Introduction: Human Immunodeficiency Virus (HIV) is a lentivirus that breaks down the body’s immune system, causing Acquired Immune Deficiency Syndrome (AIDS), that affects so many organs, heart inclusive. Information on cardiac status in HIV infected subjects in Nigeria is scanty. Aim: To evaluate the Apolipoprotein and lipid profiles of HIV subjects before and after Antiretroviral therapy (ART) in Nnewi, South East, Nigeria. Methods: A total of 100 symptomatic HIV subjects with mean age of 40.70 ±10.56 years were randomly recruited, 30 out of the symptomatic HIV positive subjects without malaria co-infection were followed up for this prospective case-controlled study. Serum lipid profile (Tchol, HDL, LDL and TG), apolipoproteins (Apo A1, A2, B, C2, C3, and Apo E) and CD4 counts were measured using standard laboratory methods. Analysis of variance, student t test, and graph pad prism were used for data analyses. Results: paired-wise comparison showed that there were significantly lower levels of CD4 counts, ApoA1, Apo A2, ApoC3, Tchol, LDL, HDL and TG but higher levels of Apo B, Apo C2 and Apo E in symptomatic HIV subjects before ART when compared with after therapy at p<0.05 respectively. Conclusion: This study showed significant reduction in the serum level of Apo A2, Apo B, Apo C3, Apo E and significant increase in levels of HDL and CD4 counts respectively in symptomatic HIV subjects as therapy lengthened, thereby suggesting improved cardiac function

I write to thank Medical Laboratory Scientists that responded to the clarion call in terms of submission of their valuable research articles for peer review and consideration. There was a tremendous improvement in the number of manuscripts we received compared to the last quarter of 2018, whereby we published only 1 article after almost 10 years of visible inactivity. In this volume 29, No.1, we are grateful to our esteemed reviewers who found seven (7) manuscripts worthy of publication. Other manuscripts received from January to April 2019 that are not published in this volume, are either rejected as recommended by the reviewers or still undergoing peer review. The article from Okoli et al., of the Department of Medical Laboratory Science, Nnamdi Azikiwe University was very topical, informative, and I chose it as the cover page. Okoli et al., used the state-of-the-art molecular techniques, utilizing 16S rRNA metagenomics and sequencing by synthesis to study the microbiome composition of the vagina and the gut of pre-menopausal women diagnosed with Bacterial Vaginosis (BV). They also determined metabolic functional predictions in silico with the 16S rRNA dataset. It is worrisome that majority of clinicians do not send women for BV investigation and when they do, Medical Laboratory Scientists rely only on Gram stain technique and inadequate culture methods that cannot detect organisms associated with BV. Metagenomics with 16S rRNA is now the Gold-Standard for detection and quantitative abundance of the presence of all types of bacteria in a specimen

Background: The emergence of highly active antiretroviral therapy (HAART) has led to dramatic improvements in prolonging the life expectancy of HIV-infected patients. However, long-term use may cause kidney derangements that may be life-threatening. Objective: This present study seeks to assess the levels of microalbuminuria and myoglobin in HIV positive subjects. Materials and Methods: One hundred and fifty subjects [50 HIV negative, 50 positive HAART naïve and 50 HAART treated subjects] were enrolled in the study. Plasma creatinine, urea, uric acid, myoglobin and urine microalbumin were assayed using standard methods. Results: Microalbuminuria was significantly higher (p<0.001) in HIV positive than HIV negative subjects, while the differences in the levels of urea, creatinine, uric acid and myoglobin were insignificant. The levels of urea (p<0.001), creatinine (p<0.018) and uric acid (p<0.001) were significantly higher in HIV positive HAART naïve than HIV positive on HAART. Even though the levels of microalbuminuria were higher while myoglobin was lower in HIV positive HAART naïve than HIV positive on HAART, the difference was not statistically significant. Conclusion: The levels of measured markers of renal function were higher in HIV positive subjects whether or not on HAART treatment. However, HAART treatment did not adversely affect renal function in this study.

