Pattern of Blood Pressure Indices among the Residents of a Rural Community in South East Nigeria

Cardiovascular diseases (CVDs) are the main causes of death in industrialized countries, and are significant causes of morbidity and mortality in sub-Saharan Africa. Hypertension is the most common cardiovascular disease in Nigerians, and the risk of CVD associated with hypertension is independent of other risk factors. Despite the high level of awareness of its presence in the developed countries, the level of control is still poor. CVDs tend to be commoner in urban settlements, and it has been hypothesized that rural sub-Saharan Africa is at an early stage of epidemiological transition from communicable to non-communicable diseases (NCD) because of the gradual adoption of unhealthy lifestyles. This study aimed at describing the pattern of blood pressure indices among the hypertensive residents of a rural community in South East Nigeria. A total of 858 individuals comprising 247 males and 611 females took part in the study. 46.4% of the subjects had hypertension. Hypertension was commoner in the males (50.2% vs. 44.8%) (χ2(1) = 1.484; P = 0.223). The males were significantly older and heavier than the females while the females had higher mean values of BMI and WC. The prevalence of hypertension is becoming alarmingly high in the rural communities of sub-Saharan Africa

Prevalence of Cardiovascular Risk Factors in the Middle-Aged and Elderly Population of a Nigerian Rural Community

Cardiovascular diseases (CVDs) causes of worldwide preventable morbidity and mortality. CVDs are a leading cause of mortality and morbidity in developing countries, and rates are expected to rise over the next few decades. The prevalence of CVD risk factors is dramatically increasing in low-and middle-income African countries, particularly in urban areas. We carried out a cross-sectional population-based survey in Imezi-Owa, a rural community in South East Nigeria to estimate the prevalence of major cardiovascular risk factors in both men and women aged 40–70 years. A total of 858 individuals made up of 247 (28.8%) males and 611 (71.2%) females were recruited. The mean age of the subjects was 59.8 ± 9.9 years. The prevalence of the different cardiovascular risk factors among the 858 subjects was as follows: hypertension 398 (46.4%) subjects, generalized obesity as determined by BMI 257 (30%) subjects, abdominal obesity 266 (31%) subjects, dysglycaemia 38 (4.4%) subjects and hypercholesterolaemia 32 (3.7%) subjects. Prevalence of hypertension and dysglycaemia was higher in men while the others were higher in women. Only hypertension (P = .117) and hypercholesterolaemia (P = .183) did not reveal any significant association with gender. Prevalence of CVD risk factors was highest in subjects aged 65 to 70 years

Effect of Vernonia amygdalina Ethanolic Root Extract on the Hepato- and Nephro-Protective Properties of Albino Rats (Rattus novergicus)

The hepato- and nephro-protective potentials of Vernonia amygdalina ethanolic root extract was evaluated for 14 days using standard bioassay in 45 normal male albino rats. The rats were divided into four treatment groups I – IV and a control group V. Groups I – IV were given 100mg.kg-1, 200mg.kg-1, 400mg.kg-1 and 600mg.kg-1 body weight, respectively while the control (group V) was given equal volume of feed and water. The extracts were administered orally to the animals for 14 days. Blood samples were collected using the ocular puncture method before and weekly after administration to evaluate the extracts’ effects on aspartate transaminase (AST), acid phosphatase (ACP), alanine transaminase (ALT), alkaline phosphatase (ALP), bilirubin, creatinine and blood urea nitrogen (BUN) levels. The mean serum levels of the liver marker enzymes AST, ACP, ALT, ALP, total bilirubin and direct bilirubin ranged from 10.00±0.53 to 11.44±0.44, 31.29±0.64 to 33.14±0.56, 27.22±0.94 to 29.67±0.37 and 37.83±0.59 to 40.57±1.02, 3.42±0.08 to 3.61±0.07 and 2.06±0.11 to 2.51±0.05 respectively. The mean levels of the nephrotic enzymes, creatinine and BUN also ranged from 39.87±1.79 to 43.04±1.57 and 6.62±0.21 to 15.98±0.17 accordingly. Although no significant difference (p>0.05) was observed in the serum levels of the liver marker enzymes and creatinine when compared with the control, a dose and duration dependent significant increase (p<0.05) occurred in the BUN level. This tends to suggest that the ethanolic root extract of Vernonia amygdalina on a short term basis has some hepato-protective property while its nephro-protective ability is still doubtful. Keywords: Vernonia amygdalina, Ethanolic root extract, Liver maker enzymes, Nephrotic enzymes, Albino rat

Intra‑cardiac masses in adults: A review of echocardiogram records at two echocardiographic laboratories in Enugu, South‑East Nigeria

