scholarly journals Assessment of Some Haemostatic Parameters in Sickle Cell Anaemia Subjects Resident in Rivers and Bayelsa States

2021 ◽  
pp. 53-64
Author(s):  
Barinaaziga S. Mbeera ◽  
Susanna O. Akwuebu ◽  
A. C. U. Ezimah ◽  
Nancy C. Ibeh ◽  
Evelyn M. Eze
Keyword(s):  
Steady State ◽  
Sample Size ◽  
Sickle Cell ◽  
Teaching Hospital ◽  
Sickle Cell Anaemia ◽  
Control Group ◽  
Port Harcourt ◽  
The Mean ◽  
The University ◽  
D Dimer

Aim: The aim of this study was to assess some haemostatic parameters in sickle cell anaemia subjects in Rivers and Bayelsa States. Study Design: This study is a cross-sectional observational study. Place and Duration of Study: This study was carried out at the University of Port Harcourt Teaching Hospital, Rivers State, and the Federal Medical Centre, Yenagoa, Bayelsa State, between the months of February and August, 2020.  Methodology: A total of four hundred and fifty (450) subjects with age range of 1-50 years were randomly selected. There were about 200 registered patients (adults and children alike) at the sickle cell clinics of the University of Port Harcourt Teaching Hospital, and the Federal Medical Centre, Yenagoa, with an average of 4 new patients per month. The sample size was obtained using a prevalence of sickle cell anaemia of 2% and the sample size was calculated using Cochran sample size formula. Five milliliters (5ml) of venous blood sample was withdrawn from the peripheral vein in the upper limb of subjects using a standard venipuncture technique. The sample was rocked gently to mix and kept at room temperature and the haemostatic parameters (vWF, FVIII, D-dimer, L-arginine, fibrinogen, ADAMTS13) were assayed quantitatively with Bioassay Technozym kit using Microplate Reader (Labtech microplate auto ELISA plate reader, an IS0 13485:2003 CE and WHO compliance Co., Ltd. Shanghai International Holding Corp. GmbH; Europe) calibrated to a wavelength of 450 nm with strict adherence to the manufacturer's instructions, while PT and APTT were analysed with Fortress reagent and Uniscope SM801A Laboratory using water bath.Data management and statistical analyses were conducted using Statistical Analyses System SAS 9.4 (SAS Institute, Cary, North Carolina, USA) and p values less than .05were considered statistically significant. Results: The results showed the mean comparison of haemostatic parameters in sickle cell anaemia and control subjects. The comparison of haemostatic parameters showed significant(p<.05) increasesand decreases inVaso-Occlusive Crisis (VOC) and steady state respectively compared with the control group. There was statistically significantreduction in the mean comparison of L-Arginine (p<.01) in VOC) condition than steady state in relation to the control group in our study population, while D-Dimer, ADAMTS13 were also significantly reduced statistically (p<.01) in VOC condition than steady state compared with the control group. However, the mean FVIII inhibitor, Fibrinogen, PT (INR) and APTT were significantly higher (p<.01) in VOC than steady state when compared to controls with normal haemoglobin (HbAA).Correlations of haemostaticparameters by sickle cell anaemia subjects’ condition showed more significant positive correlations in VOC than steady state. Conclusion: This study showed a heightened hypercoagulability in Sickle Cell Snaemia(SCA)subjects, and further pave way for better understanding particularly the diagnostic variables underlying SCA, specific to each subject condition (steady state and VOC). Subjects with SCA, particularly during VOC, undergo significant haemostatic alterations that increase their risk of developing coagulation activation-related complications. Thus, though selected markers of coagulation were significantly different between the subject conditions, they were often significantly higher in the SCA.

scholarly journals Evaluation of Changes in Haematological Parameters of Sickle Cell Anaemia Subjects in Rivers and Bayelsa States