Objectives: This study was carried out to isolate and identify gram negative bacteria in wounds and ascertain their antimicrobial susceptibility pattern. Methods: One hundred and twenty-five wound swabs were collected from patients using cotton tipped swab sticks, inoculated by standard bacteriological techniques and the isolates identified by biochemical tests. Antimicrobial susceptibility testing was done by the disc diffusion method. Results: Sixty-four isolates were obtained (51.2% prevalence). These include Pseudomonas aeruginosa (50.7%), E. coli (38.1%), Proteus vulgaris (6.3%) and Proteus mirabilis (4.8%). Ninety five percent of the isolates were resistant to 3 or more antibiotics. The 64 isolates were made up of 34 resistance phenotypes. Conclusion: There is high prevalence of multiple antibiotic resistant gram-negative isolates in wounds of the patients. It is important that the antimicrobial susceptibility pattern of wounds be determined before initiating antimicrobial therapy to avoid selection of multidrug resistant strains. Appropriate infection control measures are also necessary to curtail the spread.

Background: The relevance of Leishman stained thin blood film for assessment of blood cells morphology, White Blood Cells (WBC) differentials and inclusion bodies had long been established. The time it takes to generate results on laboratory bench is still long when compared to what is obtainable in automation. Methods: To investigate effects of reduced Leishman staining time on cell morphology, 3 thin blood films were made for 60 subjects. First group were flooded with Leishman stain for 3 minutes and further stained with diluted stain for 12 minutes while second group were stained for 6 minutes after initial flooding for 3 minutes. Third group were exposed to undiluted stain for 3 minutes only. The differential WBC values were determined and presence of malaria parasites and sickle cells were noted. Results: Mean ± SEM of the results compared using SPSS software showed no significant difference in all the cells (P>0.05) except in monocytes values between ‘3minutes’ and ‘15 minutes’ procedures (P<0.05). Presence of sickle cells and malaria parasites were recorded in 2 slides (3.3%) and 5 slides (8.3%) respectively – in all the tested groups. Conclusion: It could be concluded that 3 minutes and 9 minutes are enough to stain thin blood films using Leishman stain and obtain accurate results. The shortened protocol may become useful under emergency situations

Introduction: Diabetes mellitus is a metabolic disorder in which patients are unable to regulate glucose metabolism. It is often associated with cardiovascular diseases due to some coagulation and haemostatic changes in the affected individuals. Objective: The aim of the study was to determine any possible relationships between some coagulation parameters and cardiovascular risks in patients with type 2 diabetes mellitus. Methods and Materials: This cross-sectional prospective study was conducted among 50 diabetic patients and 20 apparently healthy individuals randomly selected. The socio-demographic and other data were obtained from each participant using structured questionnaire. 7mls of blood was collected by venipuncture out of which 2mls was dispensed into EDTA container for determination of platelet count using Mythic 18 haemoautoanalyzer and the remaining 5mls was dispensed into sodium citrate container for prothrombin time test, partial prothrombin time test, fibrinogen assay and D-dimer assay. The prothrombin time and partial prothrombin time tests were done by manual method, fibrinogen assay by Clauss method and D-dimer assay by ichroma method. Basal metabolic index (BMI) of the subjects was also obtained. Data analysis was done using statistical package for social sciences (SPSS) version 21 software, results were expressed as mean ± standard deviation; while the relationship between variables were obtained using independent t-test and Pearson’s correlation. The level of significance was set at (p<0.05). Ethical approval was sought and obtained from our institution’s ethical committee and all participants gave informed consent. Results: The results showed statistical difference between the diabetic and control groups (p<0.05). It was observed that the DM patients showed a shorter APTT-PT, and higher fibrinogen and D-dimer concentration than the control group, possibly contributing to increased prevalence of hypercoagulability in DM patients. Conclusion: This study suggests that fibrinogen and D-dimer levels could be considered as important predictors for cardiovascular risk in diabetes mellitus. Similarly, D-dimer could serve as a good biochemical marker for predicting thrombus formation in the study subjects.

