Apparently Healthy Individuals Research Articles

Occupational Exposure as it Relate to Pathogenic contamination in some Individuals in some parts of Plateau State, North Central Nigeria

This study investigated Cryptosporidium species in Apparently Healthy Individuals (AHI) of different occupation the study was carried out in Jos metropolis of Plateau State, Nigeria. Three hundred (300) samples were collected from Apparently Healthy Individuals (AHI). Samples were analyzed for Cryptosporidium infectious. Cryptosporidium species and other intestinal parasites were determined by parasitological techniques (Formol-ether and floatation concentration techniques Staining was done using Zielh Neelsen technique). Cryptosporidiosis in AHI was 37(12.3%). Younger individuals between the ages of 0-10 and 11-20, had 11(55.0%), 12 (60.0%) and 15 (57.7%), 14 (58.33%) in the male and female group. These were statistically (p< 0.05) significant. Entamoeba histolytica, Giardia intestinalis, Taenia saginata, Ancyslostoma duodenale, (Hookworm sp) Ascaris lumbricoides, and Hymenolepis nana were also identified. Of these, two major parasites implicated in gastroenteritis and diarrhea (Entamoeba histolytic and Giardia intestinalis) had prevalence of 40(13.33%) and 11(3.67%) respectively. The occurrence of this parasite in relation to the occupational group sampled showed that the prevalence was higher with the herdsmen, butchers and the farmers having 17.11%, 16.96% and 15.84% in that order with the least occurring in the businessmen with 8.33%. These results are discussed in relation to the distribution and significance of Cryptosporidium species and other enteric parasites in the environment.

SAT0071 Dependence of rheumatoid arthritis disease aggressivity and activity on the presence of parvovirus B19 infection markers

BackgroundThe role of parvovirus B19 (B19) infection as an initiator of the classic erosive rheumatoid arthritis (RA) is being constantly debated. The main argument against etiological association of B19 with...

Right bundle branch block and middle septal fiber block with or without left anterior fascicular block manifested as aberrant conduction in apparent healthy individuals: Electro-vectorcardiographic characterization

BackgroundRight bundle branch block (RBBB) evident in the precordial ECG leads may be associated with evidence of left bundle branch involvement in the limb leads. Any of the components of the left bundle can be involved, and this complex interventricular conduction abnormality has previously been described in patients with underlying heart disease. ObjectivesTo analyze the electro-vectorcardiographic manifestations of RBBB with left middle septal fiber block (LMSFB), with or without left anterior fascicular block (LAFB) in premature atrial beats of patients without apparent structural heart disease. MethodsTwelve patients (8 men/4 women; mean age: 32±8years) with premature atrial contractions with this conduction abnormality were included. Surface 12 simultaneous lead ECG recordings and the corresponding vectorcardiographic loops were analyzed. ResultsThe QRS complexes with RBBB and also LMSFB persisted for between 150 and 190ms. There were no q waves in lead I. The maximum spatial vector (72–86ms) was directed posteriorly, superiorly, and leftward, and the terminal forces were oriented anteriorly, inferiorly and rightward. In 10 patients, small q waves were apparent in leads V1–V2 and the frontal QRS axis was −60° and −70°, with the 46ms vector located at −50°±5. All of these patients most probably had LAFB in addition to LMSFB. In two patients, the initial electrical forces were directed anteriorly, inferiorly, and leftward, and the 46ms vector axis in the frontal plane was 6° and 11°, respectively, indicating absence of LAFB. ConclusionsThe combination of RBBB and LMSFB occurring in patients without apparent structural heart disease may be related to the simultaneous occurrence of block of conduction through these components of the Purkinje network. The anterior fascicle of the left bundle may also be involved.

Reference Intervals of Certain Liver Specific Biochemical Analytes in Indian Population