2021 ◽  
pp. 14-23
Author(s):  
B. S. Mbeera ◽  
S. O. Akwuebu ◽  
A. C. U. Ezimah ◽  
N. C. Ibeh ◽  
E. M. Eze
Keyword(s):  
Steady State ◽  
Sample Size ◽  
Sickle Cell ◽  
Sickle Cell Anaemia ◽  
Haemoglobin Concentration ◽  
Haematological Parameters ◽  
Control Group ◽  
Port Harcourt ◽  
Rivers State ◽  
And Control

Aim: The aim of this study was to evaluate changes in some haematological parameters in sickle cell anaemia subjects in Rivers State. Study Design:  This study is a cross-sectional observational study. Place and Duration of Study: University of Port Harcourt Teaching Hospital, Rivers State, and the Federal Medical Centre, Yenagoa, Bayelsa State, between the months of February and August, 2020.  Methodology: A total of four hundred and fifty (450) subjects with age range of 1-50 years were randomly selected. There are about 200 registered patients (adults and children alike) at the sickle cell clinics of the University of Port Harcourt Teaching Hospital, and the Federal Medical Centre, Yenagoa, with an average of 4 new patients per month. The sample size was obtained using a prevalence of sickle cell anaemia of 2% and the sample size was calculated using Cochran sample size formula. Five milliliters (5ml) of venous blood sample was withdrawn from the peripheral vein in the upper limb of subjects using a standard venipuncture technique. The sample was rocked gently to mix and kept at room temperature and the haematological parameters were analyzed within 4 hours of samples collection. The haematological parameters: total white blood cell count (WBC), red blood cell count (RBC), Haemoglobin concentration (Hb), Haematocrit, mean cell volume (MCV), mean cell haemoglobin (MCH), mean cell haemoglobin concentration (MCHC), red cell distribution width (RDW-CV), Platelet count (PLT), MPV, Neutrophils, Lymphocyte, Monocyte, Eosinophils, and Basophils) were analyzed using Mindray BC-6800 auto Haematology analyzer system. Data management and statistical analyses were conducted using Statistical Analyses System SAS 9.4 (SAS Institute, Cary, North Carolina, USA) and p values less than .05 were considered statistically significant. Results: The results showed the mean comparison of haematological parameters in sickle cell anaemia and control subjects. The mean comparison of Haemoglobin F was significantly reduced statistically (p<.05) in vaso-occlusive crises (VOC) condition than steady state compared with the control group. There was increase trend of haematological parameters showing statistically significant difference across the subject conditions compared with the control. There were exceptions in few cases especially in lymphocytes which was not significant (p>.05) in the steady state and vaso-occlusive crisis compared with the control. Similarly, Neutrophils was not significant (p>.05) in the steady state and vaso-occlusive crisis compared with the control. Furthermore, Basophils was more significant (p<.05) in the steady state than in the vaso-occlusive crisis and control groups. Similarly, absolute eosinophil was less significant statistically (p<.05) in the steady state and vaso-occlusive crisis than in the control group. Conclusion: This study has shown that there are changes in haemtological parameters between SCA subjects and control subjects and the VOC and steady state sickle cell anaemia (SCA) subjects.

scholarly journals Tetanus in School Age Children Seen at the University of Port Harcourt Teaching Hospital: A Need for Booster Doses of Tetanus Vaccine

2020 ◽  
pp. 1-9
Author(s):  
B. A. Alex-Hart ◽  
D. LongJohn
Keyword(s):  
Incubation Period ◽  
Teaching Hospital ◽  
Case Fatality ◽  
School Age Children ◽  
School Age ◽  
Tetanus Vaccine ◽  
Short Incubation Period ◽  
Port Harcourt ◽  
The Mean ◽  
The University

