Health-related quality of life among patients with bronchial asthma in Ile-Ife, Nigeria

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Exercise-induced asthma in adult Nigerian asthma patients: a comparison of step test, free running, and bicycle ergometer

Exercise is not only a very common precipitant of acute asthmatic episodes but also a potent non-pharmacological test for diagnosis of asthma. Different exercise protocols have been used; however a simple exercise test would be valuable and helpful for detecting exerciseinduced asthma (EIA). The main goal of this study was to compare the exercise-inducing capacity of free running; step test; and cycle ergometer. Forty-eight asthma patients performed and completed the exercise tests reaching at least 80-85of the predicted maximal heat rate. The peak expiratory flow (PEF) values and heart rate (HR) were used to monitor pulmonary function post-exercise and the intensity of the exercise respectively. The PEF values were measured at baseline; immediately after the exercise then at 5-minute intervals up to 30 minutes. Subjects who reached the percentage fall in PEF 15were considered positive for EIA. Free running was found to be the most asthmagenic exercise followed by the step test and cycle ergometer: 36 subjects (75) for free running versus 27 subjects (56) for step test; versus 24 subjects (50) for cycle ergometer. There is a strong and significant correlation between the percentage fall in PEF of cycle ergometer and step test (r=0.61; p0.001). Free running produced the most positive result. However; the step test is a safe; simple; portable; and readily available instrument which compares well with laboratory-based cycle ergometer. We conclude that the step-test is an inexpensive and responsive exercise protocol for assessing and evaluating asthmatics in low-income countries

Presentation of Colorectal Cancers in Benin-City; Nigeria

Background: Colorectal cancer is a major cause of cancer death worldwide; and the prevalence in Nigeria appears to be increasing due to a shift to western diets. We undertook a retrospective analysis of colorectal cancers seen at the University of Benin Teaching Hospital; Benin City from January 1983 to December 2002. Methods: One hundred and two cases involving the large bowel were encountered. These were analysed for age; sex; site; histological type and clinical features. Results: The mean age was 44.5 +/-4.5 years. Males accounted for 56 (54.9) cases; while 46(45.1) were females. Seventy two (70.2) of the tumours were located in the rectum. Adenocarcinoma was the predominant histological type; with 89 (87.2) cases. Fifty two (51) cases presented with intestinal obstruction. Conclusions: Conclusion; colorectal cancers are not rare in our environment as previously believed; though; the frequency in Benin City is relatively low

Churg Strauss Syndrome: a Review

Background:Churg Strauss syndrome is a medical condition of unknown aetiology characterized by asthma; eosinophilia and finally vasculitis involving small vesselsin the limbs and nasal sinuses and the lungs. The purpose of this review is to highlight the natural history of this condition; the pathogenesis; clinical features andtreatment modalities available and the prognosis. Methods:Literature on the subject was reviewed using manual library search; articles in journals; internet search and conference abstracts. Results : Churg Strauss syndrome has been reported to be predominantly common in middle aged individuals in their middle age of life with a history of new onset or worsened asthma. The condition has a male predisposition. Prior to the advent of steroid therapy this condition invariably leads to death; but since theintroduction of prednisolone therapy and other immunosuppressive therapy; the outlook has improved for sufferers and long term survival has been seen. Conclusion: Suspicion of this condition should be based on a good history; physical examination and laboratory investigations and diagnosis based on the criteria that has been drawn by the American College of Rheumatology

Pattern and Outcome of Childhood Teratoma: a 10-Year Review

Background: Teratomas are neoplasms which originate from pluripotent stem cells. They are composed of a wide variety of tissues foreign to the organ or anatomic site in which they arose. This study sought to determine the clinical manifestations and outcome of treatment of childhood teratomas. Method: A retrospective analysis of the case files of children treated for teratoma at the University of Benin Teaching Hospital Benin City; Nigeria between January 1999 and December 2008 was done. Results: Fifty-three children aged between 5 days and 16 years; comprising 15 males and 38 females with male:female ratio of 2:5 were treated for teratoma; gonadal 27(50.9) and extragonadal 26 (49.1). Ovarian; 23 (43.4) and sacrococcygeal; 17 (32.1) sites were frequently involved. Other sites included testicular; 4 (7.5); retroperitoneal; 4 (7.5) and renal; 2 (3.8); while posterior mediastinal; cervical and breast involvement were 1 (1.9) each. Despite late presentation; no frankly malignant primary teratoma was diagnosed. Benign cystic teratomas with malignant elements comprising yolk sac tumour and immature neuroepithelial elements (mixed germ cells tumour) were the major histological types. Complete tumour resection that included total coccygectomy; oophorectomy and orchidectomy; plus combination chemotherapy using vincristine; actinomycin; and cyclophosphamide was curative in 25 (47.2) children. Eighteen (34) cases of recurrence were all malignant. They presented very late with rapid disease progression that resulted in 10 (18.8) deaths during the five years of follow-up. Conclusion: Although all primary teratoma were benign; recurrent malignant tumours with rapid progression to carcinomatosis; multiple organs failure and deaths were common in childhood teratoma. We advocate close follow-up of all children with teratoma to detect and commence early treatment