A study of the M235T variant of the angiotensinogen gene and hypertension in a sample population of Calabar and Uyo, Nigeria

Open Access JournalA common molecular variant of the angiotensinogen gene had been reported to predispose some ethnic groups to hypertension. This case–control study was designed to determine the frequency and association of the angiotensinogen M235T allele with hypertension in residents of Calabar and Uyo cities, south–south Nigeria. The study involved 1308 subjects, 612 patients and 696 controls. The M235T variant was investigated using an allele specific polymerase chain reaction and enzymatic digestion to determine allele frequencies. Hypertensinogenic factors such as dietary habits, physical activity, smoking and drinking habits were assessed using questionnaires. Descriptive statistics, chi-square and multiple regression analysis were used to analyze the data obtained. The M235T allele frequency was high (0.94 for hypertensives and 0.96 for controls) though it was not associated with hypertension status. The odds ratio for hypertension was 0.64 (95% confidence interval: 0.39–1.06) there were no significant differences between the genotype frequency of hypertensives and controls. By multiple regression, Hypertension was observed to be associated with age and was a predictor for systolic blood pressure in both patient r2 = 0.359; p < 0.05 and control groups r2 = 0.26. Age and body mass index were predictors for diastolic blood pressure in the control group, r2 = 0.28. Although the frequency of the M235T variant was high, it was not a significant risk factor for hypertension in the study population

Reasons for patronage of traditional bone setters

Aims and Objectives: The objectives of this study were to analyze the different reasons why patients with fractures patronize traditional bone setters (TBS) and their impression of the outcome of the treatment by the TBS.Materials and Methods: A 24 month prospective observational study was conducted from February 2012 to January 2014. All the patients were recruited from the orthopedics outpatient clinic. The demographic data of each patient, the type of injury, presentation to hospital or not, reasons for leaving the hospital, reasons for patronage of the TBS and their impression of the outcome of TBS’ treatment, effect of educational background on patronage of TBS and reason for presenting to hospital for orthodox treatment. Data Analysis: Analysis was done with SPSS software Version 20.Results: A total 79 patients were recruited for the study and they had different reasons for patronizing TBS. These reasons include an external locus of decision making in 19 (24.1%) patients, and greater faith in TBS compared to orthodox medicine in 16 (20.3%). Twelve (15.2%) believed that TBS are more competent than orthodox medical practitioners while another group 11 (13.9%) considered the fees of TBS cheaper than those in the hospital. The delay in treatment in the hospital, forceful removal of patients from hospital against their will and nonsatisfaction with hospital treatment accounted for 5 (6.3%). Poor attitude of hospital staff, fear of amputation, and patients being unconscious during the injury accounted for 2 (2.5%). Their ages ranged from 17 to 83 years, with mean age of 36.8 ± 11.8 years. The male: female ratio was 1.5:1. Conclusions and Recommendations: With recent advancements in the practice of orthopedics and trauma, there is still a very high patronage of the TBS by most of our patients. This is largely due to the dependence of the patients on their sponsors for treatment, while the influence of cultural and religious beliefs continues to play a major role in these decisions.Keywords: Fractures, impressions, reasons for patronage of traditional bone setter

Clinical profile and excellent short-term treatment outcome of acute glomerulonephritis: a report from paediatric nephrology unit of university teaching hospital, Uyo, Nigeria

