level of palm wine consumption (r=+ 0.263, p<0.05) and a- GT/level of palm wine consumption (r=+ 0.518, p< 0.001) for the subjects. However, a negative correlation was obtained between GSH-Px/level of palm wine consumption (r= - 0.364, p<0.05) and selenium/ level of palm wine consumption (r=- 0.375, p< 0.05) for the subjects. CONCLUSION: Reduced plasma Se and erythrocytes GSH-Px activity with increased plasma MDA in this study revealed that palm wine consumption may deplete the body's antioxidants against free radical attacks and render the body in a state of oxidative stress.

Effect of hemodialysis on total antioxidant status of chronic renal failure patients in government hospitals in Lagos Nigeria.

BACKGROUND: Renal failure is accompanied by oxidative stress, which is caused by enhanced production of reactive oxygen species and impaired antioxidant defense. AIM: To assess the effect of hemodialysis (by cellulose membrane dialyzer) on plasma total antioxidant status and lipid peroxidation of patients in chronic renal failure before and after dialysis. OBJECTIVE: The finding would serve as guide to administration or otherwise of supplementary therapeutic antioxidant before or after hemodialysis. Also, it will assist in the choice of antioxidant impregnated over the conventional non-impregnated dialyzer membrane. MATERIALS AND METHODS: Twenty-five patients (14 men and 11 women, aged 24-75 years; median 61) with end-stage renal failure who were undergoing hemodialysis for the first time were recruited. Plasma level of potassium (K+), sodium (Na+), blood urea nitrogen (BUN), creatinine, total antioxidant status (TAS), and lipid peroxidation (MDA) were measured, before and after hemodialysis. RESULTS: The mean ± SD of plasma level of TAS (1.10 ± 0.3 mmol/L trolox Eq) for males and (1.09 ± 0.2 mmol/L trolox Eq) for females postdialysis were significantly reduced ( P < 0.05) in comparison with (1.72 ± 0.4 mmol/L trolox Eq) for males and (1.83 ± 0.7 mmol/L trolox Eq) for females predialysis, respectively. However, the mean ± SD plasma level of MDA (6.03 ± 0.4 nmol/ml) for males and (6.71 ± 0.7 nmol/ml) for females were significantly increased postdialysis ( P < 0.01) compared to predialysis (3.98 ± 0.8 nmol/ml) for males and (4.05 ± 0.9 nmol/ml) for females, respectively. CONCLUSIONS: Based on the outcome of this study, it is suggested that antioxidant-impregnated dialysis membranes and/or exogenous supplementary antioxidant would be beneficial to patients with chronic renal failure. Removal of reactive oxygen species could improve the health and general quality of life of uremic patients.

The influence of storage period on the antioxidants level of red blood cells and the plasma before transfusion.

Stored blood is used for transfusion in humans but peroxidative processes occur in stored blood before transfusion. The aim of this study was to evaluate the influence of the length of storage on plasma antioxidant levels and RBCs antioxidant enzyme activity. Blood collected from 15 donors and preserved with anticoagulant (citerate phosphate, dextrose adenine (CPDA-1) were examined. The concentration of total antioxidant status (TAS), malondialdehyde (MDA) and potassium (K+) in the plasma as well as glutathione peroxidise (GSH- Px), glutathione superoxide dismutase (SOD) and catalase (CAT) activities in erythrocytes were determined on days 1, 5, 10, 15, 20, 25, 30, 35 and 40 of storage. Day 1 of the study is the day of donation. A 24.8% increase in plasma concentration of MDA and 15.8% increase in the concentration K+ on day 15 were recorded (p < 0.05). A 27% decrease in the plasma concentration of TAS was observed on day 20 compared with day 1 (p < 0.05). Similarly GSH-Px activity is stored RBC decreased by 17.1%, on day 15 (p < 0.05). SOD activities reduced by 17.1% on day 20, CAT activities reduced by 12.6% on day 15 (in each case p < 0.05). In this study blood stored in CPDA-1 shows that those glutathione-dependent antioxidant enzymes systems in erythrocytes and antioxidant defence in plasma were depleting gradually depending on the day of storage. We concluded based on our finding that 10 days period can be considered a safe storage limits for transfusion in relation to oxidative stress the RBCs were subjected in the storage medium.