Background: Tetanus still causes significant morbidity and mortality amongst children in Nigeria despite decades of immunisation with tetanus vaccine. Objectives: To determine the prevalence, case fatality rate and predictors of fatality amongst school age children treated for tetanus at the University of Port Harcourt Teaching Hospital. Materials and Methods:  This was a retrospective study of all children aged 4 to 17 years treated for tetanus at the University of Port Harcourt Teaching Hospital between January 1, 2009 and December 31, 2019. Data was obtained from the case notes and ward registers. Socio-demographic characteristics, presenting complaints, incubation period, onset interval, number of Diphtheria, Pertussis and Tetanus (DPT) vaccine received at infancy, treatment outcome, duration and cost of hospital stay were obtained, entered into a spread sheet and analysed with SPSS version 20. Results are presented in tables and percentages. The level of significance was set at P value <0.05. Results:  During the period under review, there were 53 children aged 4 to 17 years treated for tetanus, accounting for 0.3% of the total admission. The mean age was 10.79±3.35 years. There were 33 (62.26%) males and 20 (37.74%) females. Majority 26 (49.06%) of the children were of low socioeconomic class. The commonest 28(52.8%) route of infection was broomstick injury. Majority 32(60.3%) of the children were not immunised in infancy. The mean incubation period was 7.34±4.21 days and the mean onset interval was 8.87±10.44 hours. The two most common symptoms were generalized spasms 49 (21.03%) and trismus 47 (20.17%). Short incubation period (≤4 days) and short onset interval (≤4 hours) were significantly associated with higher death rates (p=0.0002; p=0.012).  Patients with short incubation period of ≤4 days and short onset interval of≤ 4 hours are more likely to die (p=0.0002; p=0.012). Conclusion: There was a high tetanus case fatality rate amongst school age children at University of Port Harcourt. Short incubation period and onset interval were associated with higher mortality. Booster doses of TT containing vaccines should be administered to primary and secondary school children in Port Harcourt to curb the menace.

scholarly journals Assessment of serum Zinc, Copper and Selenium in non-symptomatic Sickle-Cell Anaemia patients at the University Teaching Hospital, Lusaka, Zambia

2021 ◽  
Vol 3 (2) ◽  
pp. 69-74
Author(s):  
Alfred Machiko ◽  
◽  
Trevor Kaile ◽  
Sumbukeni Kowa ◽  
Christopher Newton-Phiri ◽  
...  
Keyword(s):  
Sickle Cell ◽  
Teaching Hospital ◽  
Sickle Cell Anaemia ◽  
Serum Zinc ◽  
Binary Logistic Regression ◽  
Absorption Spectrometry ◽  
Serum Levels ◽  
Vital Role ◽  
University Teaching ◽  
The University

Background: Zinc, copper and selenium are known important trace elements playing a vital role as cofactors of enzymes such as superoxide dismutase and glutathione peroxide. They form part of the first line antioxidants enzymes in red blood cells and plasma. The study aimed at determining the serum levels of zinc, copper and selenium in asymptomatic sickle-cell anaemia patients. Methods: This was a case control study conducted from the specialist Haematology and Oncology Clinic 4 at the University Teaching Hospital, Lusaka, Zambia. 5mls of whole blood was collected from 46 sickle-cell anaemia patients and 46 healthy controls from Out-Patient Department after consent. Using Atomic Absorption Spectrometry, serum levels of zinc, copper and selenium was determined. Independent t-test was used to compare the means and a binary logistic regression for the likelihood of developing a sickling crisis, using SPSS version 20.Results: The mean serum levels of zinc in patients were lower 86.92±20.46mg/L against 91.33±43.23mg/L; p<0.028 of controls. Copper mean levels were 149.85±54.82mg/L against 134.32±54.16mg/L; p<0.191 of controls. Selenium mean levels were 0.100±0.041mg/L against 0.081±0.032mg/L; p<0.380 in patients compared to controls. The odds of developing one sickling crises in the past year given the levels of zinc, copper and selenium was [B = -.340, zinc Exp(B) =1.011, copper Exp(B) = 1.008, selenium Exp(B) = .000, DF = 1].Conclusion: Zinc is reduced in sickle-cell anaemia patients. The probability of developing a sickling crisis is lower in patients with higher serum levels of zinc and copper by 1.1% and 0.8% respectively.

