Evaluation of selected trace metals in some hypertensive subjects in a tertiary health institution in Southwest Nigeria.

Published reports on the possible roles of trace metals in the aetiology of primary hypertension have not been consistent. This study investigated the possible aetiological role of zinc (Zn), manganese (Mn), copper (Cu) and selenium (Se) in primary hypertension. Atomic absorption spectrophotometry (AAS) was used to determine the serum levels of Zn, Cu, Mn and Se in 45 patients with primary hypertension (stage I and stage II) and 47 apparently healthy control subjects (normotensives and pre-hypertensives). Both patients and control subjects were classified based on the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7). The weight, height and blood pressure of all subjects were measured and their body mass indices (BMI) computed. The mean serum zinc concentration was significantly higher in the patients with hypertension than in the control subjects (135.78 \ub1 9.10 vs 130.80 \ub1 12.50 \u3bcg/ml, p = 0.032). However, serum levels of copper (68.16 \ub1 3.72 vs 68.53 \ub1 5.33 \u3bcg/dl, p = 0.697), manganese (63.11 \ub1 4.40 vs 62.87 \ub1 4.59 \u3bcg/dl, p = 0.800) and selenium (75.91 \ub1 5.66 vs 78.13 \ub1 5.92 \u3bcg/L, p = 0.070) were not statistically different between the patients and the control subjects. This study did not show any gender-, age- or obesity-related differences in serum level of zinc, copper, manganese and selenium. Elevated level of serum zinc may play an aetiological role in subjects with primary hypertension. However, further studies will be necessary to define the roles of trace elements in the aetiology of primary hypertension in these individuals

Bioinformatics, Computational Informatics, and Modeling Approaches to the Design of mRNA COVID-19 Vaccine Candidates.

This article is devoted to applying bioinformatics and immunoinformatics approaches for the development of a multi-epitope mRNA vaccine against the spike glycoproteins of circulating SARS-CoV-2 variants in selected African countries. The study’s relevance is dictated by the fact that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) began its global threat at the end of 2019 and since then has had a devastating impact on the whole world. Measures to reduce threats from the pandemic include social restrictions, restrictions on international travel, and vaccine development. In most cases, vaccine development depends on the spike glycoprotein, which serves as a medium for its entry into host cells. Although several variants of SARS-CoV-2 have emerged from mutations crossing continental boundaries, about 6000 delta variants have been reported along the coast of more than 20 countries in Africa, with South Africa accounting for the highest percentage. This also applies to the omicron variant of the SARS-CoV-2 virus in South Africa. The authors suggest that bioinformatics and immunoinformatics approaches be used to develop a multi-epitope mRNA vaccine against the spike glycoproteins of circulating SARS-CoV-2 variants in selected African countries. Various immunoinformatics tools have been used to predict T- and B-lymphocyte epitopes. The epitopes were further subjected to multiple evaluations to select epitopes that could elicit a sustained immunological response. The candidate vaccine consisted of seven epitopes, a highly immunogenic adjuvant, an MHC I-targeting domain (MITD), a signal peptide, and linkers. The molecular weight (MW) was predicted to be 223.1 kDa, well above the acceptable threshold of 110 kDa on an excellent vaccine candidate. In addition, the results showed that the candidate vaccine was antigenic, non-allergenic, non-toxic, thermostable, and hydrophilic. The vaccine candidate has good population coverage, with the highest range in East Africa (80.44%) followed by South Africa (77.23%). West Africa and North Africa have 76.65% and 76.13%, respectively, while Central Africa (75.64%) has minimal coverage. Among seven epitopes, no mutations were observed in 100 randomly selected SARS-CoV-2 spike glycoproteins in the study area. Evaluation of the secondary structure of the vaccine constructs revealed a stabilized structure showing 36.44% alpha-helices, 20.45% drawn filaments, and 33.38% random helices. Molecular docking of the TLR4 vaccine showed that the simulated vaccine has a high binding affinity for TLR-4, reflecting its ability to stimulate the innate and adaptive immune response

PRACTICE POINTS - Natural history and epidemiology of post transplantation diabetes mellitus

Objective: High patient mortality continues to be the major threat to the success of solid organ transplantation despite improvements in the control of immunologic phenomena post-transplantation with improvements in grafts survival. Post transplantation diabetes mellitus (PTD) occurring commonly in patients receiving immunosuppressives has been identified as a major culprit. Aim: This paper reviews the current concepts of PTD. Methods: A Medline literature search limited to research / review articles in English language, spanning 1984 January – 2004 June on post transplantation diabetes mellitus or hyperglycemia was done. Results: Post transplantation diabetes mellitus is a heterogeneous condition of abnormal glucose tolerance with a variable onset, duration and severity. It is defined as a fasting plasma glucose = 7.0 mmol / L (126 mg / dL) and / or a 2 hour plasma glucose during an OGTT = 11.1mmol / L (200 mg / dL), or a casual plasma glucose = 11.1 mmol / L (200 mg / dL), on 3 or more occasions over a period of at least 3 months. The risk factors predisposing to PTD are age, recipient’s ethnicity, immunosuppressive regimen and family history of diabetes. The condition not only increases the risk of graft – related complications such as graft rejection, graft loss and infection,but also is a major determinant of the increased cardiovascular morbidity and mortality. Conclusions: The most important risk factor predisposing to the development of PTD is the immunosuppressive drugs. The selection of immunosuppressive regimen should take into account individuals diabetes risk profile and the relative diabetogenicity and risk for diabetes of each immunosuppressant, balancing minimal risk of diabetes with effective immunosuppression

