Identification of Molecular Markers Associated with COPD in non-smokers and smokers: A Bioinformatics Analysis

Background Even though the proportional burden of COPD among never-smokers is significant in both developing and developed nations, accounting for around 30% of all COPD in the community, there is little awareness of the prevalence of COPD in this population. Understanding the molecular processes that underlie COPD in nonsmokers is essential. Methods Dataset (GSE146560) was acquired from the Gene Expression Omnibus (GEO). The limma and clusterProfiler software tools were used to identify differentially expressed genes (DEGs) and conduct a functional enrichment analysis respectively. Results In all, 10,583 DEGs were found, of which 1,065 were up-regulated and 9,518 were down-regulated. The KEGG pathways such as Neuroactive ligand-receptor interaction, taste transduction, maturity onset diabetes of the young, Hippo signaling pathway, insulin secretion, dilated cardiomyopathy, morphine addiction, and calcium signaling pathway were mainly enriched in the DEGs, along with pathways for the Byzantine Arch palate, inflammation, infection, and feeding difficulties. Conclusion Particularly downregulated COPD genes such FBXL19-AS1, KRTAP5-AS1, and HAGLR antisense are identified as COPD biomarkers and may play a role in the pathogenesis of the illness. However, more investigation is required to support this study\u27s conclusions

Case Report: Unilateral post-tuberculosis lung destruction and massive haemoptysis in pregnancy with successful outcome

Post-tuberculosis destroyed lung is a fatal complication of pulmonary tuberculosis which can manifest with severe life-threatening haemoptysis. Its occurrence during pregnancy is rare and challenging because of the significant risk to both the mother and the foetus. We present an unbooked 36 year old G6P4+1 (4 alive) woman who presented with chronic cough, massive haemoptysis and multiple pregnancy (twin) at 35 week gestation. She had completed anti-tuberculosis treatment twice at and over nine years prior to presentation. On evaluation, there were clinical and radiological evidences of unilateral (right) destroyed lung but no evidence of active tuberculosis; resuscitation was with antibiotics, blood transfusion and oxygen therapy followed by an emergency caesarean delivery due to significant maternal compromise. The  symptoms resolved following antibiotic therapy and she was subsequently discharged home. Post-tuberculosis destroyed lung is a fatal uncommon condition that may present during pregnancy and requires a multi-disciplinary specialist care to ensure good maternal and foetal outcome. Keywords: Unilateral post-tuberculosis lung destruction; Massive haemoptysis; Twin pregnanc

Clinical utility of serum procalcitonin in adult patients admitted with community-acquired pneumonia in Ilorin, Nigeria

Objectives: The usefulness of biomarkers in community acquired pneumonia (CAP) has been under the research light with limited reports from Africa. This study aimed at evaluating the clinical usefulness of serum procalcitonin (PCT) in patients admitted with CAP in a tertiary hospital in Ilorin, Nigeria.Materials and Methods: This was prospective single center observational study of 102 admitted patients with clinical and radiologic features of CAP. All the patients had serum PCT assay, complete blood count, blood culture, sputum microbiology, and serological evaluation for atypical pathogens. Repeat PCT assay was done following 1 week of antibiotic therapy. The patients were classified into one of two diagnostic groups: Those with microbiologically confirmed bacterial CAP and those without bacterial CAP.Results: Over half (58/102; 56.8%) of the patients had microbiologically confirmed bacterial CAP. The baseline serum PCT concentrations were significantly higher in patients with bacterial CAP when compared to the non-bacterial CAP group (2.55 ± 0.14 vs. 0.94 ± 0.61 ng/ml; P < 0.001). There was also a statistically significant difference between the pre- and post-treatment serum PCT concentrations in the bacterial CAP group (P < 0.001) and the non-bacterial CAP group (P = 0.006). The area under the receiver operating characteristic (AUC) for pre-treatment PCT in diagnosing bacterial CAP was 0.795 (95% confidence level [CI]: 0.709–0.881) with a sensitivity of 67.2% and specificity of 79.5% at an optimal cutoff of 1.5 ng/ml. Overall, the biomarker was independently associated with white cell counts >10 × 109/L (AOR = 6.28; 95% CI: 1.30–30.32, P = 0.02). The baseline mean serum PCT levels were also significantly higher in patients admitted for 7 or more days (P = 0.010).Conclusion: Serum PCT had good diagnostic strength in patients admitted with bacterial CAP in Ilorin. The biomarker can also assist clinicians with predicting the pathogenic group and monitoring clinical progress of CAP