Introduction: There are no molecular data regarding the composition of the vagina and gut microbiome of Nigerian women with bacterial vaginosis (BV), mostly due to lack of appropriate application of high throughput sequencing methods. Here, we aimed to characterize and compare the vaginal and gut microbiome of women with bacterial vaginosis. Material and Methods: Bacterial vaginosis was initially diagnosed using the Nugent scoring method among 220 women aged 18 to 45 years. Five BV positive samples (vagina and gut) were randomly selected and sequenced with Illumina MiSeq platform for the 16S rRNA V4 region using custom-barcoded primers. Alpha-diversity was estimated for species richness by ACE, Chao1 and Jackknife method, while the diversity index was calculated by Shannon, Non-parametric Shannon, and Simpson index. For beta-diversity, Jensen-Shannon metrics were used for principle coordinates (2D) analysis at the species level. Results: Nugent scoring method showed 43 (19.5%) of the subjects had BV. The Shannon diversity index for vagina and gut samples for Subject 1, 2, 3, 4 and 5 was 2.51/3.76, 1.96/3.18, 0.28/4.69, 1.67/3.14, 1.58/3.94 respectively. The average distribution of phyla, class, order, family, genera, and species in the vaginal microbiome was 9.4, 16.8, 31.2, 63.8, 109 and 161.4 respectively whereas, in gut microbiome it was 19.6, 34.2, 68.8, 136.2, 274.4, and 410.8 respectively. Relative abundance showed Firmicutes followed by Actinobacteria, Proteobacteria, dominated the vagina while gut microbiome was dominated by Firmicutes followed by Bacteroidetes, and Proteobacteria. The phylogenetic diversity of the vagina was significantly lower than that of the gut. However, 12 genera out of 20 associated with BV were recovered from both niches with different abundance among the subjects. Functional prediction using PICRUSt and LEfSe revealed significant differences between the vagina and gut microbiome in the relative abundance of microbial genes related to some metabolic pathways. Conclusion: This is the first study using metagenomics in Nigeria that has provided an insight into the phylogenetic diversity and species richness of the vagina and gut microbiome of reproductive age women with BV. In addition, the study revealed relative abundances of microbial genes associated with metabolic functions that are upregulated in the vagina and gut of BV subjects.

Objective/purpose: The development of multidrug resistant tuberculosis and the emergence of extensively and totally drug resistant TB worsen the overall TB control programs. The World Health Organization validates the use of Line Probe Assay (LPA) for rapid detection of MDR-TB. The study evaluates the performance of LPA (MTBDRplus) compared to proportional method (PM). Methods: The study was conducted at TB reference Laboratory, Aminu Kano Teaching Hospital. Using cross-sectional study design 80 Rifampicin Resistant-TB sputum samples were purposely selected and processed according to standard mycobacteriological procedures. Their drug resistance status was detected using PM and MTBDRplus and the performance of LPA were evaluated using MedCalc Software. Results: The study indicated that 88.5% of the samples provided an interpretable result with 46.5% and 30.99% of them detected by LPA and PM as Rifampicin mono resistant. Also, 32.9% and 45.07% of them were MDR-TB by the LPA and PM respectively. Compared to PM, the sensitivity, specificity, PPV and NPV for detection of Rifampicin resistance by the LPA was 98.15%, 82.35%, 94.64% and 93.33% respectively, for detection of Isoniazid resistance was 57.14%, 94.44%, 90.91% and 69.39% respectively, and for detection of MDR-TB resistance was 75.61%, 85.71%, 93.94% and 54.55% respectively. Conclusion: The study demonstrated that the LPA (MTBDRplus) compared to PM performed very high in the detection of Rifampicin resistance more than Isoniazid resistance and MDR-TB. The study identifies the need for improving the MTBDRplus to contain other resistant gene regions to increase the detection rate of not only mono resistant TB but MDR-TB

