Structural polymorphism of glycophorins demonstrated by immunoblotting techniques

We have explored the polymorphism of the glycophorin system in the human erythrocyte membrane using the immunoblotting techniques and examining 52 individuals selected without prior bias as to their serologic state and ten documented serologic variants of M, N, S, s blood group system. Polyclonal antisera to alpha glycophorin and to alpha glycophorin CNBr carboxyl terminal fragment C (residues 82-131) and M and N specific monoclonal antibodies (MoAbs) were used. The first two reagents detect specific regions of the alpha glycophorin molecule and all electrophoretically resolved species of glycophorins immunologically related to alpha and delta glycophorins (delta glycophorin, [alpha-delta] hybrids and other glycophorins with an alteration in the carboxyl terminal segment); the M and N MoAbs identified the glycophorin species containing or lacking the M or N determinant in the amino terminal octapeptide structures. We find that immunoblotting confirmed in all cases the serologically determined phenotype; we also find that polymorphic forms of the glycophorin system are relatively infrequent; immunoblotting, independent from serologic testing, was capable of detecting five mutants, two most likely S-s-U-phenotypes; a new glycophorin species was detected in normal red cells with both antiglycophorin and antipeptide C sera, which is not evident with MoAbs; immunoblots of known glycophorin variants (En(a-), U-, Mg, Mi I, II, III, V, and Sta) confirmed but also extended our knowledge of the abnormal glycophorins involved; and the He+ and Wrb(-) cells showed normal patterns.     

Neo‐adjuvant Capecitabine Chemotherapy in Women with Newly Diagnosed Locally Advanced Breast Cancer in a Resource‐poor Setting (Nigeria): Efficacy and Safety in a Phase II Feasibility Study

The majority of clinical trials of neo‐adjuvant therapy for breast cancer have been conducted in resource‐rich countries. We chose Nigeria, a resource‐poor country, as the major site for a phase II feasibility open‐label multicenter clinical trial designed to evaluate the efficacy, safety, and tolerability of neo‐adjuvant capecitabine in locally advanced breast cancer (LABC). Planned treatment consisted of 24 weeks of capecitabine at a dose of 1,000 mg/m² twice daily (2,000 mg/m² total per day). The primary endpoints were overall, partial, complete clinical response rate (OCR, PCR, CCR) and complete pathologic response (cPR). A total of 16 patients were recruited from August 2007 to April 2010. The study was terminated early as a result of slow accrual. After the first three cycles of therapy, PCR were seen in five of 16 patients (31%; 95% CI 11–59%). Of the remaining 11 patients, eight had no response (NR) or stable disease (SD), and three had progressive disease (PD). Seven patients proceeded with further therapy of which had SD. OCR at the end of eight cycles was 44% (95% CI 20–70%). Clinical response and radiologic response by ultrasonomammography were highly concordant (spearman correlation 0.70). The most common adverse effect was Grade 1 hand–foot syndrome, which was seen in 75% of patients. Despite several limitations, we successfully carried out this phase II feasibility study of neo‐adjuvant capecitabine for LABC in Nigeria. Capecitabine monotherapy showed good overall response rates with minimal toxicity and further studies are warranted.     

Nutritional status of public primary school children: a comparison between an upland and riverine area of Ojo LGA, Lagos State Nigeria

This cross sectional study was carried out to compare the nutritional status of public primary school children in an upland and a riverine area of Ojo Local Government Area of Lagos State, Nigeria. A multistage sampling method was used to select a total of 240 children, 120 from each of the two areas. The study population for each area had an equal sex distribution (60 boys and 60 girls). Dietary, anthropometric, clinical and laboratory methods were employed. Using the National Centre for Health Statistics (NCHS/WHO) Reference values, a malnutrition prevalence of 20.8 and 30.81 for the upland and riverine populations respectively was found. There was a stunting in 15.8% of upland and 30.0% of riverine children; 3.3% and 1.7% of them were wasted, and 14.2% in the upland and 18.3% in the rural area were underweight. The mean weights and heights for boys and girls of different ages were lower for the riverine group, although no statistically significant differences were found. Anaemia occurred among 25.0% and 29.2% of the upland and riverine groups respectively. Intestinal helminth infection was found to be significantly associated with malnutrition. Ascaris had a prevalence of 46.7% in the upland and 63.3% in the riverine area. Trichuris had a prevalence of 15.0% and 19.2% in the upland and riverine area respectively. To address the malnutrition problem in these populations, efforts should be aimed at increasing food availability and quality, personal and environmental hygiene, supply of basic amenities, prevention and treatment of infection, and general living conditions of these populations.     