scholarly journals Burden and Risk Factors of Chronic Kidney Disease in Children with Sickle Cell Anaemia Aged 5 – 16 Years at the University Teaching Hospital, Lusaka - Zambia

2020 ◽  
Vol 4 (3) ◽  
pp. 40-48
Author(s):  
Nchimunya Machila ◽  
◽  
Chishala Chabala ◽  
Chisambo Mwaba ◽  
Catherine Chunda-Liyoka ◽  
...  
Keyword(s):  
Risk Factors ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Sickle Cell ◽  
Teaching Hospital ◽  
Sickle Cell Anaemia ◽  
Age At Diagnosis ◽  
University Teaching ◽  
Dipstick Urinalysis ◽  
The University

Background: Improved medical care has led to the improved life expectancy of sickle cell anaemia (SCA) patients hence complications associated with SCA such as chronic kidney disease (CKD) are being seen more frequently. Globally, nephropathy of varying severity occurs in 5 to 18 % of the SCA population across all age groups with a third of the adults proceeding to develop CKD while over 30 % of paediatric SCA patients have CKD in Africa. The mortality rate in SCA patients CKD is high. This study sought to determine the prevalence and risk factors of CKD in SCA, information that was not available in Zambia prior to this study. This information will guide in targeting and timing of screening for CKD in SCA in children in our population. Objectives: To determine the prevalence of haematuria, proteinuria, abnormal estimated glomerular filtration rate (eGFR), CKD, and risk factors of CKD among the steady-state SCA patients aged 5 to 16 years at the University Teaching Hospital (UTH), Lusaka. Methodology: This was a prospective cross-sectional study of 197 children aged 5 to 16 years with SCA at the UTH - Lusaka conducted from August 2014 to July 2015. Demographic and clinical data were collected using a structured questionnaire. Urine and blood samples were used to determine the urine albumin creatinine ratio (ACR) and full blood count /blood biochemistry respectively. CKD was defined and determined using the Kidney Disease Outcome Quality Initiative 2012 guidelines employing urine ACR, dipstick urinalysis and eGFR. In this study, spot urine ACR and dipstick urinalysis were done and repeated three months later if initial tests were abnormal. Data was analysed using SPSS version 21. Chi-square and t-test were used to compare proportions between groups. Relation between study variables and CKD were examined using logistic regression. Results: The mean age of the participants was 9.6 years (SD ±3.6). Male to female ratio was 1:1. The median age at diagnosis of SCA was 22 months (IQR = 44). The prevalence of haematuria, proteinuria and CKD among the study participants was 14.2%, 36% and 36 % respectively. Low haemoglobin and elevated mean corpuscular volume (MCV) were associated with CKD-AOR 0.62, 95% CI; 0.46-0.84 and 1.04, 95% CI; 1.01 – 1.08 respectively. Recurrent admissions (due to VOCs, severe anaemia and febrile illness) were also risk factors associated with CKD- AOR 0.52, 95% CI; 0.27-0.98. CKD was not associated with age at enrolment, sex, age at diagnosis of SCA, recurrent Vaso-occlusive crisis (VOCs) or abnormal liver function tests. Conclusion: The prevalence of CKD among the SCA patients at UTH- Lusaka is high (36%) with lower Haemoglobin, elevated MCV and recurrent admissions being risk factors for developing CKD. SCA patients should be screened for CKD routinely at least once a year. Interventions such as the early introduction of hydroxyurea, proactive blood transfusions and ACE inhibitors can reduce the risk of CKD and its progression to end-stage renal disease.

scholarly journals Evaluation of Vitamin D in Sickle Cell Anaemia Patients at Steady State

