Investigating anaemia through screening tests could be insufficient in managing chronic infections. This study investigated the involvement of iron in the anaemia of human immunodeficiency virus infection. Participants were aged 19 to 50 years, comprising 76 infected subjects and 53 controls. The CD4 + count and haemoglobin concentration were determined by automation. Serum iron and total iron binding capacity were determined colorimetrically, while serum ferritin and interleukin-6 were analyzed by enzyme linked immunosorbent assay. Percentage of treatment-naïve subjects (61%) exceeded that of subjects on treatment (39%). Generally, 12%, 16% and 8% of the infected subjects had lower serum iron, total iron binding capacity and ferritin values respectively while 50%, 51% and 35% had values higher than the reference values respectively. However 38%, 33% and 57% of the infected subjects had their values within the reference limits. Approximately 45% of infected subjects had lower haemoglobin concentration, while 55% had values within range. The iron parameters of treatment naïve infected subjects did not significantly (P> 0.05) change when compared with those on treatment but significantly changed (P < 0.5) when compared with the control group. Degree of immunosuppression adjudged by the CD4 + count was 31.5% for severe 48.7% advanced, 14.5% mild and only 5.3% normal. There are greater percentages of treatment naive subjects as well as severe immunosuppression in this locality. Approximately 45% anaemia prevalence was recorded in the studied infected population but the anaemia may not be a reflection of iron deficiency.
Aims: To investigating some demographic variables and red cell parameters of infected persons already accessing antiretroviral therapy with a view to identifying sub- groups with higher proportions of anaemia. Study Design: Cross-sectional study. Place and Duration of Study: University of Calabar Teaching Hospital Calabar Nigeria, between August 2017 and July 2018. Methodology: Subjects comprised 60 male and female HIV-infected adults attending University of Calabar Teaching Hospital Calabar, and equal number of age and sex-matched control subjects who were HIV sero-negative as at the time of this study. The infected persons were being treated with either Tenofovir+Lamivudine+Efavirenz (TLE) or Lamivudine+Zidovudine+Nevirapine (LZN). A pre-tested structured questionnaire was administered by two trained interviewers which captured the bio-data, sociodemographic variables and therapy-related information. Venous blood was collected aseptically by standard phlebotomy into appropriate sample containers for CD4 and red cell counts by automation. Results: The proportion of anaemia occurring between TLE and LZN users was observed to be in the ratio of 2:3. The RBC count, haematocrit and haemoglobin concentration were significantly lower (p=.000), while MCV, MCH and RDW were significantly higher (p=.000) in subjects infected with HIV compared to the control subjects, Duration of treatment beyond 6 years significantly raised both MCV (p=.007) and MCH (p=.006) compared to the first 3 years of treatment commencement, while the MCV, MCH and RDW-SD were significantly higher (p=.003, .014 and .018 respectively) among LZN users compared to those on TLE. Conclusion: Human immunodeficiency virus infection triggers pathologic mechanisms that culminate into anaemia. While the use of antiretroviral therapy appears to gradually resolve this derangement, the adverse effects of some of the antiretroviral agents contribute to the persistence of anaemia particularly with increasing years of treatment.
Diabetes mellitus has become increasingly prevalent over the years. The chronic hyperglycaemia of diabetes is associated with long-term damage, dysfunctions, and failure of different organs suggesting that the most effective tool to prevent complications is the effective control of hyperglycaemia itself. The study is set to determine the effect of glycemic control on plasminogen activator inhibitor type 1 (PAI-1), soluble thrombomodulin (STM) alongside fasting plasma glucose (FPG) and glycated hemoglobin (HbA1c) among type 2 diabetic subjects. One hundred diabetic subjects accessing care at the University of Calabar Teaching Hospital Calabar and 100 non –diabetics that served as controls were enrolled. Blood samples from participants were analyzed for FPG, HbA1c, PAI-1 and STM by standard methods. The result shows 74% of the diabetic to be females. Half of the diabetics were managed on only oral anti-diabetic drugs while the remaining half were either on insulin injection or a combination of oral and insulin injection. Poor glycemic control was observed in 56% of the studied subjects. The mean age of 54.69 ± 9.94 years for the diabetics was comparable to the age-matched controls (p=.097). Diabetics showed significantly higher FPG, HbA1c, PAI-1and STM (P=0.001) compared to control values. Correlations between STM, PAI 1 and glycated hemoglobin (figures 2 p=0.001, p =0.001) and STM, PAI-1 and FPG revealed significantly robust association (p=0.001, p=0.001). The study concludes that there is poor glycemic control among the treated diabetic subjects with PAI-1 and STM showing a very strong positive correlation with HbA1c than FPG.
Introduction: Although viremia has been greatly addressed in the management of human immunodeficiency virus (HIV) infection by the advancement in antiretroviral therapy, not all HIV-associated morbidities have been resolved. Observations of increased cardiovascular risk in relation to antiretroviral therapy have been reported. Full blood count continues to be useful in disease management, and efforts are directed towards optimising its utility in medical practice. Derivatives of blood cell counts have in recent times proved to be informative with regards to the inflammatory-thrombotic cycle. The utility of these derived parameters in HIV within the study locality is worth exploring. Methods: This single-site study was carried out at University of Calabar Teaching Hospital in Calabar, Cross River State of Nigeria. White blood cell and platelet counts were carried out by automation, while blood cell ratios were calculated. Statistical analysis of data was done using SPSS 22.0. A p-value of ≤ 0.05 was considered to infer a statistically significant difference. Results: Significant reductions of white blood cell parameters were recorded in HIV, particularly among infected persons on antiretroviral therapy. Platelet count and plateletcrit were significantly lower, while mean platelet volume and platelet distribution width were higher in newly diagnosed persons compared to HIV-infected subjects on therapy and control subjects. Platelet-to-lymphocyte ratio was significantly higher among subjects on therapy compared to the rest of the groups. Conclusion: Increase in platelet count following antiretroviral therapy could be posing a risk of platelet-driven morbidities as typified in the observed elevated thrombotic marker.
Medical laboratory services provide the largest body of empirical data that constitute the evidence in health care practice. It is the aim of this work to assess the usage of evidence -based practice by clinicians in our public health institution. One thousand (1000) structured questionnaires were distributed among clinicians working in one urban tertiary institution in Nigeria after given their consents to participate. The results showed that pediatrics department participated more with a percentage of 27.8% (270/970) while Community medicine showed least participation with 7.2%(70/970) .All respondents affirmed that the use of laboratory results prior to the treatment of patients is necessary. However, 75% of the respondents agreed that the formats of reporting laboratory results are standard and clear. The study further revealed that 46% of the doctors believed in having discussion with the laboratory staff over laboratory test results for better understanding as opposed to 54% who say it is not necessary. The study also showed that 71% of the doctors in the hospital usually do not request for the results of the ordered test when the patient has commenced treatment. Seventy percent (70%) of the doctors affirmed positively that the results are delivered on time. In conclusion, although clinicians agree on evidence -based practice, a greater number still do not practice it in true sense.
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