Dear EditorMost of the laboratories, all over the world consider thatReference Intervals (RI) in vogue are either inaccurate orin-appropriate for the population they serve and needsupdation. The IFCC has also stressed upon that everylaboratory must have their own set of reference limits. Therecent Clinical and Laboratory Standards Institute (CLSI)/International Federation of Clinical Chemistry (IFCC)document is an excellent aid for design and implementationof such studies [1]. Most of the laboratories in India followRI available in literature which is based on Western pop-ulation. These RI can be questioned because of differencesarising due to variations in diet, life style and environ-mental conditions and ethnicity related variations. There ishardly any documentation regarding RI of liver specificbiochemical parameters in North Indian population. Inview of this, we examined RI of liver specific biochemicalanalytes in North Indian population using IFCC/CLSIguidelines [1].The present study was conducted on 2,021 apparentlyhealthy individuals of North Indian origin ranging in age20–60 years selected randomly using defined criteria, outof which 494 were excluded using appropriate exclusioncriteria defined by IFCC and NCCLS [1]. Finally 1,527individuals were included in present study.After an overnight fasting, venous blood was drawnfrom antecubital vein using aseptic technique. Sampleswere analysed for liver specific biochemical parametersusing standard methods on fully autoanalyzer OlympusAU–400 after proper standardization with the help of cal-ibrators and quality of tests was ensured by using internaland external quality controls. Data were analyzed formiddle 95 percentile (2.5th–97.5th percentile), median and95% confidence interval using SPSS software packageversion 10.0 [4].The results of our study are depicted in the Table 1 asshown below.The upper and lower limit of RI (Reported vs. Observed)for Bilirubin (0–1.2 vs. 0.30–1.30), SGOT (0–40 vs.13–52.80), SGPT (0–50 vs. 10–68), ALP (110–310 vs.107–361.80) showed wide variation as compared to repor-ted standard RI while GGT (0–50 vs. 5.00–50.60) which isrelated to biliary disease and marker for alcoholismremained within the reported standard RI. For both enzy-matic and non enzymatic biochemical parameters uppercutoff value was greater in males (SGOT 14–55, SGPT11–70.35, GGT 6.76–51.09, Bilirubin 0.40–1.34) as com-pared to females (SGOT 13–50.43, SGPT 9–63.43, GGT3.92–48.70, Bilirubin 0.30–1.20) (Table 1). Our findingsare though consistent with studies conducted in south Indianpopulation by Sultana et al. and Ashavaid et al. to the extentthat upper cut off for most of the parameters was higher thanthe reported RI. However cut off for SGOT, SGPT and GGTin present study was lower as compared to values reportedby Sultana et al. [2]and Ashavaid et al. [3]. The variations infindings may be attributed to differences in size and habitat(rural/urban) of reference population, dietary habits, lifestyle and climatic conditions.With respect to age a progressive narrowing of referenceinterval of bilirubin was observed, this may be attributed to

Aetiology of Diarrhoea and Virulence Properties of Diarrhoeagenic &lt;i&gt;Escherichia coli&lt;/i&gt; among Patients and Healthy Subjects in Southeast Nigeria

Diarrhoeal diseases are one of the most important causes of illness and death all over the world. In Nigeria, the aetiology of diarrhoeagenic bacteria and the virulence of various Escherichia coli pathotypes have not been well-studied because most currently-published data were from the southwestern axis of the country. In total, 520 stool samples were collected from infants, young children, and other age-groups with acute diarrhoeal diseases in Enugu and Onitsha, southeastern Nigeria. Stool samples were collected from 250 apparently-healthy individuals, with similar age distribution and locality, who were considered control subjects. The stool samples were screened for diarrhea-causing bacterial agents. E. coli strains were isolated from both the groups and were examined by polymerase chain reaction (PCR) for 16 virulence genes. Of the 520 stool samples in the diarrhoea group, 119 (44.74%) were E. coli. Fifty (49.02%) were enteropathogenic E. coli (EPEC), 22 (21.57%) were enterotoxigenic E. coli (ETEC) while 7.84% was enteroaggregative E. coli (EAEC). Sex had no effect on the distribution of diarrhoeagenic bacteria, except for EIEC. The E. coli strains isolated from the diarrhoea and healthy asymptomatic age-matched control groups examined by PCR for 16 virulence genes indicate that the detection of EAEC, ETEC, EPEC, and EIEC was significantly associated with diarrhoea (p=0.0002). The study confirmed that several bacterial pathogens, such as E. coli, play an important role in the aetiology of acute diarrhoea in southeastern Nigeria. A routine surveillance, especially for diarrhoeagenic E. coli, would be useful in identifying outbreaks and help identify the potential reservoirs and transmission routes.

Prevalencia de dislipidemias en una población de sujetos en apariencia sanos y su relación con la resistencia a la insulina

Evaluate dyslipidemia prevalence and its association with insulin resistance in a cohort of apparently healthy subjects. A cross-sectional study was conducted with 1,179 donors ages 35 to 65 years. The sample population was comprised of 71% men, with an average age of 44 +/- 7. Clinical records, anthropometric data, lipid profile, fasting glycaemia, and insulin levels were obtained. Prevalence of hypertriglyceridemia was 57.3%, C-HDL under normal limits was 52.4%, and hypercholesterolemia was 48.7%. In addition, 36.8% of the obese individuals (as measured by waist perimeter) had hypertriglyceridemia/hypoalphalipoproteinemia, 35.2% had mixed dyslipidemia, and 33.4% had hypertriglyceridemia. Patterns of dyslipidemia were higher in subjects diagnosed with insulin resistance. Insulin resistance associated with hypertriglyceridemia and hypoalphalipoproteinemia was common among our studied population. However, a significant proportion of cases of apparent healthy individuals continue to go undiagnosed.

