Assessment of Serum Copeptin Level and eGFR in Adult Hypertensive Individuals Suspected with Polycystic Kidney Disease in NAUTH, Nnewi

Background: Hypertension is consistently implicated in the development of chronic kidney diseases globally, though its pathologic process in the development of autosomal dominant polycystic kidney disease is still unclear. This study is a cross-sectional prospective study designed to evaluate the renal function of hypertensive individuals suspected with Polycystic kidney disease using serum Copeptin, and estimated glomerular filtration rate (eGFR) as Biomarkers. Methods: A simple random sampling technique was employed in the recruitment of forty (40) hypertensive patients suspected with Polycystic kidney disease (test group), and forty (40) normotensive individuals (control group), both within the age range of 25 - 90 years. Blood sample was collected and serum extracted for the analysis of these parameters using microplate ELISA and colorimetric method respectively. The serum creatinine was used to calculate for the estimated glomerular filtration rate (eGFR) for each individuals, urinalysis for urine protein, body mass index (BMI), waist-hip ratio (WHR), Systolic blood pressure  (SBP) and diastolic blood pressure  (DBP) for anthropometric measurements were also performed for each individuals. Results: Serum copeptin, was significantly higher while eGFR was significantly lower in test group compared to control group, including in gender-based comparison. The mean values of age, BMI, WHR, SBP and DBP were significantly higher in test group compared to control group, including in gender-based comparison. BNP and copeptin were significantly correlated with SBP. Conclusively, the significant increase in serum copeptin with decreased eGFR among hypertensive individuals strongly indicates derangement in renal function which may suggest evidence of polycystic kidney disease and may subsequently progress to renal failure if not properly managed. The significant increases in both BMI and WHR as observed among the study group suggests overweight which is a strong risk factor of hypertension as well polycystic kidney disease. Keywords: Polycytic Kidney disease, Copeptin, eGFR, Adults, Hypertension, Nigeria DOI: 10.7176/JHMN/109-04 Publication date:June 30th 202

Prognostic values of adiponectin and leptin in assessment of osteoarthritis in menopausal HIV women in Nauth Nnewi Nigeria

Background: Human immune deficiency virus (HIV) has progressively been implicated with development of inflammatory disease including osteoarthritis. This study evaluated serum levels of adiponectin and leptin in women living with HIV with/without osteoarthritis who have been placed on highly active anti-retroviral therapy (HAART) in NAUTH, Nnewi, Nigeria. Methods: Eighty eight participants aged between 18 and 65 years attending HAART unit of NAUTH, Nnewi were randomly selected and grouped thus: Group A (premenopausal HIV seropositive women with osteoarthritis), group B (postmenopausal HIV seropositive women with osteoarthritis), group C (premenopausal HIV seropositive women) and group D (postmenopausal HIV seropositive women). Five milliliters of blood sample collected from each of participants for determination of adiponectin and leptin using enzyme linked immunosorbent assay (ELISA) technique. Results: Adiponectin level was significantly higher in postmenopausal HIV seropositive women with osteoarthritis compared with pre and postmenopausal HIV seropositive women without osteoarthritis (p<0.05 respectively). Similarly, leptin level was significantly higher in pre and post-menopausal HIV seropositive women with osteoartritis compared with their counterparts without osteoarthritis (p<0.05 respectively). A positive significant correlation was observed between Leptin and age in premenopausal HIV seropositive women with osteoarthritis. Also, a significant negative correlation was observed between adiponectin, age in pre and postmenopausal HIV seropositive women without osteoarthritis. Conclusions: The significant increases in adiponectin and leptin levels in pre and postmenopausal HIV seropositive women can be linked to severe inflammatory reaction due to osteoarthritis which might have been aggravated by combined effects of menopause and HIV infection

Assessment of serum soluble intercellular adhesion molecule-1 and albumin in human immuno-deficiency virus-infected individuals with or without malaria parasite infection in Nauth, Nnewi, Nigeria

Background: Human immunodeficiency virus (HIV) co-infection with malaria is the main cause of morbidity and mortality in developing countries, including Nigeria. Both infections have impact on the disease severity and progression. Methods: This was a cross-sectional study aimed to determine the serum soluble intracellular adhesion molecule-1 (sICAM-1) and albumin in HIV/malaria-infected individuals attending the antiretroviral therapy (ART) clinic at Nnamdi Azikiwe Teaching Hospital, (NAUTH) Nnewi, Nigeria. 168 randomly selected individuals aged 18-65 years grouped into 42 HIV-infected individuals on ART, 42 HIV-malaria c-o-infected individuals on ART, 42 malaria-infected individuals, and 42 apparently healthy individuals (control) were included in the study. Serum sICAM-1 and albumin were determined using enzyme linked immunosorbent assay (ELISA) and bromocresol green technique respectively while CD4 T-cell count was obtained from the patients’ records. Results: The mean serum sICAM-1, albumin and systolic blood pressure (SBP) levels were significantly higher in HIV individuals with and without malaria infection when compared with control participants (p<0.05) respectively. The mean CD4 T-cell count was significantly lower in HIV/malaria co-infected individuals when compared with HIV infected individuals (p <0.05). A significant negative correlation was observed between CD4 count and sICAM-1 both in HIV infected individuals and HIV-malaria co-infection (p<0.05). Conclusions: The increased sICAM-1, SBP with decreased albumin levels suggests inflammatory and vascular changes with reduced hepatic synthesis which may result in endothelial dysfunction, adverse cardiovascular conditions, and disease progression.

