Evaluation of Homocysteine Status and its Correlation with Disease Severity in Individuals with Sickle Cell Anaemia in Steady State.

INTRODUCTION: Sickle cell anaemia (SCA) is a genetic disorder associated with chronic inflammation and a hypercoagulable state. This study evaluated the serum homocysteine level and its correlation with disease severity and body mass index (BMI) among individuals with SCA in a steady state. METHODS: A cross-sectional study was carried out and the serum level of homocysteine was analysed using the ELISA method. Disease severity and BMI were also calculated. Data generated were analyzed using SPSS software, version 21. RESULTS: Ninety subjects participated in this study and were made up of 30 homozygous sickle cell (HbSS, SCA) subjects, 30 individuals with sickle cell trait (HbAS), and 30 individuals with normal adult haemoglobin (HbAA) with a mean age of 27.3 ± 6.4years, 26.0 ± 6.0years, and 27.2 ± 6.6years respectively. The mean serum level of homocysteine among HbSS was 26.2 ± 11.8umol/l which was significantly higher than 17.9 ± 8.0umol/l and 18.9 ± 7.9umol/l among HbAA or HbAS respectively (p< 0.05). Mean BMI of 21.9 ± 2.8kg/m2 among HbSS was significantly lower than those of HbAS (23.7 ± 2.5kg/m2) and HbAA (24.7 ± 2.4kg/m2) (p<0.05). There was a positive correlation between homocysteine level and disease severity in patients with HbSS, though not significant (r = 0.168; p>0.05). There was a significant negative correlation between homocysteine level and BMI(r = -0.0258; p = 0.021); and between disease severity and BMI (r = -0.400; p = 0.028). CONCLUSION: Individuals with HbSS have significantly higher mean serum homocysteine level and lower BMI compared to HbAS and HbAA. There was a positive correlation between homocysteine level and disease severity, though not significant but a strong negative correlation between homocysteine levels and BMI, and between disease severity and BMI among HbSS participants. A similar study should be carried out on a wide scale to determine the actual relationship between homocysteine level and disease severity in SCA and whether patients will benefit from routine administration of vitamin B12, vitamin B6, and folic acid.

INTRODUCTION: La drépanocytose est une maladie génétique associée à une inflammation chronique et à un état d'hypercoagulabilité. Cette étude a évalué le taux d'homocystéine sérique et sa corrélation avec la gravité de la maladie et l'indice de masse corporelle (IMC) chez les personnes atteintes d'anémie drépanocytaire à l'état stable. MÉTHODES: Une étude transversale a été réalisée et le taux sérique d'homocystéine a été analysé à l'aide de la méthode ELISA. La gravité de la maladie et l'IMC ont également été calculés. Les données générées ont été analysées à l'aide du logiciel SPSS, version 21. RÉSULTATS: Quatre-vingt-dix sujets ont participé à cette étude, dont 30 drépanocytaires homozygotes (HbSS, SCA), 30 drépanocytaires de trait (HbAS) et 30 personnes ayant une hémoglobine adulte normale (HbAA), âgés en moyenne de 27,3 ±6,4 ans, 26,0 ±6,0 ans et 27,2 ±6,6 ans, respectivement. Le taux sérique moyen d'homocystéine chez les HbSS était de 26,2 ±11,8 umol/l, ce qui était significativement plus élevé que 17,9 ±8,0umol/l et 18,9 ±7,9umol/l chez les HbAA ou HbAS respectivement (p< 0,05). L'IMC moyen de 21,9 ±2,8kg/m2 chez les HbSS était significativement inférieur à celui des HbAS (23,7±2,5kg/m2) et des HbAA (24,7 ±2,4kg/ m2) (p<0,05). Il y avait une corrélation positive entre le niveau d'homocystéine et la sévérité de la maladie chez les patients HbSS, bien que non significative (r= 0.168 ; p>0.05). Il existe une corrélation négative significative entre le taux d'homocystéine et l'IMC (r= - 0,0258 ; p = 0,021) ; et entre la gravité de la maladie et l'IMC (r = - 0,400 ; p = 0,028). CONCLUSION: Les personnes atteintes de HbSS ont un taux moyen d'homocystéine sérique significativement plus élevé et un IMC plus faible que les personnes atteintes de HbAS et de HbAA. Il existe une corrélation positive entre le taux d'homocystéine et la gravité de la maladie, une corrélation négative non significative mais forte entre le taux d'homocystéine et l'IMC, et entre la gravité de la maladie et l'IMC chez les participants HbSS. Une étude similaire devrait être menée à grande échelle pour déterminer la relation réelle entre le taux d'homocystéine et la gravité de la maladie dans le SCA et pour savoir si les patients bénéficieront de l'administration systématique de vitamine B12, de vitamine B6 et d'acide folique. Mots clés: Gravité de la maladie, homocystéine, anémie drépanocytaire.