Comparison of Functional Disability with Physical Activity in Patients with Low Back Pain

The objectives of this study were to evaluate the effects of functional disabilities and physical activity in patients with low back pain (LBP) and apparently healthy individuals (AHI).Oswestry Low back Pain disability questionnaire was administered to thirty five (35) subjects drawn from 3 various health facilities in Lagos State. Thirty five (35) apparently healthy individuals with age and physical characteristics matched with LBP subjects were recruited to serve as control. All the LBP subjects were diagnosed as having acute or chronic LBP with radiologic confirmation. All the subjects with LBP had been on medication. There was a strong positive correlation between physical activity and functional disability (p0.05) and physical activity(p>0.05). It was concluded from this study that patients with low back pain have impaired physical activity when compared with apparently healthy individuals because of functional disability associated with low back pain. Keywords: low back pain, functional disability, physical activityThe Nigerian Medical Practitioner Vol. 52 (4) 2007: pp. 97-99

Soluble tumour necrosis factor-alpha receptor I and interleukin-6 as markers of activity in thyrotoxic Graves' disease.

Autoimmune thyroid diseases are thought to be mediated by pro-inflammatory cytokines such as TNFalpha and IL-6. Serum levels of cytokines may indicate activity levels of immune functions. We investigated serum levels of IL-6 and of the soluble receptor of TNFalpha in patients with newly diagnosed onset of Graves' hyperthyroidism. The predominantly female group consisted of 39 patients, mean fT4 was 47.6 pg/ml (normal values 7.5=19.0 pg/ml). After diagnosis, all patients were treated with anti-thyroid drugs. Soluble Tumour Necrosis Factor Receptor I (TNF-RI) serum levels were found significantly increased (mean 3.7+/-1.3 ng/ml; p<0,01) compared to a matched group of apparent healthy individuals (mean sTNF-RI 1.8+/-0.5 ng/ml) and to a matched group of patients with treated Graves' disease (mean sTNF-RI 1.9+/-0.6 ng/ml). When IL-6 was assessed only 4 of the 39 patients exhibited increased serum levels. Our finding may indicate that sTNF-RI and possibly its ligand, TNFalpha, could play an important role in the onset of the acute stage of Graves' disease.

Seroconversion after Recombinant Hepatitis B Vaccination

Background: Hepatitis B virus infection is an important public health problem with significant morbidity andmortality. Recombinant hepatitis B vaccine for the prevention of hepatitis B virus infection is in practice in differentparts of the world since its availability in 1986. Government of Bangladesh has also included hepatitis B vaccine inEPI schedule since 2005.Materials and methods: This study was carried out to assess the seroconversion status among hepatitis Bvaccinated individuals. A total of 190 individuals including 150 vaccinated persons and 40 non-vaccinated apparentlyhealthy individuals were included as study population. Sources of vaccinated persons were from both EPI and non-EPI schedule of vaccination. Age and sex matched non-vaccinated individuals served as controls for the study. Allindividuals constituting the study population were screened for HBsAg by Immunochromatographic strip test andonly HBsAg-negative persons were included for estimation of their anti-HBs titer.Results: Out of 150 vaccinated individuals, 133(88.67%) were found to have anti-HBs titer in the protective level(&gt;10 IU/L), while 17(11.33%) individuals had anti-HBs titer below the protective level (&lt;10 IU/L). All non-vaccinatedcontrols had anti-HBs titers below the protective level. Regarding immune response developed among vaccinatedindividuals, 67.78%, 23.33% and 8.89% were good-responders, hypo-responders and non-responders respectively.Mean titer of anti-HBs was found significantly higher among recipients who received booster dose than those whoreceived 3 doses schedule (863.39 IU/L vs. 262.40 IU/L), indicating high antibody titer develops after booster dose.Vaccinated group included 85 (56.67%) men and 65 (43.33%) women with protective level of anti-HBs titer foundin 85.88% male and 92.31% female individuals. There was no significant difference of anti-HBs titer between maleand female (p&gt;0.05). Vaccinated individuals from lower socioeconomic condition have had comparatively low rateof protective antibody than people from middle and upper classes.Conclusion: Recombinant HB vaccine induces good level of protective immunity among vaccinated persons.Keywords: Hepatitis B; hepatitis B vaccine; seroconversion; BangladeshDOI: 10.3329/jom.v11i2.5461J MEDICINE 2010; 11 : 143-150