INTRODUCTION: To hasten management and improve patients’ quality of life, there is a need for quick, cheap and accessible biomarkers of breast cancer prognosis following confirmatory diagnosis. Tumour markers are substances produced by the tumours or by other cells of the body in response to cancer or certain benign conditions, but the role of serum tumour markers in breast cancer prognosis remains controversial due to multiorgan sources of a biomarker. This study aimed to evaluate the association of serum carcinoembryonic antigen (CEA) and carbohydrate antigen (CA 19-9 and 27-29) levels with clinicopathological parameters in patients with breast cancer. MATERIALS AND METHODS: Sera from a total of 183 breast cancer patients of different clinic-pathological characteristics were analysed for CEA, CA 19-1 and CA 27-29 using a Hitachi automatic immunoassay analyser based on chemiluminescence principle. The mean values were compared using the Student t-test while the frequencies of prevalence were compared using the X2 test. RESULTS: Mean serum CA 19-9 level was significantly higher in well-differentiated compared with moderately- differentiated or ductal- compared with lobular- breast cancer patients. The mean serum CEA 19-9 level was significantly higher in ductal- compared with lobular- breast cancer patients. A higher prevalence of metastatic or moderately-differentiated breast cancer patients had levels of CA19-9 above reference ranges while a higher prevalence of stage 2 breast cancer patients had levels of CA 27-29 above reference ranges. CONCLUSIONS: CA 19-9 differentiates breast cancer histological grades and metastasis. Therefore, CA 19-9 provides additional insight into breast cancer clinicopathological types than CEA or CA 27-29.

Background Clinical trial of IDO inhibitor or uses of micro-nutrient supplements during management of diseases is commonly done without having adequate basis for the practise. Tryptophan (Trp) is an essential amino acid needed for T-lymphocyte function, and indoleamine-2,3-dioxygenase (IDO) is a potent immunoregulatory molecule that catalyses the rate-limiting step of Trp degradation in the kynurenine (Kyn) pathway. Materials and methods Human IDO in the plasma samples was measured using ELISA in patients with non-infectious (asthma) and infectious diseases (pulmonary tuberculosis and COVID-19) compared with corresponding un-infected controls. Results Mean IDO activity in COVID-19 patients was significantly higher compared with corresponding control ( p = 0.001) while mean IDO activity in pulmonary tuberculosis patients was non-significantly higher compared with corresponding control ( p = 0.520), and mean IDO activity in asthma patients was non-significantly lower compared with corresponding control ( p = 0.102). Conclusion Our data suggest that IDO activity as an innate immune factor is increased in infectious lung diseases (COVID-19 and pulmonary tuberculosis) but reduced in non-infectious disease (asthma) and that use of tryptophan supplementation or IDO inhibitor may not be necessary in all lung diseases.

Introduction and aim. Coronavirus disease 2019 is characterised by cytokine storm and it was managed with repurposed drugs, however the effect of this treatment on cytokine storm is unknown. The aim of the study was to investigate the effect of repurposed management on serum Th1 pro-inflammation cytokine (IFN-γ) and Th2 anti-inflammation cytokine (IL-4) in COVID-19 patients. Material and methods. The levels of IFN-γ and IL-4 were determined in sera from 45 COVID-19 patients at admission followed-up till discharge after repurposed treatment using ELISA. The mean levels and proportions above normal reference ranges of IFN-γ and IL-4 were compared in COVID-19 at admission and discharge. Results. The mean values of IFN-γ and IL-4 were significantly higher in COVID-19 patients at admission compared with discharged COVID-19 patients whereas IFN-γ:IL-4 ratio was significantly higher in discharged COVID-19 patients compared with admitted COVID-19 patients. Significantly higher proportion of COVID-19 patients at discharge had IFN-γ within the normal reference ranges compared with COVID-19 patients at admission whereas the proportions of COVID-19 patients at discharge and COVID-19 patients at admission having IL-4 within the normal reference ranges were the same. Conclusion. Cytokine storm was evidenced in COVID-19 patients at admission and repurposed treatment suppressed pro-inflammation cytokine (IFN-γ) in most discharged COVID-19 patients.

Introduction. Reports continue to show that a significant association exists between serum vitamin D level and metabolic syndrome (MS)-associated inflammation. However, information on the serum levels of vitamin D and alterations in inflammation in different vitamin D status is presently lacking. Aim. To determine the serum levels of vitamin D and TNF-α, and assess their possible relationship with gender in individuals with MS. Material and methods. Sixty adults with MS and 40 controls were enrolled into this case-control study. Serum vitamin D and TNF-α levels were measured and participants stratified into different vitamin D status. Results. None of the participants had vitamin D deficiency and the mean vitamin D level was similar in MS compared with the controls. However, TNF-α level was significantly higher in MS compared with the controls. Serum vitamin D level had significant inverse correlation with serum TNF-α level in MS. Also vitamin D level was significantly lower while TNF-α level was significantly higher in female-MS compared with the male-MS. Conclusion. Adults with MS have elevated TNF-α level which appears to be associated with the serum level of vitamin D. Also, females with MS have low vitamin D level and this may exacerbate the MS-associated inflammation in them.