SEX HORMONES CHANGES ASSOCIATED WITH MENSTRUAL CYCLE IN HIV INFECTED FEMALES AT NAUTH, NNEWI, SOUTHEAST NIGERIA

Background: The association of Human Immune deficiency Virus/Acquired Immune Deficiency Syndrome (HIV/AIDS) and sex hormone changes may grossly affect the reproductive health in affected women. This was a prospective study done at Nnamdi Azikiwe University Teaching Hospital Nnewi, Anambra State, Nigeria to evaluate the sex hormone changes in HIV infected women of reproductive age group during menstrual cycle. Materials and methods: A total of 90 women (60 HIV positive, 30 Control) were studied. After detailed medical examination, a well-structured questionnaire was self-administered. Blood samples were collected under sterile conditions during the follicular and luteal phases of menstrual cycle after due informed consent had been sought and obtained. The samples were analyzed for sex hormones (Progesterone, estradiol and testosterone) using Enzyme Linked Immunosorbent Assay (ELISA) method. Results: The result showed that the sex hormones (Progesterone, estradiol and testosterone) were significantly lower at both phases of the menstrual cycle in HIV infected women when compared to the Control (P<0.05). Conclusion: The study revealed some degree of hypogonadism in HIV infected women which may have some implication in their reproductive life

SEX HORMONES CHANGES ASSOCIATED WITH MENSTRUAL CYCLE IN HIV INFECTED FEMALES AT NAUTH, NNEWI, SOUTHEAST NIGERIA

Background: The association of Human Immune deficiency Virus/Acquired Immune Deficiency Syndrome (HIV/AIDS) and sex hormone changes may grossly affect the reproductive health in affected women. This was a prospective study done at Nnamdi Azikiwe University Teaching Hospital Nnewi, Anambra State, Nigeria to evaluate the sex hormone changes in HIV infected women of reproductive age group during menstrual cycle. Materials and methods: A total of 90 women (60 HIV positive, 30 Control) were studied. After detailed medical examination, a well-structured questionnaire was self-administered. Blood samples were collected under sterile conditions during the follicular and luteal phases of menstrual cycle after due informed consent had been sought and obtained. The samples were analyzed for sex hormones (Progesterone, estradiol and testosterone) using Enzyme Linked Immunosorbent Assay (ELISA) method. Results: The result showed that the sex hormones (Progesterone, estradiol and testosterone) were significantly lower at both phases of the menstrual cycle in HIV infected women when compared to the Control (P<0.05). Conclusion: The study revealed some degree of hypogonadism in HIV infected women which may have some implication in their reproductive life

CYTOKINES CHANGES ASSOCIATED WITH MENSTRUAL CYCLE IN HIV INFECTED FEMALES AT NAUTH, NNEWI, SOUTH-EAST NIGERIA

Background: HIV infection is characterized by hormonal and immunological changes which may grossly affect the reproductive cycle in affected women. Aim: To evaluate Cytokine changes in HIV infected women during menstrual cycle. Materials and methods: A total of 90 women aged between 15 and 45 years were randomly recruited for the study. 30 of the women were normal healthy seronegative for HIV and served as control. Blood samples were collected under sterile conditions during the follicular and luteal phases of menstrual cycle after due informed consent had been obtained and the samples were analyzed for Cytokines (IL-8, IL-6, IL-4, and TNFα) using Enzyme Linked Immunosorbent Assay (ELISA) method. Results: The Cytokines (IL-8, IL-6, IL-4 and TNFα) were significantly higher at both phases of menstrual cycle in HIV infected women when compared with the Control (P<0.05). Interpretation and Conclusion: The study showed significant cytokine changes with some degree of inflammatory reactions in HIV infected women. The implication of these changes within reproductive life of the women is discussed

Assessment of Alpha Fetoprotein Levels and Gamma Glutamyl Transferase Activity in Hepatitis B and Hepatitis C Seropositive Subjects in Nnewi, Nigeria

