Passive- and active-cigarette smoking: Effects on the levels of antioxidant vitamins, immunoglobulin classes and acute phase reactants

The levels of plasma immunoglobulin classes (IgG, A and M) and acute phase proteins (α 2- macroglobulin (A2MG), C-reactive protein (CRP)) were determined using single radial immunodiffusion method. Also, determined in the plasma of the subjects were antioxidant vitamins (vitamins C and E) using spectrophotometric method. The participants were 30 subjects who had never smoked and not exposed to cigarette smoke (non smokers), 30 who had smoked at least 15 cigarettes per day for at least five years (active smokers) and 30 who had been exposed to cigarette smoke at least 2 cigarette/day on ≥5 days/wk for at least 5 years (passive smokers). Plasma levels of IgG, IgM, CRP and A2MG were significantly raised (p<0.05), while vitamins C and E (p<0.05) were significantly reduced in active smokers when compared with the controls. The plasma levels of CRP and A2MG were significantly raised (p<0.05), while vitamins C and E were significantly reduced (p<0.05) in passive smokers when compared with the controls. The levels of CRP and antioxidant vitamins were similar in active and passive smokers. This study suggested that, exposure to passive as well as active cigarette smoking cause’s inflammation as well as vitamin deficiency.Key words: Cigarette smoke, inflammation, oxidative stress, acute phase proteins, immunoglobulin classes

Foetal haemoglobin (HbF) status in adult sickle cell anaemia patients in Ibadan, Nigeria

Aim: - Elevated HbF, among other biological and environmental factors, is responsible for decrease in mortality in sickle cell anaemia (SCA). This study determined the levels of HbF in adult SCA patients in steady state compared with HbAA controls. HbF was discussed in line with the clinical course of the disease so as to emphasize the relevance of hydroxyurea in the management of adult SCA patients.Materials and methods: - The HbF levels of 66 confirmed SCA patients and 31 HbAA controls were estimated using Betke method and HbF percentage was calculated using formula: %HbF percentage = A413 filtrate x 100A413 standard x 20.Result: - A statistical significant difference in the mean of the levels of HbF in patients (5.16±4.04) compared to controls (1.04±0.44) (p = 0.000) was observed. The mean levels of HbF for males (4.71±3.49) compared to that of females (4.99) were statistically similar (p =0.773). It was also observed that the mean HbF level appears to be declining as age advances. SCA patients were classified to three categories viz: HbF <2% (21.2% SCA patients); HbF of 2.1% -10%, (68.2% SCA patients); and HbF of 10.1% -16%, (10.6% SCA patients).Conclusion: - Substantial proportion of our patients actually will require treatment with hydroxylurea to stimulate HbF production especially those with HbF percentage of <2 and some with HbF percentage of 2.1 – 10%. HPFH may be considered rare since only 10. 6% had HbF at the range of 10.1-16%. This study showed that in treating our SCA patients in Nigeria we need to adopt and encourage the use of HbF activating agents like hydroxyurea or any other safe agent that will be found to stimulate HbF production in SCD patients.Keywords: Sickle cell anaemia, HbF levels, Hydroxyurea us

Renal and hepatic profiles in Nigerian multidrug resistant tuberculosis patients with or without HIV co-infection

