Renal Status of Multiple Myeloma Patients in Ibadan, Nigeria

Introduction: The spectrum of clinical manifestation in multiple myeloma (MM) ranges from asymptomatic disease to severely debilitative state. Unexplained renal disease is an indication for the investigation of patients for MM. This study is a retrospective analysis of the renal profile of patients with multiple myeloma in relation to management strategy in our institution.Methods: Medical records of 64 patients with multiple myeloma seen between 2000 and 2008 were retrospectively reviewed at an 850–bed tertiary hospital in South-Western Nigeria. The Mahn-Whitney test was used to compare laboratory features between patient with renal failure and those without renal failure. Subjects with serum creatinine >2mg/dL were regarded to have renal failure. Overall survival was calculated from diagnosis to death or lost to follow-upResults: A total of forty three patients were eligible. The renal status was categorized into three according to serum creatinine level; those with normal serum creatinine level (0.5-1.5mg/dl) were 26 (60.5%), serum creatinine level (>1.6-1.9mg/dl), and creatinine level >2mg/dl were 3(7%) and 14(32.5%) respectively. Hyperuricaemia was observed in 6(42.9%) of MM patients with renal failure compared with 7(26.9%) of patient without renal failure (p<0.05). Twenty–one percent of those with renal failure had hypercalceamia. Thirty–six percent of the renal failure patients had haemodialysis. The average survival for all patients with renal failure was 18 months after diagnosis.Conclusion: The outcome in patients with renal failure remained poor with early mortality despite supportive management. Hyperuricaemia and dehydration, given the hot climate might have worked in concert with other factors to worsen the renal status in these patients.Keywords: renal, creatinine, myeloma, dehydratio

Do birds of a feather flock together? Comparing habitat preferences of piscivorous waterbirds in a lowland river catchment

Waterbirds can move into and exploit new areas of suitable habitat outside of their native range. One such example is the little egret (Egretta garzetta), a piscivorous bird which has colonised southern Britain within the last 30 years. Yet, habitat use by little egrets within Britain, and how such patterns of habitat exploitation compare with native piscivores, remains unknown. We examine overlap in habitat preferences within a river catchment between the little egret and two native species, the grey heron (Ardea cinerea) and great cormorant (Phalacrocorax carbo). All species showed strong preferences for river habitat in all seasons, with other habitat types used as auxiliary feeding areas. Seasonal use of multiple habitat types is consistent with egret habitat use within its native range. We found strong egret preference for aquatic habitats, in particular freshwaters, compared with pasture and arable agricultural habitat. Egrets showed greater shared habitat preferences with herons, the native species to which egrets are most morphologically and functionally similar. This is the first study to quantify little egret habitat preferences outside of its native range

Epidemic History and Evolutionary Dynamics of Hepatitis B Virus Infection in Two Remote Communities in Rural Nigeria

BACKGROUND: In Nigeria, hepatitis B virus (HBV) infection has reached hyperendemic levels and its nature and origin have been described as a puzzle. In this study, we investigated the molecular epidemiology and epidemic history of HBV infection in two semi-isolated rural communities in North/Central Nigeria. It was expected that only a few, if any, HBV strains could have been introduced and effectively transmitted among these residents, reflecting limited contacts of these communities with the general population in the country. METHODS AND FINDINGS: Despite remoteness and isolation, approximately 11% of the entire population in these communities was HBV-DNA seropositive. Analyses of the S-gene sequences obtained from 55 HBV-seropositive individuals showed the circulation of 37 distinct HBV variants. These HBV isolates belong predominantly to genotype E (HBV/E) (n=53, 96.4%), with only 2 classified as sub-genotype A3 (HBV/A3). Phylogenetic analysis showed extensive intermixing between HBV/E variants identified in these communities and different countries in Africa. Quasispecies analysis of 22 HBV/E strains using end-point limiting-dilution real-time PCR, sequencing and median joining networks showed extensive intra-host heterogeneity and inter-host variant sharing. To investigate events that resulted in such remarkable HBV/E diversity, HBV full-size genome sequences were obtained from 47 HBV/E infected persons and P gene was subjected to Bayesian coalescent analysis. The time to the most recent common ancestor (tMRCA) for these HBV/E variants was estimated to be year 1952 (95% highest posterior density (95% HPD): 1927-1970). Using additional HBV/E sequences from other African countries, the tMRCA was estimated to be year 1948 (95% HPD: 1924-1966), indicating that HBV/E in these remote communities has a similar time of origin with multiple HBV/E variants broadly circulating in West/Central Africa. Phylogenetic analysis and statistical neutrality tests suggested rapid HBV/E population expansion. Additionally, skyline plot analysis showed an increase in the size of the HBV/E-infected population over the last approximately 30-40 years. CONCLUSIONS: Our data suggest a massive introduction and relatively recent HBV/E expansion in the human population in Africa. Collectively, these data show a significant shift in the HBV/E epidemic dynamics in Africa over the last century