BACKGROUND:Maternal exposure to ambient air pollution affects placental growth markers. OBJECTIVES:Investigate impact of household air pollution (HAP) on placental growth markers. METHODS:Two groups of pregnant women were identified: firewood/kerosene stove-users (A, n=33) and bioethanol stove-users (B, n=44) that participated in a randomized control trial in Ibadan, Nigeria. A third group of non-smoking and presumed liquefied petroleum gas-using Chicago women (C, n=19) were included in this exploratory pilot to assess for possible differences between similar racial groups. Levels of placental growth factor (PlGF) and soluble fms-like tyrosine kinase 1 (sFlt-1) were measured in maternal and cord plasma using ELISA. RESULTS:Maternal and cord blood sFlt-1 and PlGF did not differ significantly between women of groups A and B. Nevertheless, both groups differed significantly from the Chicago group in that group A women had lower maternal sFlt-1 (1372.50 vs. 3194.19) but higher PlGF (1607.87 vs. 442.80), and higher cord blood sFlt-1 (2925.02 vs. 107.53) and PlGF (223.68 vs. 6.92), all p≤0.001. Group B showed similar trends (all p≤0.002). Maternal PlGF levels were positively correlated to minutes of HAP exposure when PM2.5 concentration was above 100μg/m3 in Nigerian women. CONCLUSIONS:Maternal levels of PlGF and cord blood levels of sFlt-1 and PlGF in Nigerian women with varying HAP exposures were significantly higher than Chicago-based women who had no presumed HAP exposure. It suggests that in-utero exposure to HAP influenced levels of angiogenic factors involved in normal placentation and growth and could represent compensation for pollutants exposure to preserve fetal viability.

Tuberculosis (TB) is an infectious disease which remains a global health problem till date. A number of cytokine and chemokine have been reported to be associated with MTB clearance, reactivation or cure but there are no consensus biomarkers to differentiate the severity of TB. In this study, we determined the changes in plasma C- reactive protein (C-RP) and Fibrinogen levels in Drug sensitive Tuberculosis (DSTB) patients at diagnosis, Multi drug resistant tuberculosis (MDRTB) patients at diagnosis and during chemotherapy. Twenty-four (24) patients MDRTB patients and 24 newly diagnosed DSTB patients from University College Hospital (UCH) Ibadan, Nigeria were recruited for the study by a Consultant Chest physician using clinical history, Chest X-ray and GENE Xpert test. Five (5) milliliters of blood was drawn from the anti-cubital fossa vein into lithium heparin tubes before the commencement of chemotherapy, 2 months, 4 months and 6 months of anti-TB therapy. Plasma obtained was analyzed for C-RP and fibrinogen using ELISA. Data was presented as mean ± SD. Student t-test was used for mean comparison. Statistical significance was set at p ≤ 0.05. Mean CRP level in multi-drug resistant tuberculosis patients was significantly higher at diagnosis compared with controls. Mean fibrinogen levels in the drug sensitive and multi drug resistant tuberculosis were significantly lower at diagnosis compared to controls. The mean CRP and fibrinogen levels in multi-drug resistant tuberculosis were significantly reduced during chemotherapy compared with before commencement of chemotherapy. Plasma CRP and fibrinogen are suggested as possible markers for monitoring treatment response in MDRTB patients. Keywords ; Tuberculosis, Treatment monitoring, Acute phase proteins, drug resistant.

Childlessness has adverse social, psychological and economic impact on affected couples. The contributions of males to infertility account for 40%. Hypogonadism in males has been associated with metabolic syndrome (MS). Although endocrinopathies have been observed in infertile men, similar data in males with MS in the general population is sparse. This study is therefore aimed at evaluating the endocrinopathies in Nigerian males with zero (ZMS) and MS. Sixty-seven male participants aged 18 - 70 years were purposely enrolled for this study. Fifty two males had ZMS (control) while 15 males had MS. Demography, sexual history, blood pressure, anthropometry were obtained by standard methods. Fasting plasma glucose, triglyceride and high density lipoprotein cholesterol were determined by enzymatic methods. Sex and pituitary hormones were determined by ELISA. Data analysed were statistically significant at p < 0.05. The MS group 8 (53.3%) had significantly more males with hypogonadism than the controls 2 (23.1%) (p<0.05). Compensatory hypogonadism and suboptimal hypogonadism are the most common endocrinopathies in controls and MS group. 9 (60%) and 5 (33%) of males in the MS group were overweight and obese respectively while 2 (3.8%) and 6 (11.5%) of controls were underweight and overweight. FSH had a direct relationship with age in eugonadal controls and hypogonadal males with MS while LH had an inverse relationship with age in eugonadal males in the MS group. Endocrinopathies are prevalent in Nigerian men irrespective of their metabolic status or age