Inflammation-mediated changes in haemostatic variables of pulmonary tuberculosis patients during treatment.

Tuberculosis (TB) disease is usually marked by inflammation which is closely linked to haemostasis both in health and disease. Close monitoring of haemostatic response to inflammatory changes during treatment is important to improve TB management. Here we studied associations between haemostatic markers and inflammatory cytokines in 60 TB-infected individuals, aged 18-65 years who received anti-TB therapy. They were recruited before commencement of therapy and followed up till completion of therapy after 6-months. The TNF-α, IL-6, IL-2 (pro-inflammatory cytokines) and P-selectin, GP IIb/IIIa, thrombopoietin (haemostatic variables) were significantly increased at 2 month into therapy compared to pre-treatment values and decreased at 6 month into therapy. Also at 6 month into therapy in comparison to 2-month into therapy, there were significant increase in IL-10 and TGF-ß (anti-inflammatory cytokines) as well as a significant decline in PF-4. There were significant positive correlations between GP IIb/IIIa and TNF-α, IL-6 and PSEL, IL-6 and TPO, PF4 and TGF-ß. Conclusively, the changes in the TNF-α, IL-6, IL-2 aligned with changes in the levels of P-selectin, GP IIb/IIIa, and TPO in the course of TB therapy. This may suggest that the levels of inflammatory cytokines are linked to the levels of these haemostatic variables in TB individuals.

Renal doppler indices and their correlation with laboratory indices of human immunodeficiency virus sero-positive adult individuals.

INTRODUCTION: Renal Doppler resistive index (RI) and pulsatility index (PI) values are potentially more sensitive at detecting renal abnormalities when compared to standard laboratory indices in patients with HIV/AIDS. To the best of our knowledge, there are no published research articles on renal Doppler indices and their correlation with laboratory indices of HIV sero-positive adult individuals. This study aimed to assess the renal function of HIV-sero-positive adults using RI and PI, and correlating these indices against laboratory values. METHODS: A prospective cross-sectional study was conducted from July 2019 to April 2020. A purposive sampling method was employed and included 396 HIV sero-positive adult individuals. Sampling for the renal RI and PI was performed at the level of the inter-lober arteries, in between the medullary pyramids. An RI value above 0.70 and a PI value above 1.56 were consider abnormal. Serum creatine and urea together with evidence of proteinuria were recorded at the time of scanning. RESULTS: Forty-three (10.9%) men had an abnormal RI, 32 (8.1%) had abnormal PI, five (2.5%) had abnormal creatinine, two (1%) abnormal urea and eight (4.1%) with proteinuria. In women, 29 (7.3%) had abnormal RI, 22 (5.6%) abnormal PI, four (2%) abnormal creatinine and urea and six (3%) had proteinuria. There was a statistically significant weak positive correlation between RI and PI and serum creatinine and urea (r > 0.2, P < 0.05). CONCLUSION: The proportion of patients with abnormal RI and PI was higher than the proportion of participants with abnormal serum urea, creatinine and proteinuria. Renal Doppler indices could be used be used in the early assessment of renal function in HIV sero-positive adults individuals. IMPLICATIONS FOR PRACTICE: Serum creatinine and urea are routinely used to evaluate renal function in patients with HIV/AIDS. Findings from this initial study show that RI and PI could be used detecting early renal abnormalities when compared to standard laboratory values.

Phytochemical and antifungal activities of Uvaria. chamae leaves and roots, Spondias mombin leaves and bark and Combretum racemosum leaves.

The effects of crude and dilutions of aqueous, methanolic and n-hexane extracts of Uvaria chamae (roots and leaves), Spondias mombin (leaves and bark) and Combretum racemosum (Leaves), on pathogenic candida albicans and aspergillus niger was studied. The aim was to contribute to the search for a cheaper, conventional cure for both fungi. Phytochemical analysis revealed varying degrees of alkaloids, glycosides, saponin, lipid and oil, tannins, flavonoids, terpenoids and acids. Agar diffusion method was used for anti fungal assay. Minimum inhibitory concentration (mic) used was 10 mg/ml of extract and dilutions of the non polar solvents of 10 (-1) and 10(-2) was used. Results showed that none of the plant parts was active against aspergillus niger. Combretum racemosum had no antifungal effect on tested organisms as well as the different dilutions. However crude methanolic extract of uvaria (roots and leaves), spondias ( bark and leaves ), and n-hexane extracts of uvaria (leaves and roots), produced anti candidal effects with diameters in this order 14.67 +/- 0.72mm, 10.67 +/- 0.52 mm, 11.00 +/- 0.47 mm, 15.00 +/- 0.47 mm, and 14.67 +/- 0.72 mm respectively. Some of the plant parts especially uvaria had zones of inhibition at a confidence limit comparable with control drug which is ketoconazole and it had inhibitory effects at a diameter of 20.06 +/- 0.40 mm.