Evaluation of Selected Renal Markers in Prostate Cancer

Prostate cancer is the most commonly diagnosed cancer in men and the second leading cause of cancer mortality. The study aimed to assess the level of urea, creatinine and cystatin C in prostate cancer subjects. The subjects consisted of 92 adult males between the ages of 45 to 70 years; 46 prostate cancer subjects and 46 apparently healthy subjects recruited from a Teaching Hospital in Nigeria. Urea and creatinine were estimated by colorimetric method, cystatin C was estimated using Enzyme linked immunosorbent assay (ELISA) technique. The results obtained showed that urea and creatinine were significantly high (p<0.05) while cystatin C was significantly low (p<0.05) in prostate cancer subjects compared with control subjects. Cystatin C was significantly high (p<0.05) in prostate cancer subjects on treatment compared with subjects not on treatment but there was no significant difference (p>0.05) in the levels of urea and creatinine. The research concluded that increased serum urea and creatinine concentrations as well as decreased cystatin C level may pose higher risk of renal dysfunction in prostate cancer subjects. Thus, the levels of serum urea, creatinine and cystatin C need to be evaluated in prostate cancer subjects.Keywords: Prostate cancer, cystatin C, urea, creatinin

T LYMPHOCYTE SUBSETS IN PROSTATE CANCER SUBJECTS IN SOUTH EASTERN NIGERIA

Humoral and cellular mechanisms play roles in immune response to foreign antigens. The present study was designed to determine the T lymphocyte subsets (CD4 + T cells, CD8 + T cells and CD4/CD8 ratio) in the prostate cancer subjects and control subjects. CD4 + T cells (µl/count) and CD8 + T cells (µl/count) were estimated using flow cytometric method by Partec while CD4/CD8 ratio was calculated from the resultsobtained from the CD4 + T cells and CD8 + T cells.CD4 + T cells and CD8 + T cells decreased significantly while the CD4/CD8ratio increased significantly in the prostate cancer subjects compared to the control subjects. The suppressed CD4 + and CD8 + T cell counts in prostate cancer subjects may indicate immune instability in the prostate cancer subjects

EVALUATION OF SOME INFLAMMATORY AND MUSCLE MARKERS IN PREMENOPAUSAL AND POSTMENOPAUSAL WOMEN

Background: Menopause is associated with an array of metabolic changes which results into the appearance of inflammatory conditions. Objectives: The study evaluated the levels of some inflammatory markers; C-reactive protein (CRP), rheumatoid factor, erythrocyte sedimentation rate (ESR) and uric acid. The muscle markers evaluated were creatine kinase (CK) and aspartate transaminase (AST) as well as body mass index (BMI) and blood pressure (Bp) in premenopausal and postmenopausal women. Method: The study is a case-controlled study involving 50 premenopausal and 50 postmenopausal women in Nnewi metropolis. In both study groups, anthropometric measurements including body mass index (Kg/m2) and blood pressure (mmHg) were carried out. Serum levels of uric acid, creatine kinase, C-reactive protein, aspartate transaminase, rheumatoid factor and erythrocyte sedimentation rate were measured using appropriate techniques. Results: The result showed significant increase (p<0.05) in the mean serum levels of uric acid (μmol/L), CRP (mg/L), ESR mm/hr, and AST IU/L but no significant change was observed in creatine kinase in post menopausal women. A significant positive relationship was observed between CRP and BMI (r = 0.562; p<0.01), CRP and ESR (r = 0.553; p<0.01). The prevalence of positive rheumatoid factor among postmenopausal women was determined as 16%. Conclusion: The study concluded that in postmenopausal women, there is significant increase in the levels of CRP, ESR and uric acid. There is also a significant positive relationship between CRP, ESR and BMI indicating that the degree of changes in metabolites and obesity might have a role in the mediation of inflammation in post menopausal women

HIV and Hepatitis Infections in Children Resident in Orphanage Homes Located In Anambra State, Nigeria

