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Biomedical subjects

M J Mbiti

Publications and source records attributed to M J Mbiti.

5 recordsLinked to original sources

Do healthy very-low-birth-weight infants fed on their own mothers' milk require sodium supplementation?

Sodium and potassium levels were measured weekly in mothers' milk and in serum and urine of 41 supplemented and 25 unsupplemented very-low-birth-weight infants whose mean birth weights were 1390g and 1332g, respectively (mean gestational age, 31 weeks). Sodium intake was 5.95mmol/kg/day for the supplemented group and 2.75mmol/kg/day for controls. None of the infants in either group was hyponatremic during the 6-week period of study. Urinary sodium in the supplemented group was 15.7mmol/L as compared with 7.5mmol/L in controls. Human milk sodium was significantly lower than reported elsewhere. Growth in the supplemented group was greater than in the unsupplemented group. Since no episode of hyponatremia occurred, it was concluded that routine sodium supplementation was unnecessary.

Dietary Supplements↗

Reference intervals for some biochemical parameters in the aged Kenyan population.

Serum levels for sodium, potassium, calcium, inorganic phosphate, urea nitrogen and creatinine were determined in 1101 male and 181 female patients aged 50 years and above. The determinations were carried out on the SMA II (Technicon Instruments Corp. Tarrytown, NY 10591) with a view to establish the reference intervals for this age group. Quality control of the analytical methods was carried alongside with the determinations. The data collected was used to determine the reference intervals using a simple statistical method. The results indicate that sodium and calcium intervals are low with values of 131-142 mMol/L and 1.94-2.32 mMol/L respectively, in the aged Kenyan population as compared to subjects living in the temperate environment while the interval for inorganic phosphate is comparatively high with a value of 1.2-1.97 mMol/L. Reference values for urea nitrogen, potassium and creatinine were found to be similar to those quoted for caucasians.

Age Factors↗

External quality control performance in clinical chemistry: experience in Kenya.

Analysis of eleven biochemical laboratory tests was done during an International External Quality Assessment Scheme (IEQAS) in which the clinical chemistry laboratory at Kenyatta National Hospital participated. Technicon SMA II continuous flow system was used in the biochemical analyses apart from glucose which was assayed manually by the glucose oxidase method. Using the standard deviation index (SDI), twenty six percent of the results were found to be outside the two standard deviation (2SD) limit. However, when variance index score (VIS) was used, 42% of the results were found to be outliers. Overall, our laboratory performed poorly compared to other laboratories in both the IEQAS and the United Kingdom External Quality Assurance Scheme (UKEQAS). This poor performance is attributed to the use of improper equipment which is not regularly maintained, lack of diagnostic reagents, lack of quality control (QC) materials and inadequate staff training in the field of quality control.

Animals↗

Sodium supplementation in very low birth weight infants fed on their own mothers milk: II. Effects on protein and bone metabolism.

We determined serum calcium, inorganic phosphate, alkaline phosphatase, total protein and albumin levels in a group of 66 very low birth weight (VLBW) preterm infants seen at Kenyatta National Hospital. We used these parameters as markers to study the effect of sodium supplementation on protein and bone metabolism in VLBW infants fed on their mothers' milk. 41 of the infants were supplemented with 3 mMol/kg/day sodium chloride for a duration of six weeks of postnatal life. The remaining group were fed only on their mothers' milk. Results indicated significantly increased serum levels of calcium (P < 0.01) in the non-supplemented group while inorganic phosphate and total protein levels showed significant increase (P < 0.05) in the supplemented group. Both groups had increased levels of osteoblastic activity accompanied by high rate of protein synthesis in the supplemented group compared to the non-supplemented one. These findings together with a significant difference in growth rate (P < 0.01) observed between the two groups indicate that sodium supplementation may have a significant effect on the rate of bone mineralization and protein synthesis in VLBW infants.

Alkaline Phosphatase↗

Sodium supplementation in very low birth weight infants fed on their own mothers milk I: Effects on sodium homeostasis.

Sodium supplementation was done on 41 very low birth weight (VLBW) preterm infants with 25 other infants of similar weight status as controls. All the infants were fed on their own mothers milk whose sodium and potassium content was determined. Serum and urinary sodium, potassium and creatinine levels were determined in both groups during the study period of six weeks. Determination of weight gain, length gain and head circumference gain showed that these anthropometric parameters are significantly increased by sodium supplementation while sodium and potassium concentrations were not significantly affected. There were no cases of either hypernatraemia or hyponatraemia though renal excretion of sodium was very high in the supplemented group. Conclusions drawn from the study are that very little weight gain could have been due to fluid retention and that though sodium supplementation does not affect sodium profiles in these infants it has significant effect on their growth rate which may be due to its indirect/direct association with bone and protein metabolism.

Body Height↗