Current prevalence pattern of tobacco smoking in Nigeria: a systematic review and meta-analysis

Background National smoking cessation strategies in Nigeria are hindered by lack of up-to-date epidemiologic data. We aimed to estimate prevalence of tobacco smoking in Nigeria to guide relevant interventions. Methods We conducted systematic search of publicly available evidence from 1990 through 2018. A random-effects meta-analysis and meta-regression epidemiologic model were employed to determine prevalence and number of smokers in Nigeria in 1995 and 2015. Results Across 64 studies (n = 54,755), the pooled crude prevalence of current smokers in Nigeria was 10.4% (9.0–11.7) and 17.7% (15.2–20.2) for ever smokers. This was higher among men compared to women in both groups. There was considerable variation across geopolitical zones, ranging from 5.4% (North-west) to 32.1% (North-east) for current smokers, and 10.5% (South-east) to 43.6% (North-east) for ever smokers. Urban and rural dwellers had relatively similar rates of current smokers (10.7 and 9.1%), and ever smokers (18.1 and 17.0%). Estimated median age at initiation of smoking was 16.8 years (IQR: 13.5–18.0). From 1995 to 2015, we estimated an increase in number of current smokers from 8 to 11 million (or a decline from 13 to 10.6% of the population). The pooled mean cigarettes consumption per person per day was 10.1 (6.1–14.2), accounting for 110 million cigarettes per day and over 40 billion cigarettes consumed in Nigeria in 2015. Conclusions While the prevalence of smokers may be declining in Nigeria, one out of ten Nigerians still smokes daily. There is need for comprehensive measures and strict anti-tobacco laws targeting tobacco production and marketing

Clinical and microbiological profile of adult inpatients with community acquired pneumonia in Ilorin, North Central, Nigeria

Background: The optimal management of community acquired pneumonia (CAP) depends on the clinical and microbiological profile in the locality. Objectives: To determine the clinical and microbiological profile of patients admitted with CAP in Ilorin, Nigeria. Methods: One hundred and two consenting consecutively selected patients with clinical and radiologic confirmation of CAP were recruited in 12 months. The socio-demographic, physical examination and laboratory/radiologic parameters were documented in a questionnaire. Microbiological evaluation of their sputum was done and blood samples were taken for complete blood count, culture, serum urea and serological evaluation for atypical bacteria and some viral pathogens. Results: CAP constituted 5.9% of the total medical admissions during the one-year study period. The mean age of the patients was 49 \ub1 22 years with the largest frequency in those aged 65 years and above. The commonest symptoms were shortness of breath (96.1%) and cough (94.1%), with a median duration of 3 days from symptom onset to admission. Systemic hypertension was the commonest comorbid illness (25/102; 24.5%). Klebsiella pneumoniae was the predominant pathogen isolated (20/102; 28.1%). The susceptible antibiotics were Imipenem, Ceftazidime and Ceftriaxone. Intra-hospital mortality was 17.6%. CURB \u2013 65 score of 65 2 and the presence of complications of CAP were the independent predictors of mortality. Conclusion: CAP constitutes a significant disease burden in Ilorin, Nigeria. Typical bacteria accounted for over half of the pathogens isolated from the patients with gram negative agents predominating. This highlights a possible shift in the microbiological profile which could guide empirical treatment

An audit of spirometry at the University of Ilorin Teaching Hospital, Ilorin, Nigeria (2002-2009)

