A cross-over study comparing the effects of doxazosin, moduretic and amlodipine on fasting blood glucose and blood pressure levels in 9 adult hypertensive Nigerians is presented. The results showed that doxazosin, moduretic and amlodipine were effective in reducing diastolic blood pressure and thus confirmed our previous observation of blood pressure reduction during the monotherapies of these antihypertensive agents. The study further indicated the effectiveness of doxazosin in the management of severe essential hypertension in Nigerian patients. Fasting blood glucose level significantly decreased during doxazosin treatment phase and increased during moduretic phase, while amlodipine treatment did not have any effect on blood glucose level. In conclusion, the cross-over study seem to confirm the effectiveness of doxazosin therapy and its antidiabetic effect in hypertensive patients. The effectiveness of amlodipine therapy in controlling blood pressure was also observed, but no effect on blood glucose level, while moduretic therapy has hyperglycemic effect despite its effectiveness in blood pressure control in African patients.
Abstract Background: Pregnancy is associated with biochemical alterations and may be compounded by human immunodeficiency virus (HIV) infection potentially affecting pregnancy outcome such as birth weight, Apgar score, and foetal viability (stillbirth or intrauterine foetal death [IUFD]). Aims: This prospective case–control study evaluated some biochemical parameters and their possible effects on pregnancy outcome in HIV-seropositive subjects. Patients, Materials and Methods: The study involved 136 HIV seropositives on highly active antiretroviral therapy and 137 HIV-seronegative pregnant women, recruited from the Antenatal Clinic of Nnamdi Azikiwe University Teaching Hospital, Nnewi. Pregnancy-associated plasma protein-A (PAPP-A), oestriol (E3), and progesterone were analysed using an enzyme-linked immunosorbent assay method, and the delivery outcomes were reported. Results: Progesterone was significantly higher ( P = 0.002) in HIV-seropositive individuals (59.3 ± 17.84 ng/mL) compared to controls (54.89 ± 8.24 ng/mL). There were no significant differences in the levels of E3 and PAPP-A between the two groups. In HIV seronegatives, there were no significant changes in measured biochemical parameters between trimesters ( P > 0.05). There were no significant differences in measured biochemical parameters between subjects with IUFD and subjects with live births ( P > 0.05) for both the test and control groups. Subjects with significantly lower PAPP-A in HIV seropositives had babies with higher Apgar score. The incidence of IUFD was 7.31% among HIV seropositives and 7.47% among HIV seronegatives. Conclusion: HIV infection affects some biochemical indices such as progesterone and PAPP-A but does not adversely affect pregnancy outcomes in HIV seropositives under antiretroviral therapy.
In this prospective study on vitamin D and its associated factors conducted on 256 pregnant women from Anambra state of southeastern Nigeria, Vitamin D deficiency (VDD) occurred in 36 (14.1%). Vitamin D levels were significantly associated with parity, gestational age, social class, place of abode, skin colour, workplace location, and compliance to ANC drugs. Pregnant women with these features are considered to be at risk for vitamin D deficiency. The study however did not show any association between vitamin D and maternal age, social class of the pregnant women, and the season of the year. It is recommended that vitamin D supplementation be considered routinely for women with the risk factors - especially for the grandmultipara, women at term gestational age, women of dark complexion, those with indoor work location, and of urban habitat.Impact statementWhat is already known on this subject? Vitamin D is a fat-soluble vitamin primarily responsible for calcium and phosphorous homeostasis in the human body. it is derived in the human body both from endogenous sources through cutaneous synthesis following exposure to sunlight, and from endogenous conversion from pre-vitamin D to 25-hdroxycholecalciferol (25 (OH)D. Vitamin D is essential in pregnancy for maternal health, foetal skeletal growth and bone development. Vitamin D deficiency (VDD) in pregnancy occurs globally with a prevalence of 4.7% to as high as 80%.What do the results of this study add? This study shows that parity, gestational age, social class, place of domicile, skin colour, workplace location, and compliance to ANC drugs constitutes associated factors to vitamin D levels.What are the implications of these findings for clinical practice and/or further research? These findings imply that grandmultiparous pregnant women, women at term gestational age, of dark complexion, with indoor work location, and of urban habitat, by virtue of their relatively lower levels of vitamin D, should be considered for routine vitamin D supplementation.
Continuous re-evaluation of modifiable cardiovascular risk factors (cardiovascular diseases [CVDs]) in developing nations is imperative as it lays foundation for early preventive/intervention measures at grass root level to improve/prevent CVD morbidity and mortality in those nations where health indices still score below the standard.The aim was to assess CVD risk factors as a continuous re-evaluation of these may underscore the need for early intervention measures at grass root level.A total of 257 apparently healthy inhabitants aged 18-85 years were recruited in a rural community in South Eastern Nigeria by convenient sampling. Blood pressure, waist circumference and blood lipid analysis were done procedurally and data analyzed using SPSS 16.0 statistical software.The males were older (59.41 [5.22]) than the females (53.31 [16.90]). 69.2% (133/192) were low level farmers, retirees and dependents. Total cholesterol (TC), low density lipoprotein (LDL), and risk predictive index were higher in females while triglyceride (TG), high density lipoprotein and very LDL (VLDL) were higher in males. The middle aged and elderly respectively had higher TG and VLDL compared to the young. Aside hypertriglyceridemia, all lipid abnormalities were higher in females than males both singly (high TC: 28.9% [35/121] vs. 16.9% [12/71]; high LDL cholesterol: 52.0% [63/121] vs. 31.0% [22/71]) and in combination hypercholesterolemia with hypertriglyceridemia (42.9% [52/121] vs. 36.6% [26/71]). "Multiple risk factors" also occurred more in females with seeming further increase in older age.The chances of a female having CVD after menopause seemed to outweigh that of the male. CVD preventive measures should be focused at the primary/community level as a means to curtailing the increasing morbidity and eventual mortality from CVDs.