Hepatitis B and hepatitis C viral infections are the leading cause of liver cirrhosis and hepatocellular carcinoma worldwide. These conditions, which mar the hepatic functional integrity, are characterized by alterations in the liver function markers such as alpha fetoprotein (AFP) and gamma glutamyl tranferase (GGT). In the present study, a total of 90 subjects were recruited. Out of this number, 30 were hepatitis B seropositive subjects, 30 hepatitis C seropositive individuals and the remaining 30 were apparently healthy individuals. The last group served as the control. Serum alpha fetoprotein levels were estimated by the Enzyme Linked Immunosorbent Assay (ELISA) technique and the method adopted for the determination of gamma glutamyl transferase activity was the kinetic-spectrophotometric procedure. The mean serum level of alpha fetoprotein was significantly higher in hepatitis B seropositive subjects compared with the control (P<0.05). The same pattern was observed when the mean serum activity of GGT of the hepatitis B seropositive subjects was compared with that of the control (P<0.05). Furthermore, the mean serum level of AFP and the mean serum GGT activity were significantly higher in hepatitis C seropositive individuals compared with the control (P<0.05). In contrast, no significant difference was observed in the mean serum levels of alpha fetoprotein in hepatitis B seropositive individuals compared with that of hepatitis C seropositive subjects (P>0.05). A positive correlation existed between AFP levels and GGT activity in hepatitis B seropositive subjects (r=0.31) and between AFP levels and GGT activity in hepatitis C seropositive subjects (r=0.25). These findings suggest that evaluation of serum alpha fetoprotein levels and gamma glutamyl transferase activity may be a valuable adjunct in the assessment of disease progression in hepatitis B and hepatitis C seropositive individuals. Keywords: Hepatitis, alpha fetoprotein, glatamyl transferase, disease progression

Epidemiology and pattern of limb amputations at a private hospital in Owerri, Imo State, South-East Nigeria

Background: Amputation of either the upper or lower extremities in man presents a special public health challenge due to the problems associated with patients’  rehabilitation.Objective: To determine the epidemiology and pattern of limb amputations in a private medical setting in Owerri, Imo State.Methodology: This was a 5-year retrospective epidemiological study of a total of 251patients who had amputations between 2006 and 2010.Results: Out of 251 patients studied, 166 (66.14%) were males while 85 (38.86%) were females. Lower limb amputations (LLA) occurred more frequently (189) than upper limb amputations (ULA) (62) in the ratio of 3:1. The age group with the  highest rate of amputation (LLA) in both sexes was 41-60 years (64%). Trauma was the most common reason for upper limb amputations (75.8%), while peripheral  vascular disease was the most frequent indication for lower limb amputation  (49.8%). The occupational group with the highest rate of amputation was the commercial motor cyclists (33.9%), followed by commercial drivers (21.5%). The pattern of amputation showed that digits/toes amputations were the most frequent procedures (35.1%) followed by below knee/below elbow amputations (27.2%).Conclusion: Amputations were more in the males of the productive age range, and most of them were in the lower limbs. Trauma was the most frequent indication for limb amputations. This has a far-reaching effect on family and state economy.Keywords: Diabetes mellitus, trauma, peripheral, vascular diseas

Increased incidences of Salmonella, Plasmodium falciparum and hepatitis C viral specific circulating immune complexes in participants from malaria endemic and HIV prevalent area of Nigeria

The present study used dissociated circulating immune complexes (CIC) to identity the burden of exposure to certain infectious agents. The participants were divided into HIV seropositive group (n=100) and HIV seronegative group (n=100). Polyethylene glycol (PEG) 6000 and phosphate buffer techniques were used for precipitation and dissociation of CIC in sera. The dissociated CIC were tested for Salmonella typhi antibody, Plasmodium falciparum histidine rich protein (Pf-hrp)-2 antigen and HCV antibody using commercially available kits. Result showed that Salmonella typhi antibody was detected in 76 (76%) of the HIV seropositive participants; Plasmodium falciparum histidine rich protein-2 (Pf-hrp-2) antigen was detected in 48 (48%) of HIV seropositive participants while Hepatitis C viral antibodies was detected in 20 (20%) of the HIV seropositive participants. Similarly, Salmonella typhi antibody was detected in 24(24%) of the HIV seronegative participants, Pf-hrp-2 antigen was detected in 47(47%) of the participants while Hepatitis C viral antibody was detected in 5(5%) of the HIV seronegative participants. There were significant differences between the number of HIV seropositive and seronegative participants with positive Salmonella typhi (P<0.05) and HCV antibody (P<0.05). The rates of homogeniuty and heterogeniuty of CIC in HIV seropositive participants was; 26 (34%) and 50 (66%) for Salmonella typhi antibody, 3 (6%) and 45 (94%) for Pf-hrp-2 antigen and 0 (0%) and 20 (100%) for HCV antibody, respectively. While the rates of homogeniuty and heterogeniuty of CIC in HIV seronegative participants was 1 (4.2%) and 23 (95.8%) for Salmonella typhi antibody; 25 (53%) and 22 (47%) for Pf-hrp-2 antigen and 3 (60%) and 2 (40%) for HCV antibody respectively in all cases. The finding of the present study suggest that HIV infection may enhance susceptibilty to both salmonella typhi and HCV infection but not Plasmodium falciparum. The study thus revealed that Salmonella and HCV infections may constitute the major secondary infection in HIV infected patients and could be a cause for concern as HIV progressed to AIDS