Tuberculosis (TB) is primarily a lung disease (pulmonary tuberculosis, PTB) but the bacilli can also  develop in other places in the body, such as the bones, liver and kidney as extra pulmonary tuberculosis. Hepatic and renal involvements in PTB patients are mostly secondary to TB chemotherapy that is  potentially hepato- and nephro- toxic. In this study, the biochemical parameters that indicate renal and hepatic involvements were analyzed in the sera of MDR-TB patients with and without HIV co-infection prior to commencement of chemotherapy. Out of 115 MDR-TB patients (76 males and 39 females) recruited for the study, 22 patients (11 males and 11 females) were co-infected with HIV. Serum levels of sodium (Na+), potassium (K+), chloride (Cl-) were analyzed using Easylite (ISE technology),   bicarbonate (HCO3-) was analysed using back titration method, urea and creatinine were determined spectrophotometrically using Diacetlymonoxime (DAM) method and Jaffe’s alkaline picrate method  respectively. Total and direct bilirubin, serum glutamate oxaloacetate transferase (SGOT), serum glutamate pyruvate transferase (SGPT), alkaine phosphatase(ALP), total protein (TP) and albumin (Alb) were determined using Hitachi 912 autoanalyzer. There were no statistical significant differences in the renal and hepatic parameters of TB patients with HIV compared with TB patients without HIV. However, significantly higher proportions (89%) of MDR-TB patients had their SGOT within reference range. The mean values indicate that HIV infection did not significantly alter renal and hepatic profiles inMDR-TB patients prior to treatment. LES PROFILS RENALS ET HEPATIQUES DANS MULTIRESISTANTE PATIENTS TUBERCULEUXNIGERIANS AVEC OU SANS CO – INFECTION PAR LE VIH.La tuberculose est principalement une maladie du poumon (Tuberculeuse pulmonaire TBP) mais les bacilles peuvent être également se développer dans d’autres endroits dans le corps, tels que les os, le foie et les reins comme la tuberculose extra pulmonaire. L’atteinte hépatique et rénale chez les patients atteints de TBP est surtout secondaire a la chimiothérapie de la tuberculose(TB) qui est potentiellement hépato – et néphro – toxique. Dans cette étude, les paramètres biochimiques qui indiquent les  implications rénales et hépatiques ont été analyses dans les sérums des patients atteints de MDR – TB avec ou sans Co – infection par le VIH avant le commencement de la chimiothérapie. Sur les 115 patients atteints de MDR – TB (76 males et femelles), recrutés pour l’étude, 22 patients (11 males et femelles) ont été co – infectes par le VIH. Le niveau sérique de sodium (Na⁺), de potassium (K⁺), le chlorure(C1⁻) ont été analyses en utilisant Easylite(technologie ISE), le bicarbonate (HC0₃⁻) a été analyse en utilisant la méthode de titrage de retour, l’urée et de la créatinine ont été déterminés spectrophotométrie rn utilisant la méthode Diacétyle monoxime(DAM) et la méthode de picrate alcaline de Jaffer respectivement. Bilirubine totale et directe, glutamate oxaloacetate transférase sérique(SGOT), transférase sérique de glutamate pyruvate(SGPT), phosphatase alcaline(ALP), protéines totale(TP) et albumine(Alb) ont été déterminés en utilisant Hitachi 912 autoa nalyseur. Il n’ ya pas de différence statistiquement significative dans les paramètres rénales et hépatiques des patients tuberculeux vivant avec ke VIH par rapport aux patients atteints de tuberculose sans VIH. Néanmoins, les proportions significativement élevées (89%) des patients atteints de MDR – TB ont eu leurs SGOT a porté de référence. Les valeurs moyennes indiquent que l’infection par le VIH n’a pas modifié significativement les profils rénaux et hépatiques chez les patients de TB – MRD.Mots – clés : Les reins, le foie, l’électrolyte, la tuberculose, Virus de l’immunodéficience humaine, Co – infection.Key words: Kidney, Liver, Electrolytes, Tuberculosis, Human Immunodeficiency Virus, Co-infection

Glycated haemoglobin levels in patients with multidrug-resistant tuberculosis infection during 6 months of treatment

Background: There is little information on the possible impact of drugs used in the treatment of  multi-drug resistant tuberculosis (MDR-TB) on glycaemic levels. This study therefore assessed changes in glycated haemoglobin levels in patients with MDR-TB.Materials and Methods: This longitudinal study involved 21 MDR-TB patients who were followed up for 6 months. Glycated haemoglobin (HbA1c) level of each patient was determined before the  commencement of MDR-TB drug regimen and at 2, 4 and 6 months post treatment as part of a study which investigated them every 2 months. Differences in means were assessed using the paired Student’s t-test and statistical significance was set at P<0.05.Results: A patient had undiagnosed diabetes mellitus (DM) with an HbA1c value of 6.5% and died before the second month sample collection; another patient became critically ill; therefore, 19 patients completed the study. Before the commencement of MDR-TB therapy, two patients had pre-diabetes with HbA1c values of 6.0% and 5.8% while the HbA1c values of the remaining patients were less than 5.7%. There was a significant reduction in the mean HbA1c level at 2 months post therapy compared with the baseline. However, the HbA1c levels increased slightly after the 2nd month of therapy but no significant change was observed in the HbA1c levels at 4 and 6 months of MDR-TB therapy compared with baseline.Conclusion: Diabetes mellitus is not common among Nigerians with MDR-TB and MDR-TB drug  regimen might have an acute effect on glycaemic changes in patients with MDR-TB.Keywords: Diabetes mellitus, Glycaemic change, Glycated haemoglobin, Multidrug resistant tuberculosis therap