Background: Household air pollution (HAP) is associated with adverse pregnancy outcomes. Objectives: Investigate impact of in-utero HAP exposure on placental development and chronic hypoxia. Methods: Markers of chronic placental hypoxia [Hofbauer cells (HBC), syncytial knots (SK), chorionic vascular density(cVD) and hypoxia-inducible factor (HIF)] were stained by hematoxylin-eosin and/or immunohistochemically in placenta samples collected from firewood-/kerosene-users (A, n=16), and ethanol-users (B, n=20) that participated in a randomized controlled intervention trial in Ibadan, Nigeria. A third group of non-smoking and presumed natural gas-using Chicago women (C, n=12) were included in this exploratory pilot to assess for possible differences in placenta histology between similar racial groups. All patients had uncomplicated pregnancies and delivered at term. Results: HBC, SK and cVD were significantly increased among firewood-/kerosene-users compared to ethanolusers and natural gas-using Chicago women (HBC medians 5.5, 3.5, and 2.0, respectively; SK means 55.6, 41.8 and 30.1; cVD means 8.8, 6.2, and 5.2; all p < 0.01). HIF expression was significantly higher in Group A compared to B and C (all p < 0.001). Conclusions: In-utero exposure to HAP is associated with pathologic changes and HIF expression consistent with chronic hypoxia in placenta of firewood/kerosene-users compared to ethanol-users with less HAP exposure and Chicago women with no presumed HAP exposure. Presence of chronic hypoxic signature in placenta of women exposed to HAP has implications for adverse pregnancy complications and future growth and development of the young children. Future larger studies need to focus on HAP exposure and placental disorders like preeclampsia and long-term health impact of in-utero exposure to HAP. (c) 2017 The Authors. Published by Elsevier B.V.

BACKGROUND:Pituitary and gonadal dysfunctions resulting from increased adiposity leading to disturbances of sexual and reproductive functions have been reported in males with metabolic syndrome (MS) and type 2 diabetes mellitus (DM2). The aim of this study was to evaluate sexual dysfunction, leptin, and reproductive hormones in Nigerian males with MS and DM2.METHODS:Participants were 104 men (34 males with DM2, 17 men with MS and 53 men with normal body mass index (18.5-24.9 Kg/m (2)) without MS (controls)). The International Diabetes Federation (2005) criteria were used for MS diagnosis. Reproductive history, anthropometry, blood pressure (BP) and 10 ml fasting blood samples were obtained by standard methods. Fasting plasma glucose, total cholesterol, triglycerides and high density lipoprotein cholesterol were determined by enzymatic methods while low density lipoprotein cholesterol was calculated. Leptin, follicle stimulating hormone (FSH), luteinising hormone (LH), prolactin, testosterone and oestrogen were determined by enzyme immunoassay (leptin by Diagnostic Automation, Inc.; others by Immunometrics (UK) Ltd.) while oestrogen-testosterone ratio was calculated. Data analyzed using ANOVA, Chi square and multiple regression were statistically significant at p<0.05.RESULTS:Testosterone was significantly lower in MS than controls while oestradiol and ETR were significantly higher in MS compared with controls and DM2 group (p<0.05). ETR significantly predicted testosterone in all groups (p<0.05). Significantly lower libido was observed in men in MS than controls and DM2 groups (p<0.05).CONCLUSION:Sexual and reproductive dysfunction may be related to increased conversion of testosterone to oestrogen in increased adipose mass in men with metabolic syndrome and type 2 diabetes mellitus.

Background Visual function is important for optimal orientation in functional and social life, and has an effect on physical and emotional well-being. Visual impairment, therefore, leads to restrictions in all aspects of daily living and is related to quality of life. The aim of this study was to provide information on the causes of visual impairment in patients presenting to their family physician, the spectrum of impairment, and its impact on quality of life for these patients. Methods This descriptive cross-sectional study of 375 adult patients with ocular symptoms was performed in the general outpatient department of the University College Hospital, Ibadan, from July to September, 2009. After checking their presenting visual acuity, the patients were interviewed using the Vision-Related Quality of Life questionnaire to determine the impact of visual impairment on their quality of life. Ophthalmic examinations were performed to determine the causes of visual impairment. The results were analyzed using proportions and percentages. Results The main causes of visual impairment were cataracts (58.7%), refractive error (19.4%), and glaucoma (2.9%). Visual impairment was found to be associated with advancing age, low education, and unemployment (P<0.001). Most patients (85.1%) were found to have good quality of life overall. Quality of life was found to be poor in the domains of visual function (64.2%) and social interaction (50.9%). Quality of life was found to be related to the degree of visual impairment, ie, blind patients reported poor quality of life (41.4%) when compared with those having low vision (8.6%) or near normal vision (2.4%, P<0.001). Conclusion This study identified poor quality of life in patients with a higher degree of visual impairment. Family physicians need to identify these visually impaired patients early and make timely referrals.