Background: Acute glomerulonephritis (AGN), the commonest of which is acute post streptococcal glomerulonephritis, is common in school aged children and typically presents with haematuria, oedema, oliguria and varying degrees of renal insufficiency. This study evaluated epidemiologic factors, presentations and treatment outcome of AGN patients at University of Uyo Teaching Hospital, (UUTH), Uyo, Nigeria.Methods: This cross-sectional study was conducted among children with AGN at the paediatric nephrology unit of UUTH from January 2015 to December 2019. Data were analysed with statistical package for social sciences version 25 and p values <0.05 were considered statistical significant.Results: Fifteen out of 12,403 paediatric admissions had AGN, giving an average yearly hospital incidence of 3/year and 0.12% of total admission. Age range was three to 15 years. Mean age was 8.07±3.94 years and median was 7.00 years. Males were nine with a male/female ratio of 1.5:1. Eight (53.3%) belonged to the lowest socioeconomic class. Haematuria and peripheral oedema were universal presentations and 4 (26.7%) had antecedent pharyngeal infection. Other clinical presentations were: Oliguria 11(73.3%), Grade II hypertension 10 (66.7%), and pulmonary oedema 5 (33.3%). Four (26.7%) each had acute kidney injury, hyperkalaemia and dipstick massive proteinuria. Other complications were congestive cardiac failure 2 (13.3%), and seizures with encephalopathy in 1 (6.7%). Proteinuria was significantly associated with age at p=0.034 (Fisher Exact test). Major treatment modalities were: fluid management, loop diuretics and antibiotics as indicated.Conclusions: Short-term outcome was excellent with 100% discharge within 28 days of hospitalisation and the majority being discharged within two weeks

Predictors of C - reactive protein Response in Children Infected with Plasmodium falciparum Malaria

Objective: To assess the predictors of C-reactive protein response in plasmodium falciparum malaria as seen in children in a malaria endemic region of Nigeria. Design: A prospective cross-sectional study. Setting : The Children Out-patient (CHOP) Clinic, Children Emergency Unit (CHEU), Child Welfare/Growth Monitoring Clinic, Immunisation Centre and Paediatric Ward of the University of Uyo Teaching Hospital (UUTH), Uyo in Akwa-Ibom State. Subjects : Three hundred and sixty children aged six to sixty months with microscopically confirmed P. falciparum malaria compared with 360 healthy children without malaria parasitaemia matched for age and gender. Results: The predictors of the C-reactive protein response in malaria (CRP ≥ 10mg/l) were fever (t = 6.867; p = 0.001), malaria parasite count (t = 5.387; p = 0.001), severe anaemia (t = -11.23; p = 0.001) and age. Younger children had a greater CRP response. The logistic regression curve showed a 66.9% sensitivity, 92.1% specificity, positive predictive value, 83.2% and negative predictive value of 82.2% of predicting C-reactive protein response in malaria. Conclusion: P. falciparum malaria induces significant CRP responses. Younger children who present with fever, hyperparasitaemia and severe anaemia are more likely to have C-reactive protein response with malaria

An Evaluation of the Antimicrobial Synergy of Garlic (Allium sativum) and Utazi (Gongronema latifolium) on Escherichia coli and Staphylococcus aureus

As part of the on-going search for potent and resistance-free antimicrobial medicinal plants, the antimicrobial and synergistic effects of the plants, Allium sativum (E1) and Gongronema latifolium (E2) on Escherichia coli and Staphylococcus aureus were investigated. The sensitivities of E. coli and S. aureus to E1 and E2 and the minimum inhibitory concentrations of the plant extracts, individually and in combination with themselves, and with ciprofloxacin (CPX) and ampicillin (AMP), were tested using standard procedures. E1 and E2 individually showed appreciable antimicrobial effect (zones of inhibition > 16mm). The combination of E1 and E2 against the test organisms was not effective due to antagonism between E1 and E2. E1 or E2 when combined with CPX, completely suppressed the effect of CPX against E. coli, and rather produced additive effect on S. aureus similar to the combination of E2 and AMP against S. aureus, although CPX alone was more effective than either E1 or E2, unlike AMP. Synergism was observed in the combination of E1 and AMP against S. aureus. It is concluded that synergism associated with the combination of medicinal plants is doubtful. However, the synergistic or additive effect between garlic and conventional drugs to some strains of bacteria which are resistant to some conventional drugs, gives hope of fighting drug resistance

