Peak Expiratory Flow as a Surrogate for Health Related Quality of Life in Chronic Obstructive Pulmonary Disease: A Preliminary Cross Sectional Study

Background: Health Related Quality of Life (HRQL) measures can capture the non-respiratory effects of Chronic Obstructive Pulmonary Disease (COPD). However the relationship with Peak Expiratory Flow (PEF) is not well understoodAim: To determine the relationship of PEF and quality of life measurements in patients with COPD Settings and Design: A cross section of consecutive patients in a university clinicMethods: Stable patients with COPD defined by the Global Initiative on chronic Obstructive Lung Disease (GOLD) criteria, were recruited into the study. Spirometry was done using American Thoracic Society’s standards and  reference equations from African American norms of the US population. Quality of life was measured with the St George’s Respiratory Questionnaire (SGRQ)Results: Out of 50 patients recruited for the study, 48 provided complete data with acceptable spirometry and PEF data. The mean (SD) age and body mass index was 68.4 (8.9) years and 21.4 (4.6) kg/m2 respectively and 96% of the patients were in moderate-severe stages of COPD using the GOLD criteria. Percent predicted PEF correlated with percent predicted FEV1; r= 0.559 p<0.001 and also showed a significant, though moderate correlation between PEF readings and SGRQ scores especially in the activity (r= -0.455 p< 0.01) and total scores (r=-0.415 p<0.01) for pre bronchodilator (BD) percent predicted PEF. In regression analysis, PEF was associated with SGRQ (-0.11 95% CI -0.19, -0.03) after adjusting for age, sex, height, smoking and disease severityConclusions: PEF correlates with SGRQ scores and may be a useful surrogate for HRQL in patients with COPDKey words: Peak expiratory flow, quality of life, spirometry, primary car

Self-reported asthma symptoms among adults aged 20-30 years in a Nigerian university: a cross sectional study

Background: Despite concerns about the increasing incidence of asthma in developing countries, there is insufficient data on burden and risk factors for asthma among adults in sub-Saharan Africa. The aim of thisstudy was to determine the prevalence of asthma among young adults in north-central Nigeria. Methods: This cross-sectional study was carried among 20-30 year old medical undergraduates of the University of Jos, Nigeria. A modified version of the European Community Respiratory Health Survey stage 1questionnaire was administered to subjects to obtain bio data, asthma symptoms, and possible risk factors. Factors associated with current asthma symptoms were evaluated using logistic regression models. Results: A total 177 of 185 questionnaires were returned(response rate 95.7%). Forty two (22.7%) persons reported at least one asthma symptom in the 12 months preceding the study, with 16.4% (29) reporting episodes of recurrent wheeze. Nine persons (5.1%) had a previous diagnosis of asthma; 24.1% among persons with recurrent wheeze in 2 the 12 months preceding the study (x2 =24.59; p<0.01).There was no association between asthma and household smoking, cooking fuel and parental level of education. Conclusions: We found a high frequency of asthma symptoms among persons aged 20-30 years. Risk factors for asthma in this population require further evaluation.Keywords: Bronchial Asthma, Sub-Saharan Africa, Lung disease, Obstructive lung disease, Respiratory disease.High Med Res J 2013;13:8-1

The Politics of Intergovernmental Relations: Assessing the Many Phases and Challenges of Nigeria’s Judicial System

The judiciary is an important organ of government as it functions as a counterbalancing institution in states. Notwithstanding the nature of the political system in place, either democratic or nondemocratic, the judiciary plays the essential role of interpreting the extant laws and adjudicating between competing interests whether domiciled in individuals, groups, institutions of government or the various arms of government. The stabilising role of the judiciary in modern governance is exemplified by its ingrained function of checking the excesses of individuals, groups and government institutions through the application of state laws. Since Nigeria’s independence, its judiciary has been discharging its constitutional responsibilities. The journey of the Nigerian judiciary has been quite explosive, considering that it traversed both the jackboot of military authoritarianism and democratic governance in diverse forms, with each presenting its own peculiar bouquet of challenges. This chapter examines the various phases and attendant challenges that the Nigerian judiciary has passed through. It chronicles its many challenges and triumphs as well as low points. In sum, the Nigerian judiciary has acquitted itself admirably in dealing with such challenges as judicial independence, judicial accountability and crisis of condence occasioned by judicial recklessness and corruption. However, Nigeria’s judicial system still has room for further improvement in order to continue to command the respect of the citizens and thus, deserve such epithets as “the last hope of the common man”, “the bulwark of the people’s liberty”, “the defender of the rights of the people” and “the bastion of constitutional democracy,” among others, which demonstrate public acceptance and confidence