Inter-relationships between lifestyle and diabetes mellitus,overweight/obesity and hypertension in Nigeria

This study of inter-relationship between life styles and diabetes mellitus, overweight/obesity and hypertension was carried out to determine the life styles of the bank workers and the nutritional related diseases. A total sample of 570 was systematically drawn from workers of the United Bank for Africa Plc in Lagos for this study, with the following results. Not surprisingly the level of education influenced life style (P<0.05). There was also a statistically significant relationship between life style and the consumption of alcohol and diabetes, but no relationship was found between smoking and diabetes. There was a significant correlation with their consumption of fatty foods and vegetables. A relationship between increased protein intake and an increase in educational status (P<0.05) was found. There was association between obesity and hypertension (P<0.05), and between increase in frequency of clinic visitation and hypertension which was statistically significant (Chi square P<.05).     

Comparison of dental caries experience in children of different socio economic status

In this study, an attempt has been made to discover any differences in caries incidence at various socioeconomic levels, and all contributory factors. Two schools were chosen to participate, one affluent (School B) and the other from a relatively lower socioeconomic level (School A). 60 students were randomly selected from each school. The following results were enumerated from the study:

Socio economic status was seen to be of similar proportions in the populations studied - 40% skilled in School A, 53.3% in B; 43.3% semiskilled in A, 46.7% in B. However only School A had an unskilled group - 16.7%.

Caries incidence was 63.3% in School A and 70% in School B. The pattern in both schools was also similar when the caries incidence was examined from the different socioeconomic levels. The skilled groups had 42.1% and 47.6% of the caries experience in Schools A and B respectively, whilst the semiskilled groups made up 42.1% (A) and 52.3% (B). Unskilled group in School A had 15.8% of the sample's caries.

The slightly higher incidence in the semi-skilled group of School B was attributed to the fact that this group ate more snacks, sweets, biscuits etc. on a regular basis than did the other groups.

Those in the skilled groups of both schools did not seem to eat diets different from those in the other groups, probably because the general economic recession has led to a lot of belt-tightening, so that people no longer spend so much on foods which are not absolutely necessary. Also, those in the affluent School B appeared to eat the same diet as those in School A, despite the fact that they could afford to pay N400 a term as school fees.     

An anti-EnaTS detected in the serum of an MiI homozygote

The serum of EH reacted with all red cells (RBCs) except her own, ficin- or trypsin-treated red cells, and En(a-) red cells. This reactivity defined an anti-EnaTS specificity. The red cells of the proposita typed as M-N+S-S+, Vw+Mur-Hil-Hut-Anek-Lane-, Wr(a-b+), EnaKT+. Red cells of five relatives were Vw+ and positive with her serum. Titration studies suggest that EH is genetically an MiI homozygote and that her Vw+ relatives are MiI heterozygotes. There is no history of consanguinity. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis and immunoblotting studies have agreed with the serologic observations. A variant sialoglycoprotein of faster mobility than normal glycoprotein A, but no normal glycoprotein A, was detected on her red cells. Treatment with N-glycanase did not alter the mobility, which indicated that there was no N-glycosylation of residue 26. These findings are in agreement with the reported properties of the Mi.I-specific glycoprotein A. The relatives' Vw+ red cells showed the variant sialoglycoprotein and normal glycoprotein A. EH appears to be the first reported MiI homozygote.     

Antibiotic resistance in bacteria - an emerging public health problem

The discovery and eventual introduction of anti-microbial agents to clinical medicine was one of the greatest medical triumphs of the twentieth century that revolutionized the treatment of bacterial diseases. However, the gradual emergence of populations of antibiotic-resistant bacteria resulting from use, misuse and outright abuse of antibiotics has today become a major public health problem of global proportions. This review paper examines the origins and molecular epidemiology of resistance genes, global picture of antibacterial resistance, factors that favour its spread, strategies for its control, problems of control and the consequences of failure to contain antibiotic resistance in bacteria.