Diagnostic value of lipids, total antioxidants, and trace metals in benign prostate hyperplasia and prostate cancer

Background: Considerable overlap exists in the value of total prostate specific antigen (tPSA) in both prostate cancer (Pca) and benign prostate hyperplasia (BPH). Developing an effective biochemical screening test that will complement PSA assay could reduce the associated cost of care and give timely attention to prostate cancer patients even when they are still asymptomatic is therefore desirable. This work was therefore an attempt to evaluate the possible roles of lipids, antioxidants, and trace metals in breaking the diagnostic tie between Pca and BPH.Materials and Methods: Anthropometric characteristics, total prostate specific antigen (tPSA), serum lipids (total cholesterol, LDL cholesterol, HDL cholesterol, and triglycerides), Vit. E, total antioxidant status (TAS), and trace metals (Se, Cu, Fe, Zn, and Mn) were determined in 40 patients with histopathological diagnosis of BPH and Pca. Forty age matched control subjects were also recruited from the same community. Informed consent was obtained from all the participants in the study. A P-value < 0.05 was considered significant.Results: There were significant variations in the weight, hip circumference, and body mass index (BMI) across the group but the post hoc test did not show any difference between patients with prostate cancer and BPH. Among the biochemical parameters studied, only the total cholesterol and triglyceride differed significantly between patients with BPH and prostate cancer patients. Cut-offs from ROC for BPH and prostate cancer at 88.9 sensitivity and 66.7% specificity (95% CI) were 88.5 mg and 161 mg/dl for triglycerides and cholesterol respectively. Furthermore there were no significant variations in the mean levels of copper and tPSA, Vit E, and LDL cholesterol among the study subjects and the controls.Conclusion: Prior to prostate biopsy, serum lipid (especially, fasting triglycerides, total cholesterol) could help in early discrimination of patients with BPH from prostate cancer in adjunct to total PSA and other management protocol for diagnosis of prostate cancer. The use of trace metal or antioxidants may have limited advantages. Further studies in this regard will be very desirable to see if this pattern of triglyceride and total cholesterol values in BPH and Pca are sustainable

Allergy sensitization and asthma among 13-14 year old school children in Nigeria

Background: The prevalence of asthma and role of atopy in asthma among children has not been clearly defined in Nigeria.Objective: To determine the prevalence of asthma and investigate risk factors related to allergy sensitization among urban and rural school children in southwest Nigeria.Methods: Validated ISAAC questionnaire was administered to 1736 high school children in randomly selected schools in rural and urban communities. Identified asthma cases were matched to controls. Allergy skin tests, blood eosinophil count, serum IgE and stool examination for parasites were performed. Dust samples from homes were also collected and analyzed for allergens.Results: The prevalence of asthma was 7.5% (95% CI 6.0 to 9.2%) and 8% (95% CI 6.0-10.4%) in the rural and urban communities respectively . Risk factors for asthma included cigarette-smoking, cats in the home and family size. Eosinophil count (109/L) was elevated in asthmatics [0.70 (95% CI 0.48-1.11) vs. 0.32 (95% CI 0.19-0.69); p<0.01], but IgE levels were similar between the two groups (298±229 IU/mL vs. 288±257; p=0.97). Positive skin tests to cat hair, cockroach, mango blossom and mouse epithelium were more frequent in asthmatics than in healthy controls, especially in the rural communities. There was no correlation between allergens in dust collected from homes and skin test reactivity.Conclusion: Asthma prevalence is similar in rural and urban children in Southwest Nigeria and atopy with elevated IgE was not observed to be a major factor for asthma in our cohort of children in both communities.Key words: Asthma, risk factors, prevalence, atopy, sensitization, childre

Changes in mediators of inflammation and pro-thrombosis after 12 months of dietary modification in adults with metabolic syndrome.

