The Role of Oxidative Stress in Diabetes Mellitus: A 24-year Review

Background: Diabetes mellitus is a widespread and devastating disease. Diabetes is associated with several mechanisms of tissue damage, one of which is oxidative stress. Oxidative stress and oxidative damage to tissues are common end points to chronic diseases such as atherosclerosis, diabetes and cardiovascular diseases. Oxidative stress plays an important role in the pathogenesis of and the complications of diabetes. Hyperglycaemia results in overproduction of oxygen free radicals which contributes to the progression of diabetes.Objective: This review aims at determining the role of oxidative stress in diabetes and diabetic complications.Method: Relevant literatures were reviewed from medical journals, library search, Pub Med search, Google search and other internet search engines (Google Scholar, Hinarii, Ask.com) from 1987 to 2011.Results: Several studies demonstrated that oxidative stress plays a role in the progression of diabetes and also in the development and progression of diabetic complications.Conclusion: Increasing evidence has implicated a role for oxidative stress in progression of diabetes and diabetes associated complications. Antioxidant therapy has been effective in management of diabetes and diabetic complications. In addition, physical exercise and insulin therapy can also improve diabetes through the reduction of oxidative stress.Keywords: Oxidative stress, free radicals, antioxidants, diabetes, diabetic complications

Socio-demographic and clinical characteristics of children who received emergency blood transfusion in a secondary health facility at Awka.

Background: Severe anaemia is one of the major causes of morbidity and mortality in children in developing countries and could be managedby urgent blood transfusion to save life, though with its attendance risks like exposure to human immunodeficiency virus (HIV) and other bloodborne infections.Objective: To determine the socio demographic and clinical characteristic of children found to have received emergency blood transfusion inAwka, Anambra state.Patients and methods: The hospital records of children aged above one month to 18 years who received emergency blood transfusion atchildren’s ward of Amaku General Hospital Awka (AGHA) between march 1, 2007 to August 31st, 2009 were studies.Results: Of the 391 patients and admitted during the period, 35 (8.9%) had emergency blood transfusion. The youngest child was 7 months andoldest 14 years. More than 65% of those transfused were less than 5 years. There was no statistically significant sex difference among thosetransfused ( p > 0.05). The middle socio-economic class patients presented with severe anaemia more than other social class. Malaria was the commonest cause of anaemia requiring emergency blood transfusion accounting for 51.4% as a single entity or 28.6% in combination with otherconditions.Conclusion: Severe anaemia requiring urgent blood transfusion was caused mostly by malaria. Measures aimed at addressing poverty andmalaria attacks were suggested as a way forward. These will help reduce the incidence of severe anaemia and thus the need for emergency bloodtransfusion

Prevalence and pattern of bacteria and intestinal parasites among food handlers in the Federal Capital Territory of Nigeria

Background: In developing countries, biological contaminants largely bacteria and other parasites constitute the major causes of food‑borne diseases often transmitted through food, water, nails, and fingers contaminated with faeces. Accordingly, food‑handlers with poor personal hygiene could be potential sources of infections by these micro‑organisms. Objective: This study was aimed at determining the prevalence and pattern of bacteria and intestinal parasites among food handlers in the Federal Capital Territory. Materials and Methods: The study was a descriptive one in which a multistage sampling technique was employed to select 168 food handlers of various types. Subjects’ stool, urine, and fingernail analyses were carried out and the result scientifically scrutinized. Results: Fingernail bacteria isolates include: E. Coli (1.8%), coagulase‑negative staphylococcus (17.9%), Staphylococcus aureus(7.1%), Klebsiella species (2.4%), Serratia species (1.2%), Citrobacter species (1.2%), and Enterococcus species (1.8%). The subjects’ stool samples tested positive: For A. lumbricoides (14.9%), T. trichuria(1.8%), S. starcolaris (3.0%), E. histolytica (10.7%), G. lambilia (1.8%), S. mansoni (1.2%), and Taenia species (4.8%). Furthermore, 42.3% and 15.5% of the stool specimen tested positive for Salmonella and Shigella species, respectively. Conclusion: Food establishments should screen and treat staff with active illness, and regularly train them on good personal and workplace hygiene practices.Keywords: Bacteria, federal capital territory, food handlers, intestinal parasitesNigerian Medical Journal | Vol. 53 | Issue 3 | July-September | 201

Constraints to utilization of maternal health services at the primary health care level in Nnewi, Nigeria

Background: Ensuring universal access to quality maternal health services brings to the fore the need to determine and tackle factors that deter women from utilizing these services.Objective: To determine the constraints to utilization of maternal health services in the primary health centres in Nnewi, Nigeria.Methodology: This was a cross-sectional survey. Using the multi-stage sampling technique, 280 women utilizing maternal health services from four randomly selected public primary health centres in Nnewi, Nigeria, were chosen for the study. Data collection employed a mix of quantitative and qualitative methods. Quantitative data was analyzed using the Statistical Package for Social Sciences (SPSS) version 16 (2007).Results: The mean age of the 280 respondents studied was 29.2±5.9 years; 168 (60%), 70 (25%) and 26 (9.3%) of the respondents accessed ante-natal care, post-natal care and delivery services, respectively. Eighty-four (30%) mothers were not vaccinated against tetanus for such reasons as non-availability of vaccines (28.6%), fear of side effects (25%), and lack of belief in vaccination efficacy (20.3%). Difficulties experienced before accessing the facilities were: bad state of roads (60.7%), lack of transportation (34.6%) and high transportation cost (25%). Whereas, difficulties experienced at the facilities were: lack of equipment and supplies (27.5%), lack of transportation (13.2%) and unavailability of drugs (11.1%).Conclusion: This study found that apart from ante-natal care, other maternal health services were underutilized. Funding, good access roads, affordable transportation and appropriately integrated services would boost utilization.Keywords: Accessibility, drugs, education, equipment, funds, transportatio

