Background. ABO hemolytic disease of the newborn is the most common hemolytic consequence of maternofetal blood group incompatibility restricted mostly to non-group-O babies of group O mothers with immune anti-A or anti-B antibodies. Aim. We estimated the risk of ABO HDN with view to determining need for routine screening for ABO incompatibility between mother and fetus. Materials and Methods. Prevalence of ABO blood group phenotypes in blood donors at the donor clinic of the Lagos University Teaching Hospital and arithmetic methods were used to determine population prevalence of ABO genes. We then estimated proportion of pregnancies of group O mothers carrying a non-group-O baby and the risk that maternofetal ABO incompatibility will cause clinical ABO HDN.
Results. Blood from 9138 donors was ABO typed. 54.3%, 23%, 19.4%, and 3.3% were blood groups O, A, B, and AB, respectively. Calculated gene frequencies were 0.1416, 0.1209, and 0.7375 for A, B, and O genes, respectively. It was estimated that 14.3% of deliveries will result in a blood group O woman giving birth to a child who is non-group-O. Approximately 4.3% of deliveries are likely to suffer ABO HDN with 2.7% prone to suffer from moderately severe to severe hemolysis.
SUMMARYObjective: Prescribing, adherence, and adverse drug events to HAART in a large antiretroviral programme in Lagos was evaluated. Design A retrospective 5 year open cohort study Setting The AIDS Prevention Initiative in Nigeria (APIN) clinic at LUTH is one of the United States Presidential Emergency Plan for AIDS Relief (PEP-FAR) funded centers for HIV relief program in Nigeria Participants The case files of 390 patients on HAART and attending the APIN clinic were reviewed sequel to random selection. Main outcome measures: Demographics of the patients and pattern of antiretroviral (ARV) combination drugs prescribed were extracted from their case files. The details of the adverse drug events (ADEs) were extracted from drug toxicity forms regularly filled for each patient. A Chi-square test with Yates correction was used to determine the association between adherence and therapeutic outcome Results A total of 2944 prescriptions were assessed. Zidovudine + lamivudine + nevirapine (35.87%) and stavudine + lamivudine + nevirapine (35.63%) were the most frequently prescribed combinations. Over 2000 ADEs were reported with cough (13.3%), fever (8.75%) and skin rashes (8.01%) being the most frequently reported. Drug adherence was associated with good therapeutic outcome (χ2 = 115.60, p<0.0001). Conclusions: Zidovudine + lamivudine + nevirapine was the most frequently prescribed ARV combination. Cough was the most frequently reported ADE. Interventions aimed at rational prescribing of ARV drugs and improving adherence to antiretroviral drugs is essential for good therapeutic outcome in the treatment of HIV infection.
Hyperhomocysteinaemia has been linked in various studies worldwide to the occurrence of cardiovascular disorders and endothelial cell injury. In Nigeria with one of the highest maternal/neonatal mortality and morbidity, it is significant to explore means of predicting pregnancy-induced hypertension. This study was carried out at the Lagos University Teaching Hospital which is a major referral center in the South-western part of Nigeria. It was set to determine the mean plasma homocysteine levels and corpuscular haemoglobin in pre-eclamptic/eclamptic Nigerian women. A total of 150 subjects consisting of 100 primigravidae and 25 diagnosed cases of pre-eclampsia/eclampsia and 25 non-pregnant females were enrolled in the study. 60 primigravidae were lost to follow up or had incomplete data. The mean value of homocysteine in the control group, and eclamptic group was 7.5±3.4 µmol/L and 16.1±6.5 µmol/L respectively. There is positive and significant correlation between plasma homocysteine in the eclamptic group and the mean MCV (r=0.97, p=0.01), and between plasma homocysteine, systolic and diastolic blood pressure of the eclamptic group (r=0.944, p=0.0001; r=0.98, p=0.0001). The study further supports earlier findings of increased homocysteine levels in the occurrence of pre-eclampsia/eclampsia.
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