Solomon Nwabueze Ukibe

Assessment of the Effects of Oxidative Stress on Some Reproductive Hormones in Male Hypertensive Subjects at NAUTH, Nnewi

Background: This is a prospective case control study, aimed at assessing the effect of oxidative stress using Malondialdehyde (MDA) Superoxide Dismutase (SOD) and Total antioxidant capacity (TAC) on some reproductive hormones Follicle stimulating hormone (FSH), Luteinizing hormone (LH) and Testosterone (TT) in male hypertensive subjects at NAUTH Nnewi, Anambra State, Nigeria.Methods: 90 newly diagnosed adult male hypertensive and sixty normotensive control subjects aged between 30-65 (49.98 ± 9.90) years were randomly recruited for the study. Blood sample were collected from all the participants, separated and stored frozen at ˗20°C until assayed for male sex hormones using standard ELISA methods and oxidative stress markers (MDA, SOD and TAC) using Spectrophotometric method. Blood pressures were measured using accosson sphygmomanometer and stethoscope, and high blood pressure was considered when systolic blood pressure (SBP) is greater than 140 mmHg and diastolic blood pressure (DBP) greater than 90 mmHg persistently for three days. A well-structured questionnaire was administered to ascertain the bio-data and anthropometric index of all the participants.Results: SBP and DBP were significantly higher in hypertensive male subjects 157.10 ± 15.40, 99.40 ± 8.94) compared to controls (114.50 ± 8.3, 76.60 ± 5.90) (p=0.000 respectively). FSH and LH (11.94 ± 4.14, 8.46 ± 2.54) were significantly higher while TT (3.19 ± 1.63) was significantly lower in hypertensive subjects compared to controls (7.16 ± 3.40, 3.31 ± 1.74) (7.32 ± 2.54) (p=0.000 respectively). More so, the mean levels of MDA and SOD in hypertensive subjects (1.43 ± 0.45, 15.36 ± 6.15) were significantly higher compared to control (0.63 ± 0.29, 5.28 ± 2.70) (p=0.000) while TAC in hypertensive subjects (18.19 ± 5.46) was significantly lower compared to control subjects (36.93 ± 7.55) (p=0.000). Significant positive correlation was observed between SBP, DBP and FSH, LH, SOD, MDA while significant negative correlation existed between SBP, DBP and TT, TAC. TT and LH were significantly positively correlated with TAC and MDA.Conclusion: Hypertensive male subjects showed significantly higher levels of FSH and LH with lower testosterone levels which suggest hypogonadism and significantly higher MDA and SOD with lower levels of TAC indicating some degree of oxidative stress with suppressed body’s antioxidant defense. The positive and negative correlation observed in blood pressure, male sex hormones and oxidative stress markers also showed that oxidative stress may contribute significantly to the hypogonadism observed which may affect the reproductive potentials in these subjects.

Possible impact of variations in some Cytokine levels during menstrual cycle in women of reproductive age infected with Pulmonary Tuberculosis at Nnewi, Nigeria'

Objective: The second leading cause of human mortality from infectious diseases worldwide is Mycobacterium tuberculosis (Mtb). This chronic infection is accompanied by prolonged cytokine production, which might affect the immuno-reproductive communication and favour the establishment of an adverse state. This was a prospective study designed to evaluate possible impact of some cytokine variations on menstrual cycle in TB infected females. Methods: A total of 90 premenopausal females aged (18-45) years were randomly recruited and grouped into 30 Symptomatic TB, 30 Symptomatic TB females on ATT and 30 Control females. Blood samples were collected at follicular (Fp) and luteal phases (Lp) of menstrual cycle for determination of IL-8, IL-6, TNFα, IL-4, CD4+ T-cells, and Absolute Lymphocytes counts using enzyme-linked immunosorbent assay (ELISA), Cyflow SL Green Cytometer and Sysmex K21N Hematology Analyzer respectively. Results: There was significantly higher IL-6, IL-8, IL-4 and TNFα with lower CD4 T-cells and Abs Lym counts in TB and TB on ATT compared to Control females at both phases of menstrual cycle (P<0.05). All the cytokines were significantly lowered with higher CD4 T-cells in TB on ATT compared to TB females at both phases (P<0.05). Hypogonadism correlated positively with pro and anti-inflammatory cytokines Conclusion: The study revealed significant cytokine alterations which suggest active inflammatory process while CD4 T-cells and Abs Lym dropped showing some degree of derangement in cellular immunity at both phases of menstrual cycle; which tends to normalize on treatment. This may affect the reproductive potentials in these women.