Human immunodeficiency virus (HIV) and hepatitis infections are among viral infections transmissible among inmates of orphanage and motherless babies’ homes. Records are scanty on the prevalence of HIV and hepatitis infections in children resident in orphanage homes in Anambra State, Nigeria. This study investigated the prevalence of HIV and Hepatitis infections in children resident in eight orphanages in Anambra State. A total of 300 subjects consisting of 172 orphans, 100 children from community setting serving as controls, 14 female consented care givers in the orphanages and 14 females in community setting served as controls. All the subjects and control groups were investigated for HIV using rapid test and molecular technique. ELISA assay and liver enzyme estimation were used for Hepatitis investigation. The prevalence of 0.6%, 0.0%, 0.6%, and 9.9% were observed in HIV, hepatitis A, B and C respectively. Liver enzymes (serum alanine and aspartate amino transferases) did not show significant increase. The viral load and CD4+ count of the HIV positive child were 373 copies/ml and 28% respectively. Three (21.4%) of the care givers in the orphanages tested positive to HCV infection while none of the females in the community tested positive to the virus. HCV infections were most common in ages 0-5 years. The infection may be at dormant phase in the homes. Thus, continuous monitoring for progression into active hepatitis C infection is necessary for disease management in the orphanage homes

PREVALENCE OF HEPATITIS B AND C VIRAL INFECTIONS IN PREGNANT WOMEN ATTENDING ANTENATAL CLINIC IN NNEWI, NIGERIA

Infections due to Hepatitis B and C viruses are significant health problems around the globe, Nigeria inclusive. This study was conducted among 100 pregnant women attending ante natal clinic at NnamdiAzikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria to determine the seroprevalence of Hepatitis B Virus (HBV) and Hepatitis C Virus (HCV) and to determine whether liver amino transferases can be affected. The blood samples were tested for hepatitis B surface antigen (HBsAg) and Anti-HCV using HBsAg and Anti-HCV one step rapid test strip and furthermore using ELISA technique. Serum alanine aminotransferase (ALT) and serum aspartate aminotransferase (AST) activities were also estimated in all the subjects using Reitman - Frankel method. The results showed that six percent(6%) and one percent (1%) of the 100 blood samples tested positive for HBV and HCV respectively. The mean AST levels for HBsAg negative and positive subjects were 10.55±2.36 and 12.17±2.23 respectively while the mean ALT levels were 5.54±1.94and 8.00±3.10 respectively. The mean AST for anti-HCV negative and positive subjects were 10.67±2.38 and 9.00±0.00 respectively while the ALT were 5.71±2.09 and 4.00±0.00 respectively There was significant increase in the levels of ALT between the HBsAg positive and negative pregnant subjects (P&lt;0.05). HBV and HCV infection can be present in pregnant women and can alter liver amino transferases. Therefore testing for HBsAg and Anti-HCV is recommended for all pregnant women at first prenatal and postnatal visit so that HBsAg and HCV positive mothers will receive prompt intervention

Fertility Hormones, CD4+T Cells and CD8+Tcells In HIV Seropositive Subjects In Onitsha, Nigeria

Human immunodeficiency Virus (HIV) infection and Acquired immunodeficiency syndrome (AIDS) have become global health concern. The uses of antiretroviral therapy (ART) have been shown to improve health but are associated with a wide array of immunologic, endocrinologic and metabolic abnormalities. This study determined the levels of fertility hormones, CD4 and CD8+Tcells in HIV seropositive subjects and seronegative subjects. A total of one hundred and seventy HIV seropositive subjects were investigated while fifty HIV seronegative subjects served as controls. Eighty-five HIV seropositive subjects were on antiretroviral therapy consisting of three drug combinations (Zidovudine 300mg twice daily; Lamivudine 150mg twice daily; Tenofovir 300mg once daily; Efavirenz 600mg once daily and Stavudine 30mg twice daily for body weight of 60kg). Eighty five HIV seropositive subjects were not on antiretroviral therapy. Fertility hormones (Follicle Stimulating Hormone, Leutinising Hormone, Prolactin and Testosterone) were determined using Enzyme linked immunosorbent assay (ELISA) method. CD4+Tcells and CD8+Tcells were determined using flow cytometry. The serum levels of the fertility hormones in HIV seropositive males on antiretroviral therapy (ART) and those not on ART showed significant reduction (P<0.05) when compared with that of HIV seronegative male control subjects. The serum levels of the hormones in HIV seropositive females on ART and those not on ART showed no significant difference compared with those of HIV seronegative control female subjects. The CD4+T cell counts of HIV seropositive male and female subjects on ART and those not on ART showed significant reduction (P<0.05) when compared with the HIV seronegative control subjects. There was significant increase in the levels of CD8+T cell counts of the HIV seropositive males and females on ART. HIV infection is associated with variations in the male hormonal fertility profiles but without significant effect on women hormonal fertility profiles. However, CD4+Tcells decrease while CD8+T cells increase as HIV/AIDS progresses

