Changes in Liver Function Enzymes of HIV/AIDS Patients Treated with Antiretroviral Drugs (ARVS) in Specialist Hospital, Sokoto, Nigeria

This study assessed the effect of Human Immunodeficiency Virus and Antiretroviral Drugs (ARVs) on liver enzyme markers (Aspartate aminotransferase, Alanine aminotransferase and Alkaline phosphatase) and CD4 T-cells. A total of Seventy Five (75) individuals were enrolled into the study, which comprised Twenty Five (25) HIV negative (control), Twenty Five (25) HIV positive non-treated with ARVs and Twenty Five (25) HIV positive treated with antiretroviral drugs (ARVs). Females were found to be the majority of HIV infected patients and most patients were at the middle age of 20-39 years. AST and ALT were assessed according to the Reitman and Frankel’s (1957) method, while ALP was based on King Armstrong’s (1980) method and CD4 T-cells using a method assayed of Cassens et al., (2004). The result show a significant increase (p<0.05) in AST and ALT levels of HIV positive non treated group compared to HIV negative group (control). AST and ALT levels of HIV positive treated with ARVs is significantly higher in comparison to HIV positive non-treated group. But the ALP activity was significantly lower (p<0.05) in HIV positive treated group compared to non-treated group. Infection by HIV increases the activities of the three enzymes, which may be due to liver cells apoptosis caused by HIV infection, intact immune response to HIV replication which subsequently leads to hepatocellular necrosis and inflammation. But at the commencement of antiretroviral therapy the activities of the three afore-mentioned enzymes decreases which may be as result of decrease in the negative effect of the virus to the liver enzymes by ARVs. For clinical significance, it is necessary to investigate the activities of liver enzymes in HIV positive patients in order to monitor the diagnosis and advanced infection of the liver cells by HIV.Keywords: Aspartate aminotransferase, Alanine aminotransferase, Alkaline phosphatase, Human immunodeficiency virus and antiretroviral drug

Potassium Bromate Content of Bread Produced in Sokoto Metropolis

Fifteen different bread samples were randomly collected from various local bakeries located in Sokoto metropolis. The samples were analysed for presence and quantity of potassium bromate. All the samples were analysed using the redox titrimetric method for the detection of potassium bromate. All the samples contained potassium bromate with sample L having the highest quantity (56.20mg/g) and sample D having the lowest quantity of potassium bromate (14.70mg/g). This study has shown that in spite of National Agency for Food and Drug Administration and Control (NAFDAC) campaign for bromate-free bread most of the bread marketed and consumed in Sokotometropolis contains potassium bromate with the quantity varying from one bakery to another. This suggests that consumers of marketed bread in Sokoto stand the risk of potassium bromate toxicity.Key words: Bread, Potassium, bromat

The effects of aluminium and selenium supplementation on brain and liver antioxidant status in the rat

This in vivo study was designed to investigate the potential of aluminium (Al), in the absence of added iron, to participate in either antioxidant or pro-oxidant events. Some markers of oxidative stress were determined in liver and brain of rats exposed to aluminium lactate, either alone or in the presence of dietary supplements of selenium (se) as selenite. Exposure to aluminium for 21 days resulted in a statistically significant (P0.05) was observed in the GSH content. Contrary to what is known, Al exposure resulted in statistically significant decrease (

Oxidant status of children infected with

Background: Malaria is a global menace caused by the transfer of a plasmodium parasite to a host by an infected anopheles mosquito. Upon infection, the overwhelmed host releases free radicals which have the capacity to induce oxidative damage by lipid peroxidation. This study was undertaken to assess the effect of malaria caused by Plasmodium falciparum on some antioxidant markers and lipid peroxidation levels in children attending hospitals in Katsina State, Nigeria.Materials and Methods: Blood samples were collected from untreated subjects upon confirmation of Plasmodium falciparum parasitaemia using the Giemsa stain technique. One hundred and sixty (160) consenting individuals (80 infected patients and 80 uninfected subjects) comprising of both sexes were randomly selected. The levels of antioxidant markers and malondialdehyde (MDA) - a lipid peroxidation marker were determined. Descriptive analysis was employed using SPSS version 16.0 and significance between groups was ascertained using students' T-test.Results: P. falciparum malarial infection significantly (p <0.05) reduced the antioxidant markers [vitamins A, C, & E; and reduced glutathione (GSH)] by 65.4%, 29.7%, 48.1%, 40.4% respectively in males and by 54.2%, 36.6%, 55.7% , 36.6% in females when compared with values obtained from uninfected, healthy children. Conversely, lipid peroxidation levels were significantly (p <0.05) higher in children with parasitaemia than in nonparasitaemic controls. Males showed greater than 200% increase, while it increased by 138% in females.Conclusion: Our findings indicate a reciprocal relationship, where high levels of lipid peroxidation correspond to low levels of antioxidants, which may be due to over utilization of the antioxidants in order to counteract the effect of free radicals. This may be responsible for oxidative stress and consequently, tissue damage associated with pathology of malaria in Nigerian children.Key words: Antioxidant markers, Plasmodium falciparum, lipid peroxidation and children