Background: Transthoracic echocardiography (TTE) is an excellent initial diagnostic technique used to evaluate and diagnose cardiac masses, even though transoesophageal echocardiography (TEE) provides superior image resolution and better visualization of cardiac masses, especially in patients with suboptimal transthoracic echocardiographic studies. TTE is the clinical procedure of choice for identification of left ventricular thrombi. TTE has greater than 90% sensitivity and greater than 85% specificity for detection of left ventricular thrombi and is probably superior to the sensitivity and specificity of TEE, especially for apical thrombi.Aims: The study aimed to identify the common types of cardiac masses and their commonest locations in the heart.Materials and Methods: We did a retrospective review of our echocardiogram reports from May 2003 to July 2012 to identify the frequency of intra‑cardiac masses in adults, as well as the gender distribution and commonest location of these masses.Results: There were 2,814 echo examinations in adults over this period, comprising 1,661 males (59.1%) and 1,153 females (40.9%). Intra‑cardiac masses were found in 20 of these patients representing 0.7% of the study population. Thrombi were the commonest masses noted in our study, and there were more masses in the atria than in the ventricles. The left heart chambers also had more masses than the right heart chambers. There was no sex difference in the frequency of cardiac masses.Conclusion: Intra‑cardiac masses are rare, and transthoracic echocardiography is still valuable in the diagnosis and initial characterization of cardiac masses.Keywords: Adults, echocardiography, intra‑cardiac masses, NigeriaNigerian Journal of Clinical Practice • Oct-Dec 2013 • Vol 16 • Issue

Atrial Septal Defects Presenting Initially in Adulthood: Patterns of Clinical Presentation in Enugu, South-East Nigeria

This paper aimed to evaluate the patterns of clinical presentation of adults with atrial septal defects (ASDs) who were diagnosed from transthoracic echocardiographic examination at the echocardiographic laboratory of the University of Nigeria Teaching Hospital Ituku-Ozalla, Enugu, Nigeria, from February 2002 to June 2010. 2251 new echocardiogram scans, with additional 373 repeat scans, were done within the period. 32 adults had ASDs (1.3%), made up of 9 males and 23 females. Secundum ASD constituted 75% while dyspnoea on exertion was the commonest symptom. Congestive cardiac failure was the clinical syndrome most commonly encountered, and most patients presented in the third decade. This paper demonstrated that ASDs are common congenital heart diseases in adult Nigerians, and that they are important causes of congestive heart failure. All adults with congestive heart failure must be referred for echocardiography for early identification of causes like ASDs, which are often forgotten, before the development of irreversible changes in the lungs

CaV1.2 and CaV1.3 voltage-gated L-type Ca2+ channels in rat white fat adipocytes

L-type channel antagonists are of therapeutic benefit in the treatment of hyperlipidaemia and insulin resistance. Our aim was to identify L-type voltage-gated Ca2+ channels in white fat adipocytes, and determine if they affect intracellular Ca2+, lipolysis and lipogenesis. We used a multidisciplinary approach of molecular biology, confocal microscopy, Ca2+ imaging and metabolic assays to explore this problem using adipocytes isolated from adult rat epididymal fat pads. CaV1.2, CaV1.3 and CaV1.1 alpha1, beta and alpha2delta subunits were detected at the gene expression level. The CaV1.2 and CaV1.3 alpha1 subunits were identified in the plasma membrane at the protein level. Confocal microscopy with fluorescent antibodies labelled CaV1.2 in the plasma membrane. Ca2+ imaging revealed that the intracellular Ca2+ concentration, [Ca2 +]i was reversibly decreased by removal of extracellular Ca2+, an effect mimicked by verapamil, nifedipine and Co2+, all blockers of L-type channels, whereas the Ca2+ channel agonist BAY-K8644 increased [Ca2+]i. The finding that the magnitude of these effects correlated with basal [Ca2+]i suggests that adipocyte [Ca2+]i is controlled by L-type Ca2+ channels that are constitutively active at the adipocyte depolarized membrane potential. Pharmacological manipulation of L-type channel activity modulated both basal and catecholamine-stimulated lipolysis but not insulin-induced glucose uptake or lipogenesis. We conclude that white adipocytes have constitutively active L-type Ca2+ channels which explains their sensitivity of lipolysis to Ca2+ channel modulators. Our data suggest CaV1.2 as a potential novel therapeutic target in the treatment of obesity

The Pleiotropic CymR Regulator of Staphylococcus aureus Plays an Important Role in Virulence and Stress Response

We have characterized a novel pleiotropic role for CymR, the master regulator of cysteine metabolism. We show here that CymR plays an important role both in stress response and virulence of Staphylococcus aureus. Genes involved in detoxification processes, including oxidative stress response and metal ion homeostasis, were differentially expressed in a ΔcymR mutant. Deletion of cymR resulted in increased sensitivity to hydrogen peroxide-, disulfide-, tellurite- and copper-induced stresses. Estimation of metabolite pools suggests that this heightened sensitivity could be the result of profound metabolic changes in the ΔcymR mutant, with an increase in the intracellular cysteine pool and hydrogen sulfide formation. Since resistance to oxidative stress within the host organism is important for pathogen survival, we investigated the role of CymR during the infectious process. Our results indicate that the deletion of cymR promotes survival of S. aureus inside macrophages, whereas virulence of the ΔcymR mutant is highly impaired in mice. These data indicate that CymR plays a major role in virulence and adaptation of S. aureus for survival within the host

