Body mass index and asthma severity in a population of Nigerian asthmatics.

BACKGROUND: Asthma and obesity have considerable impact on public health. There is increase prevalence of both conditions worldwide. This study was undertaken to determine the prevalence of obesity among asthma patients as well as determine the effect of body mass index (BMI) on asthma severity and pulmonary functions. METHODS: The study was conducted at the asthma clinic of the medical outpatient of Lagos State University Teaching Hospital, Ikeja. Ethical clearance was obtained from the hospital's research and ethics committee. Non probability sampling method was used with consecutive asthma patients diagnosed by the respiratory physicians according to NHLBI guideline recruited into the study. The weight, height and pulmonary function tests were carried out using standard methods. Acarefully designed interviewer administered questionnaire were used to collect information on the socio demographic characteristics of the patient, asthma symptoms, control use of rescue medications and emergency visits. RESULTS: One hundred and fifty eight (158) asthma patients participated in the study. There were 63 (39.9%) males and 95 (60.1%) females. The prevalence of obesity was 53.8%. The mean age of respondents was 46.48 +/- 17.16 years. Age, educational level and employment status were related to the body mass index while gender and duration of asthma were not. There was no difference in the severity of asthma and utilization of emergency services across the BMI categories. The obese asthmatics generally recorded lower lung function volumes compared with the non-obese asthmatic groups. CONCLUSION: Prevalence of obesity is high among the asthmatics studied. There is no difference in asthma severity across the BMI categories. Pulmonary functions are lower in obese asthmatics.

Five-year Audit of Spirometry at the Lasuth; Ikeja; South-West Nigeria

Spirometry is a non-invasive tool of importance in respiratory medicine. There is an enormous burden ofpulmonary disease worldwide, including in Nigeria.This retrospective study was done to determine the utilisation of spirometry services in the Lagos StateUniversity Teaching Hospital (LASUTH). It determined the sources of referral, indications, and pattern of pulmonary abnormalities.This is a retrospective study. An audit was done on the data collected at the Pulmonary Function Laboratory of the LASUTH between September 2006 and October 2011. Spirometry was done using the Gold Standard Vitalograph spirometer. The demographic characteristics of the patients who had spirometry as well as FEV1, (forced expiratory volume in 1 second)FVC (forced vital capacity), and their predicted values were noted.A total of 849 patients had spirometry done over the 5-year period. Slightly more than half were male patients. The mean age of the patient was 50±19 years. There was a steady increase in the number of spirometry tests performed from 2006 reaching a peak in 2009. Thereafter, a sharp decline was seen in 2010 with a steady rise in the first 10 months of 2011.The most common indication for spirometry was in the evaluation and assessment of asthma in 487 patients (57%). Most of the referrals for spirometry were from the medical department of the hospital representing 532 (63%) patients; 202 (24%) of the request were from the general out-patient department by family physicians, while 115 (13%) came from the surgical department. The outcome of the ventilatory abnormalities showed that 372 (44%) had normal ventilatory indices, 206 (24%) had obstructive patterns,169 (20%) had mixed type, while restrictive patterns were seen in 102 (12%).We concluded that although spirometry is frequently used in our clinical practice, this can be improved upon

Efficacy of a clinical stroke score in monitoring complications in acute ischaemic stroke patients could be used as an independent prognostic factor.

BACKGROUND: Presence of medical complications in stroke patients has been established. The efficacy of a stroke score in intensive monitoring of these complications in acute ischaemic stroke patients has not been studied. METHODS: Eighty-seven patients with acute ischaemic stroke were assessed with National Institute of Health Stroke Scale (NIHSS) by the examiner within days of admission; (1, 7, 30, and 90 days). Onset and types of complications were documented within the duration of the study period, using a questionnaire and laboratory investigations. RESULTS: Fifty-nine [67.8%] patients in the study population had complications, with mean initial NIHSS score 17.1 ± 7.9; mortality was 39%, and 27.8% of survivors had good recovery. In patients without complications, the mean initial NIHSS score was 11.4 ± 6.0; mortality was not observed, and 50% of survivors had good recovery. CONCLUSION: All patients without complications survived. High NIHSS scores, (with minimal changes below baseline) were related to high mortality and morbidity in the complications group.