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.

Cardiovascular and electrocardiographic changes in Nigerians with a normal pregnancy.

INTRODUCTION: Pregnancy is associated with major haemodynamic and cardiac changes, which can mimic or precipitate cardiac diseases. There is a paucity of this kind of data among pregnant Nigerian women. This study was aimed at describing the cardiovascular and electrocardiographic changes found among healthy pregnant Nigerian women. METHODS: This was an age-matched control study of 69 consecutive normal pregnant and 70 healthy non-pregnant controls. The study protocol included history, physical examination and 12-lead electrocardiography. RESULTS: Diastolic blood pressure < 60 mmHg was significantly commoner among pregnant subjects than controls (64.7 vs 24.3%, respectively, p < 0.005). Mean heart rate was higher among pregnant women (88.34 ± 11.46 bpm) than the controls (75.16 ± 12.22 bpm, p = 0.020). Pregnant subjects also had a higher proportion of left ventricular hypertrophy (LVH) (10.2 vs 0%, p < 0.05) than non-pregnant controls. Abnormal cardiac findings included a loud second heart sound (P(2)), missed beats and systolic murmurs (41.2% in pregnant subjects vs 12.9% in non-pregnant controls, p < 0.05). Negroid-pattern ST-segment elevation was commoner among controls (24.3%) than pregnant subjects (2.9%, p < 0.005). Arrhythmias were rare among the study participants. CONCLUSION: Significant findings on examination were low diastolic blood pressure and a systolic ejection murmur. However, ECG changes showed a normal frontal-plane QRS axis, normal PR interval, significantly rare normal Negroidpattern ST elevation, significant LVH based on Araoye RI > 12 mm and a rarity of all forms of arrhythmias. These data may help resolve some cardiac diagnostic difficulties during pregnancy.

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

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

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.