Browsing by Author "Desalu, OO"

Now showing 1 - 9 of 9
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    Advanced sickle cell associated interstitial lung disease presenting with Cor Pulmonale in a Nigerian.
    (Nigerian Medical Association., 2012) Fawibe, AE; Kolo, PM; Ogunmodede, JA; Desalu, OO; Salami, AK
    Previous studies have reported abnormal pulmonary function and pulmonary hypertension among Nigerians with sickle cell disease, but there is no report of interstitial lung disease among them. We report a Nigerian sickle cell patient who presented with computed tomography proven interstitial lung disease complicated by pulmonary hypertension and cor pulmonale.
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    Assessment of the level of asthma control among adult patients in two tertiary care centers in Nigeria
    (International association for the care of asthma, 2012) Desalu, OO; Fawibe, AE; Salami, AK
    Background: According to the Global Initiative for Asthma (GINA) guidelines, the goal of asthma management is to achieve clinical control. Uncontrolled asthma places a significant social and economic burden on patients. Objective: The two aims of this study were to (1) assess the level of asthma control (according to the GINA definition of "control") among adult patients attending two tertiary care centers in Nigeria and (2) to determine the predictors associated with uncontrolled asthma. Methods: This cross-sectional study was carried out from June 2009 to December 2010. The participants were all 18 years old or older with physician-diagnosed asthma. First, the participants completed an interviewer-administered questionnaire, which included items that collected their socio-demographic information and clinical data. Second, anthropometric indices were measured and spirometry was conducted to determine each participant's lung function. Finally, the researcher team members assessed each participant's inhaler device technique. The outcome measures were (1) uncontrolled asthma, (2) partly controlled asthma, and (3) controlled asthma. Results: One hundred and twenty-four asthma patients participated in the study. Of these, 69.3% had uncontrolled asthma, 22.6% had partly controlled asthma, and 8.1% had controlled asthma. Multivariate analysis showed that uncontrolled asthma was strongly associated with asthma severity based on clinical features, the incorrect use of an inhaler device, the use of oral corticosteroids, an abnormal pulmonary function test, the presence of comorbidity, and the lack of adherence to inhaled corticosteroids (ICSs). The results also revealed that increasing age and a lack of tertiary education were weakly associated with asthma control. In this study, gender, marriage, smoking status, occupation, socioeconomic status, income, and the duration of the asthma were not associated with asthma control. Conclusion: A significant proportion of the sampled patients had uncontrolled asthma. To reduce this number, health care providers must reinforce the education of each asthma patient and promote the regular assessment of asthma control at every clinic visit, identify those with poor control, and institute the appropriate therapy needed to achieve clinical control.
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    An audit of Spirometry at the University of Ilorin Teaching Hospital, Ilorin, Nigeria (2002—2009).
    (Usmanu Danfodiyo University, Sokoto, 2010) Desalu, OO; Salami, AK; Fawibe, AE; Oluboyo, PO
    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
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    Factors affecting interest in respiratory medicine as a subspecialty of choice: survey of internal medicine residents in Nigeria
    (The Nigerian Postgraduate Medical Journal, 2013) Desalu, OO; Onyedum, CC; adeoti, AO; Ozoh, OB; Sogaolu, OM; Gundiri, LB; Adekoya, AO; Salami, AK; Fawibe, AE
    Aims and objectives: The objective of this study was to determine the factors that affect the interest in respiratory medicine (RM) as a subspecialty of choice among internal medicine residents in Nigeria. Subjects, materials and methods: This was a cross-sectional study of 136 internal medicine residents recruited from seven teaching hospitals from January 2011 to June 2011. A semi-structured questionnaire that was self administered by residents was used to obtain socio-demographic information and factors affecting residents' interest in respiratory medicine. Results: Out of 136 residents that completed the study, 78 (57.4 %) were junior residents (PG year 1-3) and 58(42.6%) were senior residents (PG year >3). Thirty four (43.6%) junior residents and 21(36.2%) senior residents considered respiratory medicine as a sub-specialty of choice. Only 2(3.5%) of the senior residents were presently committed to RM. In the junior residents, interest in respiratory medicine was correlated with personal intelligence and ability (RR=2.58, ;95% confidence interval(CI): 1.16-7.07, p-0.01) , availability of respiratory physician (RR=2.42; 95% CI 1.07-7.63 ,p-0.02) and postgraduate examiners in RM in training institutions RR= (2.20; 95% CI 1.06-5.45,p-0.03), experience during rotation in medical school and residency (RR=2.11 ; 95% CI 1.11-4.21,p-0.03) and future annual income (RR=2.04;C:I1.03-4.68,p-0.04). In the senior residents, interest in RM was correlated with the availability of postgraduate examiners in RM in training institutions (RR- 6.36; 95% CI 1.16-66.80, P-<0.01), future opportunity for scholarships and travel grants (RR- 4.23; 95% CI 1.19-25.92,p-< 0.01), personal intelligence and ability (RR= 3.41; 95% CI.16-13.87,p-0.01) and prospect for rapid elevation in career (RR=2.92; 95% CI 1.03-11.91,p -0.04). Provisions of modern facilities in training institutions, mentoring by senior colleagues and promotion of subspecialty by respiratory physicians were rated by the senior residents as the most important ways of increasing interest in respiratory medicine and making it a specialty of choice. Conclusion: The interest in respiratory medicine among internal medicine residents is low and decline as their level of training advances. The factors affecting the interest in respiratory medicine have been highlighted and the policy makers need to understand, and if possible modify these factors by formulating appropriate changes to our training programs so as to increase future numbers of respiratory physician.