The influence of storage period on the antioxidants level of red blood cells and the plasma before transfusion

Stored blood is used for transfusion in humans but peroxidative processes occur in stored blood before transfusion. The aim of this study was to evaluate the influence of the length of storage on plasma antioxidant levels and RBCs antioxidant enzyme activity. Blood collected from 15 donors and preserved with anticoagulant (citerate phosphate; dextrose adenine (CPDA-1) were examined. The concentration of total antioxidant status (TAS); malondialdehyde (MDA) and potassium (K+) in the plasma as well as glutathione peroxidise (GSH - Px); glutathione superoxide dismutase (SOD) and catalase (CAT) activities in erythrocytes were determined on days 1;5;10;15;20;25;30;35 and 40 of storage. Day 1 of the study is the day of donation.A 24.8increase in plasma concentration of MDA and 15.8increase in the concentration K+ on day 15 were recorded (p0.05). A 27decrease in the plasma concentration of TAS was observed on day 20 compared with day 1 (p0.05). Similarly GSH-Px activity is stored RBC decreased by 17.1; on day 15 (p0.05). SOD activities reduced by 17.1on day 20; CAT activities reduced by 12.6on day 15 (in each case p0.05). In this study blood stored in CPDA-1 shows that those glutathione-dependent antioxidant enzymes systems in erythrocytes and antioxidant defence in plasma were depleting gradually depending on the day of storage. We concluded based on our finding that 10 days period can be considered a safe storage limits for transfusion in relation to oxidative stress the RBCs were subjected in the storage medium

Assessment of preventive oral health knowledge and practices among rural and urban mothers in Lagos state.

AIMS AND OBJECTIVES: To evaluate students' performance and its predictors in the preclinical examinations at the College of Health Sciences, Ladoke Akintola University of Technology Ogbomoso Nigeria. MATERIALS AND METHODS: A cross section of students' records admitted into medical programme in 1999/2000 sessions was studied. RESULTS: Younger students performed consistently better than the older ones in all the three subjects taken at the MBBS1. It was also noticed that the male students performed better, a statistically significant mean difference in score was observed in Biochemistry P>0.05. Students with better Ordinary level aggregate grade of (5-15) in the five core subjects at SSCE, consistently had better results in all the subjects taken at MBBS1 examination compared to their counter-part with aggregate SSCE grade of (16-30). Students that were admitted through JAMB performed better in all the three subjects than those that were admitted through pre-degree programme and the transferred students. However, the mean difference was statistically significant P<0.05 in Biochemistry only. CONCLUSION: Better performance at MBBS1 was found in younger age group, those with aggregate grade of (5-15) in SSCE and those admitted through JAMB. Ordinary level requirement irrespective of the mode of admission should not be compromised. Schools that admit students through pre-degree, transfer or direct entry will have to be more conscious of the quality of students they admit and also operate such system with utmost transparency and with a principle of promoting good academic standard.

Plasma lipid peroxidation and totalantioxidant status among dyslipidaemic and hypertensive Nigerians with high risk of coronary heart disease.