Background: The emergence of highly active antiretroviral therapy (HAART) has led to dramatic improvements in prolonging the life expectancy of HIV-infected patients. However, long-term use may cause kidney derangements that may be life-threatening. Objective: This present study seeks to assess the levels of microalbuminuria and myoglobin in HIV positive subjects. Materials and Methods: One hundred and fifty subjects [50 HIV negative, 50 positive HAART naïve and 50 HAART treated subjects] were enrolled in the study. Plasma creatinine, urea, uric acid, myoglobin and urine microalbumin were assayed using standard methods. Results: Microalbuminuria was significantly higher (p<0.001) in HIV positive than HIV negative subjects, while the differences in the levels of urea, creatinine, uric acid and myoglobin were insignificant. The levels of urea (p<0.001), creatinine (p<0.018) and uric acid (p<0.001) were significantly higher in HIV positive HAART naïve than HIV positive on HAART. Even though the levels of microalbuminuria were higher while myoglobin was lower in HIV positive HAART naïve than HIV positive on HAART, the difference was not statistically significant. Conclusion: The levels of measured markers of renal function were higher in HIV positive subjects whether or not on HAART treatment. However, HAART treatment did not adversely affect renal function in this study.

Objectives: This study was carried out to isolate and identify gram negative bacteria in wounds and ascertain their antimicrobial susceptibility pattern. Methods: One hundred and twenty-five wound swabs were collected from patients using cotton tipped swab sticks, inoculated by standard bacteriological techniques and the isolates identified by biochemical tests. Antimicrobial susceptibility testing was done by the disc diffusion method. Results: Sixty-four isolates were obtained (51.2% prevalence). These include Pseudomonas aeruginosa (50.7%), E. coli (38.1%), Proteus vulgaris (6.3%) and Proteus mirabilis (4.8%). Ninety five percent of the isolates were resistant to 3 or more antibiotics. The 64 isolates were made up of 34 resistance phenotypes. Conclusion: There is high prevalence of multiple antibiotic resistant gram-negative isolates in wounds of the patients. It is important that the antimicrobial susceptibility pattern of wounds be determined before initiating antimicrobial therapy to avoid selection of multidrug resistant strains. Appropriate infection control measures are also necessary to curtail the spread.

Introduction: Human Immunodeficiency Virus (HIV) is a lentivirus that breaks down the body’s immune system, causing Acquired Immune Deficiency Syndrome (AIDS), that affects so many organs, heart inclusive. Information on cardiac status in HIV infected subjects in Nigeria is scanty. Aim: To evaluate the Apolipoprotein and lipid profiles of HIV subjects before and after Antiretroviral therapy (ART) in Nnewi, South East, Nigeria. Methods: A total of 100 symptomatic HIV subjects with mean age of 40.70 ±10.56 years were randomly recruited, 30 out of the symptomatic HIV positive subjects without malaria co-infection were followed up for this prospective case-controlled study. Serum lipid profile (Tchol, HDL, LDL and TG), apolipoproteins (Apo A1, A2, B, C2, C3, and Apo E) and CD4 counts were measured using standard laboratory methods. Analysis of variance, student t test, and graph pad prism were used for data analyses. Results: paired-wise comparison showed that there were significantly lower levels of CD4 counts, ApoA1, Apo A2, ApoC3, Tchol, LDL, HDL and TG but higher levels of Apo B, Apo C2 and Apo E in symptomatic HIV subjects before ART when compared with after therapy at p<0.05 respectively. Conclusion: This study showed significant reduction in the serum level of Apo A2, Apo B, Apo C3, Apo E and significant increase in levels of HDL and CD4 counts respectively in symptomatic HIV subjects as therapy lengthened, thereby suggesting improved cardiac function.

