Neurological Complications Of Chronic Myeloid Leukaemia: Any Cure?

Objective: To attempt to explain the non-reversal, contrary to the widely held view, of the neurological deficits complicating chronic myeloid leukaemia. Method: Using patients\' case folders and haematological malignancy register all cases of chronic myeloid leukaemia seen in Jos University Teaching Hospital between July 1995 and June 2005 were retrospectively studied. All the available literature on the subject was also reviewed. Results: Thirty-three cases of chronic myeloid leukaemia were seen within the study period. Five (15.15%) of them had one or more sensori-neural defects. Of the five, two (40%) patients presented with bilateral hearing impairment, each beginning with the left ear; one (20%) presented with left ear hearing loss; one (20%) came with severe left ear tinnitus; one (20%) presented with complete bilateral hearing and bilateral visual losses. Fundoscopy showed leukaemic deposits on the retina. Other causes of blindness and deafness, e.g. trauma and foreign body in the ear respectively, were excluded. Conclusion: While the complications due to hyperleucocytosis-induced stasis recover following the conventional treatment, those due to other pathogenetic mechanisms such as leukaemic deposits do not return to their pre-morbid states following disease control despite the use of the currently available treatment protocols. For future research, more still needs to be done to elicit other uncommon pathogenetic mechanisms underlying these complications with a view to finding specific treatment measures for worrisome chronic myeloid leukaemia-related sensori-neural deficits. Keywords: Neurological complications, chronic myeloid leukaemia, cure. Nigerian Journal of Clinical Practice Vol. 11 (3) 2008: pp. 246-24

Public perceptions and attitudes toward thalassaemia: Influencing factors in a multi-racial population

<p>Abstract</p> <p>Background</p> <p>Thalassaemia is a common public health problem in Malaysia and about 4.5 to 6% of the Malays and Chinese are carriers of this genetic disorder. The major forms of thalassaemia result in death <it>in utero </it>of affected foetuses (α-thalassaemia) or life-long blood transfusions for survival in β-thalassaemia. This study, the first nationwide population based survey of thalassaemia in Malaysia, aimed to determine differences in public awareness, perceptions and attitudes toward thalassaemia in the multi-racial population in Malaysia.</p> <p>Methods</p> <p>A cross-sectional computer-assisted telephone interview survey of a representative sample of multi-racial Malaysians aged 18 years and above was conducted between July and December 2009.</p> <p>Results</p> <p>Of a total of 3723 responding households, 2846 (76.4%) have heard of thalassaemia. Mean knowledge score was 11.85 (SD ± 4.03), out of a maximum of 21, with higher scores indicating better knowledge. Statistically significant differences (<it>P </it>< 0.05) in total knowledge score by age groups, education attainment, employment status, and average household income were observed. Although the majority expressed very positive attitudes toward screening for thalassaemia, only 13.6% of married participants interviewed have been screened for thalassaemia. The majority (63.4%) were unsupportive of selective termination of foetuses diagnosed with thalassaemia major.</p> <p>Conclusion</p> <p>Study shows that carrier and premarital screening programs for thalassaemia may be more effective and culturally acceptable in the reduction of pregnancies with thalassaemia major. The findings provide insights into culturally congruent educational interventions to reach out diverse socio-demographic and ethnic communities to increase knowledge and cultivate positive attitudes toward prevention of thalassaemia.</p

Randomized Controlled Trials of HIV/AIDS Prevention and Treatment in Africa: Results from the Cochrane HIV/AIDS Specialized Register

INTRODUCTION: To effectively address HIV/AIDS in Africa, evidence on preventing new infections and providing effective treatment is needed. Ideally, decisions on which interventions are effective should be based on evidence from randomized controlled trials (RCTs). Our previous research described African RCTs of HIV/AIDS reported between 1987 and 2003. This study updates that analysis with RCTs published between 2004 and 2008. OBJECTIVES: To describe RCTs of HIV/AIDS conducted in Africa and reported between 2004 and 2008. METHODS: We searched the Cochrane HIV/AIDS Specialized Register in September 2009. Two researchers independently evaluated studies for inclusion and extracted data using standardized forms. Details included location of trials, interventions, methodological quality, location of principal investigators and funders. RESULTS: Our search identified 834 RCTs, with 68 conducted in Africa. Forty-three assessed prevention-interventions and 25 treatment-interventions. Fifteen of the 43 prevention RCTs focused on preventing mother-to-child HIV transmission. Thirteen of the 25 treatment trials focused on opportunistic infections. Trials were conducted in 16 countries with most in South Africa (20), Zambia (12) and Zimbabwe (9). The median sample size was 628 (range 33-9645). Methods used for the generation of the allocation sequence and allocation concealment were adequate in 38 and 32 trials, respectively, and 58 reports included a CONSORT recommended flow diagram. Twenty-nine principal investigators resided in the United States of America (USA) and 18 were from African countries. Trials were co-funded by different agencies with most of the funding obtained from USA governmental and non-governmental agencies. Nineteen pharmaceutical companies provided partial funding to 15 RCTs and African agencies co-funded 17 RCTs. Ethical approval was reported in 65 trials and informed consent in 61 trials. CONCLUSION: Prevention trials dominate the trial landscape in Africa. Of note, few principal investigators and funders are from Africa. These findings mirror our previous work and continue to indicate a need for strengthening trial research capacity in Africa

The Prevalence Of Hepatitis B Surface Antigen And Human Immunodeficiency Virus Antibodies Among Persons With Sickle Cell Anaemia In Zaria

