Electrocardiographic Study in Adult Homozygous Sickle Cell Disease Patients in Lagos, Nigeria

Background. This study sought to identify the pattern of electrocardiographic changes in steady state adult sickle cell anaemia. Methods. A case-control, cross-sectional study was conducted amongst sickle cell patients attending the sickle cell clinic of Lagos State University Teaching Hospital, Ikeja, and HbAA controls. All consenting participants had haemoglobin electrophoresis done and were subjected to electrocardiography (ECG). The descriptive data were given as means ± standard deviation (SD). The differences were considered to be statistically significant when the p value obtained was <0.05. Results. A total of ninety-three sickle cell anaemia (SCA) patients and ninety haemoglobin AA (controls) were enrolled. There was no significant difference in the age of the participants with SCA and that of the controls but the body mass index was significantly higher in controls (\u1d45d = 0.0001). Overall, 73.1% (68 of 93) had abnormal ECG while only 2 of 90 (2.2%) of controls had abnormal ECG.The common abnormalities observed were left ventricular hypertrophy, biventricular hypertrophy, and right ventricular hypertrophy. Conclusion. Patients with SCA in steady state tend to have normal heart rate but about 50% of them would have had ECG changes before the age of 20 years. ECG being a noninvasive test may be used to identify patients at risk for early intervention

Knowledge, attitude and practices of HIV post exposure prophylaxis amongst health workers in Lagos University Teaching Hospital

Introduction: timely PEP after needle stick exposure to high risk body fluids can reduce the rate of  occupational transmission significantly. Ignorance of this may increase the risk of seroconversion to HIV for healthcare workers. This study was conducted with the aim of demonstrating the current level of knowledge and practise of healthcare workers as regards PEP. Methods: this was a cross-sectional study, pretested questionnaire were self administered to 372  health workers from various clinical specialties. The responses were collated and analyzed; results were presented in frequency tables. Results: this study revealed a high level of awareness among the  respondents as 83.3% were aware of  PEP. Despite the high level of awareness, respondents still have an inadequate knowledge about PEP, only  32% of the respondents could name at least two of the recommended drugs for PEP, only 54.0% of respondents knew when to commence PEP following occupational exposure to HIV. There was a low level of practice of PEP among the respondents as only 6.3% of respondents had PEP despite occurrence of needle stick injury. Conclusion: this study revealed a general low level use of PEP despite the average knowledge of PEP and the  favourable attitude towards HIV PEP amongst the respondents.Key words: Post exposure prophylaxis, human immunodeficiency virus, Health care worker

Cord blood full blood count parameters in Lagos, Nigeria

Introduction: Full blood count (FBC), one of the most frequently requested for laboratory investigations, is a simple, fast and cheap test and is a reliable indicator of health. Due to its usefulness in the  assessment of health status of individuals, its parameters in cord blood, a major source of haemopoietic stem cell transplantation and an ideal source for laboratory investigations for newborns were determined to provide a useful guide to local neonatologists and stem cell transplant physicians. Methods: Three millilitres of umbilical cord blood was collected from 130 normal birth weight newborns (69 males and 61 females) whose cord were clamped immediately after delivery, at a teaching hospital in Lagos, Nigeria and full blood count parameters were determined using Sysmex autoanalyzer, model  KX-21N. Consented mothers of the newborns were selected based on, age between 18 and 45 years;  uneventful pregnancy and delivery and haemoglobin (Hb) concentration ≥ 10 g/dL. Results: There were no statistical gender differences in the mean values of Hb concentrations (M=13.27  ±1.60 g/dL; F=13.32±1.61g/dL; p=0.93), total white cell count (M=3.16±5.43 × 109/L; F=13.07±4.98  × 109/L; p= 0.92), platelet count (M= 223.64± 64.21 × 109/L; F=226.69±80.83 × 109/L; p=0.81) and other parameters. Conclusion: Mean values of full blood count parameters obtained in this study are  comparable to reports from other studies in developing countries and could be a useful guide for neonatologists and stem cell transplant physicians in our geographical location.Key words: Haemoglobin, cord blood, stem cell, umbilical cord, neonatologis

LIPID PROFILE AND DISEASE SEVERITY IN SICKLE CELL DISEASE PATIENTS IN LAGOS STATE. NIGERIA

ABSTRACT Background: Sickle cell anaemia is an autosomal recessive disorder that arises due to the substitution of glutamic acid with valine. This occurs at position 6 of the haemoglobin b chain, resulting in the synthesis of abnormal haemoglobin and the consequent production of the characteristic sickled red blood cells. Studies have documented several alterations in lipid homeostasis in this population. Both hyper and hypolipidaemias are known to be associated with increased morbidity and mortality and it is therefore imperative to evaluate their relationships with sickle cell anaemia. Aim: The aim of this study was to establish baseline serum lipid levels in sickle cell anaemia patients in LASUTH and correlate this with severity scores in the patients. Subjects and Methods: Serum Total cholesterol (TC), Triglycerides (TG), Low-density lipoproteins (LDL), High-density lipoproteins (HDL) and Very low-density lipoproteins (VLDL) were measured in 57 Haemoglobin SS (HbSS) patients in steady state. All patients used had been fasting for at least 10 hours prior to sample collection. The LDL/HDL was also calculated. Their disease severity was calculated using an objective scoring method. Results: Our results showed that there was no significant correlation between serum lipid levels and disease severity score. Keywords: sickle cell disease, serum total cholesterol, low-density lipoproteins, high-density lipoproteins, triglycerides, disease severity

