Background: Continental Africa is facing an epidemic of chronic kidney disease (CKD). APOL1 risk variants have been shown to be strongly associated with an increased risk for non-diabetic kidney disease including HIV nephropathy, primary non-monogenic focal and segmental glomerulosclerosis, and hypertension-attributed nephropathy among African ancestry populations in the USA. The world's highest frequencies of APOL1 risk alleles have been reported in West African nations, overlapping regions with a high incidence of CKD and hypertension. One such region is south-eastern Nigeria, and therefore we sought to quantify the association of APOL1 risk alleles with CKD in this region. Methods: APOL1 risk variants were genotyped in a case-control sample set consisting of non-diabetic, CKD patients (n = 44) and control individuals (n = 43) from Enugu and Abakaliki, Nigeria. Results: We found a high frequency of two APOL1 risk alleles in the general population of Igbo people of south-eastern Nigeria (23.3%). The two APOL1 risk allele frequency in the CKD patient group was 66%. Logistic regression analysis under a recessive inheritance model showed a strong and significant association of APOL1 two-risk alleles with CKD, yielding an odds ratio of 6.4 (unadjusted p = 1.2E-4); following correction for age, gender, HIV and BMI, the odds ratio was 4.8 (adjusted p = 5.1E-03). Conclusion: APOL1 risk variants are common in the Igbo population of south-eastern Nigeria, and are also highly associated with non-diabetic CKD in this area. APOL1 may explain the increased prevalence of CKD in this region.

IntroductionCaring for a mentally ill family member is a challenging task. Caregivers who are first-degree relatives (FDR) are at a higher risk of experiencing the negative consequences of caregiving. This study was aimed at determining burden of care and its correlates in caregivers who are first-degree relatives of patients with schizophrenia.MethodsA dyad of 255 patients and caregivers was recruited. A socio-demographic questionnaire was administered to both. The GHQ-12 was used to screen for psychiatric morbidity in the FDRs. Caregiver's burden was assessed with the Zarit Burden Interview. Patients' illness severity and level of functioning were assessed using the Brief Psychiatric Rating Scale and the Global Assessment of Functioning scales respectively.ResultsThe mean ± SD age of caregivers and patients were 45.1 ±12.3 and 36.7 ±13.4 years respectively. About 49% of caregivers experienced high burden of care. Older caregiver's age (r = 0.179; p < 0.004) and greater illness severity (r = 0.332; p < 0.0001) in the patient had weak to moderate positive correlation with burden of care. Caregiver's burden also increased with poorer functioning of the patient (r = -0.467 p < 0.0001). Independent predictors of caregiver burden were low level of education of the caregiver (OR 2.45; 95% CI 1.27-4.73), psychiatric morbidity in the caregiver (OR 6.74; 95% CI 2.51-18.15) and poor patient functioning (OR 2.81; 95% CI 1.27-6.18).ConclusionCaregivers who are first-degree relatives of patients with schizophrenia experience varying degrees of burden of care during caregiving. Routine screening and early psychological intervention would help to ameliorate these negative consequences of caregiving.

Chronic myeloid leukemia (CML) is a myeloproliferative disorder characterized by a triphasic clinical course, the morphologic expansion of a terminally differentiated myeloid cell and the presence of the BCR‐ABL1 fusion gene, the hallmark of CML. The fusion gene is usually, but not always, associated with a Philadelphia chromosome, the result of a reciprocal exchange of genetic material between chromosome 22 and chromosome 9, which leads to the production of the activated BCR‐ABL1 gene and oncoprotein. The breakpoint in the BCR gene occurs commonly downstream of exons e13 or e14 (M‐BCR) and less frequently downstream of exons e1 and e2 (m‐BCR). Less than 1% of cases carry a breakpoint downstream of exon 6 or 8 (“variant fusion genes”) or exon 19 (μ‐BCR). Breakpoints in the ABL1 gene cluster upstream of exon a2 (or of exon a3 in less than 5% of patients with CML). Conventional cytogenetic, fluorescence in situ hybridization, and molecular testing for the BCR‐ABL1 fusion gene are key investigations for the diagnosis and monitoring of CML. Treatment using tyrosine kinase inhibitors has revolutionized the management of CML with hematologic and cytogenetic response within 12–18 months observed in >85% of patients. Nevertheless, between 15 and 20% of patients may evolve to blastic phase. Measurement of low level or “minimal” residual disease using molecular tests is becoming the gold‐standard approach to measure response to therapy due to its higher sensitivity compared to other routine techniques. The technical aspects and clinical applications of molecular monitoring will be the main focus of this article. Am. J. Hematol., 2009. © 2009 Wiley‐Liss, Inc.

