ICU-acquired weakness: A multicentre survey of knowledge among ICU clinicians in South-Western Nigeria.

BACKGROUND: Knowledge of ICU clinicians about Intensive Care Unit Acquired Weakness (ICU-AW) is a vital step in implementing prevention strategies. AIM OF STUDY: The purpose of this study was to investigate the level of knowledge of ICU clinicians in teaching hospitals in Southwest Nigeria about ICU-AW. METHODS: ICU clinicians were surveyed using a self-administered questionnaire to obtain data on knowledge about ICUAW. Data were summarized as frequency and percentages, mean and standard deviation using SPSS version 20. RESULTS: Total of 134 ICU clinicians (56 anesthetists, 35 physiotherapists, and 43 nurses) responded to the questionnaire, of which 100 were aware of ICUAW. Three of the 100 correctly identified ICU-AW as a neuromuscular disease. Totally, 40% correctly indicated Medical Research Council Scoring Scale as a diagnostic tool for ICU-AW. Severe sepsis and prolonged mechanical ventilation were the two highest identified risk factors for ICU-AW. However, only 35% of respondents were able to identify either use of aminoglycosides, and prolonged use of vasopressors as risk factors for ICUAW. Almost half (49%) reported having methods of managing ICUAW at their institution. CONCLUSION: Though awareness about Intensive care unit-acquired weakness (ICUAW) among clinicians in teaching hospitals in the Southwestern Nigeria is high, but knowledge about diagnosis and classification is low. This highlights the need for specialized training of ICU clinicians about ICUAW to enhance prevention and early detection.

OBESITY PHENOTYPE INFLUENCES TREND IN PULMONARY FUNCTION INDICES RECOVERY FOLLOWING ABDOMINAL SURGERY: PRELIMINARY REPORT FROM A NIGERIAN POPULATION.

BACKGROUND: Obesity phenotypes are known to have varying effects on pulmonary function but their effects on trends of pulmonary function indices' recovery among abdominal surgery patients is unclear. OBJECTIVE: To investigate the influence of obesity phenotype on pulmonary function trend among abdominal surgery patients. METHODS: An observational study involving 28 female patients aged 20-60 years who were never-smokers. Participants were classified into four groups namely: healthy BMI without abdominal obesity; healthy BMI with abdominal obesity; overweight/obese without abdominal obesity; and overweight/obese with abdominal obesity. Pulmonary function indices (FEV1, FVC and PEF) were taken day-1 pre-op; 5th, 6th and 7th day post-surgery. Data were summarized using mean and standard deviation, while Kruskal-Wallis and Jonckheere trend test were used to test for differences and trend across the groups at p < 0.05. RESULTS: Participants were comparable in age and height. Pre-op, group IV had the lowest pulmonary function indices and group I had the highest FEV1, FVC. At 7-day post-op, there was significant difference in pulmonary function indices across the groups, while trend test showed that obesity pattern had significant effect on the trend of FEV1, FVC and PER with group I having the highest values, followed by group III and group II, while group IV had the lowest values. CONCLUSION: Obesity phenotype had significant effect on trend of pulmonary function indices among participants. Patients with abdominal obesity, irrespective of BMI, had poor pulmonary function.

Effects of combined aerobics and abdominal strengthening exercises on abdominal adiposity in sedentary adults.

BACKGROUND: Excess abdominal adiposity has been associated with increased morbidity and mortality. Though aerobic exercises significantly reduce general adiposity, it has no effect on abdominal adiposity. However the effects of a combination of aerobic and abdominal strengthening exercises on abdominal adiposity are not known. OBJECTIVE: This study was designed to evaluate the effects of a 12-week aerobic and abdominal strengthening exercise programme on abdominal adiposity in sedentary adults. METHODS: A total of 105 consenting sedentary adults participated in this study. They were randomly recruited from the Ibadan metropolis. Participants went through exercise training which included aerobic and abdominal strengthening exercises. Exercise was carried out thrice weekly for 12 consecutive weeks. Abdominal adiposity indices of Waist Circumference (WC), Waist-to-Hip Ratio (WHR), Sum of Abdominal Skinfold (SAS) were measured at baseline, 4th, 8th and 12th weeks. Data were analyzed using descriptive statistics of mean and standard deviation and repeated measures ANOVA at p = 0.05. RESULTS: 74 participants with mean age (34.8 +/- 9.1 yrs) completed the study. At the end of the 12 -week exercise, there was significant reduction in WC (94.8 +/- 10.2 to 89.2 +/- 9.8 cm), WHR (0.89 0.06 to 0.86 +/- 0.05) and SAS (88.9 +/- 10.9 to 77.3+/- 13.5 mm) among the female participants. Within the male participants, there was significant reduction in WC (88.5 +/- 7.4 to 83.8 +/- 4.7 cm), and in SAS (60.1 +/- 8.4 to 54.5 +/- 8.5 mm), but no statistically significant difference was observed in the WHR (0.88 +/- 0.04 to 0.87 +/- 0.06). CONCLUSION: Twelve-week aerobic and abdominal strengthening exercise programme, without caloric restriction, reduced abdominal adiposity in apparently-healthy sedentary adults, hence it is recommended for its beneficial effects on abdominal adiposity.