Acute kidney injury requiring hemodialysis in the tropics

The morbidity and mortality from acute kidney injury (AKI) have remained relatively high over the last six decades. The triad of infections, nephrotoxins and obstetric complications are still major causes of acute kidney injury in the tropics. This retrospective study is a five-year audit of acute renal failure (ARF) (or stage 3 AKI) in patients requiring hemodialysis at the renal unit of the Department of Medicine of the Ladoke Akintola University of Technology (LAUTECH) Teaching Hospital, Osogbo, Nigeria. A total of 80 patients with AKI were treated over a five-year period at our center, of which 45 (56.2%) were in ARF, i.e. stage 3 AKI requiring hemodialysis. There were 24 males and 21 females. The most common cause of ARF among the patients was sepsis syndrome 16 (35.5%), while pregnancy-related cases accounted for 15 (33.3%) and nephrotoxins for 6 (13.3%). Five (33%) of the 15 pregnancy-related patients survived, and all were cases of septic abortion. Of the other 10 patients that did not survive, three (30%) had post-partum hemorrhage and seven (70%) post-partum eclampsia. In all, the mortality rate among our AKI presenting for hemodialysis at our center over a given year period was 28.8%. Majority of these were eclampsia related. The causes of ARF still remain the same in the tropics, eclampsia portends poor prognosis. Concerted efforts should be made at limiting this trend by active preventive services and early recognition of high-risk obstetrics cases

Metabolic Syndrome: Comparison of Occurrence Using Three Definitions in Hypertensive Patients

Objective: To compare the frequency of occurrence of metabolic syndrome using three international definitions and to study the distribution of cardiovascular risk factors among newly diagnosed hypertensive Nigerian subjects

Comparison of Neuropsychological Patterns in Nigerians with different Heart Failure Phenotypes

Objective The aim of this study was to determine the influence of left ventricular dysfunction type on the pattern of neuropsychological dysfunctions among heart failure (HF) subjects. Method A sub-analysis of the data of subjects recruited in a cross-sectional survey of cognitive dysfunction among Nigerians with HF was performed. Cognitive performance on the Community Screening Interview for Dementia (CSI\u27D), Word List Learning Delayed Recall (WLLDR), Boston Naming Test (BNT), and Modified Token Test (MTT) were compared between heart failure with reduced ejection fraction (HFrEF) and heart failure with preserved ejection fraction (HFpEF). Clinical and echocardiographic correlation analysis with cognitive performance was performed. Results Subjects with HFpEF were impaired on the WLLDR (71.4% vs. 34.6%, p = .026). The group with HFpEF scored lower on the language domain (definition subscale) of CSI\u27D (p = .036), and WLLDR (p = .005). The performance on the MTT (p = .185) and BNT (p = .923) were comparable between the two groups. An inverse relationship was found between pulse pressure and delay recall (r = −.565 p = .003) among the cohort with HFpEF whereas body mass index, BMI (r = −.737, p = .023) and tricuspid valve E/A ratio, TVEA (r = −.650, p = .042) showed an inverse relationship with the total CSI\u27D score in the cohort with HFrEF. Conclusions Cognitive dysfunction is largely similar between the two groups. Delay recall is however poorer among subjects with HFpEF. Regular cognitive screening is advocated among HF subjects to prevent non-adherence with therapeutic options

Evaluation of selected trace metals in some hypertensive subjects in a tertiary health institution in Southwest Nigeria.

Published reports on the possible roles of trace metals in the aetiology of primary hypertension have not been consistent. This study investigated the possible aetiological role of zinc (Zn), manganese (Mn), copper (Cu) and selenium (Se) in primary hypertension. Atomic absorption spectrophotometry (AAS) was used to determine the serum levels of Zn, Cu, Mn and Se in 45 patients with primary hypertension (stage I and stage II) and 47 apparently healthy control subjects (normotensives and pre-hypertensives). Both patients and control subjects were classified based on the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7). The weight, height and blood pressure of all subjects were measured and their body mass indices (BMI) computed. The mean serum zinc concentration was significantly higher in the patients with hypertension than in the control subjects (135.78 ± 9.10 vs 130.80 ± 12.50 μg/ml, p = 0.032). However, serum levels of copper (68.16 ± 3.72 vs 68.53 ± 5.33 μg/dl, p = 0.697), manganese (63.11 ± 4.40 vs 62.87 ± 4.59 μg/dl, p = 0.800) and selenium (75.91 ± 5.66 vs 78.13 ± 5.92 μg/L, p = 0.070) were not statistically different between the patients and the control subjects. This study did not show any gender-, age- or obesity-related differences in serum level of zinc, copper, manganese and selenium. Elevated level of serum zinc may play an aetiological role in subjects with primary hypertension. However, further studies will be necessary to define the roles of trace elements in the aetiology of primary hypertension in these individuals