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    General Practitioner (GP)-reported Follow-up Visits among Asthma Patients in North Central Nigeria
    (Usmanu Danfodiyo University, Sokoto, 2011) Fawibe, AE; Joseph, KJ; Olaosebikan, OF; Salami, AK; Oluboyo, PO; Desalu, OO
    Background: Despite the benefits of regular follow-up in the long-term care of asthma, no previous study has reported on it among asthma patients in Nigeria. Objective: This survey was designed to evaluate GP-reported follow-up visits among asthma patients in North Central Nigeria. Methods: It was a cross-sectional survey conducted among GPs in three North Central states of Nigeria. Results: Overall, 48.3% of the GPs reported that their patients usually come for follow-up visits. About 63.6%, 40.0%, and 55.3% of the GPs in Kwara, Kogi, and Niger states, respectively, reported that their patients came for follow-up visits in the month prior to this study. Less than two-third of GPs in both private (55.1%) and public (56.8%) hospitals reportedly attended to patients on follow-up visits. About 46.5%, 37.5%, and 52.0% of the GPs who attended to patients <1 week, 1-2 weeks and >2 weeks prior to the study reported that their patients came for follow-up visits. There was significant difference (P = 0.04) in the reported follow-up visits by GPs who attended to ≥10 asthma patients compared to others. None of the nine GPs who reportedly treated ≥ 10 patients in the preceding month of the study attended to any patient on follow-up visits. Conclusion: The GP-reported rates of follow-up visits in patients that are accessing asthma care from GPs practicing in the North Central part of Nigeria are low. Further studies to identify barriers to follow-up visits and how to correct them are therefore recommended.
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    Prevalence of cough among adults in an urban community in Nigeria.
    (West Africa College of Physicians and Surgeons, 2011) Desalu, OO; Salami, AK; Fawibe, AE
    Background: Cough is the commonest symptom for which patients seek medical attention and may be a warning sign of an impending disease. Objective: To determine the prevalence of cough among adults in an urban community in Nigeria. Methods: We conducted a cross sectional study among subjects aged >18 years from May 2009 to October 2009 in Ilorin, Nigeria. A semi-structured questionnaire was used to collect the data. The American College of Chest Physicians (ACCP) and the European Respiratory Society (ERS) cough guidelines were used to define acute, sub acute and chronic cough. Results: A total of 472 subjects participated in this study, 238(50.4%) were men and 234(49.6%) were women. Ninety-seven (20.6%) had cough in the preceeding 12 months. Thirty-one (6.6%) had cough at the time of interview, of which 17(3.6%) were productive. The prevalence of acute cough was 3.8%, sub acute 1.7% and chronic cough was 1.1%. All types of cough were common in those aged <45 years, unskilled workers, low educational attainment, while chronic cough was common in the women. The risk of coughing increased with tobacco smoking and the number of sticks smoked per day. Majority of subjects with acute cough [16(88.9%)], sub acute cough [8(100%)] and chronic cough [3(60 %)], were yet to consult a doctor. Conclusion: Our study revealed a low prevalence of cough among adults in this urban community in Nigeria. It is imperative to enlighten the community on the importance of seeking early treatment for cough, which may be a warning sign of life threatening lung disease.
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    The Profiles and outcome of Unilateral Tuberculous Lung Destruction in Ilorin. Nigeria.