Asymptomatic Bacteremia in Children Infected with Human Immunodeficiency Virus in Calabar, South-South, Nigeria

Background: Asymptomatic Human Immunodeficiency Virus (HIV) infected children are prone to serious bacterial infection as a result of poor immunity.Objective: This was to determine the common pathogenic organisms responsible for bacteremia among asymptomatic HIV infected children attending the outpatient clinics at the University of Calabar Teaching Hospital, Nigeria.Subjects and Methods: This prospective non randomized cross-sectional study was conducted over 6months from January 1st to 30th June 2014 among cohorts of HIV infected Anti-retroviral (ARV) naive and experienced children attending the clinic. Ethical approval was obtained from the ethical committee of the institution. Blood culture specimens were collected from all HIV infected patients who met the criteria for enrollment. All specimens with isolated bacteria organisms were treated with antibiotics according to the sensitivity pattern, in addition to administered Anti-retroviral drugs.Results: Out of the total of 109 patients recruited, 38(34.9%) had bacteremia. There were more males (57.9%), and most of them (63.2%) had Highly Active Anti-Retroviral Therapy (HAART) for more than 24weeks. Bacteremia was inversely proportional to the CD4 count. The commonest organism isolated was unclassified Coliforms (47.3%) followed by Staphyloccocus aureus (39.5%).Conclusions: HIV infected children are prone to bacteremia especially among those with low CD4 count. Coliform was the commonest organism isolated. We recommend that HIV infected children be routinely investigated for bacteremia

Exposure of Petrol Station Attendants and Auto Mechanics to Premium Motor Sprit Fumes in Calabar, Nigeria

A population-based-cross-sectional survey was carried out to investigate the potential risk of exposure to premium motor spirit (PMS) fumes in Calabar, Nigeria, among Automobile Mechanics (AM), Petrol Station Attendants (PSA) and the general population. Structured questionnaire was administered on the randomly chosen subjects to elicit information on their exposure to PMS. Duration of exposure was taken as the length of work in their various occupations. Venous blood was taken for methaemoglobin (MetHb) and packed cells volume (PCV). Mean MetHb value was higher in AM (7.3%) and PSA (5.8%) than in the subjects from the general population (2.7%). PCV was lower in PSA (30.8%), than AM (33.3%) and the subjects from the general population (40.8%). MetHb level was directly proportional, and PCV inversely related, to the duration of exposure. The study suggested increased exposure to petrol fumes among AM, PSA, and MetHb as a useful biomarker in determining the level of exposure to benzene in petrol vapour

A study of the M235T variant of the angiotensinogen gene and hypertension in a sample population of Calabar and Uyo, Nigeria

AbstractA common molecular variant of the angiotensinogen gene had been reported to predispose some ethnic groups to hypertension. This case–control study was designed to determine the frequency and association of the angiotensinogen M235T allele with hypertension in residents of Calabar and Uyo cities, south–south Nigeria.The study involved 1308 subjects, 612 patients and 696 controls. The M235T variant was investigated using an allele specific polymerase chain reaction and enzymatic digestion to determine allele frequencies. Hypertensinogenic factors such as dietary habits, physical activity, smoking and drinking habits were assessed using questionnaires. Descriptive statistics, chi-square and multiple regression analysis were used to analyze the data obtained.The M235T allele frequency was high (0.94 for hypertensives and 0.96 for controls) though it was not associated with hypertension status. The odds ratio for hypertension was 0.64 (95% confidence interval: 0.39–1.06) there were no significant differences between the genotype frequency of hypertensives and controls. By multiple regression, Hypertension was observed to be associated with age and was a predictor for systolic blood pressure in both patient r2=0.359; p<0.05 and control groups r2=0.26.Age and body mass index were predictors for diastolic blood pressure in the control group, r2=0.28.Although the frequency of the M235T variant was high, it was not a significant risk factor for hypertension in the study population