Serum uric acid and urea levels were determined in 27 pregnant and 17 non-pregnant black African women. Uric acid levels for the pregnant women were significantly raised, and the relationship between uric acid elevation and gestational proteinuric hypertension was discussed. In conclusion, we recommend that uric acid estimation should be included during routine antenatal clinics in normal pregnancy. That the use of uric acid levels should be encouraged for the diagnosis and management of gestational proteinuric hypertension in African pregnant women. The above recommendation will help to reduce prenatal morbidity and mortality in African pregnant women.
Objectives: This work was designed to determine zinc and Selenium levels in Motor Mechanics, Paints Sprayers, Smokers, Lubricant Workersand BatteryWorkers exposed to lead in Nnewi, South Eastern Nigeria.Subjects and methods: 100 exposed subjects were used for the study. The subjects were aged 25-30 years. The control subjects consisted of100 apparently healthy non-exposed age-matched individuals. The participants were educated on the benefits of the study and their informedconsent obtained before commencement of the study. Blood lead, zinc and selenium levels were determined in both exposed and controlsubjects.Results: The result shows that there was a significant increase in the blood lead level in the exposed subjects (23.00ƒÝg/dL„b1.77), whencompared with controls lead levels (10.68ƒÝg/dL „b29, P< 0.05),a significant decrease in zinc levels ( 104.73ƒÝg/dL „b1.9 ),when compared with controls zinc levels(130.68ƒÝg/dL „b1.24, P< 0.05) and a significant decrease in selenium levels( 60.99ƒÝg/dL „b1.01) when compared with thecontrols selenium levels (99.13ƒÝg/dL „b1.09 P< 0.05).Conclusion: These findings stated above appear to suggest that the occupationally exposed subjects have reduced serum zinc and selenium,with increase blood lead.
Human Immunodeficiency virus (HIV) infection is associated with increased of developing heart disease. Information on cardiac status in HIV infected in Nigerians is lacking. We assessed the impact of HIV infection on serum Myoglobin, Troponin, total CK, CK-MB, LDH and AST of HIV infected adults presenting at Nnamdi Azikiwe University Teaching Hospital Nnewi, Anambra State. The aim of this study is to determine some cardiac biomarkers in adult HIV seropositive participants, blood samples collected from the 300 randomly recruited participants were used for HIV screening, CD4 + T cell count, serum Myoglobin, Troponin, total CK, CK-MB, LDH and AST. Standard Laboratory methods were used for the analysis. The results showed that the mean serum Myoglobin and Troponin levels were significantly higher in symptomatic HIV participants not on antiretroviral therapy (ART) compared with asymptomatic HIV participants at P< 0.05, in each case. Also, the mean serum Myoglobin and Troponin levels were significantly higher in symptomatic HIV participants not on ART compared with HIV asymptomatic HIV participants at P<0.05 in each case. Again, the mean serum total Creatine kinase, CK-MB, LDH and AST were significantly higher in symptomatic HIV participants not on ART compared with asymptomatic HIV participants at P<0.05 respectively. Similarly, the mean serum total Creatine kinase, CK-MB, LDH and AST were significantly higher in symptomatic HIV participants not on ART compared with HIV seronegative control subjects at P<0.05 in each case. Once again, the mean serum total Creatine kinase, CK-MB and AST were significantly higher in asymptomatic HIV participants compared with HIV seronegative control subjects at P<0.05 respectively. Increased levels of some cardiac markers were seen in HIV infected participants. Keywords : HIV, cardiac markers, participants.
To determine the antioxidant status of HIV and malaria co-infected participants.Blood samples collected from the 193 randomly recruited participants were used for HIV screening, Plasmodium falciparum antigen screening, malaria parasite density count, CD4(+) T cell count, glutathione reductase, glutathione peroxidase and total antioxidant status measurement. Standard laboratory methods were used for the analysis.The results showed that glutathione reductase, glutathione peroxidase, total antioxidant status and CD4(+) T cell count were significantly lowered in symptomatic HIV participants with and without malaria co-infection (P<0.01) in each case compared with control participants. Also, glutathione reductase, glutathione peroxidise, total antioxidant status and CD4(+) T cell count were significantly lowered in asymptomatic HIV participants with and without malaria co-infection (P<0.05) in each case, compared with control participants without malaria. Similarly, these antioxidants were significantly lowered in control participants with malaria infection (P<0.05) compared with control participants without malaria. The malaria parasite density in symptomatic HIV infected participants was negatively associated with glutathione reductase (r = -0.906, P<0.01), glutathione peroxidase (r = -0.719, P<0.01) and total antioxidant status (r = -0.824, P<0.01).The antioxidant activity was affected in HIV infected participants with malaria co-infection. Malaria co-infection in HIV seems to exert additional burden on antioxidants. This calls for concern in malaria endemic areas with increasing prevalence of HIV infection.
