ObjectivesWe sought to examine the utility of serum albumin measurement in staging AIDS and monitoring patients' response to therapy. MethodsThe possible importance of serum albumin measurement in assessing AIDS stage and in monitoring the response to highly active antiretroviral therapy using CD4 cell count and body weight as parameters was examined in 185 consecutive HIV-infected, therapy-naïve individuals who were recruited for antiretroviral therapy at the university of Ilorin Teaching Hospital. The regimen included lamivudine, stavudine and nevirapine. The diagnosis of AIDS was established through a combination of clinical features and HIV seropositivity using two different enzyme-linked immunosorbent assay techniques. Serum albumin level was determined by the Bromocresol green method, while the CD4 lymphocyte count was obtained using the Dynal T4 count method. Body weight was measured in kilograms with light clothes on. ResultsThere were significant positive correlations between pretreatment albumin and both pretreatment CD4 cell count and pretreatment weight, and between post-treatment albumin and both posttreatment weight and post-treatment CD4 cell count up to a count of 700 cells/mL. There were also significant positive correlations between increase in serum albumin and both increase in body weight and duration of treatment. ConclusionsWe conclude that, in developing countries where many patients may not be able to afford to pay for CD4 cell counts and viral load tests, which are the traditional markers for HIV disease, serum albumin would be a very useful surrogate test for predicting severity of HIV infection and for clinical monitoring of response to antiretroviral therapy.

Summary The phase III Transfusion and Treatment of severe anaemia in African Children Trial (TRACT) found that conservative management of uncomplicated severe anaemia [haemoglobin (Hb) 40–60 g/l] was safe, and that transfusion volume (20 vs. 30 ml/kg whole blood equivalent) for children with severe anaemia (Hb <60 g/l) had strong but opposing effects on mortality, depending on fever status (>37·5°C). In 2020 a stakeholder meeting of paediatric and blood transfusion groups from Africa reviewed the results and additional analyses. Among all 3196 children receiving an initial transfusion there was no evidence that nutritional status, presence of shock, malaria parasite burden or sickle cell disease status influenced outcomes or modified the interaction with fever status on volume required. Fever status at the time of ordering blood was a reliable determinant of volume required for optimal outcome. Elevated heart and respiratory rates normalised irrespective of transfusion volume and without diuretics. By consensus, a transfusion management algorithm was developed, incorporating three additional measurements of Hb post‐admission, alongside clinical monitoring. The proposed algorithm should help clinicians safely implement findings from TRACT. Further research should assess its implementation in routine clinical practice.

The article aims to draw attention of clinicians to the addictive potentials of Pentazocine use in sickle cell anaemia patients and to highlight some of the associated problems of pentazocine abuse. It also hopes to stimulate the need to review guidelines for the use of analgesics in the management of bone pain crisis or other chronic pains. Two case reports of pentazocine abuse seen in a psychiatry clinic at the University of Ilorin Teaching Hospital (UITH) Ilorin, Nigeria were made. It was found that both patients who were sickle cell anaemia (HbS) patients were first given intramuscular pentazocine in private hospitals during an episode of bone pain crises. They claimed that though the bone pain crises subsided after a few days on admission, they continued to feign pains in order to be given pentazocine because they enjoyed its dysphoric effect. There were features of pentazocine dependence as shown by intense craving for the drug, excessive sweating, body (not bone) pains, signs of needle pricks on the body, sudden extravagance, begging for money, stealing and poor academic performance among other things. There was no clinical evidence of bone crisis or complications of sickle cell anaemia. It was concluded that more than before, clinicians should be cautious in the use of analgesics which has potential for addiction in sickle cell anaemia and chronic pain patients.

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Background: Laboratory request form is an important means of interaction between clinicians and laboratory service providers. The omission of information on the request form may result in laboratory errors which may have a negative impact on patients’ outcome. Objective: To assess the pattern of completion of laboratory request forms in a tertiary facility. Methods: Two thousand, two hundred and forty-one laboratory request forms sent to the laboratory over a period of two months were assessed for their level of completeness.  Results: Out of 2241 laboratory request forms, only 5 (0.2%) was fully completed. The most complete information on the forms included types of investigation required (98.9%), the gender of the patient (97.8%), the identity of consultant-in-charge of the patient (95.3%) and the referring physician's name and signature (93.8%). The least provided information was the time of collection of the specimen (0.7%). Conclusion: This study shows that laboratory request forms are frequently incompletely and inadequately completed. Continuous medical education of clinicians on the need for adequate completion of request forms is required.