BACKGROUND: The oxidative modification hypothesis of atherosclerosis predicts that low density lipoprotein-cholesterol (LDL-C) oxidation is an early event in atherosclerosis and that oxidized LDL-C contributes to atherogenesis OBJECTIVE: To determine a link, if any, between the plasma lipid peroxidation and total antioxidant status (TAS) among dyslipidemic and hypertensive Nigerian patients with high risk of coronary heart disease. METHODS: The study groups comprised 58 hypertensive adult Nigerians whose fasting plasma total cholesterol (TC) levels were > 5.5 mmol/L and with high risk coronary heart disease (CHD) lipid fraction i.e. 'the ratio of high density lipoprotein cholesterol to total cholesterol' (HDL-C/TC) < 0.13 were selected for the study. The control groups comprised 58 non hypertensive adult Nigerians with (HDL-C/TC) > 0.30. RESULTS: The mean +/- SD TAS level (1.02 +/- 0.15 mmol/L trolox) for males and (0.99 +/- 0.17 mmol/L) for females were significantly reduced (p < 0.05) compared to the controls; however (MDA) level (5.15 +/- 0.82 mmol/ml) for males and (5.06 +/- 0.73 mmol/ml) for females were significantly increased (p < 0.01) compared to the controls. The mean +/- SD plasma TC and LDL-C malonyl level (5.87 +/- 0.23 mmol/L and 4.65 +/- 0.34 mmol/L) were significantly increased (p < 0.01) in males hypertensive compared to the control. An inverse correlation between the TAS/TC(r = -0.53, p < 0.001) and TAS/LDL-C (r = -0.50, p < 0.001), however a direct correlation between the MDA/TC(r = 0.51, p < 0.001) and MDA/LDL-C (r = 0.48, p < 0.01) for males hypertensive were found. In female subjects the mean +/- SD plasma TC (5.95 +/- 0.13 mmol/L) and LDL-C (4.45 +/- 1.04 mmol/L) were significantly increased (p < 0.05) and (p < 0.01) respectively compared to the controls. Also in hypertensive females inverse correlation between the TAS/TC (r = -0.59, p < 0.001) and TAS/LDL-C (r = -.41, p < 0.01), and a direct correlation between the MDA/TC ( r= .48, p < 0.01) and MDA/LDL-C (r = 0.31, p < 0.05) were found. CONCLUSION: Since dyslipidaemia, hypertension and lipid peroxidation were directly relate to the severity of atherosclerosis, elimination of free radicals in the plasma before the peripheral tissues can take them up might reduce atherosclerosis. In view of our present findings, a management strategy aimed at simultaneously reducing lipid peroxidation and increasing total antioxidant status in dyslipidemic patients may be of benefit.

Predictors of students'performance in the pre-clinical MBBS programme in a Nigerian University.

AIMS AND OBJECTIVES: To evaluate students' performance and its predictors in the preclinical examinations at the College of Health Sciences, Ladoke Akintola University of Technology Ogbomoso, Nigeria. MATERIALS AND METHODS: A cross section of students' records admitted into medical programme in 1999/2000 sessions was studied. RESULTS: Younger students performed consistently better than the older ones in all the three subjects taken at the MBBS1. It was also noticed that the male students performed better, a statistically significant mean difference in score was observed in Biochemistry P<0.05. Students with better Ordinary level aggregate grade of (5-15) in the five core subjects at SSCE, consistently had better results in all the subjects taken at MBBS1 examination compared to their counter-part with aggregate SSCE grade of (16-30). Students that were admitted through JAMB performed better in all the three subjects than those that were admitted through pre-degree programme and the transferred students. However, the mean difference was statistically significant P<0.05 in Biochemistry only. CONCLUSION: Better performance at MBBS1 was found in younger age group, those with aggregate grade of (5-15) in SSCE and those admitted through JAMB ordinary level requirement irrespective of the mode of admission should not be compromised. Schools that admit students through pre-degree, transfer or direct entry will have to be more conscious of the quality of students they admit and also operate such system with utmost transparency and with also operate such system with utmost transparency and with a principle of promoting good academic standard.

Chloroquine resistant Plasmodium falciparum malaria in Osogbo Nigeria: efficacy of amodiaquine + sulfadoxine-pyrimethamine and chloroquine + chlorpheniramine for treatment.

