Evaluation of antioxidant status of female diabetic patients in Nnamdi Azikiwe University Teaching Hospital, Anambra State, Nigeria.

Diabetes mellitus has become an onerous disease to developing countries such as Nigeria. Rapid acceptance of urbanisation and sedentary life styles pose an encumbrance to its prevention and management. Increased oxidative stress in diabetes mellitus has been implicated as a culprit in perpetuating antioxidant depletion and diabetic complications in diabetes mellitus individuals. This study aims to evaluate the level of antioxidant status in type 2 diabetes mellitus (DM) female participants visiting the out-patient diabetic clinic of Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi, Anambra State, Nigeria. A total of 86 participants aged 51±10 years were recruited for this study. The test group consists of 43 already confirmed type 2 diabetes mellitus females, while the control group consists of 43 apparently healthy females. The test subjects were further subgrouped into good and poor glycaemic control groups, using a cut-off of <7% for HbA1c. Whole blood was collected from participants and aliquoted into specified sample containers for analysis of the following parameters: random blood glucose (RBG; mg/dL), glycosylated haemoglobin (HbA1c; %), glutathione reductase (GR; U/L) and total antioxidant status (TAS; mmol/L). Results from this study showed that the mean differences in RBG (197.74±49.29 mg/dL) and HbA1c (9.86±1.44%) were significantly higher in the test group compared to the control group RBG (104.79±11.33 mg/dL) and HbA1c (5.21±1.23%) (P<0.05). The mean differences of GR (45.81±20.45 U/L) and TAS (1.81±1.04 mmol/L) were significantly lower in the test group compared to the control group GR (61.21±14.34 U/L) and TAS (2.73±2.08 mmol/L) (P<0.05). The poor glycaemic test group was observed to have the highest RBG (200.34±50.4 mg/dL) and HbA1c (10.23±1.33%) compared both to good glycaemic test group RBG (186.38±45.39 mg/dL), HbA1c (6.54±0.45%) and non-diabetic group RBG (104.79±11.33 mg/dL) and HbA1c (5.21±1.23%) (P<0.05). Glutathione reductase (40.66±15.48 U/L) and TAS (1.80±1.08 mmol/L) were significantly more depleted in the poor glycaemic test group compared to the non-diabetic group GR (61.21±14.34 U/L), TAS (2.73±2.08 mmol/L) and good glycaemic test group GR (68.38±25.09 U/L), TAS (1.86±0.92 mmol/L) (P<0.05). Out of the 43 participants in the test group, only 18.6% had good glycaemic control and 81.4% had poor glycaemic control. There were significant negative correlations between RBG and TAS (r=-0.260; P=0.015); RBG and GR (r=-0.403; P=0.000) and HbA1c and GR (r=-0.471; P=0.000) (P<0.05). However, HbA1c and TAS showed no significant correlation (r=-0.170; P=0.119) (P>0.05). This study concludes that there is antioxidant depletion in females with type 2 diabetes.

Evaluation of hormonal changes in menstrual cycle of women infected with pulmonary tuberculosis in Nnewi, south eastern Nigeria.

BACKGROUND & OBJECTIVE: The present study was designed to evaluate the hormonal changes in menstrual cycle of premenopausal women infected with pulmonary tuberculosis in Nnamdi Azikiwe University Teaching Hospital Nnewi. MATERIAL AND METHODS: A prospective study involving sixty-seven (67) female participants within the child-bearing age were randomly recruited and grouped based on their tuberculosis status as: Symptomatic TB infected females (n=20), Symptomatic TB infected females on ATT (n=20) and Control females (n=27). After due consent, a detailed medical history was obtained and routine investigations of pulmonary tuberculosis and confirmation using Ziehl Neelsen and sputum culture techniques for AFB and chest x-ray were done. Blood samples collected from the participants were used for hormonal assay using immunoenzymometric method. RESULTS: The results showed that the serum levels of FSH and LH (IU/ml) were significantly higher while progesterone and estradiol were significantly lower in Symptomatic TB females compared to Symptomatic TB females on ATT at follicular and luteal phases of menstrual cycle (P<0.05). The serum levels of FSH and LH were significantly reduced in Symptomatic TB females on ATT while progesterone and estradiol were significantly increased at follicular and luteal phases of menstrual cycle (P<0.05). FSH was significantly higher at follicular phase while estradiol was significantly higher at luteal phase of menstrual cycle in Symptomatic TB females on ATT. CONCLUSION: Tuberculosis induced hypogonadism in affected women which seemed to be reversed on treatment. Routine investigation for Tuberculosis should be done for women presenting with infertility, since early treatment can reverse the abnormality.