2020 ◽  
Vol 1 (2) ◽  
Author(s):  
Umar Aminu Abdullah ◽  
Mohammed Bashir AbdulRahman ◽  
Bello Aminu ◽  
Abubakar Umar Musa ◽  
Isah Balarabe
Keyword(s):  
Vitamin D ◽  
Steady State ◽  
Sickle Cell ◽  
Sickle Cell Anaemia ◽  
Public Health Problem ◽  
Bone Fragility ◽  
Sub Saharan Africa ◽  
Major Public Health Problem ◽  
The Mean ◽  
Sub Saharan

Background: Sickle cell anaemia is a major public health problem in sub-Saharan Africa with high morbidities like bony alterations and bone fragility especially in those with vitamin D deficiency. There is paucity of research data on bone biomarkers in patients with sickle cell anaemia especially in Northern Nigeria. The aim of this study was to evaluate vitamin D in adult sickle cell anaemia patients at steady state. Materials and Methods: Seventy-seven patients with sickle cell anaemia and equal number of apparently healthy matched controls were recruited for the study. Various biochemical parameters of bone metabolism were measured. Data were analysed using IBM SPSS version 23.0. Results: The mean age of SCA adult patients and controls wer

Cardiovascular changes in children with sickle cell crisis

2020 ◽  
Vol 30 (2) ◽  
pp. 162-170
Author(s):  
Richard Onalo ◽  
Peter Cooper ◽  
Antoinette Cilliers ◽  
Uche Nnebe-Agumadu
Keyword(s):  
Pulmonary Hypertension ◽  
Steady State ◽  
Sickle Cell ◽  
Myocardial Ischaemia ◽  
Sickle Cell Anaemia ◽  
Cardiac Biomarkers ◽  
Systemic Hypertension ◽  
Cardiovascular Changes ◽  
Sickle Cell Crisis ◽  
The Mean

AbstractBackground:Sickle cell anaemia is characterised by frequent, sometimes serious events referred to as “crisis”. Cardiopulmonary consequences such as pulmonary hypertension and myocardial ischaemia may accompany a serious crisis.Objective:To determine the cardiovascular changes that occur during a severe sickle cell crisis.Methods:A cross-sectional comparative study of sickle cell anaemia in children (5–17 years) admitted during a severe crisis (cases) and those in steady state (controls) was conducted over a 2-year period. Effects of the crisis on the cardiopulmonary system were assessed. The diagnosis of myocardial ischaemia was made using electrocardiography and serological cardiac biomarkers, while cardiac dysfunction and the presence of pulmonary hypertension were determined using echocardiography. The presence of systemic hypertension and tachycardia was also evaluated.Results:A total of 176 patients were recruited, 92 in steady state (male:female ratio, 1.2:1) and 84 in severe crisis (male:female ratio, 1.3:1). The mean age was 10.4 ± 3.2 years for steady state and 10.5 ± 3.4 years for those in crisis. The mean heart rate in crisis was higher than in steady state (p < 0.0001). The blood pressures (systolic, p < 0.0001, diastolic, p < 0.0001, mean, p < 0.0001) as well as myocardial ischaemia scores (p < 0.0001) were higher in patients with crisis than in those in steady state. Similarly, conduction abnormalities, pulmonary hypertension, and ventricular dysfunction were more prevalent in the crisis than in the steady state.Conclusion:The present data suggest that sickle cell crisis results in a derangement of clinical, electrocardiographical, and echocardiographical parameters in children with sickle cell anaemia. Further research on these cardiovascular events may improve the overall care of these patients.