Background: Spirometry is a noninvasive and cost-effective physiologic test that greatly complements other investigative procedures in evaluation of respiratory conditions. This study was aimed at auditing the spirometry performed at the University of Ilorin Teaching Hospital (UITH) Ilorin, Nigeria, and highlighting some of the challenges associated with the procedure. Methods: We reviewed and analyzed the record of spirometry performed at the cardiopulmonary unit of the hospital from June 2002 to December 2009. Results: A total of 119 patients had spirometry tests from 2002 to 2009 and their age ranged from 15 to 85 years with a mean of 47.6 \ub1 14.8 years. There were 69 (58%) males and the male:female ratio was 1.4:1. More than half (65%) of the tests were in patients <50 years old. The rate of spirometry performed annually increased from 12 (10.1%) in 2002 to 31 (26.1%) in year 2009. Evaluation of bronchial asthma was the most common indication for spirometry (43 patients; 36.1%). Majority of the requests (84 patients; 70.6%) were from adult respiratory physicians. The identified challenges were lack of awareness of the range of diseases that could be investigated by spirometry, lack of skills in interpreting the results, lack of time and delays in replacing exhausted consumables and faulty components of spirometer. Conclusion: Gradually, the trend of spirometry request is increasing in UITH; however, a wider acceptability could be achieved for this test by raising the level of awareness and improving the skills of all doctors on the usefulness and interpretation of spirometry.Arri\ue8re-plan: Spirom\ue9trie est un test physiologique invasive et rentable qui compl\ue8te consid\ue9rablement les autres proc\ue9dures d\u2019enqu\ueate dans l\u2019\ue9valuation des conditions respiratoires. Cette \ue9tude visait \ue0 la spirom\ue9trie effectu\ue9e \ue0 l\u2019Universit\ue9 de l\u2019h\uf4pital d\u2019enseignement Ilorin (UITH) Ilorin, Nigeria, l\u2019audit et de mettre en \ue9vidence certains des d\ue9fis li\ue9s \ue0 la proc\ue9dure. M\ue9thodes: Nous a examin\ue9 et analys\ue9 l\u2019enregistrement de spirom\ue9trie effectu\ue9e \ue0 l\u2019unit\ue9 de l\u2019h\uf4pital de juin 2002 \ue0 d\ue9cembre 2009 de cardio-pulmonaires. R\ue9sultats: Un total de 119 patients avait spirom\ue9trie tests depuis 2002 pour 2009 et leur \ue2ge variait de 15 \ue0 85 ans avec une moyenne de 47.6 \ub1 14,8 ans. Il y avait des hommes (58%) 69 et le ratio hommes: femmes \ue9tait 1.4:1. Plus de la moiti\ue9 (65%) des tests \ue9taient chez les patients < \ue2g\ue9 de 50 ans. Le taux de spirom\ue9trie effectu\ue9e annuellement une augmentation de 12 (10,1%) en 2002 \ue0 31 (26,1%) dans l\u2019ann\ue9e 2009. \uc9valuation de l\u2019asthme bronchique indiquait la plus commune pour la spirom\ue9trie (43 patients; 36,1%). La majorit\ue9 des demandes (84 patients; 70,6%) \ue9taient des m\ue9decins respiratoires adultes. Les d\ue9fis identifi\ue9s \ue9taient le manque de connaissance de la plage de maladies qui pourraient \ueatre \ue9tudi\ue9s par la spirom\ue9trie, manque de comp\ue9tences dans l\u2019interpr\ue9tation des r\ue9sultats, le manque de temps et de retards dans le remplacement des consommables \ue9puis\ue9s et composants d\ue9fectueuses de Spirom\ue8tre. Conclusion: Progressivement, la tendance de la demande de la spirom\ue9trie augmente dans UITH; toutefois, une plus large acceptabilit\ue9 pourrait \ueatre obtenue pour ce test par \ue9lever le niveau de sensibilisation et d\u2019am\ue9lioration des comp\ue9tences de tous les m\ue9decins sur l\u2019utilit\ue9 et l\u2019interpr\ue9tation de la spirom\ue9trie

An audit of spirometry at the University of Ilorin Teaching Hospital, Ilorin, Nigeria (2002-2009)