Chloroquine (CQ) resistance in Plasmodium falciparum contributes to increasing malaria-attributable morbidity and mortality in Sub-Saharan Africa. Despite a change in drug policy, continued prescription of CQ did not abate. Therefore the therapeutic efficacy of CQ in uncomplicated falciparum malaria patients was assessed in a standard 28-day protocol in 116 children aged between six and 120 months in Osogbo, Southwest Nigeria. Parasitological and clinical assessments of response to treatment showed that 72 (62.1%) of the patients were cured and 44 (37.9%) failed the CQ treatment. High initial parasite density and young age were independent predictors for early treatment failure. Out of the 44 patients that failed CQ, 24 received amodiaquine + sulphadoxine/pyrimethamine (AQ+SP) and 20 received chlorpheniramine + chloroquine (CH+CQ) combinations. Mean fever clearance time in those treated with AQ+SP was not significantly different from those treated with CH+CQ (p = 0.05). There was no significant difference in the mean parasite density of the two groups. The cure rate for AQ+SP group was 92% while those of CH+CQ was 85%. There was a significant difference in parasite clearance time (p = 0.01) between the two groups. The 38% treatment failure for CQ reported in this study is higher than the 10% recommended by World Health Organization in other to effect change in antimalarial treatment policy. Hence we conclude that CQ can no more be solely relied upon for the treatment of falciparum malaria in Osogbo, Nigeria. AQ+SP and CH+CQ are effective in the treatment of acute uncomplicated malaria and may be considered as useful alternative drugs in the absence of artemisinin-based combination therapies.

Chloroquine resistant Plasmodium falciparum malaria in Osogbo Nigeria: efficacy of amodiaquine + sulfadoxine-pyrimethamine and chloroquine + chlorpheniramine for treatment

Chloroquine (CQ) resistance in Plasmodium falciparum contributes to increasing malaria-attributable morbidity and mortality in Sub-Saharan Africa. Despite a change in drug policy, continued prescription of CQ did not abate. Therefore the therapeutic efficacy of CQ in uncomplicated falciparum malaria patients was assessed in a standard 28-day protocol in 116 children aged between six and 120 months in Osogbo, Southwest Nigeria. Parasitological and clinical assessments of response to treatment showed that 72 (62.1 percent) of the patients were cured and 44 (37.9 percent) failed the CQ treatment. High initial parasite density and young age were independent predictors for early treatment failure. Out of the 44 patients that failed CQ, 24 received amodiaquine + sulphadoxine/pyrimethamine (AQ+SP) and 20 received chlorpheniramine + chloroquine (CH+CQ) combinations. Mean fever clearance time in those treated with AQ+SP was not significantly different from those treated with CH+CQ (p = 0.05). There was no significant difference in the mean parasite density of the two groups. The cure rate for AQ+SP group was 92 percent while those of CH+CQ was 85 percent. There was a significant difference in parasite clearance time (p = 0.01) between the two groups. The 38 percent treatment failure for CQ reported in this study is higher than the 10 percent recommended by World Health Organization in other to effect change in antimalarial treatment policy. Hence we conclude that CQ can no more be solely relied upon for the treatment of falciparum malaria in Osogbo, Nigeria. AQ+SP and CH+CQ are effective in the treatment of acute uncomplicated malaria and may be considered as useful alternative drugs in the absence of artemisinin-based combination therapies.

Serum concentration of acute phase protein and lipid profile in HIV-1 seropositive patients and its relationship to the progression of the disease.

AIMS AND OBJECTIVES: To evaluate the effect of HIV-1 infection and its progression on lipid profiles, acute-phase proteins and to determine which of the parameters may serve as an early indicator of the progression of HIV infection. MATERIALS AND METHODS: A cross-sectional study was conducted on sixty-two HIV-1 infected subjects attending HIV clinic, the patients consisted of 29 males and 33 females aged between 20-60 years (mean age 31+/- 7 years) who were screened for HIV-1 by ELISA test. Absolute CD4+ T lymphocyte was counted and HIV infected individuals were classified according to the Centre for Disease Control and Prevention (CDC) Criteria; CD4+ counts e"500/mm3 (asymptomatic), CD4+ counts 200-499/mm3 (symptomatic) and CD4+ counts d"199/mm3 (symptomatic) with full blown AIDS. Serum concentrations of total protein, albumin, gamma globulin, acute-phase protein, and lipid profile were determined. RESULTS: There was significantly increased gamma globulin fraction of the serum protein in HIV patients with CD4+ counts of e"500/mm3, 200-499/mm3 and d"199/mm3 when compared with the controls. Serum triglyceride was significantly increased in HIV patients with CD4+ counts of d"199/mm3 only, whereas a significantly decreased serum HDL-cholesterol in HIV patients with CD4+ counts of 200-499/mm3 and d"199/mm3 was found when compared with the controls. Haptoglobin, C-reactive protein and a1-acid glycoprotein were significantly increased in HIV patients with CD4+ counts of 200-499/mm3 and d"199/mm3 when compared with the controls. However, albumin was significantly reduced in HIV patients with CD4+ counts of d"199/mm3 when compared with the controls. There was direct correlation between HDL-cholesterol and the CD4+ counts, on the other hand, an inverse correlation between C-reactive protein, haptoglobin and a1-acid glycoprotein against CD4+ counts was found. CONCLUSION: A decreased HDL-cholesterol had direct correlation with the CD4+ counts in all the stages of HIV infection; however, increased haptoglobin and C-reactive protein had inverse correlation with the CD4+ counts in all the stages of HIV infection. Therefore HDL-cholesterol, C-reactive protein and haptoglobin may serve as indicators of disease progression in HIV infection.