Impact of thyroid function abnormalities on reproductive hormones during menstrual cycle in premenopausal HIV infected females at NAUTH, Nnewi, Nigeria

Background This was a prospective study designed to evaluate the impact of thyroid function abnormalities on reproductive hormones during menstrual cycle in HIV infected females at Nnamdi Azikiwe University Teaching Hospital Nnewi, South-East Nigeria. Methods The study randomly recruited 35 Symptomatic HIV infected females and 35 Symptomatic HIV infected females on antiretroviral therapy (HAART) for not less than six weeks from an HIV clinic and 40 apparently heathy control females among the hospital staff of NAUTH Nnewi. They were all premenopausal females with regular menstrual cycle and aged between 15–45 years. Blood samples were collected at follicular and luteal phases of their menstrual cycle for assay of Thyroid indices (FT3, FT4 and TSH) and Reproductive indices (FSH, LH, Estrogen, Progesterone, Prolactin and Testosterone) using ELISA method. Results The result showed significantly higher FSH and LH but significantly lower progesterone (prog) and estrogen (E2) in the test females compared to control females at both phases of menstrual cycle (P<0.05). There was significantly lower FT3 but significantly higher TSH value in Symptomatic HIV females (P<0.05). FSH, LH and TSH values were significantly lowered while prog and FT3 were significantly higher in Symptomatic HIV on ART compared to Symptomatic HIV females (P<0.05). FT3, FT4, Prog and E2 were inversely correlated while FSH and LH were positively correlated with duration of HIV infection in HIV females (P<0.05 respectively). There was a direct correlation between CD4+ count and FT3 while inverse correlation was found between CD4+ count and TSH levels (P<0.05). Discussion The present study demonstrated hypothyroidism with a significant degree of primary hypogonadism in Symptomatic HIV infected females at both follicular and luteal phases of menstrual cycle which tends to normalize on treatments.

Possible Changes in Maternal Plasma Cortisol, AdrenocorticotropicHormones, Pregnancy Associated Plasma Protein-A and Alpha-fetoproteinin HIV Pregnant Women at NAUTH Nnewi, Nigeria

Background: There is limited information on if HIV infection induces stress in pregnancy. HIV can possibly contribute to the alterations in some fetal viability hormones thereby lead to adverse pregnancy outcome. The present study aimed to assess the possible changes in maternal cortisol, Adrenocorticotropic (ACTH), Pregnancy associated plasma protein-A (PAPP-A) and alpha-fetoprotein (AFP) hormone concentrations in HIV-infected pregnant women and their pregnancy outcomes. Methods: A cross sectional study of 80 (Eighty) volunteer pregnant women aged (18-49) years recruited during routine antenatal clinics in Nnamdi Azikiwe Teaching Hospital, Nnewi, Anambra State, Nigeria was conducted. The participants were divided into groups: 40 (forty) apparently healthy pregnant and 40 (forty) HIV-infected pregnant women. 5 ml of morning blood samples were collected from each subject in their 1st and 2nd trimesters for estimation of Cortisol, ACTH, AFP and PAPP-A using ELISA method. Results: The result showed that the mean systolic and diastolic blood pressures (mmHg) of HIV pregnant women were significantly higher than control (p<0.05 respectively). The mean value of cortisol (ng/ml) in HIV pregnant women was significantly higher when compared with control subjects (p<0.05). Cortisol showed inverse significant correlation with AFP in HIV-infected pregnant women. Maternal outcomes showed thatt HIV-infected pregnant women had significantly higher incidence of miscarriages and preeclampsia with higher incidence of perinatal outcomes such as low birth weight babies (LBW), preterm delivery, spontaneous abortion, still birth and low Apgar scores when compared with apparently normal pregnant women (P<0.05 respectively). Conclusion: the significantly higher cortisol level and BP in HIV pregnant women is indicative of oxidative stress due to perceived stress by HIV infection which might predispose the affected women to hypertension and preeclampsia. The highest adverse reactions observed in HIV pregnant women might be related to the damaged immune system by HIV infection however, the placental defect associated with increased placental permeability to AFP and the activity of the insulin-like growth factor (IGF) system is not related to the activity of stress thereby do not influence their birth outcomes.

SEX HORMONES CHANGES ASSOCIATED WITH MENSTRUAL CYCLE IN HIV INFECTED FEMALES AT NAUTH, NNEWI, SOUTHEAST NIGERIA

The field of Depth of Anaesthesia (DOA) is a very challenging area for neuro-fuzzy control since direct measurements are unavailable. During anaesthesia, the blood pressures (BP), the mean arterial blood pressure (MAP) and the heart rate (HR) are monitored to maintain hemodynamic stability and to assess the level of consciousness. The purpose of this study is to find the best input-output definitions in the Adaptive-Network-based Fuzzy Inference System (ANFIS) to control the Sevoflurane dose to patient under the general anaesthesia with the classical MAP and HR parameters. The best models have been found among many possible input combinations. This study helps to provide an alternate control for the dose of Sevoflurane which is widely used as an anaesthetic agent. The models have been trained and validated by clinical data. The results show that the patients can be modelled by ANFIS if sufficient HR and MAP data are provided. Furthermore, the model performance could be increased if the patients are grouped as adults and children. The performance (up to 0.99) in this study is comparable to recent works in similar subject which detect DOA by Electroencephalograms (EEG).