Influence of ARVs on Some Biochemical Changes in Liver Non Enzymatic Markers of HIV Positive Patients Attending Specialist Hospital Sokoto, Nigeria

Both HIV infection and antiretroviral drugs (ARVs) are associated with abnormalities of liver function, revealed by both enzymatic and non-enzymatic markers. This study evaluated the effect of HIV infection and antiretroviral drugs on the liver non enzymatic marker (total and direct bilirubin, total protein and albumin level) of HIV positive patients (pre-highly active antiretroviral therapy and those on therapies) attending the voluntary counselling and testing units in the state. Seventy five subjects were enrolled into the study, which constituted 25 HIV negative individuals (control group), 25 HIV positive patient not on antiretroviral therapy and 25 on the therapy. Bilirubin, albumin, total protein and CD4 cell count were determined using standard methods. Significantly (p<0.05) higher level of total bilirubin, direct bilirubin and total protein in the HIV positive non-treated with ARVs was observed compared to the control group. At the initiation of antiretroviral therapy the levels of the three parameters were lower, though statistically not significant except for total protein. Albumin level and CD4 cell count were significantly (p<0.05) lower in the non-treated group compared to the control subjects. But at the initiation of therapy the serum levels of Albumin and CD4 count was significantly (p<0.05) higher except for albumin level. HIV infection lowers the level of liver non enzymatic markers, which increase at the initiation of antiretroviral therapy.Keywords: Bilirubin, Albumin, Total protein and CD4 cel

Hepatoprotective Effect of the Aqueous Leaf Extract of Andrographis paniculata Nees Against Carbon Tetrachloride – Induced Hepatotoxicity in Rats

Hepatoprotective effect of the aqueous leaf extract of Andrographis paniculata was investigated against CCl4 – induced hepatic injury in rats. Significant (P<0.05) increase of serum levels of alanine aminotransferase (ALT), aspartate amino transferase (AST), alkaline phosphatase (ALP), total bilirubin (TBL), direct bilirubin (DBL), total cholesterol (CHL),  triglycerides (TG), low density lipoprotein (LDL), very low density lipoprotein (VLDL) and malondialdehyde (MDA) in CCl4 intoxicated rats were restored to normal levels when treated with the extract and CCl4. Significant (P<0.05) decrease of serum levels of total protein (TP), albumin (ALB), high density lipoprotein (HDL) and reduced glutathione (GSH) in CCl4 intoxicated rats were restored to normal levels when treated with the extract and CCl4. The LD50 of the leaf extract was greater than 3000 mg/kg. The study demonstrated that A. paniculata possesses significant hepatoprotective effects and may be the source of lead compound in the management of liver diseases.Key words: Hepatoprotective, Andrographis paniculata, Carbon Tetrachloride, Liver Disease

In Vitro Assay of Bacterial Load on Some Ruminant Hide and Skin from North Western Nigeria

Consumption of meat is considered a vital source of essential amino acids, vitamins and minerals which makes it a critical dietary requirement for humans and other organisms. However, in Sub Saharan Africa, despite accounting for a large chunk of livestock production, it is in short supply due to poverty and cultural practices. Hence, encourages the demand and consumption of other meat products such as singed ruminant hide and skin. This study was carried out to evaluate the effect of singeing on bacterial population of hides and skin of cattle, camel, goat and sheep sold for human consumption in the seven North-western states of Nigeria using standard methods. Data obtained for the bacteria load showed that the highest mean count for singed hides and skins of cattle, camel, goat and sheep mean log10 CFU/g;5.10\ub10.13, 5.08\ub10.10, 5.06\ub10.05 and 5.05\ub10.09 respectively which were less than the unsigned (control), mean log10 CFU/g5.71\ub10.02, 5.70\ub10.03, 5.71\ub10.02 and 5.69\ub10.08. The high occurrence of bacteria was slightly within unacceptable limits for the ruminant hides and skin sampleslog10 CFU/g; cattle: 5.22 camel: 5.19, goat: 5.23 and sheep: 5.19. This require urgent mitigation as it is slightly contaminated. However, the lower bacterial counts taken for ruminant sampleslog10 CFU/g; cattle: 4.82, camel: 4.83, goat: 4.84 and sheep: 4.79 were all within the marginal acceptable standard. Succinctly, 60% of the ruminant hides and skin samples require correctional measures whereas, 40% were out rightly contaminated. Hence, urgent action is needed across the abattoirs of Northwestern states of Nigeria to curtail the tide of unsafe hides and skin consumptions. Conclusively, the study established as thus; significantly, Singeing reduces (p < 0.05) the bacterial load on ruminant hides and skin and all samples were considerably high and exceeding the WHO satisfactory level

Fluoroquinolones and isoniazid-resistant tuberculosis: implications for the 2018 WHO guidance.