Hepatitis B virus infection is endemic in many parts of sub-Saharan Africa including Nigeria. Occult hepatitis B virus infection (OBI) is a challenging clinical problem characterized by the absence of Hepatitis B surface Antigen (HBsAg) and low viral DNA load. We aimed at determining the prevalence of OBI among repeat blood donors in Abakaliki, south-eastern Nigeria. Of 113 informed consented repeat blood donors enrolled into the study, 12 donors (10.6%) tested positive to both serological HBsAg screening, anti-HBc total and hepatitis B virus (HBV) DNA Nested PCR tests. One donor (0.9%) tested HBsAg positive, anti-HBC positive but Nested PCR negative. All donors were negative for HIV 1 and 2 and HCV infections. Of the 100 HbsAg negative repeat blood donors, 8.0% (eight donors) were HBV DNA positive by nested PCR method and anti-HBc total positive by ELISA. The median viral load, determined by real time PCR-Taqman chemistry, in the OBI blood samples was 51 IU/ml compared to 228 IU/ml of the HBsAg screen positive donors. The observed OBI prevalence of 8.0% corroborated with high endemicity of HBV infection in Abakaliki. We therefore recommend routine HBV DNA testing by real time PCR method on all sero-negative blood donations in Abakaliki and for a similar policy to be evaluated across the sub-Saharan Africa.

Purpose: To review current therapeutic efficacy of artemether-lumefantrine (AL) for the treatment of uncomplicated Plasmodium falciparum malaria in patients in failure, while 4 (3.4 %), 30 (25.4 %), and 84 (75.1 %)

Objective: To measure the transcript levels of Aurora kinases and compare them to their immunoreactivity patterns in prostate tumors. Materials and Methods: A total of 26 cases of prostate cancer (PCa) and 38 cases of benign nodular hyperplasia (BPH) were sampled from archived formalin-fixed paraffin-embedded tissues. Tissue sections were lysed, total RNA extracted and cDNA made by random hexamer priming while slide sections were immunostained for the kinases. Normalized relative quantitation was performed for all the kinases using real-time PCR on TaqMan chemistry. Results: The immunoreactivity profile showed 15.4, 53.8 and 30.7% positivity for Aurora kinases A, B and C in PCa cases, respectively, while the positivity was 76.3, 73.7 and 84.2% for the same kinases in BPH cases. The immunoreactivity was preponderant on epithelial tissue compared to stromal component. Conclusion: Aurora kinases were significantly overexpressed in BPH cases compared to PCa cases. At the transcript level, there was no significant differential expression in the kinases between PCa and BPH cases.

Objective: Our aims were to measure the level of expression of Abelson (ABL1), β-glucuronidase (GUS) and glucose-6-phosphate dehydrogenase (G6PD) genes in exfoliated urine cells from healthy and transrectal ultrasound biopsy patients with elevated prostate-specific antigen levels and/or abnormal digital rectal examinations or urinary symptoms indicative of prostate problems, as well as in archived formalin-fixed paraffin-embedded prostate materials. Materialsand Methods: Real-time quantitative polymerase chain reaction (RQ-PCR) was used to evaluate the suitability of the 3 control genes, i.e. ABL1, GUS and G6PD, as control genes for prostate cancer cells. Exfoliated urine cells from 30 healthy males, 53 male patients, 138 cases of archived paraffin-embedded prostate tissues and 3 prostate cell lines were sampled. All cells were lysed in guanidine isothiocyanate buffer from which RNA was extracted and converted to cDNA by random hexamer priming. RQ-PCR was performed using TaqMan chemistries. Results: There was no significant difference in the level of expression for each of the 3 control genes in the cell lines. There was a significant difference in GUS transcript level between patients and healthy controls in both urine and prostate tissue sections (p < 0.05). G6PD transcript numbers also differed significantly from those of GUS in the prostate cell lines and tissue sections (p < 0.05). The transcript numbers of all the control genes were significantly reduced in aged samples (p < 0.001). Conclusion: The ABL1 gene was the most stable control gene in both clinical specimens and cell lines. Therefore, we recommend its use to enable standardization and interlaboratory comparisons for the RQ-PCR of prostatic tumour markers.

BackgroundDiabetes mellitus increases the risk of cardiovascular diseases and all-cause mortality. The present study investigated the effect of an eight-week aerobics programme on fasting blood sugar (FBS), cardiovascular parameters, peripheral oxygen saturation (SpO2), and body mass index (BMI) among subjects with type-2 diabetes mellitus (T2DM).MethodsA pretest-posttest experimental design was employed. Fifty subjects, diagnosed with T2DM, attending the Diabetes Clinic of the University of Nigeria Teaching Hospital, Enugu, were conveniently recruited, gender and age-matched, and randomised into exercise and control groups. The intervention included an eight-week aerobic exercise at 60%–79% HRmax for 45 min–60 min, 3-days per week. The FBS, SpO2, BMI, resting heart rate (RHR), and systolic (SBP) and diastolic blood pressure (DBP) of the subjects were measured before and after the intervention. The paired and independent t-test(s) were used for the analyses within and between the groups, respectively (P ≤ 0.05).ResultsThe exercise group had a significantly lower SBP (15.0 mmHg, P = 0.001), DBP (7.9 mmHg, P = 0.001), RHR (4.8 bpm, P = 0.001), FBS (34.9 mg/dl, P = 0.001), and BMI (2.3, P = 0.001), while the SpO2 improved by 3.9% with P = 0.001, relative to the control group.ConclusionAerobics is an efficacious adjunct therapy in controlling the FBS level, blood pressure, BMI, and improving SpO2 among T2DM subjects.