Infant feeding choices practiced among HIV positive mothers attending a prevention of mother to child transmission (PMTCT) of HIV Program in Nnewi, Nigeria

Background: The HIV epidemic has significantly altered the context within which women make decisions about how they will feed their infants. This study examined the antenatal infant feeding choices and actual infant feeding practices of HIV-positive mothers in order to assess adherence to the 2010 WHO national infant feeding guidelines in Nnewi, Nigeria. Methods: The study was conducted between January 2012 and February 2013 at Nnamdi-Azikiwe University Teaching Hospital (NAUTH) in Nnewi-Anambra State, Nigeria. It was a prospective cohort study of HIV positive women attending the Prevention of Mother-To-Child Transmission (PMTCT) clinic in NAUTH. Women received HIV Counseling and Testing (HCT) from trained HIV positive women working in the hospital and from members of HIV support groups. The women made an informed decision on their infant feeding choice and received antiretroviral (ARV) treatment or prophylaxis (WHO option B) following WHO 2010 guidelines. Each mother-baby pair was followed up until the HIV sero-status of the baby was determined by DNA PCR (6-8weeks after cessation of breastfeeding). Results: The overall HIV MTCT rate was 19 of 583 (3.3%; 95% confidence interval (CI): 2.0 - 5.0). Only 94 (16.1%; 95% CI: 13.2 - 19.4) mothers complied with the WHO 2010 recommendation of exclusive breastfeeding (EBF) and ARV treatment or prophylaxis. Overall, 431 (73.9%) mother-baby pairs received prophylactic ARV intervention; in 88 (15.1%) pairs, the baby or the mother received ARV; while in 64 (11.0%) pairs, neither mother nor baby received ARV. When the mother-baby pair received ARV, MTCT was 0.8%, 1.7% and 5.9% for Exclusive Formular Feeding (EFF), EBF and Mixed Feeding (MF), respectively. When either mother or baby received intervention, MTCT rates increased to 3.3%, 4.8% and 7.7% for EFF, EBF and MF, respectively. The rate of MTCT was further increased to 5.1%, 6.7% and 23.5% when neither mother nor baby received intervention for EFF, EBF and MF respectively. Conclusion: EFF is still the infant feeding option preferred and practiced by majority of our HIV positive mothers despite the promotion of the safety of EBF with ARV interventions according to WHO 2010 guideline. It will take some time to change existing belief in EFF for us to achieve the required shift to EBF in our practice area. We also demonstrated that ARV treatment/chemoprophylaxis for both mother and baby is an important measure for achieving the reduction of MTCT of HIV in breastfeeding setting mixed feeding practice is associated with an increased rate of MTCT and should be strongly discouraged. Increasing the uptake of ARV treatment/ chemoprophylaxis and ensuring appropriate counseling about infant feeding practices have the potential to markedly decrease the rate of MTCT of HIV in developing countries

The Seroprevalence and Co-Existence of Chlamydia Trachomatis and Herpes Simplex Virus Antibodies among Students in a Tertiary Institution

