A Synopsis of Asthma Research in Nigeria between 1970 and 2010

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Ventiliatory Function in Nigerians with Type 2 Diabetes

Reduced ventilatory function in type 2 diabetes has been reported in other parts of the world. This study aimed to assess the ventilatory function in Nigerians with type 2 diabetes and its relationship to the duration of symptoms of diabetes, glycaemic control, age, and body mass index (BMI). One hundred and one (101)patients with type 2 diabetes were matched to 104 control subjects with normal glucose tolerance. Historical and clinical data were documented and venous blood sampled for HbA1c in the diabetes group. Peak expiratory flow rate (PEFR), forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC) and the ratio of the FEV1 to the FVC as a percentage (FEV1/FVC%) were measured for both groups. Study subjects and controls were similarly matched. Mean PEFR (L/s), FEV1 (L), and FVC (L) were 5.6±2.24, 2.36±0.74,and 2.94±0.90, respectively, in the diabetes group and 6.31±1.62, 2.58±0.62, and 3.19±0.79, respectively, in the control group (p=0.006, 0.02, and 0.03, respectively).The FEV1/FVC% was 81.90±24.17 in the diabetes group and 81.26±5.99 in controls (p= 0.86). Compared with predicted values for Nigerians, 11 (11%) of diabetes subjects had restrictive lung disease and 6 (6%) had obstructive lung disease while 1 (1%) of controls had restrictive lung disease and 5 (5%) had obstructive lung disease (c2=9.46, p=0.009). In multivariate analysis, age was inversely related to the PEFR (p=0.04). BMI was inversely related to PEFR, FEV1, and FVC (p= 0.01, 0.001, 0.002, respectively). Duration of diabetes was also inversely related to FEV1 (p= 0.02). HbA1c was not significant for any ventilatory index. It was concluded that Nigerians with type 2 diabetes have significantly lower ventilatory function (with a restrictive pattern),compared with matched controls. Symptom duration,age, and BMI are independent determinants of ventilatory function

Eligibility of Nigerians with Type 2 Diabetes Mellitus for Inhaled Insulin

Parenteral delivery of insulin has been shown to reduce acceptance of insulin as a treatment option in type 2 diabetes mellitus (DM) patients.The advent of inhaled insulin is aimed at circumventing this problem; however inhaled insulin is a treatment option only for DM patients with normal lung function.The study set out to evaluate the forced expiratory volume in the first second in Liters (FEV1) of Nigerians with type 2 DM and thus determine the proportion potentially eligible for inhaled insulin.FEV1 was measured in 101 subjects with type 2 DM and 104 age; gender and body mass index matched controls without DM. All subjects were 'never smokers' without any physical condition that could compromise lung function. We then determined the proportion of subjects with FEV1; more than 70of normal; which defines eligibility for inhaled insulin.On the basis of the mean FEV1 in Liters of matched controls in this study being 2.58+ 0.62; the cot off for minimium FEV1 to qualify for inhaled insulin therapy was determined as 1.80 liters (i.e 70of 2.58). A total of 83 (84) of the 101 subjects with type 2 DM had FEV1 1.8 liters indicative of eligibility for inhaled insulin. Male sex; shorter duration of DM; normal body mass index (BMI) and younger age were associated with eligibility.A high proportion of Nigerians with type 2 DM attending tertiary care are eligible for inhaled insulin therapy making it a treatment option. The feasibility of this treatment option in terms of acceptability; affordability; side effect profile and efficacy in blood glucose control in Nigerians is an important research focus

Evaluation of Glutaraldehyde Test in the Diagnosis of Pulmonary Tuberculosis in Nigeria

In the developing world with scarcity of diagnostic facilities; the diagnosis of pulmonary tuberculosis (PTB) could often be difficult. Previous methods have proved inadequate; especially where TB is endemic. Serologic tests for the diagnosis of TB require advanced technology which is not readily available. The study therefore proposed to evaluate the usefulness (or otherwise) of the glutaraldehyde test (GT) in the diagnosis of PTB in this environment. Two hundred and ten consecutive consenting adults 18 years and above with newly diagnosed sputum smear positive PTB attending 4 government hospitals in the Lagos area were studied over one year. Age and sex matched controls from LUTH who had no symptoms or signs of TB were also studied. All cases had sputum smear examination (by the Ziehl-Neelsen method) and the glutaraldehyde test. Considering the normal gelification time of 215 seconds (at 1 SD); the glutaraldehyde test had a sensitivity; specificity; positive and negative predictive values of 92.40