Efficient discovery of anti-inflammatory small-molecule combinations using evolutionary computing

The control of biochemical fluxes is distributed, and to perturb complex intracellular networks effectively it is often necessary to modulate several steps simultaneously. However, the number of possible permutations leads to a combinatorial explosion in the number of experiments that would have to be performed in a complete analysis. We used a multiobjective evolutionary algorithm to optimize reagent combinations from a dynamic chemical library of 33 compounds with established or predicted targets in the regulatory network controlling IL-1β expression. The evolutionary algorithm converged on excellent solutions within 11 generations, during which we studied just 550 combinations out of the potential search space of ~9 billion. The top five reagents with the greatest contribution to combinatorial effects throughout the evolutionary algorithm were then optimized pairwise. A p38 MAPK inhibitor together with either an inhibitor of IκB kinase or a chelator of poorly liganded iron yielded synergistic inhibition of macrophage IL-1β expression. Evolutionary searches provide a powerful and general approach to the discovery of new combinations of pharmacological agents with therapeutic indices potentially greater than those of single drugs

The effects of methionine acquisition and synthesis on Streptococcus pneumoniae growth and virulence

Extent: 14 p.Bacterial pathogens need to acquire nutrients from the host, but for many nutrients their importance during infection remain poorly understood. We have investigated the importance of methionine acquisition and synthesis for Streptococcus pneumoniae growth and virulence using strains with gene deletions affecting a putative methionine ABC transporter lipoprotein (Sp_0149, metQ) and/or methionine biosynthesis enzymes (Sp_0585 - Sp_0586, metE and metF). Immunoblot analysis confirmed MetQ was a lipoprotein and present in all S. pneumoniae strains investigated. However, vaccination with MetQ did not prevent fatal S. pneumoniae infection in mice despite stimulating a strong specific IgG response. Tryptophan fluorescence spectroscopy and isothermal titration calorimetry demonstrated that MetQ has both a high affinity and specificity for L-methionine with a KD of ~ 25 nM, and a DmetQ strain had reduced uptake of C14-methionine. Growth of the ΔmetQ/ΔmetEF strain was greatly impaired in chemically defined medium containing low concentrations of methionine and in blood but was partially restored by addition of high concentrations of exogenous methionine. Mixed infection models showed no attenuation of the ΔmetQ, ΔmetEF and ΔmetQ/DmetEF strains in their ability to colonise the mouse nasopharnyx. In a mouse model of systemic infection although significant infection was established in all mice, there were reduced spleen bacterial CFU after infection with the ΔmetQ/ΔmetEF strain compared to the wild-type strain. These data demonstrate that Sp_0149 encodes a high affinity methionine ABC transporter lipoprotein and that Sp_0585 – Sp_0586 are likely to be required for methionine synthesis. Although Sp_0149 and Sp_0585-Sp_0586 make a contribution towards full virulence, neither was essential for S. pneumoniae survival during infection.Shilpa Basavanna, Suneeta Chimalapati, Abbas Maqbool, Bruna Rubbo, Jose Yuste, Robert J. Wilson, Arthur Hosie, Abiodun D. Ogunniyi, James C. Paton, Gavin Thomas and Jeremy S. Brow

Methionine biosynthesis and transport are functionally redundant for the growth and virulence of Salmonella Typhimurium

Methionine (Met) is an amino acid essential for many important cellular and biosynthetic functions, including the initiation of protein synthesis and S-adenosylmethionine-mediated methylation of proteins, RNA, and DNA. The de novo biosynthetic pathway of Met is well conserved across prokaryotes but absent from vertebrates, making it a plausible antimicrobial target. Using a systematic approach, we examined the essentiality of de novo methionine biosynthesis in Salmonella enterica serovar Typhimurium, a bacterial pathogen causing significant gastrointestinal and systemic diseases in humans and agricultural animals. Our data demonstrate that Met biosynthesis is essential for S. Typhimurium to grow in synthetic medium and within cultured epithelial cells where Met is depleted in the environment. During systemic infection of mice, the virulence of S. Typhimurium was not affected when either de novo Met biosynthesis or high-affinity Met transport was disrupted alone, but combined disruption in both led to severe in vivo growth attenuation, demonstrating a functional redundancy between de novo biosynthesis and acquisition as a mechanism of sourcing Met to support growth and virulence for S. Typhimurium during infection. In addition, our LC-MS analysis revealed global changes in the metabolome of S. Typhimurium mutants lacking Met biosynthesis and also uncovered unexpected interactions between Met and peptidoglycan biosynthesis. Together, this study highlights the complexity of the interactions between a single amino acid, Met, and other bacterial processes leading to virulence in the host and indicates that disrupting the de novo biosynthetic pathway alone is likely to be ineffective as an antimicrobial therapy against S. Typhimurium