Objective: This study evaluated the effects of a 12-month dietary modification on indices of inflammation and pro-thrombosis in adults with metabolic syndrome (MS). Materials and methods: This longitudinal study involved 252 adults with MS recruited from the Bodija market, Ibadan and its environs. Participants were placed on 20%, 30% and 50% calories obtained from protein, total fat and carbohydrate respectively and were followed up monthly for 12 months. Anthropometry and blood pressure were measured using standard methods. Fasting plasma glucose (FPG), total cholesterol (TC), triglycerides (TG), high density lipoprotein-cholesterol (HDL-C), fibrinogen, plasminogen activator inhibitor-1 (PAI-1)], interleukin-6 (IL-6) and interleukin-10 (IL-10) were measured using spectrophotometric methods and ELISA as appropriate. Data was analysed using ANCOVA, Student\u2019s t-test, Mann-Whitney U and Wilcoxon signed-rank tests. P-values less than 0.05 were considered significant. Results: After 6 months of dietary modification, there was a significant reduction in waist circumference (WC), while the levels of HDL-C, fibrinogen and PAI-1 were significantly increased when compared with the corresponding baseline values. However, WC and fibrinogen reduced significantly, while HDL-C and IL-10 significantly increased after 12 months of dietary modification as compared with the respective baseline values. Conclusion: Long-term regular dietary modification may be beneficial in ameliorating inflammation and pro-thrombosis in metabolic syndrome

Lead Exposure: A Contributing Cause of the Current Breast Cancer Epidemic in Nigerian Women

Breast cancer incidence in Nigerian women has significantly increased during the past three decades in parallel with the rapid industrialization of that country. This suggested that the associated widespread contamination of the soil and of the water supplies by lead (Pb) and other industrial metals was a major contributing cause. Because of its many domestic, industrial, and automotive uses, Pb is of particular concern as it has been shown to promote the development of mammary tumors in murine mammary tumor virus-infected female C3H mice at levels as low of 0.5 ppm Pb in the drinking water. Lead belongs to the group of selenium-antagonistic elements that interact with selenium (Se), abolishing its anti-carcinogenic effect. Lead on chronic, low-level exposure in addition also accelerates tumor growth rates. Higher levels of Pb were found in blood and head hair samples of newly diagnosed patients with breast cancer, all with infiltrating ductal carcinoma, the most common form of breast cancer in Nigeria, seen at Obafemi Awolowo University, than in cancer-free controls from the same area. Evidence for interactions between Pb and Se was obtained from blood, hair, and tumor biopsy tissue analyses. Furthermore, the Pb levels in hair samples of the patients were directly correlated with the volumes of their tumors, in accord with the tumor growth-promoting effects of Pb. Conversely, Se levels in hair and blood were inversely correlated with the tumor volumes, consistent with the anti-proliferative effects of Se. Several other elements, e.g., Cd, Hg, Cr, Sn, and As, were detected in the scalp hair of the patients and the controls, although at significantly lower levels than those of Pb. However, correlation calculations revealed them also to interact with Se, suggesting that only a fraction of the Se in organs and tissues is actually present in bioactive forms. In metal-exposed subjects, a state of latent Se deficiency may exist, resulting in depressed immune functions and increased cancer susceptibility. Evidence is presented to show that Pb and other metals also interact with iodine, another vitally important essential trace element believed to protect against breast cancer development. Public health programs aiming at lowering the breast cancer risk of Nigerian women thus will have to include effective measures to protect the population from exposures to Pb and other industrial metals that are presently contaminating the environment and the water supplies

Leucocyte Phagocytosis In Children With Urinary Schistosomiasis And Asymptomatic Malaria Parasitemia

In the participants considered for this study, leucocyte migration, neutrophil candidacidal activity and ability to generate reactive oxygen were determined as percentage migration index (%M. I), candidacidal phagocytic index (%C.I) and bacterial stimulated nitroblue tetrazolium (NBT) dye reduction index (%NBT) respectively. Also, malaria density was counted from thick blood film of glass slide stained with Giemsa stain. The participants were 54 school children having urinary schistosomiasis without malaria parasites (USS-M), 18 children with both urinary schistosomiasis and malaria parasites (USS+M), 46 children with malaria parasites without urinary schistosomiasis (M-USS) and 29 controls. The mean % M.I was least while %NBT index was highest in USS+M subjects but M-USS subjects had least %C.I. Malaria density was higher in M-USS subjects than USS+M subjects. The results of this study showed that low prevalence and reduced severity of malaria parasites in children with urinary schistosomiasis may be due to adequate production of leucocyte migration inhibitory factor (LMIF) and reactive oxygen species. Key words: Leucocyte phagocytosis, malaria, schistosomiasis, Nigeria Afr. J. Clin. Exper. Microbiol. 2005; 6(2): 81-8