I write to thank Medical Laboratory Scientists that responded to the clarion call in terms of submission of their valuable research articles for peer review and consideration. There was a tremendous improvement in the number of manuscripts we received compared to the last quarter of 2018, whereby we published only 1 article after almost 10 years of visible inactivity. In this volume 29, No.1, we are grateful to our esteemed reviewers who found seven (7) manuscripts worthy of publication. Other manuscripts received from January to April 2019 that are not published in this volume, are either rejected as recommended by the reviewers or still undergoing peer review. The article from Okoli et al., of the Department of Medical Laboratory Science, Nnamdi Azikiwe University was very topical, informative, and I chose it as the cover page. Okoli et al., used the state-of-the-art molecular techniques, utilizing 16S rRNA metagenomics and sequencing by synthesis to study the microbiome composition of the vagina and the gut of pre-menopausal women diagnosed with Bacterial Vaginosis (BV). They also determined metabolic functional predictions in silico with the 16S rRNA dataset. It is worrisome that majority of clinicians do not send women for BV investigation and when they do, Medical Laboratory Scientists rely only on Gram stain technique and inadequate culture methods that cannot detect organisms associated with BV. Metagenomics with 16S rRNA is now the Gold-Standard for detection and quantitative abundance of the presence of all types of bacteria in a specimen

Introduction: Diabetes mellitus is a metabolic disorder in which patients are unable to regulate glucose metabolism. It is often associated with cardiovascular diseases due to some coagulation and haemostatic changes in the affected individuals. Objective: The aim of the study was to determine any possible relationships between some coagulation parameters and cardiovascular risks in patients with type 2 diabetes mellitus. Methods and Materials: This cross-sectional prospective study was conducted among 50 diabetic patients and 20 apparently healthy individuals randomly selected. The socio-demographic and other data were obtained from each participant using structured questionnaire. 7mls of blood was collected by venipuncture out of which 2mls was dispensed into EDTA container for determination of platelet count using Mythic 18 haemoautoanalyzer and the remaining 5mls was dispensed into sodium citrate container for prothrombin time test, partial prothrombin time test, fibrinogen assay and D-dimer assay. The prothrombin time and partial prothrombin time tests were done by manual method, fibrinogen assay by Clauss method and D-dimer assay by ichroma method. Basal metabolic index (BMI) of the subjects was also obtained. Data analysis was done using statistical package for social sciences (SPSS) version 21 software, results were expressed as mean ± standard deviation; while the relationship between variables were obtained using independent t-test and Pearson’s correlation. The level of significance was set at (p<0.05). Ethical approval was sought and obtained from our institution’s ethical committee and all participants gave informed consent. Results: The results showed statistical difference between the diabetic and control groups (p<0.05). It was observed that the DM patients showed a shorter APTT-PT, and higher fibrinogen and D-dimer concentration than the control group, possibly contributing to increased prevalence of hypercoagulability in DM patients. Conclusion: This study suggests that fibrinogen and D-dimer levels could be considered as important predictors for cardiovascular risk in diabetes mellitus. Similarly, D-dimer could serve as a good biochemical marker for predicting thrombus formation in the study subjects.

Background: The relevance of Leishman stained thin blood film for assessment of blood cells morphology, White Blood Cells (WBC) differentials and inclusion bodies had long been established. The time it takes to generate results on laboratory bench is still long when compared to what is obtainable in automation. Methods: To investigate effects of reduced Leishman staining time on cell morphology, 3 thin blood films were made for 60 subjects. First group were flooded with Leishman stain for 3 minutes and further stained with diluted stain for 12 minutes while second group were stained for 6 minutes after initial flooding for 3 minutes. Third group were exposed to undiluted stain for 3 minutes only. The differential WBC values were determined and presence of malaria parasites and sickle cells were noted. Results: Mean ± SEM of the results compared using SPSS software showed no significant difference in all the cells (P>0.05) except in monocytes values between ‘3minutes’ and ‘15 minutes’ procedures (P<0.05). Presence of sickle cells and malaria parasites were recorded in 2 slides (3.3%) and 5 slides (8.3%) respectively – in all the tested groups. Conclusion: It could be concluded that 3 minutes and 9 minutes are enough to stain thin blood films using Leishman stain and obtain accurate results. The shortened protocol may become useful under emergency situations