Prevalence and transmission pattern of Plasmodium falciparum infection in Osogbo metropolis, southwest, Nigeria.

Plasmodium falciparum malaria is an endemic disease especially in tropical areas with heavy rainfall that spread round the year. We therefore sought to investigate the prevalence pattern and clinical presentation of falciparum malaria in Oso degrees c were assessed and screened for plasmodium falciparum infection by clinical assessment and microscopy using both thick and thin blood smears over a period of 12 months- August 2004 and July 2005. The prevalence of Plasmodium falciparum infection was found to be 52.8% with 341/646 of the patients been positive for Plasmodium falciparum parasite based on microscopy. Three hundred and five (47.2%) were aparasitaemic of which 162 (25.1%) had bronchopneumonia, 99 (15.3%) had upper respiratory tract infection, 32 (5.0%) had gastroenteritis and 12 (1.9%) had Otitis media. Between August and November 2004, 250 patients were screened and 160 (57.6%) of these patients were positive, while 180 patients were screened between December 2004 and March 2005 and 51 (28.3%) were positive. Between April 2005 and July 2005, 216 patients were screened and 130 (60.2%) of the patients were positive. When compared, the differences in the percentage of patients with positive microscopy in December to March with April to July and August to November were found to be significant (P < 0.0001), whereas the percentage difference in patients with positive microscopy in August to November and April to July was not significant (P = 0.442). The result of this study clearly shows that there are two distinct peaks of malaria transmission pattern in consonance with the rainfall pattern in the area.

Plasma selenium concentration and glutathione peroxidase activity in HIV-1/AIDS infected patients: a correlation with the disease progression.

AIMS AND OBJECTIVES: To find a correlation, if any, between the concentration of plasma selenium and erythrocyte activity in HIV-infected patients with the progression of the disease. MATERIALS AND METHODS: Plasma selenium concentration and erythrocyte glutathione peroxidase (GSH-Px) activity were measured in 62 HIV-1 seropositive patients before commencing antiretroviral drug. Thirty (30) age-matched and apparently healthy HIV-1/11 seronegative subjects were recruited as control subjects. HIV-1 seropositive patients were classified according to the Centre for Disease Control and Prevention (CDC) Criteria. RESULTS: The mean plasma selenium concentrations of 0.53+/-0.06_mol/L and 0.71+/-0.10_mol/L were significantly reduced (P<0.001) in HIV- 1 patients with CD4+ count of <200 lym/mm3 and that of 200-499 lym/mm3 respectively when compared with the controls which is 1.01+/-0.10_mol/L. The mean erythrocyte GSH-Px activity of 15.1+/-2.4 U/g Hb and 20.7+/-3.7U/g Hb of HIV-1 seropositive patients with CD4+ count of <200 lym/mm3 and 200-499 lym/mm3 respectively were significantly reduced (P<0.001) compared with 31.5+/-4.5 U/g Hb for the control. Our results clearly show that there is reduced scavenging antioxidant i.e Selenium and GSH-Px which will lead to oxidative stress in the HIV-1 patients when compared with controls, and decrease significantly with the progression of disease, i.e. AIDS

High Risk Coronary Heart Disease, Lipid Fractions and Transferrin Saturation among Hypertensive Nigerians.

