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Articles by Robert A. Ngala
Total Records ( 3 ) for Robert A. Ngala
  Robert A. Ngala , David Opoku and George Asare
  The use of Highly Active Antiretroviral Therapy (HAART) has improved the prognosis of HIV-infected individuals. However, the beneficial effect of reduced risk of early death from opportunistic infections and other consequences of HIV infection is reduced because Antiretroviral Therapy (ART) also carries negative side effects, including hepatotoxicity. The study examines hepatotoxic effect of HAART and hepatitis co-infection in HIV patients. Alkaline phosphatase, alanine transaminase, aspartate transaminase, gamma glutamyl transferase were determined from the serum of 100 HAART-experienced and 50 HAART-naïve HIV infected subjects enzymatically using Junior Flexor autoanalyser. Serum proteins were assayed by the biuret reaction and bilirubin determination was based on the diazo coupling reaction of Ehrlich method. HBV surface antigen (HBsAg) was detected by enzyme-linked immunosorbent assay. Globulins, total proteins, alkaline phosphatase, alanine transaminase, aspartate transaminase and gamma glutamyl transferase were significantly (p<0.001) elevated in the HIV HAART-experienced patients than the controls. Forty six percent of the HAART-experienced developed hepatotoxicity. Based on bilirubin levels, 11% of the HAART-experienced had hepatotoxicity. Nine percent of the HAART-experienced were co-infected with hepatitis B and 77% of them developed hepatotoxicity whilst 22% of the HAART-naïves were co-infected with hepatitis B and 73% of these developed hepatotoxicity. Hepatotoxicity was negatively correlated with alkaline phosphatase, alanine transaminase, aspartate transaminase, gamma glutamyl transferase and total plasma proteins. HAART induced hepatotoxicity in HIV patients more than HAART-naïve. There is an increased risk of hepatotoxicity in HIV patients’ co-infection with hepatitis B virus and on antiretroviral therapy.
  Robert A. Ngala , Martin A. Akilla and Edwin D. Doodaah
  Overweight and obesity, associated with type 2 diabetes have been characterized by Body Mass Index, waist circumference or waist-to-hip ratio. However, because of the limitation of the Body Mass Index in expressing fat distribution and the fact that visceral obesity has been more implicated in type 2 diabetes than subcutaneous fat, other diabetes markers are being investigated. A hospital-based case control study, using convenience sampling techniques, sought to determine the most appropriate surrogate makers of type 2 diabetes, among Ghanaian diabetics, using thigh circumference, waist-to-thigh ratio, waist circumference, Body Mass Index, plasma creatinine and lipid profile. The 134 diabetics and 70 control subjects were enrolled. Demographics were gathered and anthropometric variables considered were; body weight, measured with scale (Hospibrand ZT-120, England), waist circumference and thigh circumference, measured with a measuring tape (Gay Mills, WI), while height measured with stadiometer (Fischer Scientific). About 5 mL of overnight fasting venous blood sample were drawn for biochemical assays: Plasma glucose, total cholesterol, high density lipoprotein, low density lipoproteins and triglycerides were determined by enzymatic methods and the creatinine assessment based on the Jaffé reaction, were all done on COBAS Intergra 400 Plus auto analyzer (Germany). Data were analysed using Graph Pad Prism version 5.0 (Graph Pad Software, San Diego, California). Continuous variables expressed as Mean±SD. Subjects compared using unpaired t-tests, one-way ANOVA followed by the Bonferroni test for multiple comparisons. Total body weight, waist circumference, waist-to-thigh ratio and triglycerides were significantly elevated in the diabetic subjects, while High density lipoprotein was significantly reduced. Considering gender and the diabetics compared to control group, there was no significant difference in plasma creatinine levels. Though Waist Circumference (WC), Waist-to-Thigh Ratio (WTR) and Body Mass Index (BMI) were significantly higher in the diabetics as compared to the controls, only WC and WTR predicts dysglycaemia in a linear regression analysis. Waist circumference and waist-to-thigh circumference ratio were better markers of type 2 diabetes in individuals, who are moderately obese than BMI.
  Robert A. Ngala , Michael B. Yakass , K. Bedu- Addo and Edem K. Hiadzi
  Assisted reproduction is expensive, time-consuming and stressful for patients. The accurate determination of ovarian reserve is important for this procedure. Basal hormonal levels may help to predict ovarian reserve after stimulation. The aim of this study was to assess basal hormonal markers; Luteinizing Hormones (LH), Follicle stimulating (FSH), prolactin and anthropometric indices as predictive markers of ovarian response in patients seeking assisted reproduction. A total of 104 subjects were recruited at the Lister Hospital Fertility Centre in Accra-Ghana for this study. Anthropometric parameters: Body Mass Index (BMI) and Waist-to-Hip Ratio (WHR) were measured. Lifestyle features; exercise and smoking patterns were assessed from a questionnaire. Blood samples were drawn on second day of their menstrual cycle in the month prior to the in vitro fertilization (IVF) procedure and basal luteinizing hormones, FSH and prolactin assayed by ELISA method. Subjects who yielded four or less oocytes were classified as poor responders whereas those who yielded more than 4 oocytes were termed as normal responders. Basal FSH and age (12.9±0.51 IU L–1 and 40±0.54 years) were significantly (p<0.01) higher in poor responders than normal responders 9.7±0.61 IU L–1 and 36±0.42 years, respectively. Increasing age, (42.44±0.47 years), high basal FSH (13.41±0.91 IU L–1) and high FSH/LH ratio (2.74±0.64) significantly but negatively correlated with retrieved oocyte (7.28±2.03) and ovarian capacity (8.44±1.16) when compared to low age (28.08±0.65 years), normal FSH (7.64±1.21 IU L–1) and FSH/LH (1.23±0.16) with retrieved oocyte (20.31±3.30) and ovarian capacity (20.92±2.63), respectively. Subjects engaged in moderate to high forms of exercise recorded a normal response. Number of retrieved oocytes and ovarian capacity were negatively correlated to WHR and BMI. Basal FSH and FSH/LH ratio better predicted response of subjects after ovarian stimulation. Obesity negatively impacted on ovarian response.
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