A Rare Case of Nonsecretory Multiple Myeloma in Lagos, Nigeria: A Case Report and Literature Review

Multiple myeloma (MM) is a plasma cell disorder associated with clonal proliferation of plasma cells. Nonsecretory multiple myeloma (NSMM) is a rare variant of MM and accounts for approximately 1% to 5% of all cases. It is defined as symptomatic myeloma without detectable monoclonal immunoglobulin on serum or urine electrophoresis. This variant usually poses a diagnostic challenge to the clinician. We present a 60-year-old Nigerian man who was investigated extensively for bone pain, weight loss, and anaemia. He was eventually diagnosed as having nonsecretory multiple myeloma based on histology and immunohistochemistry results of bone marrow trephine biopsy. He is currently being managed with bortezomib, doxorubicin, and thalidomide, as well as zoledronic acid. He is also on anticoagulation. He continues to show remarkable clinical improvement. We describe this case report and literature review for better awareness amongst medical practitioners and pathologists

Seroprevalence of human T lymphotropic virus antibodies among healthy blood donors at a tertiary centre in Lagos, Nigeria

Introduction: Transmission of human T-lymphotropic viruses (HTLV) occurs from mother to child, by sexual contact and blood transfusion. Presently, in most centres in Nigeria, there is no routine pre-transfusion screening for HTLV. The study aims to determine the prevalence of HTLV-1 and HTLV-2 among healthy blood donors at a tertiary centre in Lagos. Methods: A cross-sectional study was carried out at the blood donor clinic of the Lagos State University Teaching Hospital (LASUTH), Ikeja. About 5mls of venous blood was collected from each subject into a sterile plain bottle after obtaining subject's consent. The serum separated and stored at -200C. Sera were assayed for HTLV by an enzyme-linked immunoassay (ELISA) for the determination of antibodies to HTLV 1 and HTLV -2. Western blot confirmatory testing was done on reactive samples. All donors were also screened for HIV, HBsAg and HCV by rapid kits. Results: The seroprevalence of HTLV -1 by ELISA was 1.0% and 0.5% by Western Blot among blood donors. A total of 210 healthy blood donors were enrolled. Only 2 (1.0%) blood donors were repeatedly reactive with ELISA test. On confirmatory testing with Western Blot, 1 (0.5%) blood donor was positive for HTLV. All the healthy blood donors were negative for HIV, HbsAg and HCV. None of the 210 blood donors had been previously transfused; as such no association could be established between transfusion history and HTLV positivity among the blood donors. Conclusion: The seroprevalence of HTLV in this environment is low among healthy blood donors

Seroprevalence of human T lymphotropic virus antibodies among healthy blood donors at a tertiary centre in Lagos, Nigeria

Introduction: Transmission of human T-lymphotropic viruses (HTLV) occurs from mother to child, by sexual contact and blood transfusion. Presently, in most centres in Nigeria, there is no routine  pre-transfusion screening for HTLV. The study aims to determine the prevalence of HTLV- 1 and HTLV-2 among healthy blood donors at a tertiary centre in Lagos.Methods: A cross-sectional study was carried out at the blood donor clinic of the Lagos State University Teaching Hospital (LASUTH), Ikeja. About 5mls of venous blood was collected from each subject into a  sterile plain bottle after obtaining subject's consent. The serum separated and stored at -200C. Sera were assayed for HTLV by an enzyme-linked immunoassay (ELISA) for the determination of antibodies to HTLV 1 and HTLV -2. Western blot confirmatory testing was done on reactive samples. All donors were also screened for HIV, HBsAg and HCV by rapid kits. Results: The seroprevalence of HTLV -1 by ELISA was 1.0% and 0.5% by Western Blot among blood donors. A total of 210 healthy blood donors were enrolled. Only 2 (1.0%) blood donors were repeatedly reactive with ELISA test. On confirmatory testing with Western Blot, 1 (0.5%) blood donor was positive for HTLV. All the healthy blood donors were negative for HIV, HbsAg and HCV. None of the 210 blood donors had been previously transfused; as such no association could be established between transfusion history and HTLV positivity among the blood donors. Conclusion: The seroprevalence of HTLV in this environment is low among healthy blood donors.Key words: Seroprevalence, HTLV, healthy blood donors, Nigeri

Mean platelet volume and platelet counts in type 2 Diabetes: Mellitus on treatment and non-diabetic mellitus controls in Lagos, Nigeria