BACKGROUND AND OBJECTIVES: Hypertension and hypercholesterolemia are well established independent risk factors of coronary heart disease. Moreover, drug treatment of hypertension also affects lipid metabolism. Recently, body iron status has also been implicated as a risk factor of coronary heart disease. It is not however clear whether hypertension or hypercholesterolaemia directly or indirectly influences body iron status. This study was therefore decided to look at the association between transferrin saturation and hypercholesterolaemia in adult hypertensive Nigerians with high risk Coronary Heart Disease (CHD) lipid fraction. MATERIALS AND METHODS: The study group comprises eighty two adult Nigerians who are known hypertensives with high risk coronary heart disease lipid fraction: that is the ratio of high density lipoprotein cholesterol to total cholesterol (HDL-C/TC) <= 0.13 while the control subjects comprises eighty adult Nigerians who are also known hypertensives with normal HDL-C/TC ratio (>=0.30). RESULTS: The total iron binding capacity is not significantly different between the two groups. Also, serum iron and transferrin saturation were not significantly different in the two groups. Transferrin saturation does not show appreciable correlation with total cholesterol, LDL-cholesterol, HDL-cholesterol and triglyceride levels in any of the two groups. CONCLUSION: The association between transferrin saturation and hypercholesterolaemia in hypertensive is not strong enough to possibly suggest that one influences the other. However, the influence of antihypertensive drugs on lipid metabolism cannot be ruled out in this study because subjects and controls were not selected based on type or class of medication. KEYWORDS: transferrin saturation, high risk CHD lipid fraction, hypertensives.

Total antioxidant status and lipid peroxidation in HIV-1 infected patients in a rural area of south western Nigeria.

Total serum antioxidant status (TAS) and lipid peroxidation were evaluated in 62 HIV-1 seropositive patients before the commencement of antiretroviral drug therapy. Twenty-four (24) age-marched and apparently healthy HIV-1 seronegative subjects were recruited as control subjects. HIV-1 seropositive patients were classified according to the Centre for Disease Control and Prevention (CDC) Criteria. The mean serum malondialdehyde (MDA) concentrations of 5.58 +/- 0.99nmol/ml and 4.24 +/- 0.80nmol/ml were significantly elevated in HIV-1 infected patients with CD4+ count of <200 lym/mm3 and that of 200-499 lym/mm3 respectively when compared with the control which is 3.37 +/- 0.56nmol/ ml (P<0.001). Whereas when compared with control, the serum MDA concentration of 3.45 +/- 0.48nmol/ml in HIV-1 patients with CD4+ count of >500 lym/mm3 was not significant (P>0.05). In the intra groups comparison serum concentration of MDA were significantly elevated when compared with each other (P<0.001). The mean serum total antioxidant status (TAS) of 1.30 +/- 0.11mmol/L, 1.12 +/- 0.24 mmol/L and 0.95 +/- 0.17mmol/L of HIV- 1 seropositive patients with CD4+ count of >500 lym/mm3, 200-499 lym/mm3 and <200 lym/mm3 respectively were significantly reduced compared with 1.69 +/- 0.23mmol/L for the control group (P<0.001). Similarly in the intra groups comparison, serum concentration of TAS were significantly reduced when compared with each other (P<0.001). The weight of 54.81 +/- 5.13 Kg for HIV-I seropositive patients with CD4+ count of <200 lym/mm3 was significantly reduced when compared with 69.17 +/- 4.38Kg for the control (P<0.05). Our results clearly show that severe oxidative stress occurs in the serum of seropositive patients in comparison with controls, and increases significantly with the progression of disease, i.e. AIDS > symptomatics > asymptomatics > controls. The inclusion of antioxidants in the therapeutic approach in managing HIV- 1 seropositive patients will prevent the additional damage that free radicals could do to such patients.