Audit of the red cell units supply of a busy Hospital blood bank in Nigeria

No Abstract

The lupus anticoagulant in a population of healthy Nigerian adults

No Abstract.Keywords: lupus coagulant; aPTT; KCT; antiphospholipid syndromeAnnals of Ibadan Postgraduate Medicine Vol. 3 (1) 2005: pp. 45-4

Assessment Of Immunoglobulin Levels In The Cause Of False Pass Rate In The Use Of Copper Sulphate (CuSO )4 As Pre-donation Screening Test

Click on the link to view the abstract.The Tropical Journal of Health Sciences Vol 20 No 2 (July 2013

Antisickling Activity of the Fresh and Dried Roots of Cissus populnea Guill. Et Perr (Vitaceae)

Research into plants with claimed traditional use in the management of sickle cell anaemia constitutes a useful research strategy in the search for new antisickling drugs and templates. The root of Cissus populnea has been used traditionally in the management of sickle cell disease (SCD). Phytochemical screening of the fresh and powdered sample of the root of C. populnea (CP) was done using standard methods followed by in vitro antisickling evaluation of extracts, solvent-partitioned fraction (ethylacetate) and the vacuum liquid chromatographic fractions (VLC) of the fresh and dried roots of C. populnea with sodium metabisulphite induced sickling of HbSS erythrocytes. p-hydroxybenzoic acid and normal saline were used as positive and negative controls respectively. Phytochemical screening revealed the presence of tannins, saponins and cardiac glycosides. The result of this study showed that the extracts and solvent partitioned fraction (ethylacetate) from the root of CP have antisickling property with a higher activity for the ethylacetate partitioned fraction of the dried roots compared to that of the fresh roots. The VLC fractions exhibited higher activity than the crude extracts; fraction 3 (FR3) had the maximum activity of 96.4% while 88.6% activity was demonstrated for the standard drug (PABA) at an incubation time of 45 min. This study has thus provided scientific evidence for the traditional use of CP in the management of SCD.Keywords: Sickle Cell Disease, Cissus populnea, Antisickling Activit

Seroprevalence and risk factors for human T cell lymphotropic viruses types 1 and 2 among blood donors in Jos, Nigeria

ABSTRACT Aims: To determine the seroprevalence and risk factors of human T cell Lymphotrophic viruses 1 and 2 among blood donors in Jos, Plateau state, Nigeria. Methods: A cross sectional study of 500 consecutive blood donors from the blood bank of Jos University Teaching Hospital and National Blood Transfusion Services Jos were recruited into the study. Questionnaires were administered and blood samples were collected from all participants. Sera of the blood donors were assayed for HTLV 1 and 2 using microenzyme-linked immunosorbent assay. Data was analysed using Epi Info version 3.5.1 and statistical significance was set at p-values ≤0.05. Results: The mean age of the study population was 29.9±8.9 years with a male -female ratio of 4. donors had different forms of exposure to risk factors, none was positive for HTLV-1 or HTLV-2. Conclusion: Human T cell lymphotrophic virus had zero seroprevalence among tested blood donors in Jos. However, continuous surveillance is necessary to keep the prevalence at low ebb. Further studies using larger sample size to include other healthy adults, commercial sex workers and pregnant women should be carried out in the entire country to define the prevalence of the virus in Nigeria

Socioeconomic constraints to effective management of Burkitt's lymphoma in south-eastern Nigeria

This paper presents health outcomes and associated socioeconomic factors of 41 children admitted to a tertiary care institution in south-east Nigeria with Burkitt's lymphoma (BL) between 1987 and 2004. BL responds well to chemotherapy and does not pose a significant threat to health in industrialized nations. However, in resource-poor settings where it is endemic, socioeconomic factors significantly affect access to care for affected children, making this readily treatable condition a cause of considerable distress and early death in affected children. Half of the children reported in this paper presented with late stage disease. Although laboratory facilities were available, they were not accessible to all the children. Nearly a quarter of parents of these children could not afford the cost of confirmatory tests, and about a fifth (n = 8; 19.5%) of the children received no chemotherapy because of their parents' inability to pay. Only 21 of 41 children (51.2%) remained on treatment long enough (at least 12 weeks) to enable them to be confirmed either as short-term cure (n = 9; 64.3%), or as early relapse (n = 2; 4.9%). Owing to financial constraint, 13 of the parents (31.7%) withdrew their children against medical advice (n = 7; 17.1%) or left the hospital (n = 6; 14.6%). To address the challenge posed by these factors, we call for the establishment of a regional BL programme in Africa to help establish a critical mass of resources (human and material) to facilitate the development of an effective and accessible control programme in the region