INTRODUCTION: 2018 World Health Organization (WHO) guidelines for the treatment of isoniazid (H)-resistant (Hr) tuberculosis recommend a four-drug regimen: rifampicin (R), ethambutol (E), pyrazinamide (Z) and levofloxacin (Lfx), with or without H ([H]RZE-Lfx). This is used once Hr is known, such that patients complete 6 months of Lfx (≥6[H]RZE-6Lfx). This cohort study assessed the impact of fluoroquinolones (Fq) on treatment effectiveness, accounting for Hr mutations and degree of phenotypic resistance. METHODS: This was a retrospective cohort study of 626 Hr tuberculosis patients notified in London, 2009-2013. Regimens were described and logistic regression undertaken of the association between regimen and negative regimen-specific outcomes (broadly, death due to tuberculosis, treatment failure or disease recurrence). RESULTS: Of 594 individuals with regimen information, 330 (55.6%) were treated with (H)RfZE (Rf=rifamycins) and 211 (35.5%) with (H)RfZE-Fq. The median overall treatment period was 11.9 months and median Z duration 2.1 months. In a univariable logistic regression model comparing (H)RfZE with and without Fqs, there was no difference in the odds of a negative regimen-specific outcome (baseline (H)RfZE, cluster-specific odds ratio 1.05 (95% CI 0.60-1.82), p=0.87; cluster NHS trust). Results varied minimally in a multivariable model. This odds ratio dropped (0.57, 95% CI 0.14-2.28) when Hr genotype was included, but this analysis lacked power (p=0.42). CONCLUSIONS: In a high-income setting, we found a 12-month (H)RfZE regimen with a short Z duration to be similarly effective for Hr tuberculosis with or without a Fq. This regimen may result in fewer adverse events than the WHO recommendations

Perception and beliefs about mental illness among adults in Karfi village, northern Nigeria

BACKGROUND: This study was designed to examine the knowledge, attitude and beliefs about causes, manifestations and treatment of mental illness among adults in a rural community in northern Nigeria. METHODS: A cross sectional study design was used. A pre-tested, semi-structured questionnaire was administered to 250 adults residing in Karfi village, northern Nigeria. RESULTS: The most common symptoms proffered by respondents as manifestations of mental illness included aggression/destructiveness (22.0%), loquaciousness (21.2%), eccentric behavior (16.1%) and wandering (13.3%). Drug misuse including alcohol, cannabis, and other street drugs was identified in 34.3% of the responses as a major cause of mental illness, followed by divine wrath/ God's will (19%), and magic/spirit possession (18.0%). About 46% of respondents preferred orthodox medical care for the mentally sick while 34% were more inclined to spiritual healing. Almost half of the respondents harbored negative feelings towards the mentally ill. Literate respondents were seven times more likely to exhibit positive feelings towards the mentally ill as compared to non-literate subjects (OR = 7.6, 95% confidence interval = 3.8–15.1). CONCLUSIONS: Our study demonstrates the need for community educational programs in Nigeria aimed at demystifying mental illness. A better understanding of mental disorders among the public would allay fear and mistrust about mentally ill persons in the community as well as lessen stigmatization towards such persons

Development and validation of the ISARIC 4C Deterioration model for adults hospitalised with COVID-19: a prospective cohort study

BACKGROUND: Prognostic models to predict the risk of clinical deterioration in acute COVID-19 cases are urgently required to inform clinical management decisions. METHODS: We developed and validated a multivariable logistic regression model for in-hospital clinical deterioration (defined as any requirement of ventilatory support or critical care, or death) among consecutively hospitalised adults with highly suspected or confirmed COVID-19 who were prospectively recruited to the International Severe Acute Respiratory and Emerging Infections Consortium Coronavirus Clinical Characterisation Consortium (ISARIC4C) study across 260 hospitals in England, Scotland, and Wales. Candidate predictors that were specified a priori were considered for inclusion in the model on the basis of previous prognostic scores and emerging literature describing routinely measured biomarkers associated with COVID-19 prognosis. We used internal-external cross-validation to evaluate discrimination, calibration, and clinical utility across eight National Health Service (NHS) regions in the development cohort. We further validated the final model in held-out data from an additional NHS region (London). FINDINGS: 74 944 participants (recruited between Feb 6 and Aug 26, 2020) were included, of whom 31 924 (43·2%) of 73 948 with available outcomes met the composite clinical deterioration outcome. In internal-external cross-validation in the development cohort of 66 705 participants, the selected model (comprising 11 predictors routinely measured at the point of hospital admission) showed consistent discrimination, calibration, and clinical utility across all eight NHS regions. In held-out data from London (n=8239), the model showed a similarly consistent performance (C-statistic 0·77 [95% CI 0·76 to 0·78]; calibration-in-the-large 0·00 [-0·05 to 0·05]); calibration slope 0·96 [0·91 to 1·01]), and greater net benefit than any other reproducible prognostic model. INTERPRETATION: The 4C Deterioration model has strong potential for clinical utility and generalisability to predict clinical deterioration and inform decision making among adults hospitalised with COVID-19. FUNDING: National Institute for Health Research (NIHR), UK Medical Research Council, Wellcome Trust, Department for International Development, Bill & Melinda Gates Foundation, EU Platform for European Preparedness Against (Re-)emerging Epidemics, NIHR Health Protection Research Unit (HPRU) in Emerging and Zoonotic Infections at University of Liverpool, NIHR HPRU in Respiratory Infections at Imperial College London