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

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

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

Secondhand smoke exposure among nonsmoking adults in two Nigerian cities

Background: Tobacco control policy can only succeed if the burdens of smoking are known. The objective of this study was to determine the prevalence and correlates of secondhand smoke (SHS) exposure among nonsmoking adults in two Nigerian cities. Materials and Methods: We carried out a cross-sectional study from October 2009 to April 2010 among adult population of two Nigerian cities: Enugu and Ilorin. A semi-structured questionnaire was administered by interviewers to obtain socio-demographic information; and information regarding pattern of SHS exposure, awareness of tobacco control policy and the harmful effects of SHS. SHS exposure was defined as regular exposure to tobacco smoke in the previous 30 days in a nonsmoking adult. Results: Of the 585 nonsmoking adults that completed the study, 38.8% had regular exposure to SHS; mostly, in public places (24.4%). More men were exposed at public places when compared with women (27.0% vs. 19.5%). The strongest factor associated with exposure to SHS in women was having a smoking spouse [prevalence rate (PR) ratio-7.76; 95% confidence interval (CI), 3.08-9.42]; and in men, it was lack of home smoking restriction (PR ratio-6.35; 95% CI, 4.51-8.93). Among men, SHS exposure at any location was associated with lack of secondary school education, residing in slum apartment (house with many households), living with a smoking family member (non-spouse), lack of home smoking restriction, and alcohol intake. Among women, SHS exposure at any location was associated with having a smoking spouse, residing in slum apartment and lack of home smoking restriction. Seventy-two percent of respondents were aware of the harmful effects of SHS on their health. Lack of awareness of the harmful effects was significantly associated with increasing age (r= +0.45; P = &lt;0.01), lack of secondary school education (r= 120.10; P = 0.04), residing in slum apartment (r =-0.12; P = 0.03) and being a widow/ widower (r= +0.24; P &lt; 0.01). Only 17.4% of the employees reported availability of outdoor smoking area at their workplaces. Conclusion: Our results show that prevalence of SHS exposure was the highest in public places. These findings underscore the need for enactment of comprehensive smoke-free legislation and implementation of educational strategies to reduce SHS exposure in homes

Secondhand smoke exposure among nonsmoking adults in two Nigerian cities

Background: Tobacco control policy can only succeed if the burdens of smoking are known. The objective of this study was to determine the prevalence and correlates of secondhand smoke (SHS) exposure among nonsmoking adults in two Nigerian cities. Materials and Methods: We carried out a cross-sectional study from October 2009 to April 2010 among adult population of two Nigerian cities: Enugu and Ilorin. A semi-structured questionnaire was administered by interviewers to obtain socio-demographic information; and information regarding pattern of SHS exposure, awareness of tobacco control policy and the harmful effects of SHS. SHS exposure was defined as regular exposure to tobacco smoke in the previous 30 days in a nonsmoking adult. Results: Of the 585 nonsmoking adults that completed the study, 38.8% had regular exposure to SHS; mostly, in public places (24.4%). More men were exposed at public places when compared with women (27.0% vs. 19.5%). The strongest factor associated with exposure to SHS in women was having a smoking spouse [prevalence rate (PR) ratio-7.76; 95% confidence interval (CI), 3.08-9.42]; and in men, it was lack of home smoking restriction (PR ratio-6.35; 95% CI, 4.51-8.93). Among men, SHS exposure at any location was associated with lack of secondary school education, residing in slum apartment (house with many households), living with a smoking family member (non-spouse), lack of home smoking restriction, and alcohol intake. Among women, SHS exposure at any location was associated with having a smoking spouse, residing in slum apartment and lack of home smoking restriction. Seventy-two percent of respondents were aware of the harmful effects of SHS on their health. Lack of awareness of the harmful effects was significantly associated with increasing age (r= +0.45; P = <0.01), lack of secondary school education (r= −0.10; P = 0.04), residing in slum apartment (r =-0.12; P = 0.03) and being a widow/ widower (r= +0.24; P < 0.01). Only 17.4% of the employees reported availability of outdoor smoking area at their workplaces. Conclusion: Our results show that prevalence of SHS exposure was the highest in public places. These findings underscore the need for enactment of comprehensive smoke-free legislation and implementation of educational strategies to reduce SHS exposure in homes

Awareness of the Warning Signs, Risk Factors, and Treatment for Tuberculosis among Urban Nigerians

Objectives. To determine the awareness of the warning signs, risk factors, and treatment of tuberculosis among urban Nigerians. Methods. This was a cross-sectional survey among 574 adults in Ilorin, Nigeria. Semistructured questionnaire was administered by trained interviewers to obtain information about awareness of tuberculosis warning signs, risk factors, and treatment. Results. Majority of the subjects (71.4%) were aware of at least one warning sign of tuberculosis. Cough (66.2%), weight loss (38.0%), and haemoptysis (30.7%) were the most identified warning signs. The predictors of awareness of warning sign were increasing age (), higher family income (), higher level of education (), and belonging to Christian faith (). Awareness of risk factors for tuberculosis was higher for tobacco smokers (77.0%) and history of contact with a case of TB (76.0%). Less than half were aware of HIV infection (49.8%), alcohol consumption (42.5%), chronic kidney disease (40.4%), extremes of ages (39.4%), cancers (36.9%), and diabetes mellitus (27.5%) as risk factors for TB. Tuberculosis was reported to be curable by 74.6% of the subjects and 67.9% knew that there are medications for treatment of tuberculosis, while 11.5% knew the duration of treatment. Conclusion. This study has revealed that the awareness of HIV and noncommunicable diseases as risk factors for TB is poor. This study has therefore demonstrated the need for health education programs that will emphasize recognition, identification, and modification of risk factor for TB