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Background: Acute episode of pain is the most frequent symptom for which patients with sickle cell disease (SCD) seek medical attention. The neuropeptide Substance P (SP) has been suggested as a possible aetiologic factor. This study compared the serum levels of SP in SCD subjects in painful vaso-occlusive crisis with those in steady state and normal HbAA subjects. Methodology: This case-controlled study investigated eighteen SCD patients in vaso-occlusive crisis (VOC) and eighteen in steady state, while fourteen HbAA subjects were recruited as controls. Blood was collected in plain bottles and subsequently, the serum was separated for SP assay using the ELISA technique. Each sample was run, and results were confirmed in duplicate. Optical density was read at an absorbance of 450nm. Results: The study showed that SP was significantly higher in SCD patients in steady state (184.79±18.67ng/L versus 104.17±19.24ng/L) compared to the controls (t=2.97, p=0.006); while the values obtained in those in VOC (375.78±76.21ng/L) were also significantly higher (t=2.433, p=0.02) than those in steady state (184.79±18.67ng/L). The SP value in the SCD patients in VOC was almost twice as much as those in steady state and about three times as much as the value in the controls and the differences were statistically significant (t=7.72, p=0.001). Conclusion: The study showed significantly higher SP levels in VOC compared to steady state or HbAA subjects suggesting that SP may be a marker for pain sensitisation. [ABSTRACT FROM AUTHOR]

BACKGROUND: Vitamin D supplementation has been shown to improve hemoglobin levels in patients with sickle cell anemia (SCA). However, very little is known about the prevalence of its deficiency, its role in hemolysis, and its effects on transfusion requirements in SCA, hence this study. PATIENTS AND METHODS: Serum level of vitamin D was determined in 50 SCA patients in steady state, 50 SCA patients in hemolytic crises, and 50 in normal HbAA individuals. All were 18 years or older and were age- and sex-matched. In addition, PCV and hemoglobin (Hb) concentration, absolute reticulocyte count, uric acid, total and conjugated bilirubin, creatinine, lactate dehydrogenase (LDH), and estimated glomerular filtration rate (eGFR) were also assessed in all subjects and controls. Baseline sociodemographic, clinical, and anthropometric data were also recorded. RESULTS: The prevalence of vitamin D insufficiency and deficiency was found to be 18% and 79%, respectively. The mean serum levels of vitamin D were 18.84 ± 6.86 ng/mL and 17.58 ± 6.23 ng/mL in the steady-state and the hemolytic crises SCA groups, respectively. Transfusion requirements were found to be higher in SCA patients with lower vitamin D levels. Unlike those in crisis who received one or more units of blood transfusion, 42% of those in the steady state did not receive blood transfusion over the same period of 12 months. Hemoglobin levels were, however, found to predict reduced vitamin D levels. CONCLUSION: Vitamin D deficiency (VDD) is highly prevalent among adults with SCA and those with lower vitamin D levels are more anemic and hence may require more blood transfusions. [ABSTRACT FROM AUTHOR]

Background: Hepatitis B virus (HBV) transmission through blood transfusion is reduced by screening for hepatitis B surface antigen (HBsAg). However this method cannot detect the presence of occult hepatitis B virus infection. This study sought to determine the prevalence of occult hepatitis B virus infection among blood donors in Ile-Ife, Nigeria. For the first time in Nigeria we employed an automated real-time PCR- method to investigate the prevalence of occult HBV in blood donors. Methods: Blood donors screened with HBsAg immunochromatographic rapid test kits at the blood transfusion units of two hospitals and found to be negative were recruited into the study. Questionnaires to elicit risk factors for HBV infection were administered and then 10 ml of blood was collected from each donor. Plasma samples obtained from these HBsAg negative blood donors were screened again for HBsAg using an enzyme-linked immunosorbent assay (ELISA) method, and those found negative were screened for the presence of total antibody to the HBV core antigen (anti-HBc) using ELISA method. Those positive to anti-HBc were then tested for HBV DNA, using an automated realtime PCR method. Results: Five hundred and seven blood donors found HBsAg negative by immunochromatographic rapid test kits at both blood transfusion units, were tested for HBsAg using ELISA and 5 (1 %) were HBsAg positive. The 502 found negative were tested for anti-HBc and 354 (70.5 %) were found positive implying previous exposure to HBV and 19 (5.4 %) of the 354 anti-HBc positive had HBV DNA signifying occult HBV infection. No risk factors were found to be associated with the presence of HBV DNA among those who tested positive. Conclusion: Occult HBV infection exists in blood donors in Ile-Ife, Nigeria and the use of HBsAg alone for screening prospective donors will not eliminate the risk of HBV transmission in blood transfusion or stem cell transplantation. [ABSTRACT FROM AUTHOR]