Secondary Infertility in Port Harcourt: Pattern and Socio-Dermographic Relationship

2021 ◽  
pp. 66-74
Author(s):  
Emmanuel Okwudil Oranu ◽  
Gregory Ifechukwude Oyiana
Keyword(s):  
Pelvic Inflammatory Disease ◽  
Teaching Hospital ◽  
Inflammatory Disease ◽  
P Value ◽  
Secondary Infertility ◽  
Port Harcourt ◽  
The Mean ◽  
Socio Demographic Factors ◽  
The University ◽  
The Relationship

Background: Secondary Infertility is viewed as a social stigma, especially in Nigeria, due to the high premium placed on procreation. Observation suggests that this condition is on the increase in our environment. Hence, the need to determine the pattern and the relationship between the socio-demographic factors with infective causes of this condition; which will subsequently allow the tailoring of the individual investigation and subsequent treatment. Objective: To determine the prevalence and pattern as well as the relationship between the socio-demographic factors with infective causes of secondary infertility among women who attended the gynaecological clinic of the University of Port Harcourt Teaching Hospital (UPTH) between January 2012 and December 2016 Methods: This is a retrospective descriptive study design, based on findings from the folders, admission and outpatient registers, of infertile couples presenting at the gynaecology clinic of the University of Port Harcourt Teaching Hospital, over a five-year period (January 2012 – December 2016). Data were collected from all documented and laboratory findings. The data extracted from the case records were the socio-demographic characteristics of the patient, the duration of infertility as well as the causes. They were analyzed using SPSS version 20. Results: The mean age of women was 33.14±4.93 years. The prevalence of secondary infertility was 12% of all outpatient gynaecological consultation. The mean duration of secondary infertility was 3 years. The infective causes of secondary infertility [recurrent pelvic inflammatory disease(PID), sexually transmitted infections(STI), post abortal sepsis, puerperal sepsis, HIV/AIDS, mumps orchitis were commoner among the 31-40 years’ category, (45.8%), the infective causes were also commoner among women with primary level of education, (62.5%, p-value=0.001) as well as women who were self-employed (49%, p-value=0.041). Recurrent pelvic inflammatory disease was identified in majority of cases (37.1%). Abnormal semen analysis, hyper-prolactinaemia and uterine fibroid, also contributed significantly to infertility; 18.5%, 19.7% and 24.3% respectively. Conclusion:  Infective causes are at the root cause of secondary infertility; the more educated the couple, the higher their socioeconomic status, the lesser the impact of infection on secondary infertility.

scholarly journals Evaluation of Acute Painful Episodes with Foetal Hemoglobin Level and Other Haematological Parameters in Sickle Cell Patients in Abuja Nigeria

2019 ◽  
pp. 1-5
Author(s):  
O. Chinwe Okeke ◽  
O. Ernest Ukaejiofo ◽  
E. Nnodu Obiageli ◽  
D. Ezigbo Eyiuche ◽  
C. Okeke Chinedu
Keyword(s):  
Sickle Cell ◽  
Sickle Cell Anaemia ◽  
Haematological Parameters ◽  
Severe Illness ◽  
Control Group ◽  
The Mean ◽  
Hb Concentration ◽  
The Relationship ◽  
Painful Episode ◽  
Apparently Healthy

Introduction: Heterogeneity in sickle cell anaemia manifestations ranges from near asymptomatic cases to severe illness.  Objective: This study determined the relationship between foetal haemoglobin F level, other haematological parameters and acute painful episode score of sickle cell disease patients in FCT Abuja Nigeria. Methods: 60 Sickle cell patients were selected for the study. 20 severe crises, 20 non-severe crisis SS were enrolled in the study. Control group comprised 20 apparently healthy haemoglobin AA individuals. Data were analysed descriptively. Results: Hb F level increased significantly in non-severe crisis sickle cell anaemia (7.12%± 3.6) and severe crisis (5.30%±2.3) groups, compared to the control group (0.32±1.8). This trend was also observed in RDW, MCHC and MCV. The mean Hb concentration and haematocrit (Hct) were significantly lower for both non- severe crisis and severe crisis SCA groups. There was no significant correlation between HbF and any of the haematological parameters in both non severe crisis and severe crisis groups. Patients with SCA had higher levels of HbF than matched controls. HbF had no correlation with any of the haematological parameters in both severe and non-severe SCA groups studied. Conclusion: Further studies should focus on environmental factors contributing to this variability.

Sign in / Sign up

Export Citation Format

Share Document