    (West Africa College of Physicians and Surgeons, 2011) Fawibe, AE; Salami, AK; Oluboyo, PO; Desalu, OO; Odeigah, LO
    Background: Unilateral tuberculous lung destruction is a serious chronically disabling and often fatal complication of pulmonary tuberculosis. A few previous studies have dealt with some aspects of this entity among Nigerians with pulmonary tuberculosis but these studies may not truly reflect its current trends. Objective: To describe the presenting profiles and outcome of unilateral tuberculous lung destruction among patients with pulmonary tuberculosis. Methods: The study was a chart review of the medical records of adult patients with pulmonary tuberculosis complicated by unilateral lung destruction seen between January 1999- December 2008. Data extracted included demographic, and outcome of treatment. The clinical features, sputum results and illustrative cases are presented. Results: Unilateral lung destruction complicated 74(1.3%) of 5,926 pulmonary tuberculosis cases seen over the review period. Most cases occurred in males [45(60.8%)] and they were predominantly [51(68.9%)] below 40 years of age. Most of them [52(70.2%)] presented after six months of symptoms. Forty-seven (63.5%) of them had had previous exposure to antituberculosis drugs. The left lung was affected in 49 (66.2%) patients. Only 25 (33.8%) of them were cured while the adjusted mortality rate was 25.5%. Male gender, presence of dyspnoea on mild exertion and right ventricular failure were significantly associated with increased mortality. Conclusion: Unilateral tuberculous lung destruction has unacceptably high mortality rate which can be prevented by patient presenting early to the hospital, prompt diagnosis and strict adherence to the standard treatment.
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    A Retrospective Evaluation of Pretreatment and Follow-up Monitoring of HIV—infected Adult Patients in a Resource—Poor Setting.
    (International Association of Physicians in AIDS care, Chicago., 2010) Fawibe, AE; Olafimihan, KO; Salami, AK; Desalu, OO; Odeigah, LO
    The rapid scale-up of antiretroviral therapy (ART) is associated with the challenges of ensuring that HIV care delivered to clients is of the highest quality. This study was designed to evaluate the pretreatment and 12 month follow-up monitoring of clinical and laboratory profiles of HIV-infected patients at the adult HIV clinic of the University of Ilorin Teaching Hospital, in Nigeria. It was a retrospective analysis of records of 440 adult patients who were on follow-up visits for 1 or more years. Two hundred two (45.9%) were male and 238 (54.1%) were female. Weight was documented at baseline in 314 (71.4%) and at month 12 of follow-up in 258 (58.6%). Baseline World Health Organization (WHO) clinical stage was documented in 269 (61.1%). Baseline CD4 count, full blood count (FBC), creatinine (Cr), liver function tests (LFT), fasting blood sugar (FBS), and fasting serum lipids (FSL) were documented in 243 (55.6%), 260 (59.1%), 143 (32.5%), 136 (30.9%), 268 (60.9%), and 161 (36.6%), respectively. At 12th month of follow-up visit, the CD4 count, FBC, Cr, LFT, FBS, and FSL were documented in 121 (27.5%), 94 (21.4%), 59 (13.4%), 77 (17.5%), 179 (40.7%), and 95 (21.6%), respectively. This report shows that the pretreatment and the 12th-month follow-up mon itoring of HIV-infected adult patients in our center was less than optimal. We recommend periodic self-assessment by care pro viders to monitor compliance with standards.
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    Utilisation of spirometry among hospitalised patients with clinical findings of COPD in a tertiary hospital in Nigeria.
    (National Postgraduate Medical College of Nigeria, 2011) Desalu, OO; Salami, AK; Fawibe, AE; Oluboyo, PO
    Aims and objective: The aim of this study was to determine the rate of spirometry utilisation among hospitalised patients with clinical findings of chronic obstructive pulmonary disease (COPD) in a tertiary hospital in Nigeria. Patients and Methods: A case record review of hospitalised patients with clinical findings of COPD from January 2002 to June 2009 from the record of the cardiopulmonary unit of the University of Ilorin Teaching Hospital Ilorin, Nigeria was carried out. Age and sex, hospital stay, admitting physician, and outcome of admission were obtained. Results: A total of 228 patients were hospitalised with clinical findings of COPD, 185 (81.1%) were males and 43(18.9 %) were females. The rate of utilisation of spirometry in hospitalised patients (228) with clinical findings of COPD was 8.3%. More than half of those that had spirometry were aged ≥65 years. Majority (16; 84.2%) of those that underwent spirometry were under the care of the pulmonologist (p<0.001). Age, sex, total days of hospitalisation of patients were not significantly associated with utilisation of spirometry. Conclusions The utilisation of spirometry among hospitalised patients with clinical findings of COPD in this study was very low when compared to the developed countries. Our study has highlighted the experience of a low income country and the need to increase the awareness of the role of spirometry in the evaluation of COPD among doctors