Selenium, Zinc and Megnesium Status of HIV Positive Adults Presenting at a University Teaching Hospital in Orlu-Eastern Nigeria

No Abstract

Iron status of some pregnant women in Orlu town-Eastern Nigeria

BACKGROUND:  High prevalence of anaemia has been reported among pregnant women especially in developing nations. This paper considers maternal haemoglobin (Hb) level, serum total iron, iron binding capacity, and serum ferritin in antenatal women in Orlu- Imo State Nigeria. PATIENTS AND METHODS: Haemoglobin level, serum iron, serum ferritin, and total iron binding capacity (TIBC) were measured in different trimesters among 90 pregnant women aged 20-45 years, on iron supplements attending antenatal clinic of Imo State University Teaching Hospital Orlu. First trimester comprised of 16.7% (n=15), second trimester comprised of 50% (n=45) while as third trimester comprised of 33.3% (n=30). 30 non-pregnant women aged 26-40 years were used as controls.RESULT:   The mean Hb level was 11.28 ± 1.4 g/dl in first trimester, 9.5 ± 1.9g/dl in second trimester, 10.4 ± 1.2g/dl in third trimester, and 10.9 ± 1.5g/dl in controls. Mean serum iron level was 142 ± 23µg/ml in first trimester, 235 ± 118µg/ml in second trimester, 251 ± 118µg/ml in third trimester, and 99±19.4µg/ml in controls. Mean serum ferritin was 57.7 ± 30ng/ml in first trimester, 37.6 ± 17ng/ml in second trimester, 37.3±20ng/ml in third trimester, and 86.7±16.9ng/ml in controls. TIBC was 337±90 µg/dl in first trimester, 441±119µg/dl in second trimester, 482 ± 149µg/dl in third trimester and 271.8±89.0µg/ml in controls.Hb level was relatively stable in pregnancy, but was significantly (p<0.05) lowest in the second trimester compared with controls. Serum iron and TIBC progressively increased from first trimester to third trimester. Conversely, serum ferritin declined progressively from first trimester to third trimester. The increments in serum iron was statistically significant (p<0.05) between first and second trimester, but not significant between second and third trimester. TIBC was significantly higher in third trimester compared with first trimester.  Serum ferritin was significantly lower in second and third trimesters compared with controls. This implies a progressive mineral transfer from mother to fetus. TIBC and serum iron were significantly (p<0.05) lowest in non-pregnant controls compared with the three trimesters of pregnancy. Conversely ferritin was significantly (p<0.05) higher among the non-pregnant controls compared with the three trimesters of pregnancy. This implies that the non-pregnant women had more iron store and had less iron need than their pregnant counterpart. The higher iron need in pregnancy necessitated its mobilization from its stores. CONCLUSION: This study encourages more critical antenatal care especially at second trimester of pregnancy with much emphasis on dietary supplementation of iron and minerals through adequate consumption of local vegetables and other food diets rich in iron. There was poorest antenatal attendance in the first trimester. Pregnant women in this environment should be encouraged to register early for antenatal care.KEYWORDS: Pregnancy, anaemia, Iron status

Selenium exposure and the risk of type 2 diabetes: a systematic review and meta-analysis

In 2007, supplementation with the trace element selenium in a trial was unexpectedly found to be associated with an excess risk of type 2 diabetes. Given the concerns raised by these findings and the large number of recent studies on this topic, we reviewed the available literature with respect to this possible association. In this paper, we assessed the results of both experimental and nonexperimental epidemiologic studies linking selenium with type 2 diabetes incidence. Through a systematic literature search, we retrieved 50 potentially eligible nonexperimental studies and 5 randomized controlled trials published through June 11, 2018. To elucidate the possible dose-response relation, we selected for further analysis those studies that included multiple exposure levels and serum or plasma levels. We computed a pooled summary risk ratio (RR) of diabetes according to selenium exposure in these studies. We also computed a RR for diabetes incidence following supplementation with 200 \ub5g/day of selenium compared with placebo in trials. In the nonexperimental studies, we found a direct relation between selenium exposure and risk of diabetes, with a clear and roughly linear trend in subjects with higher plasma or serum selenium levels, with RR at 140 \ub5g/L of selenium exposure compared with a referent category of\u2009<\u200945 \ub5g/L equal to 3.6 [95% confidence interval (CI) 1.4-9.4]. A dose-response meta-analysis focusing on studies with direct assessment of dietary selenium intake showed a similar trend. In experimental studies, selenium supplementation increased the risk of diabetes by 11% (RR 1.11, 95% CI 1.01-1.22) compared with the placebo-allocated participants, with a higher RR in women than in men. Overall, results from both nonexperimental and experimental studies indicate that selenium may increase the risk of type 2 diabetes across a wide range of exposure levels. The relative increase in risk is small but of possible public health importance because of the high incidence of diabetes and the ubiquity of selenium exposure