Hepatitis B virus DNA in patients with HBsAg in south western Nigeria

There are about 400 million people with chronic hepatitis B virus (HBV) infection worldwide with a potential of adverse sequelae including hepatocellular carcinoma. Recent data have shown that the level of HBV DNA in serum or plasma of an infected person probably reflects more accurately the replicative activity of the virus and therefore may serve as a better maker for management of the infection. This study was designed to determine the rate of detection of HBV DNA in blood samples of patients with HBsAg positive in Nigeria in comparison with the HBe and anti‐HBe used widely as serological markers of infectivity. Plasma samples from 105 patients with HBsAg positive were tested for the presence of HBeAg and anti‐HBe using a commercial enzyme‐linked immunosorbent assay while plasma HBV DNA was quantified using the COBAS Amplicor HBV Monitor assay. Of the 105 HBsAg samples, 17 (16.2%) and 85 (81%) were positive for HBeAg and anti‐HBe, respectively, while 8 (7.6%) were negative for both HBeAg and anti‐HBe. HBV DNA was detected in 86 (81.9%) of the samples, out of which 15 (18.1%) and 67 (80.7%) were positive for HBeAg and anti‐HBe, respectively. HBV DNA was detected in 78.4% of the HBeAg negative samples and in all the eight samples that were negative for both HBeAg and anti‐HBe. The implication of these findings in the management of patients with HBV infection is compelling. J. Med. Virol. 85:214–218, 2013. © 2012 Wiley Periodicals, Inc.     

Incidence and survival trends of lip,intra-oral cavity and tongue base cancers in south-east England

Background

Oral cavity cancers are on the increase in the UK. Understanding site-specific epidemiological trends is important for cancer control measures.This study demonstrates the changing epidemiological trends in lip, intra-oral cavity and tongue base cancers in south-east England from 1987 to 2006.

Aim: Methods

This was a retrospective study using anonymised data obtained from the Thames Cancer Registry (TCR) London. Data were analysed using SPSS v.17 and survival analyses with Kaplan-Meier and Cox regression. Age standardisation of the incidence rates was performed. It was conducted in south-east England, which has an average population of 12 million. The study analysed 9,318 cases (ICD-10 code C00–C06, C14). Kent Research Ethics Committee UK granted ethical approval.

Results

Oral cancers were more common in men, with male: female ratio of 1.6:1. Tongue cancers had the highest frequency at 3,088 (33.1%).Incidence varied with each cancer type. Mean incidence (per 1,000,000) ranged from 2.3 (lip cancer) to 13.8 (tongue cancer). There has been a statistically significant increase in incidence for cancers of the tongue base, other parts of tongue, gum and palate (p<0.001).Median survival time varied by sub-site, with lip cancer having the best median survival time (11.09 years) compared with tongue base cancer (2.42 years). Survival analyses showed worse prognosis for men, older age at diagnosis, and presence of synchronous tumours (p<0.001).

Conclusion

There is a rising incidence of tongue and tongue base, gum and palate cancers in south-east England with wide variability in survival. Oral cancer awareness and screening programmes should be encouraged.     

Demographic factors related to male involvement in reproductive health care services in Nigeria

Objectives Men play a well-recognised role in reproductive health care. They are pertinent to the achievement of female reproductive health. This study assessed male involvement in reproductive health issues in Nigeria and identified relevant factors.

Methods This was a cross-sectional study of 1530 married men aged 25 to 45 years selected by a multi-stage sampling procedure. Bivariate and logistic regression analyses were performed, with male involvement in reproductive health care as the dependent variable.

Results The mean age of the respondents was 38.64 (± 5 SD) years. Although 65.9% of the respondents discussed reproductive health issues with their wife, only 39.6% accompanied them during visits to clinics. Less than one-third (30.9%) of the respondents were involved in reproductive health care. Male involvement in reproductive health care is predicted by having completed at least secondary education (OR 4.337; p = 0.007), having one or no living child (OR 2.002; p = 0.001), and approval of family planning (OR 2.637; p = 0.000).

Conclusions Male involvement in reproductive health care is predicted by level of education, number of living children and approval of family planning. There is a need to focus on the identified factors in order to strengthen and increase male participation in reproductive health care.     

An improved PCR method for detection of HIV-1 proviral DNA of a wide range of subtypes and recombinant forms circulating globally

Proviral DNAs are being measured increasingly as a marker of the efficacy of highly active anti-retroviral therapy (HAART) and is accepted for the early diagnosis of perinatal HIV-1 infections. This requires a standardized test which enables the detection of a wide range of subtypes worldwide including O, N and circulating recombinant forms (CRFs). Based on a previous publication, a PCR - Test for HIV-1 provirus detection in peripheral blood mononuclear cells (PBMCs) was developed. Blood samples from 80 individuals infected with HIV-1 and 20 persons negative for HIV-1&2 from Africa and Germany were tested for the presence of HIV-1 provirus DNA. The primer system used enables the detection of proviral DNA despite the high concentrations of human DNA. The limit of detection was determined to be 5 copies per 10(5) cells. All 20 samples from persons negative for HIV were negative for HIV-1 proviral DNA while provirus DNA was amplified from 76 of the 80 (95%) samples from persons infected with HIV. The amplified products were detected by gel-electrophoresis, flow cytometry and real-time PCR. All three detection systems provided the same results.     

Effect of Magnesium pre-treatment on alloxan induced hyperglycemia in rats

Background

The role of vitamins and mineral supplementation in the prevention of diabetes mellitus is not well elucidated.

Objective

The effect of prior administration of magnesium on alloxan induced diabetes was assessed in rats.