Introduction: There are no molecular data regarding the composition of the vagina and gut microbiome of Nigerian women with bacterial vaginosis (BV), mostly due to lack of appropriate application of high throughput sequencing methods. Here, we aimed to characterize and compare the vaginal and gut microbiome of women with bacterial vaginosis. Material and Methods: Bacterial vaginosis was initially diagnosed using the Nugent scoring method among 220 women aged 18 to 45 years. Five BV positive samples (vagina and gut) were randomly selected and sequenced with Illumina MiSeq platform for the 16S rRNA V4 region using custom-barcoded primers. Alpha-diversity was estimated for species richness by ACE, Chao1 and Jackknife method, while the diversity index was calculated by Shannon, Non-parametric Shannon, and Simpson index. For beta-diversity, Jensen-Shannon metrics were used for principle coordinates (2D) analysis at the species level. Results: Nugent scoring method showed 43 (19.5%) of the subjects had BV. The Shannon diversity index for vagina and gut samples for Subject 1, 2, 3, 4 and 5 was 2.51/3.76, 1.96/3.18, 0.28/4.69, 1.67/3.14, 1.58/3.94 respectively. The average distribution of phyla, class, order, family, genera, and species in the vaginal microbiome was 9.4, 16.8, 31.2, 63.8, 109 and 161.4 respectively whereas, in gut microbiome it was 19.6, 34.2, 68.8, 136.2, 274.4, and 410.8 respectively. Relative abundance showed Firmicutes followed by Actinobacteria, Proteobacteria, dominated the vagina while gut microbiome was dominated by Firmicutes followed by Bacteroidetes, and Proteobacteria. The phylogenetic diversity of the vagina was significantly lower than that of the gut. However, 12 genera out of 20 associated with BV were recovered from both niches with different abundance among the subjects. Functional prediction using PICRUSt and LEfSe revealed significant differences between the vagina and gut microbiome in the relative abundance of microbial genes related to some metabolic pathways. Conclusion: This is the first study using metagenomics in Nigeria that has provided an insight into the phylogenetic diversity and species richness of the vagina and gut microbiome of reproductive age women with BV. In addition, the study revealed relative abundances of microbial genes associated with metabolic functions that are upregulated in the vagina and gut of BV subjects

Objective/purpose: The development of multidrug resistant tuberculosis and the emergence of extensively and totally drug resistant TB worsen the overall TB control programs. The World Health Organization validates the use of Line Probe Assay (LPA) for rapid detection of MDR-TB. The study evaluates the performance of LPA (MTBDRplus) compared to proportional method (PM). Methods: The study was conducted at TB reference Laboratory, Aminu Kano Teaching Hospital. Using cross-sectional study design 80 Rifampicin Resistant-TB sputum samples were purposely selected and processed according to standard mycobacteriological procedures. Their drug resistance status was detected using PM and MTBDRplus and the performance of LPA were evaluated using MedCalc Software. Results: The study indicated that 88.5% of the samples provided an interpretable result with 46.5% and 30.99% of them detected by LPA and PM as Rifampicin mono resistant. Also, 32.9% and 45.07% of them were MDR-TB by the LPA and PM respectively. Compared to PM, the sensitivity, specificity, PPV and NPV for detection of Rifampicin resistance by the LPA was 98.15%, 82.35%, 94.64% and 93.33% respectively, for detection of Isoniazid resistance was 57.14%, 94.44%, 90.91% and 69.39% respectively, and for detection of MDR-TB resistance was 75.61%, 85.71%, 93.94% and 54.55% respectively. Conclusion: The study demonstrated that the LPA (MTBDRplus) compared to PM performed very high in the detection of Rifampicin resistance more than Isoniazid resistance and MDR-TB. The study identifies the need for improving the MTBDRplus to contain other resistant gene regions to increase the detection rate of not only mono resistant TB but MDR-TB.