The role of antioxidants treatment on the pathogenesis of malarial infections: a review

Oxidative damage is one of the most important pathological consequences of malarial infections. It affects vital organs of the body manifesting in changes such as splenomegaly, hepatomegaly, endothelial and cognitive damages. The currently used antimalarials often leave traces of these damages after therapy, as evident in memory impairment after cerebral malaria. Hence, some research investigations have focused attention on the use of antioxidants, alone or in combination with antimalarials, as a viable therapeutic strategy aimed at alleviating plasmodium-induced oxidative stress and its associated complications. However, the practical application of this approach often yields conflicting outcomes because some antimalarials specifically act via induction of oxidative stress. This article critically reviews most of the studies conducted on the potential role of antioxidant therapy in malarial infections. The most frequently investigated antioxidants are vitamins C and E, N-acetylcystein, folate and desferroxamine. Some of the investigations measured the effects of direct administration of the antioxidants on the plasmodium parasites while others performed an adjunctive therapy with standard antimalarials. The therapeutic application of each of the antioxidants in malaria management depends on the targeted aspect of malarial pathology. It is hoped that this article will provide an informed basis for future research activities on the therapeutic role of antioxidants on malarial pathogenesis.     

Cervical ripening: how long can the Foley catheter safely remain in the cervical canal?

This was a prospective study involving 85 patients admitted for induction of labour with unfavourable cervix at Usman Danfodiyo University Teaching Hospital, Sokoto, Nigeria. A size 16-20 Foley catheter was passed transcervically into the extra-amniotic space under aseptic technique and the balloon inflated with 30-50 mls sterile water. Each patient was placed on prophylactic antibiotics. The balloon was expelled within 12 hours in 22 (39%) patients. Twenty eight patients expelled the balloon in 12-24 hours, 14 in 25-48 hours, 6 in 49-72 hours and 4 after 72 hours. The average duration of catheter placement when the gestational age was 20-27 weeks was 44.8 hours, which was significantly longer than 19.6 hours obtained for term pregnancies (p < 0.05). Induction of labour was successful in 77 (91%) patients and there was no significant maternal morbidity. The results of our study suggest that the balloon of the Foley catheter can safely remain in the extra-amniotic space longer than 24 hours for cervical ripening if the cervix is unfavourable, provided the membranes are intact and the feto-maternal conditions remain satisfactory.     

Evaluation of serum lipid profile of under-five Nigerian children

BACKGROUND: Serum lipid profile assay forms one of the special investigations in most chemical pathology laboratories worldwide. Several studies in children from different countries have shown that serum lipids exhibit age and geographical pattern of variation prior to puberty. This study was conducted to evaluate serum lipid profile in Nigerian children aged 6 to 36 months. METHODS: A total of 115 randomly selected apparently healthy children were studied. These consisted of 38, 40 and 37 children in groups I (6 to 12 months), II (13 to 24 months) and III (25 to 36 months) respectively. There were 60 male and 55 female children. Serum concentrations of total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), triglyceride (TG) were measured by enzymatic colorimetric method using reagent kits supplied by Human, Gesel Für Biochemica Und Diagnostica mbH (Wiesbaden, Germany). Serum low density lipoprotein cholesterol (LDL-C) and very low density lipoprotein cholesterol (VLDL-C) were subsequently estimated using Friedewald formula. RESULTS: The reference ranges and (Mean +/- SEM) of serum TC, LDL-C, HDL-C, TG, VLDL-C and TC/HDL-C for the total group of children were 1.55-5.42(2.89 +/- 0.12), 0.50-3.29(1.28 +/- 0.15), 0.45-2.77(1.12 +/- 0.14). 0.93-3.43(0.79 +/- 0.14), 0.17-0.72(0.35 +/- 0.14) mmol/L and 1.01-4.74(2.19 +/- 0.13) respectively. There were no sex differences in all these parameters. Serum levels of TC, LDL-C, HDL-C and TC/HDL-C in the 3 age groups were also statistically similar (p > 0.05). Concentrations of TG and VLDL-C were lower (p < 0.001) in group II than in I. These values were also significantly lower (p < 0.02) in group III than in I. Serum TG and VLDL-C in groups II and III were statistically comparable (p > 0.05). CONCLUSION: Serum concentrations of TC, TG and VLDL-C decrease with advancing age, with more marked decrease between first and second years of life. We hereby recommend that the reference values established in this study be utilized for the interpretation of serum lipid results in pre-school children in Nigerian hospitals and possibly elsewhere in Africa.     

Anaemia and iron status of symptom-free adult males in northern Nigeria

The prevalence of anaemia and iron deficiency have been evaluated in 276 symptom-free male inhabitants of northern Nigeria. One hundred and eighteen were classified as non-elite and 158 as elite. Twenty-six of the elite had a high consumption of alcohol, and have been considered as a separate sub-group. Measurements included haemoglobin (Hb), serum iron (SI), total iron-binding capacity (TIBC), free erythrocyte protoporphyrin (FEP) and serum ferritin (SF). The prevalence of anaemia (Hb less than 13.0 g dl-1) was considerably higher in non-elite (35.6%) than in 132 non-alcohol drinking elites (7.0%), while none of the alcohol drinkers was anaemic. The geometric mean SF was 54.6 micrograms l-1 in the non-elites, 100.6 micrograms l-1 in the non-drinking elites and 149.3 micrograms l-1 in the alcohol-drinkers. Iron deficiency [at least two of transferrin saturation (TS) less than or equal to 20%, FEP greater than or equal to 70 micrograms dl-1 and SF less than or equal to 30 micrograms l-1] was diagnosed in 15.3% of the non-elites and in only 1.3% of the elites. Iron deficiency in the non-elites probably resulted from poor availability of iron from the local staples guinea corn (Sorghum spp.) and millet (Pennisetum spp.), with chronic haemorrhage due to helminthic infestations contributing in some. Evidence of iron overload (TS greater than 90%, SF greater than 600 micrograms l-1 was found in two of the drinkers, one of whom had a history of prolonged consumption of burukutu, a beer locally brewed from cereals.     

Childhood renal disorders in Saudi Arabia

An overview of childhood renal disorders in Saudi Arabia is presented, based largely on the experience in a large teaching hospital. The pattern of disorders is similar to that in other parts of the world, but the relative frequency of the various diseases appears to be different. Heredofamilial disorders are common, renal calculi are relatively frequent, and mesangioproliferative glomerulonephritis is a frequent cause of nonminimal change nephrotic syndrome. Preventable causes of end-stage renal failure include reflux nephropathy and posterior urethral valves. Although nephropathy associated with collagen vasculitides is not frequent, the prognosis of the disease is poor. IgA nephropathy appears to be a rarity.