Sexually transmitted infections (STI) occur worldwide with more than 340 million cases occurring annually in adults aged 15-49 years. The aim of the study is to determine the prevalence and co-existence of Chlamydia trachomatis and Herpes simplex virus (HSV) antibodies among students in a tertiary institution in Anambra State, Nigeria. This is a cross sectional descriptive study of the co–existence of Chlamydia trachomatis and HSV antibodies among students in a tertiary institution in Anambra State Nigeria carried out using enzyme immunoassay kits for determination of IgG class antibodies. The seroprevalence of HSV antibodies, (27.3%), was slightly higher than that of Chlamydia trachomatis, (21.6%) among the students. Also more of the students, (18.2%) were positive to HSV antibodies only, when compared to 12.5% of them that were positive to Chlamydia trachomatis antibodies only, while 9.1% of them were seropositive to both organisms. The antibody titres to both organisms were found to be significantly higher among students with high risk sexual behaviours. The seroprevalence and co-existence of these organisms were high in both populations thus there is need to institute appropriate control measures to reduce the prevalence of these infections

The Incidence of Diabetes Mellitus among Human Immunodeficiency Virus (HIV) Positive Patients on Therapy in Nnewi.

Diabetes Mellitus (DM) is a common disorder affecting individuals of all ages. Similar to general population, diabetes mellitus (DM) can also be seen in HIV infected subjects. In this study, 150 confirmed HIV positive subjects, 50 of whom were on the first line drug of Lamividine, Nevirapine, Combivir, Co mbipack and efavirenze were recruited. The second group of 50 subjects was on second line drugs which consisted of Truvada and Aluvida. Truvada is from first line drug and comprises tenofovir and emtricitabine while aluvida is protease inhibitor and comprises lopinavir and ritonavir. The third group of 50 subjects was not on antiretroviral therapy and was used as control. All the patients were screened for diabetes mellitus (DM) before the commencement of antiretroviral therapy and found to be negative. Assay was performed three months after the commencement of therapy. There is a prevalence of 6% diabetes mellitus in those on second line drugs which comprised mostly protease inhibitors compared to 0% of those on the first line drug and control samples using a cut-point of 11.0 mmol/L of random blood sugar as recommended by World Health Organization (WHO). It is possible that the rise in blood glucose level may be a result of Aluvida , a protease inhibitor rather than Truvada a first line drug. There is also a prevalence of 10% impaired glucose intolerance based on WHO cut-point of 8.0mmol/l. Most of the patients recruited for this work had CD4 less than 350 cells/ l, which is the WHO cut point before drug can be administered to a patient. Therefore primary care for HIV – infected individuals with reference to DM and its complication is important

Risky sexual behaviors and prevalence of chlamydia trachomatis antibodies among students in a tertiary institution

Chlamydia infection is a common sexually transmitted infection in humans caused by Chlamydia trachomatis. This infection occurs frequently in sexually active adolescent and young adults. This study determined the prevalence of Chlamydia trachomatis antibodies among students involved in risky sexual behavior in a tertiary institution. A total of 92 students consisting of 46 males and 46 females between ages 16 and 25 years who were involved in risky sexual behaviors were investigated. Gamma immunoglobulin (IgG) and Mu immunoglobulin (IgM) antibodies to Chlamydia trachomatis were assayed in the serum of the students using enzyme linked immunosorbent assay. Of the total students, 71.9% had multiple sex partners while 28.3% had single sex partners. The overall prevalence of Chlamydia trachomatis IgG and IgM antibodies were 56.5% and 40.2% respectively. Prevalence of Chlamydia trachomatis IgG and IgM, though more in ages 16-20 is not statistically significant (p&gt;0.05) over higher ages. No significant difference was recorded in the prevalence of Chlamydia trachomatis antibodies among gender. A very significant difference (p&lt;0.05) was recorded among students involved in multiple sex partnership in relation to those having single sex partners. Risk of Chlamydia trachomatis was high among sexually active students especially among students involved in multiple sex partnership behavior. In view of the subtle nature of Chlamydia trachomatis infection and the long term deleterious effects it may produce, it is pertinent to campaign against risky sexual activities, especially among students in higher institutions to reduce the rate of infection and safeguard their future