Possible biochemical impact of malaria infection in subjects with HIV co-infection in Anambra state, Nigeria.

BACKGROUND & OBJECTIVES: The present study was designed to determine possible contributory impact of malaria infection on some biochemical markers in subjects with HIV co-infection in order to know if they are adverse or protective. METHODS: Participants were recruited at the Voluntary Counseling and Testing Unit, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria and grouped into: (i) Malaria and HIV co-infection group (n = 45); and (ii) HIV infected group without concurrent malaria infection (n = 57). Standard laboratory methods were used for the HIV and Plasmodium falciparum antigen screening, malaria parasite density, CD4+ T-cell count, packed cell volume, white blood cell count, serum iron and albumin concentrations. RESULTS: The results showed that serum iron and albumin were significantly reduced and raised respectively in 'Malaria-HIV co-infection group' compared with 'HIV infection group' (p < 0.05 and p < 0.05). A positive association was observed between age and serum iron concentration in malaria and HIV co-infected group (r = 0.580; p < 0.05) while negative associations were observed between PCV and serum iron (r = - 0.388; p < 0.05) and between CD4+ T-cells and serum iron concentration (r = -0.362; p < 0.05) in malaria and HIV co-infected group. The CD4+ T-cell count, WBC count, PCV were not significantly different between the Malaria-HIV co-infection group and HIV infection group. INTERPRETATION & CONCLUSION: In the present study serum iron and albumin concentrations were the most sensitive indicators that showed the contributory impact of malaria infection on biochemical index in HIV co-infected subjects. The findings suggest that at the defined stage of HIV infection in the present study, malaria co-infection may moderate the impact of HIV infection on iron metabolism and hepatic synthesis of albumin.

Prevalence of malaria as co-infection in HIV-infected individuals in a malaria endemic area of southeastern Nigeria.

BACKGROUND & OBJECTIVE: The present study was conducted on the prevalence of malaria as co-infection amongst 'asymptomatic HIV' and 'symptomatic HIV' subjects to see if such prevalence deviated from that commonly reported in apparently health individuals in same locality. METHODS: A prospective study that involved 196 participants grouped according to their HIV status as: 'asymptomatic HIV seropositive group' (n = 101); 'symptomatic HIV seropositive group' (n = 48) and 'control HIV-seronegative group (n = 47). Blood samples collected from the participants were used for double HIV screening by rapid immunoassay technique and immunochromatographic technique, and for the diagnosis of Plasmodium falciparum malaria using rapid P. falciparum antigen detection method. RESULTS: The result showed that the prevalence of P. falciparum malaria as a co-infection amongst the asymptomatic HIV seropositive group was 12 (11.8%) and amongst the symptomatic HIV seropositive group was 16 (33.3%). However, the prevalence rate of P. falciparum malaria amongst the control HIV seronegative group was 5 (10.6%) and the combined burden of P. falciparum malaria amongst both groups of HIV seropositives was 28 (18.9%). INTERPRETATION & CONCLUSION: The present study observed different prevalence rates of P. falciparum malaria amongst the three groups. The prevalence was tripled in symptomatic HIV seropositive group. This shows a clear departure from possible obtainable prevalence of malaria infection alone in this malaria endemic area. Due to the mortality rates associated with malaria infection in an endemic area, it may be necessary that routine malaria screening be adopted as part of the management policy to check the co-infection.