Background:Sickle cell disease (SCD) is an inherited haemoglobinopathy characterised by recurrent organ hypoxia-reperfusion cycles which may result in repeated organ damage including the lungs and heart. In SCD, pulmonary hypertension is a known complication that may precede or complicate acute chest syndrome which is often fatal. This study seeks to know the prevalence of pulmonary hypertension and its relationship with clinical and laboratory parameters in sickle cell disease patients attending a tertiary hospital in Lagos.Materials and Methods:This was a case — control study involving patients with sickle cell disease recruited from adult sickle cell clinic of Lagos State University Teaching Hospital, Ikeja and HbAA controls matched for age and sex from a tertiary educational institution in Lagos. Both the patients and controls were subjected to echocardiography and pulmonary hypertension was deduced from their cardiac tricuspid regurgitant jet velocity. Other parameters measured were age, body mass index, full blood count, red cell indices, foetal haemoglobin, chest X-ray, liver function tests, lactate dehydrogenase and pulmonary function tests. Consenting patients were 56 HbSS in steady state and 28 HbAA controls matched for age and sex. Data was analysed using SPSS version 16.0.Results:The mean age of patients was 22 ± 6 years. In two 2 of 56 (3.6%) of the participants with sickle cell disease, the pulmonary artery pressure was > 25mmHg and there was significant difference in the mean of the pulmonary artery pressure of the control and that of the patients (P-value 0.013). Also, using the appropriate correlation tests, there was significant relationship between the pulmonary artery pressure and lactate dehydrogenase, aspartate transferase and haematocrit in patients with sickle cell disease.Conclusion:Sickle cell disease is an independent cause of pulmonary artery hypertension. Variation in cardiovascular reactions to recurrent hyperhaemolysis and hyperdynamic state in sickle cell disease may explain differences in the development of cardiac complications. Exploration of these reactions may reveal other therapeutic measures to prevent complications in sickle cell disease. Clinical assessment of adult patients with sickle cell disease should include echocardiography.
BackgroundTo find out the prevalence, clinical and biochemical correlates of Breast Artery Calcification (BAC) in the Nigerian women.FindingsThis is a cross sectional study involving 54 consecutive adult female subjects sent to the Radiology Department of the Lagos State University Teaching Hospital (LASUTH), Ikeja-Lagos, Nigeria for screening and diagnostic mammography. The study was carried out for a period of five months.The prevalence of BAC was 20%. Ageing was found to be related to BAC. Cardiovascular risk factors including diabetes mellitus (DM), hypertension, obesity, alcohol ingestion, use of oral contraceptives and hormone replacement therapy, were not significantly related to the presence of BAC in this study.ConclusionThis study showed that though the presence of BAC in a mammogram is related to age, it may not predict or serve as a significant marker for cardiovascular diseases (CVD) in women in our environment.
Introduction: Human immunodefi ciency virus infection damages the immune system making those affected more susceptible to opportunistic infections and malignancies which are common in the chest. This study sought to determine the pattern of chest X-ray lesions and the corresponding CD4 counts of HIV positive patients reporting in the antiretroviral clinic of this teaching hospital for the fi rst time. Methodology: Consecutive HIV positive patients that attended the antiretroviral clinic of the Lagos State University Teaching Hospital, (LASUTH) from September 2009 to January 2011 were recruited. Their chest x-rays were assessed for the presence of pulmonary lesions and baseline CD 4 counts were done to assess their degree of immunosuppression. Data were analyzed using the Statistical Package for Social Sciences, version 16.0. Results: There were 211 subjects, 151 females and 60 males with a M:F ratio of 1:2.5 The mean age of participants was 36.5±11.9. Mean baseline CD4 count for the subjects was 279±220.7 cells/mm3. Almost two thirds (64.9%) cases had normal chest x-rays with their mean CD4 count as 277.65±228.54 cells/mm3. The commonest lesions seen in the lungs include pulmonary infi ltrations, 55 (26.1%), cardiomegaly, 24 (11.4%), pulmonary consolidation, 21 (10%) and lymphadenopathy, 14 (6.6%). The commonest radiological diagnosis made were Atypical pneumonitis, 39 (18.5%), pulmonary TB, 13 (6.2%), pneumonia 13 (6.2%) and cardiomegaly13 (6.2%) respectively.Patients with chest findings had lower mean CD4 counts, 239 cells/mm3 when compared to those without, 244 cells/mm3. Conclusion: Pulmonary infiltration was the commonest lesion, while the commonest diagnosis was atypical pneumonitis. Patients with chest x-ray lesions were found to have lower CD4 counts with probable worse destruction of their immune system. SAARC Journal of Tuberculosis, Lung Diseases & HIV/AIDS; 2013; X(2); 27-34 DOI: http://dx.doi.org/10.3126/saarctb.v10i2.9710
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