Ferritin concentrations in low-birth babies in South-west Nigeria

In the absence of acute phase reaction, ferritin concentration has been used as a standard measurement of iron stores. Low birth weight babies are at risk of developing iron lack because ferritin concentration at birth is influenced by duration of gestation, maternal iron status and conditions altering maternal­foetal iron exchange. Aim: The aim of this study was to determine the ferritin concentrations of low birth weight babies in comparison with that of normal birth weight babies. Materials and methods: Fortyfour normal birth weight (NBW) babies and 40 low birth weight (LBW) babies were recruited for the study. About 1.0ml of venous blood was drawn aseptically from each subject into a micro EDTA tube, centrifuged at 5000rpm for 5 minutes, the plasma separated into cryotubes and stored at-20oC until ready for quantitative determination of ferritin concentrations using direct immunoenzymatic colorimetric method.Data obtained was analysed statistically using the Statistical Package for Social Sciences (SPSS,version 23, Chicago, IL, USA). Results: Gestational age correlated positively with ferritin concentrations in LBW neonates (p<0.05)while APGAR score correlatepositively with ferritin concentrations in normal birth weight babies (r=0.398; p<0.05). Thoug not statistically significant (p=0.214), median values for ferritin concentrations were 188.5µg/ dl and 373µg/dl for LBW and NBW neonates respectively. Conclusion: Gestational age correlated positively with ferritin concentrations in LBW neonates

Mean platelet volume and platelet counts in type 2 diabetes: mellitus on treatment and non-diabetic mellitus controls in Lagos, Nigeria.

INTRODUCTION: The Mean platelet volume and platelet counts are indicators of thrombotic potentials, and risk factors for microvascular complications in diabetics. This study aimed to establish variations in platelet counts and mean platelet volume in type 2 diabetic patients on treatment and non-diabetic controls. METHODS: This was an unmatched case-control study involving 200 participants consisting of 100 diabetics and 100 non-diabetic controls. Four and half milliliters of blood was collected from diabetics and non diabetic controls into EDTA anticoagulant tubes. Full blood count was performed using the Sysmex KN-21N, (manufactured by Sysmex corporation Kobe, Japan) a three- part auto analyzer able to run 19 parameters per sample including platelet counts and mean platelet volume. RESULTS: The mean fasting blood sugar for the diabetics was 147.85±72.54 mg/dl and the controls 95.20±30.10 mg/dl. The mean platelet count for the diabetics was 235.29±76.81*10(9)/L and controls, 211.32±66.44*10(9)/L. The mean platelet volume, for the diabetics was 8.69±0.67 fl and the controls, 8.91±0.80 fl. There was a statistically significant difference in platelet counts of diabetics and healthy controls p =0.038 while none existed between the mean platelet volume in diabetics and healthy controls p=0.593. CONCLUSION: This study revealed a higher mean platelet count for diabetics on treatment than for non diabetic controls while mean platelet volume was lower in cases than controls. However, both parameters in diabetics on treatment were within the normal reference range for healthy individuals.

Cord blood full blood count parameters in Lagos, Nigeria.

INTRODUCTION: Full blood count (FBC), one of the most frequently requested for laboratory investigations, is a simple, fast and cheap test and is a reliable indicator of health. Due to its usefulness in the assessment of health status of individuals, its parameters in cord blood, a major source of haemopoietic stem cell transplantation and an ideal source for laboratory investigations for newborns were determined to provide a useful guide to local neonatologists and stem cell transplant physicians. METHODS: Three millilitres of umbilical cord blood was collected from 130 normal birth weight newborns (69 males and 61 females) whose cord were clamped immediately after delivery, at a teaching hospital in Lagos, Nigeria and full blood count parameters were determined using Sysmex autoanalyzer, model KX-21N. Consented mothers of the newborns were selected based on, age between 18 and 45 years; uneventful pregnancy and delivery and haemoglobin (Hb) concentration ≥ 10 g/dL. RESULTS: There were no statistical gender differences in the mean values of Hb concentrations (M = 13.27 ±1.60 g/dL; F = 13.32±1.61g/dL; p = 0.93), total white cell count (M = 3.16±5.43 × 10(9)/L; F = 13.07±4.98 × 10(9)/L; p= 0.92), platelet count (M= 223.64± 64.21 × 10(9)/L; F = 226.69±80.83 × 10(9)/L; p = 0.81) and other parameters. CONCLUSION: Mean values of full blood count parameters obtained in this study are comparable to reports from other studies in developing countries and could be a useful guide for neonatologists and stem cell transplant physicians in our geographical location.