Aims: To determine the prevalence of Human Immunodeficiency Virus (HIV) and Hepatitis B Virus (HBV) infection among persons with sickle cell anaemia. Methods: Serum samples of 47 non- transfused persons with sickle cell anaemia (controls) and 73 transfused (subjects) were sreened for HIV antibody or the Hepatitis B surface antigen using ELISA based kits and methods. Results: Non of the 47(0%) control persons were positive for either HIV antibody or the Hepatitis B surface antigen. Three out of 73 transfused persons were positive for the HIV antibody. Of these, one was positive for HIV-1, another was positive for HIV-2 and a third was positive for both HIV-1 and HIV-2 antibodies. Another three out of 73bv transfused persons were positive for the Hepatitis B surface antigen (HbsAg). None of the participants was co-infected with both HIV and HBV. Conclusion: Blood transfusion increases the risk of both HIV and HBV by at least a factor of 4. Key words: Blood Transfusion; Sickle cell Anaemia; HIV-1; HIV-2; HBV. Highland Medical Research Journal Vol.2(1) 2004: 28-3

Relation between erythrocyte sedimentation rate, clinical and immune status in HIV Infected patients

No Abstract

The Prevalence Of Hepatitis B Surface Antigen And Human Immunodeficiency Virus Antibodies Among Persons With Sickle Cell Anaemia In Zaria

Aims: To determine the prevalence of Human Immunodeficiency Virus (HIV) and Hepatitis B Virus (HBV) infection among persons with sickle cell anaemia. Methods: Serum samples of 47 non- transfused persons with sickle cell anaemia (controls) and 73 transfused (subjects) were sreened for HIV antibody or the Hepatitis B surface antigen using ELISA based kits and methods. Results: Non of the 47(0%) control persons were positive for either HIV antibody or the Hepatitis B surface antigen. Three out of 73 transfused persons were positive for the HIV antibody. Of these, one was positive for HIV-1, another was positive for HIV-2 and a third was positive for both HIV-1 and HIV-2 antibodies. Another three out of 73bv transfused persons were positive for the Hepatitis B surface antigen (HbsAg). None of the participants was co-infected with both HIV and HBV. Conclusion: Blood transfusion increases the risk of both HIV and HBV by at least a factor of 4. Key words: Blood Transfusion; Sickle cell Anaemia; HIV-1; HIV-2; HBV. Highland Medical Research Journal Vol.2(1) 2004: 28-3

Relation between Erythrocyte Sedimentation Rate, Clinical And Immune Status In HIV Infected Patients

Background: The objective of this study was to determine the clinical and immunologic implications of an elevated ESR in HIV-infected patients. Method: One hundred and four consecutive HAART naïve human immunodeficiency virus (HIV)-infected adult patients and fifty one controls were studied. Detailed history was taken and full physical examination was conducted. Erythrocyte sedimentation rate (ESR), CD4+ T lymphocyte count, and complete blood count were performed. Results: The mean (± SD) of ESR in the patients was 84.5 ± 36.8 mm/1st one hour and that for the controls was 20.4 ± 17.6 mm/1st one hour. The patients\' ESR was significantly higher than those of the controls (p < 0.0001). There was a significant difference between the mean ESR of symptomatic (87.6 ± 37.0 mm/1st hr) and asymptomatic patients (61.0 ± 26.1 mm/1st hr) (p = 0.018), and between asymptomatic patients (mean ± SD = 61 ± 26.1 mm/1st one hour) and controls (mean ± SD = 20.4 ± 17.6 mm/1st one hour) (p = 0.000).The mean (± SD) CD4+ lymphocytes count of the patients and controls were 155.4 ± 90.6 cells/ &#956;L, and 655.7 ± 17.6 cells/&#956;L, respectively. The CD4+ cells count was significantly lower in the patients than in the controls (p < 0.0001). Conclusion: ESR may be useful in monitoring HIV/AIDS disease. Keywords: HIV/AIDS, ESR, CD4+ T lymphocyte.Nigerian Journal of Medicine Vol. 17 (4) 2008: pp. 420-42

Peak Expiratory Flow Rate In Cigarette Smokers

Objective: To compare lung function between smokers and non-smokers using Peak Expiratory Flow Rate (PEFR). Methods: This study examines the peak expiratory flow rate (PEFR) of three hundred and forty cigarette smokers, age and sex-matched with PEFR of equal number of non-smokers. Results: The mean PEFR of all smokers (males and females) was 225.0 + 62.79 L/min. (

Chronic lymphocytic leukaemia: a-twenty-years experience and problems in Ile-Ife, South-Western Nigeria

Aim: To investigate the usefulness of some clinical and laboratory parameters in assessing the prognosis and survival of CLL in a resource-limited setting. Methods: Between September 1986 and March 2007, 79 consecutive patients were retrospectively studied. Diagnosis was based on clinical and haematological findings.Results: A total of 79 patients, aged 30 to 81 (median = 60) years were managed. There were 34 males and 45 females (ratio = 0.8:1). About 86.1% were aged above 50 years. Massive splenomegaly and  hepatomegaly were recorded in 70.9% and 29.1% of patients, respectively. More than 63% presented in stage C. Anaemia was recorded in 74.7%. Haematocrit correlated negatively with WBC but positively with platelet count. The spleen correlated positively with liver. The overall survival at 2 years was 70.2%. Logistic regression showed that younger age, male sex, higher haematocrit, and lower platelet count improved survival, while lower WBC, moderate hepatomegaly and splenomegaly conferred survival advantage.Conclusion: It could be concluded that massive splenomegaly is a common finding in the majority of our patients. Non availability of immunophenotyping facility is a major constraint.Keywords: CLL, diagnostic problems, resource-limited settin