Background: Spirometry is a noninvasive and cost-effective physiologic test that greatly complements other investigative procedures in evaluation of respiratory conditions. This study was aimed at auditing the spirometry performed at the University of Ilorin Teaching Hospital (UITH) Ilorin, Nigeria, and highlighting some of the challenges associated with the procedure. Methods: We reviewed and analyzed the record of spirometry performed at the cardiopulmonary unit of the hospital from June 2002 to December 2009. Results: A total of 119 patients had spirometry tests from 2002 to 2009 and their age ranged from 15 to 85 years with a mean of 47.6 ± 14.8 years. There were 69 (58%) males and the male:female ratio was 1.4:1. More than half (65%) of the tests were in patients <50 years old. The rate of spirometry performed annually increased from 12 (10.1%) in 2002 to 31 (26.1%) in year 2009. Evaluation of bronchial asthma was the most common indication for spirometry (43 patients; 36.1%). Majority of the requests (84 patients; 70.6%) were from adult respiratory physicians. The identified challenges were lack of awareness of the range of diseases that could be investigated by spirometry, lack of skills in interpreting the results, lack of time and delays in replacing exhausted consumables and faulty components of spirometer. Conclusion: Gradually, the trend of spirometry request is increasing in UITH; however, a wider acceptability could be achieved for this test by raising the level of awareness and improving the skills of all doctors on the usefulness and interpretation of spirometry.Arrière-plan: Spirométrie est un test physiologique invasive et rentable qui complète considérablement les autres procédures d’enquête dans l’évaluation des conditions respiratoires. Cette étude visait à la spirométrie effectuée à l’Université de l’hôpital d’enseignement Ilorin (UITH) Ilorin, Nigeria, l’audit et de mettre en évidence certains des défis liés à la procédure. Méthodes: Nous a examiné et analysé l’enregistrement de spirométrie effectuée à l’unité de l’hôpital de juin 2002 à décembre 2009 de cardio-pulmonaires. Résultats: Un total de 119 patients avait spirométrie tests depuis 2002 pour 2009 et leur âge variait de 15 à 85 ans avec une moyenne de 47.6 ± 14,8 ans. Il y avait des hommes (58%) 69 et le ratio hommes: femmes était 1.4:1. Plus de la moitié (65%) des tests étaient chez les patients < âgé de 50 ans. Le taux de spirométrie effectuée annuellement une augmentation de 12 (10,1%) en 2002 à 31 (26,1%) dans l’année 2009. Évaluation de l’asthme bronchique indiquait la plus commune pour la spirométrie (43 patients; 36,1%). La majorité des demandes (84 patients; 70,6%) étaient des médecins respiratoires adultes. Les défis identifiés étaient le manque de connaissance de la plage de maladies qui pourraient être étudiés par la spirométrie, manque de compétences dans l’interprétation des résultats, le manque de temps et de retards dans le remplacement des consommables épuisés et composants défectueuses de Spiromètre. Conclusion: Progressivement, la tendance de la demande de la spirométrie augmente dans UITH; toutefois, une plus large acceptabilité pourrait être obtenue pour ce test par élever le niveau de sensibilisation et d’amélioration des compétences de tous les médecins sur l’utilité et l’interprétation de la spirométrie

Cardiac autonomic dysfunction in sickle cell anaemia and its correlation with QT parameters

Background : Abnormalities of QT parameters together with cardiac autonomic neuropathy (CAN) confer significant risks of cardiac morbidity and mortality in patients with diabetes mellitus. We questioned whether or not CAN influences occurrence of QT interval prolongation and dispersion in patients with sickle cell anaemia (SCA). Materials and Methods : Forty stable adult sickle cell patients with 44 healthy haemoglobin AA controls were studied. Baseline electrocardiograms were obtained and cardiovascular autonomic function tests were performed using standard protocols. Results : Mean corrected QT (QTc) in sickle cell patients was significantly higher (P = 0.001) than the mean of controls. Similarly, mean QT dispersion (QTcd) was higher (P = 0.001) in the former than in the latter. Mean QTc in patients with CAN was longer than patients with normal autonomic function (461 ± 26 ms versus 411 ± 23 ms), P = 0.001 (OR of 17.1, CI 3.48-83.71). Similarly, QTcd was higher (P = 0.001) in patients with CAN than those with normal cardiac autonomic function. Positive correlations were found between CAN with QTc and QTcd (r = 0.604, P = 0.001, r = 0.523, P = 0.001, respectively). Conclusion : CAN is a risk factor for abnormalities of QT parameters in SCA and both may be harbinger for cardiac death