Gestational thrombocytopaenia among pregnant women in Lagos, Nigeria.

BACKGROUND: Thrombocytopaenia is a common haematologic abnormality during pregnancy. Pregnant women with thrombocytopenia have a higher risk of bleeding excessively during or after childbirth, particularly if they need to have a caesarean section or other surgical intervention during pregnancy, labour or in the puperium. The aim of this study was to determine the prevalence of gestational thrombocytopaenia among pregnant women reporting for antenatal care at tertiary health care centres in Lagos. MATERIALS AND METHODS: Platelet count was analyzed in 274 consecutive pregnant women who gave informed consent and 70 non-pregnant female staff of the hospitals. Platelet count was performed on each sample using the Sysmex KN-21N automated haematology analyzer. The study design was cross-sectional, proportions were analyzed for statistical significance with the chi-square, and Odds ratio was also calculated. Thrombocytopaenia is classically defined as a platelet count of less than 150 × 10(9)/L.34 Counts from 100 to 150 × 10(9)/L are considered mildly depressed, 50 to 100 × 10(9)/L are moderately depressed and less than 50 × 10(9)/L are severely depressed. RESULTS: Thirty-four (13.5%) pregnant women were thrombocytopaenic compared with three (4.3%) non-pregnant women. This was statistically significant; P = 0.03; Odds ratio: 3.5 (95% CI 1.03-11.82). Out of the 37 pregnant women who were thrombocytopaenic, most of them (78%) had mild thrombocytopenia, only 6% had severe thrombocytopaenia. CONCLUSION: The prevalence of gestational thrombocytopaenia in this study was 13.5%. Although majority of the pregnant women had mild thrombocytopaenia, healthcare providers should screen all pregnant women routinely for thrombocytopaenia to avoid excessive bleeding during or after childbirth.

Urine methylmalonic acid levels in HIV-infected adults with peripheral neuropathy.

BACKGROUND: Cobalamin deficiency and peripheral neuropathy (PN) are commonly seen in HIV-infected adults. The level of urine methylmalonic acid (UMMA), a reliable indicator of tissue cobalamin status, was determined in HIV infected subjects with and without PN to establish this association. METHODS: One hundred and ninety-eight (198) consenting HIV infected subjects with and without PN were recruited for the study. UMMA level was determined by Cation Exchange High Performance Liquid Chromatography (HPLC) with Ultraviolet detector in 165 subjects. Simple proportions of patients with raised UMMA (defined as value> 3.4 mg in 24hr) were determined for each arm. RESULTS: Among the 198 subjects studied, 146 had PN and 52 had no PN. From the 165 subjects whose UMMA was studied, raised UMMA was found in 76.6% (36 of 47) of subjects with no PN as compared with 53.4% (63 of 118) of those with PN (p=0.018). CONCLUSION: Cobalamin deficiency (measured by UMMA level) even though common in HIV infected subjects, may not be the cause of peripheral neuropathy in these subjects.

Plasma folate studies in HIV-positive patients at the Lagos university teaching hospital, Nigeria.

INTRODUCTION: In various studies globally, the prevalence of anemia in persons with HIV infection range from 10 to 20% at initial presentation, and anemia is diagnosed in 70 to 80% of these patients over the course of HIV disease. The etiology of anemia in this group of patients has not been fully established, thus a need to evaluate the role of plasma folate as a possible etiological factor. OBJECTIVE: This study was set to determine plasma folate levels in newly diagnosed, treatment naïve, HIV-positive patients, and relate this to other hematological changes. MATERIALS AND METHODS: A total of 200 participants were recruited for this study, of which 100 were HIV positive, treatment naive patients who were recruited at the point of registration and 100 were HIV-negative subjects (controls). 5 ml of venous blood was collected and plasma extracted for folic acid estimation by HPLC. A full blood count, CD4 and Viral load were estimated. RESULTS: Mean ages for control and study group were 38 ± 2.3 and 32 ± 1.7 years, respectively. Mean plasma folate concentration among the study group (5.04 µg/l) was significantly lower than that for the control group (15.89 µg/l; P = 0.0002). Prevalence of anemia among the study group was 72% (144 of 200), with a mean hemoglobin (Hb) concentration of 9.5 g/dl compared with mean Hb of 13.0 g/dl among the control group (P = 0.002). Plasma folate correlated positively with CD4 cell count (r = 0.304, P<0.05) and inversely with the viral load (r = -0.566; P<0.05). CONCLUSION: Plasma folate level is a predictor of anemia in early HIV infections.