Methods

36 Male albino rats were used for this study. The animals were divided into 6 groups of 6 animals each; group 1 was healthy control; groups 2 served as diabetic control. Animals in group 3 received magnesium (100 mg/kg) i.p one hour prior to alloxan (120 mg/kg) administration, group 4 were also received magnesium (150 mg/kg) i.p one hour prior to alloxan administration. Animals in group 5 received magnesium (100 mg/kg) i.p only; group 6 animals received magnesium (150 mg/kg) i.p only. Blood samples were obtained from all animals and plasma glucose levels were determined on Day 0 (prior to treatment), Day 2, Day 5, Day 7 and Day 10 after the commencement of treatment.

Results

There was significant increase (P<0.001) in plasma glucose values in the alloxan treated group when compared with the control values. There was also a significant increase (P<0.01) in plasma glucose levels in the magnesium-pretreated (100 mg/kg and 150 mg/kg) diabetic groups when compared with healthy controls whereas there was a significant reduction (P<0.01) in plasma glucose level when compared with the diabetic control.

Conclusion

This study has shown that magnesium pretreatment may delay the onset and subsequently cause a reduction in hyperglycemia in alloxan induced diabetes. This effect of magnesium may be attributed to its role as a scavenger of highly reactive hydroxyl radicals generated through alloxan reactions, its potentiation of glutathione antioxidant production and its role as a calcium blocker.     

Baseline CD4 T Cell Level Predicts Recovery Rate after Initiation of ART in HIV Infected Nigerians

The most characteristic immunologic disorder in HIV infection is the progressive loss of CD4 T lymphocytes, thus, it remains the most important and commonly used marker for monitoring of immune status of HIV-infected individuals. This study monitored CD4 T lymphocyte cell dynamics among HIV patients on ART, and consequently defined an optimal baseline level required for enhanced ARV treatment. Ninety-eight (M = 33; F = 65) out of 106 consenting HIV-infected ARV-naïve patients enrolled and monitored for 24 months were considered in the analysis. The patients were classified into four groups based on baseline CD4 T lymphocyte cell levels, and specific parameters were evaluated at interval. Median CD4 T lymphocyte increased from 114 (Range: 6–330) at baseline to highest 357 (Range: 15–1036) cells/μL at 18 months of therapy. Fifty (51.0%), 58(59.2%), 75(76.5%), 69(70.4%), 63(64.3%), and 69(70.4%) doubled their preceding CD4 levels during the 3^rd, 6^th, 9^th, 12^th, 18^th, and 24^th months of ART, respectively. Maximum 337, 302, 360, and 475 cells/μL of blood were attained by groups commenced on ART with baseline CD4 ≤ 50, 51–100, 101–200, and 201–350 cells/μL of blood, respectively. The results show that higher baseline CD4 T lymphocyte cell level correlates with enhanced restoration and plateau after commencement of ART.     

Validation of the Edinburgh Postnatal Depression Scale as a screening tool for depression in late pregnancy among Nigerian women

This study aimed to examine the validity of the Edinburgh Postnatal Depression Scale (EPDS) as a screening tool for depression in late pregnancy among Nigerian women. A total of 182 women in late pregnancy (32–36 weeks) completed either the English or the translated Yoruba language version of the EPDS and a proportion of them were then assessed for the presence of DSM-IV major and minor depressive disorders using the MINI International Neuropsychiatric Interview. A cut-off score of 10 on the EPDS was found to be the best for screening for both major and minor depression (sensitivity = 0.867, specificity = 0.915, Diagnostic Likelihood Ratio for a positive result = 10.200). When screening for major depression only, a cut-off of 12 was found to the most appropriate (sensitivity = 1.000, specificity = 0.961, Diagnostic Likelihood Ratio for a positive result = 25.641). The EPDS is a valid and useful instrument in screening for depression in late pregnancy among Nigerian women.     

Etoricoxib in the treatment of osteoarthritis over 52-weeks: a double-blind,active-comparator controlled trial [NCT00242489]

Background  

The aim of this study was to evaluate the long-term efficacy and tolerability of etoricoxib, a COX-2 selective inhibitor, in osteoarthritis (OA) patients.     

Determinants and outcomes of adherence to recommendations from a multidisciplinary tumour conference for hepatocellular carcinoma

Background

The multidisciplinary tumour conference (MTC) represents the standard of care in the management of hepatocellular carcinoma (HCC). Clinical outcomes in relation to adherence and non-adherence to MTC recommendations have not been studied.

Methods

A total of 137 patients with HCC and cirrhosis whose cases were submitted to a first MTC discussion between 1 January 2009 and 31 December 2010 were identified. Clinical data, management recommendations, adherence, treatment regimens and overall survival were reviewed.

Results

There were 419 MTC discussions on 137 patients with cirrhosis and HCC. The MTC recommendations made in 145 discussions on 90 separate patients were not followed. Patient-related reasons for deviation from MTC recommendations included failure to attend for follow-up (n = 24, 16.6%), clinical deterioration (n = 19, 13.1%) and patient preference (n = 13, 9.0%). Physician-related reasons for discordance included treating physician preference (n = 43, 29.7%) and finding that the patient was not a candidate for the recommended intervention (n = 37, 25.5%). After the first MTC discussion, 62.0% of patients received the recommended treatment; these patients were more likely to be alive at 1 year compared with those who did not receive the recommended treatment (P = 0.007). More of the patients who followed recommendations underwent liver transplantation (25.6% versus 14.4%; P = 0.10).

Conclusions

There are patient-related as well as physician-related reasons for non-adherence to recommendations. Non-adherence affects clinical outcomes and can be avoided in selected cases.