OBJECTIVES: The advent of the tyrosine kinase inhibitors has markedly changed the prognostic outlook for patients with Ph+ and/or BCR-ABL1+ chronic myeloid leukemia (CML). This study was designed to assess the overall survival (OS) of Nigerian patients with CML receiving imatinib therapy and to identify the significant predictors of OS. METHODS: All patients with CML receiving imatinib from July 2003 to June 2013 were studied. The clinical and hematological parameters were studied. The Kaplan–Meier technique was used to estimate the OS and median survival. P-value of ,0.05 was considered as statistically significant. RESULTS: The median age of all 527 patients (male/female = 320/207) was 37 (range 10–87) years. There were 472, 47, and 7 in chronic phase (CP), accelerated phase, and blastic phase, respectively. As at June 2013, 442 patients are alive. The median survival was 105.7 months (95% confidence interval [CI], 91.5–119.9); while OS at one, two, and five years were 95%, 90%, and 75%, respectively. Multivariate Cox regression analysis revealed that OS was significantly better in patients diagnosed with CP (P = 0.001, odds ratio = 1.576, 95% CI = 1.205–2.061) or not in patients with anemia (P = 0.031, odds ratio = 1.666, 95% CI = 1.047–2.649). Combining these variables yielded three prognostic groups: CP without anemia, CP with anemia, and non-CP, with significantly different median OS of 123.3, 92.0, and 74.7 months, respectively (X2 = 22.042, P = 0.000016). CONCLUSION: This study has clearly shown that for Nigerian patients with CML, the clinical phase of the disease at diagnosis and the hematocrit can be used to stratify patients into low, intermediate, and high risk groups. [ABSTRACT FROM AUTHOR]

Objective. The tyrosine kinase inhibitors have markedly changed the disease course for patients with Ph+ and/or BCR-ABL1+ chronic myeloid leukemia (CML). This study was embarked upon to assess the long-term effects of imatinib therapy on survival in adult Nigerian patients with CML. Methods. All adult patients on imatinib (400–600 mg) seen from July 2003 to December 2010 were assessed. Male/female distribution was 171/101, with a median age of 38 (range, 20–75) years. Overall survival (OS) and progression-free survival (PFS) were determined using the Kaplan-Meier techniques. Results. Of all the 272 patients, 205 were in chronic phase, 54 in accelerated phase, and five in blastic phase, at commencement of imatinib. As at December 2010, 222 were alive. OS at 1 and 5 years was 94% and 63%, while PFS was 89% and 54%, respectively. Similarly, amongst the 205 patients in chronic phase, OS at 1 and 5 years was 97% and 68%, while PFS was 92% and 57%. Conclusion. Imatinib’s place as first-line therapy in the treatment of CML has further been reinforced in our patients, with improved survival and reduced morbidity, comparable with outcomes in other populations. [ABSTRACT FROM AUTHOR]

Objective: We aimed in this paper to investigate some immunohematological characteristics of Nigerian sickle cell anemia (SCA) patients with osteomyelitis. Material and Methods: Thirty SCA patients with osteomyelitis (SO) and 30 SCA patients without osteomyelitis (S) were investigated. The PCV, WBC and platelet count were done on automated counter, while the erytorocyte sedimentation rate (ESR) was determined by Westergren's technique. C3 activator, C1-INH, IgA, IgG and IgM were estimated by the single radial immunodiffusion method. Results: The SO patients weighed less (z =1.943, p<0.055) and were shorter (z = -2.064, p<0.039). High serum levels of IgG, IgM, C1-INH and C3 activator were also found in the SO group. ESR correlated positively with hematocrit (r=0.371, p<0.04) and C3 activator (r=0.468, p<0.03) in SO. Similarly, WBC correlated positively with C1-INH (r=0.806, p<0.01), while we also noted positive correlation between C1-INH and C3 activator (r=0.525, p<0.02). In SO, ESR correlated positively with both IgM (r=0.531, p<0.02) and C3 activator (r=0.449, p<0.05). Conclusion: This study suggests some derangement in immune status in Nigerian SCA patients with osteomyelitis and that C1-INH and C3 activator may be useful markers of immune status in SCA patients. [ABSTRACT FROM AUTHOR]