Introduction: The Mean platelet volume and platelet counts are indicators of thrombotic potentials, and risk factors for microvascular complications in diabetics. This study aimed to establish variations in platelet counts and mean platelet volume in type 2 diabetic patients on treatment and non-diabetic controls. Methods: This was an unmatched case-control study involving 200 participants consisting of 100 diabetics and 100 non-diabetic controls. Four and half milliliters of blood was collected from diabetics and non diabetic controls into EDTA anticoagulant tubes. Full blood count was performed using the Sysmex KN-21N, (manufactured by Sysmex corporation Kobe, Japan) a three- part auto analyzer able to run 19 parameters per sample including platelet counts and mean platelet volume. Results: The mean fasting blood sugar for the diabetics was 147.85±72.54 mg/dl and the controls 95.20±30.10 mg/dl. The mean platelet count for the diabetics was 235.29±76.81*109/L and controls, 211.32±66.44*109/L. The mean platelet volume, for the diabetics was 8.69±0.67 fl and the controls, 8.91±0.80 fl. There was a statistically significant difference in platelet counts of diabetics and healthy controls p =0.038 while none existed between the mean platelet volume in diabetics and healthy controls p=0.593. Conclusion: This study revealed a higher mean platelet count for diabetics on treatment than for non diabetic controls while mean platelet volume was lower in cases than controls. However, both parameters in diabetics on treatment were within the normal reference range for healthy individuals

Prevalence of Priapism and Its Awareness amongst Male Homozygous Sickle Cell Patients in Lagos, Nigeria

Background. Priapism is a pathological condition of penile erection that persists beyond, or is unrelated to, sexual stimulation. Impotence and infertility are major problems in male sickle cell disease patients, and priapism has been implicated as a cause of impotence and infertility. The aim of this study is to determine priapism prevalence and assess the knowledge of male homozygous male patients about it in Lagos, Nigeria. Methods. A cross-sectional study was conducted amongst male homozygous sickle cell disease patients of Lagos State University Teaching Hospital. Pretested questionnaires were distributed to determine the prevalence and assess their knowledge on priapism. Data were analyzed using SPSS version 16.0. Results. A total of 114 consenting subjects filled the questionnaires, 85 of 114 (74.6%) had not heard about priapism before this study. A total of 77 of 114 (67.5%) did not know that they are at risk of priapism. Whilst 84 of 114 (73.7%) were not aware that priapism is a complication of SCD. The majority, 94 of 114 (82.5%), were not aware that priapism could cause impotence. Conclusion. There is a need to create more awareness about this complication amongst sickle cell disease patients in order to stem the incidence of impotence and infertility amongst them

EFFECT OF YOGURT INTAKE ON PLASMA GLUCOSE AND SERUM LIPID PROFILE IN APPARENTLY HEALTHY STUDENTS OF COLLEGE OF HEALTH SCIENCES, NNEWI, ANAMBRA STATE, NIGERIA.

This study was designed to investigate the effect of oral intake of yogurt on plasma glucose and serum lipid profile levels (total cholesterol, triglyceride, high-density lipoprotein and low-density lipoprotein) in apparently healthy students. A total of 30 subjects (16 males and 14 females) were recruited to serve as both test and control groups. Each subject was advised to abstain from milk and similar probiotic food consumption for three weeks. Baseline samples (after an overnight fast and 2 hours postprandial after oral intake of carbohydrate meal) were collected from both males and females at day 0 as control samples, and levels of glucose and lipid profile were evaluated. Subsequently, in addition to their normal diet, each of the subjects received 100ml of yoghurt daily for 21 days. After an overnight fast, post research (test 1stand 2nd) samples (fasting blood sample and 2 hours postprandial after oral intake of carbohydrate meal) were collected on days 11 and 22 respectively and the levels of glucose and lipid profile were re-evaluated. Blood glucose and lipid concentrations were determined using standard methods. There were a significant increase in mean serum triglyceride (TG) value 11days following yogurt intake (intermediate consumption) when compared to the baseline level (0.63±0.15 Vs 0.53±0.19; p&lt;0.05). Also, there was a significant decrease in mean serum TG value 21 days following yogurt intake (post-consumption) when compared to baseline and intermediate levels (0.50±0.19 Vs 0.53±0.19 and 0.50±0.19 Vs0.63±0.15; p&lt;0.05) respectively. There were a significant increase in mean serum high-density lipoprotein (HDL) value 21days following yogurt intake when compared to day 11 (intermediate consumption) and baseline levels (1.36±0.34 Vs 1.14±0.24 and 1.36±0.34 Vs 0.99±0.19; p&lt;0.05) respectively. Also, there was a significant increase in mean serum total cholesterol (TC) value 21 days following yoghurt intake when compared to day 11 and baseline levels (p&lt;0.05) respectively. The low-density lipoprotein (LDL) level remained unchanged 11 and 21 days following yoghurt intake (p&gt;0.05). There was a significant increase in the mean blood glucose level (p&lt;0.05). In conclusion, this study has shown that the lipid profile and blood glucose levels in individuals consuming yogurt may experience significant alterations which may have important clinical implications in the management of diabetes. Further studies may be necessary for understanding the mechanism behind these effects. Keywords: Yogurt; Probiotics; Diabetes mellitus; Cardiovascular disease; Glucose; Lipid profile