Browsing by Author "Fawibe, AE"

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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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    Cardiac autonomic dysfunction in sickle cell anaemia and its correlation with QT parameters.
    (Nigerian Medical Association., 2013) Kolo, PM; Sanya, EO; Olanrewaju, TO; Fawibe, AE; Soladoye, A
    Background: Abnormalities of QT parameters together with cardiac autonomic neuropathy (CAN) confer significant risks of cardiac morbidity and mortality in patients with diabetes mellitus. We questioned whether or not CAN influences occurrence of QT interval prolongation and dispersion in patients with sickle cell anaemia (SCA). Materials and methods: Forty stable adult sickle cell patients with 44 healthy haemoglobin AA controls were studied. Baseline electrocardiograms were obtained and cardiovascular autonomic function tests were performed using standard protocols. Results: Mean corrected QT (QTc) in sickle cell patients was significantly higher (P = 0.001) than the mean of controls. Similarly, mean QT dispersion (QTcd) was higher (P = 0.001) in the former than in the latter. Mean QTc in patients with CAN was longer than patients with normal autonomic function (461 ± 26 ms versus 411 ± 23 ms), P = 0.001 (OR of 17.1, CI 3.48-83.71). Similarly, QTcd was higher (P = 0.001) in patients with CAN than those with normal cardiac autonomic function. Positive correlations were found between CAN with QTc and QTcd (r = 0.604, P = 0.001, r = 0.523, P = 0.001, respectively). Conclusion: CAN is a risk factor for abnormalities of QT parameters in SCA and both may be harbinger for cardiac death.
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    Drug prescription pattern for asthma among Nigerian doctors in general practice: A cross-sectional survey.
    (Saudi Thoracic Society, 2012-04) Fawibe, AE; Onyedum, CC; Sogaolu, OM; Ajayi, AO; Fasae, AJ
    Background: A wide range of medications are now available for the treatment of asthma and selection of the optimal treatment combination of agents is essential. Objectives: This study was designed to evaluate a self-reported drug prescribing pattern for asthma among Nigerian doctors in general practice. Methods: It was a cross-sectional survey conducted among general practitioners in six states of Nigeria. Results: For acute severe asthma, 75.9% of the doctors prescribed intravenous methylxanthines, which was combined with oral or inhaled short-acting β(2) agonists (SABA) by 56.3% of them. Systemic steroids were prescribed mainly via the intravenous route by 58.8% of them. Aberrant drugs such as antibiotics, antihistamines, and mucolytics were prescribed by 25.6% of them. For long-term, follow-up treatment of asthma, oral steroids, and oral SABA were commonly prescribed, while inhaled corticosteroids (ICS) and ICS/LABA (long acting beta agonists) were infrequently prescribed. Aberrant drugs such as analgesics, antimalaria, and antihistamines were prescribed by 22.8% of them. About 48% of the doctors had never attended any form of update training on asthma management, whereas, only 16.3% attended update training on asthma within the last year preceding this study. Awareness of international guidelines on asthma treatment was poor among them with only 16.4% being able to mention any correct guideline on asthma management. Conclusion: The poor anti-asthma prescribing behavior among these doctors is associated with a low level of participation at update training on asthma management and poor awareness of asthma guidelines. The Nigerian Medical Association and the Nigerian Thoracic Society should urgently address these problems.
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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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    FEMALE SEXUAL DYSFUNCTION IN WOMEN ATTENDING THE LENTIVIRAL CLINIC AT THE UNIVERSITY OF ILORIN TEACHING HOSPITAL, ILORIN, NIGERIA
    (NIGERIAN JOURNAL OF FAMILY PRACTICE, 2021) Odeigah, L O; Fawibe, AE; Bolarin, MT; Obalowu, IA; Mutalub, YB; Williams, FE
    Introduction: Sexual dysfunction in HIV positive women is common and it is often associated with psychosocial distress. Not much scientific attention has been focused on this important aspect of the life of the HIV-positive woman especially in Nigeria and in the West African sub-region at large, where issues pertaining to sexuality are hardly ever discussed due to cultural restrictions and taboos. Objectives: To determine the prevalence, psychological status, and socio demographic/clinical factors associated with sexual dysfunction in HIV-positive women at the lentiviral clinic of the University of Ilorin Teaching Hospital, Ilorin, Kwara State. Methods: This was a hospital based cross-sectional study conducted over a six month period. Data were collected from 370 respondents using a structured questionnaire. The General Health Questionnaire (GHQ12) was used to assess their psychological status while the modified Female Sexual Function Index Questionnaire (FSFI) was used to assess female sexual dysfunction. Questionnaire was interviewer administered and the data was analyzed using Epi-info 2011 package. Results: It showed that the prevalence of Sexual Dysfunction in HIV positive women was sixty one percent (61%). Thirty five percent (35%) of the respondents had significant psychological distress. The presence of psychological distress was significantly associated with Female Sexual Dysfunction (FSD). There was no association between FSD and religion, ethnicity, duration of marriage or presence of other chronic diseases. Increasing age, multiple sex partners, non-disclosure of HIV status, stigma, on-going stressful event, being underweight or obese were significantly associated with FSD. High level of education, being married, monogamy, WHO clinical stage I disease and higher CD4 count were associated with better sexual functioning. Conclusion: This study brings to the fore the need for physicians and healthcare workers who render comprehensive care as frontline doctors to acquire skills needed to attend to and alleviate the sexual problems of women in an African setting.
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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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    Management of Asthma in Sub-Saharan Africa: The Nigerian Perspective
    (Pan African Thoracic Society, 2008) Fawibe, AE
    Asthma is a very common respiratory disorder with rising prevalence rates worldwide. The advances in our understanding of its pathogenesis and introduc tion of new medications in its management have not been of much benefit to most patients in Africa. This is due to various complex and interrelated reasons such as lack of proven diagnostic and monitoring facili ties, inadequate knowledge of current management of asthma by doctors, poor compliance by patients, use of traditional medicines of unproven efficacy, fake/substandard drugs, and lack of locally designed guidelines based on local resources. The solutions to these problems require the full participation of all. Governments need to provide the appropriate envi ronment for the care-givers and patients; on the other hand the care-givers need to update themselves on the current management of asthma, while the patients need to take the treatment of their illness seriously and also develop a strong management partnership with their care-givers.
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    Managing acute chest syndrome of sickle cell disease in an African setting
    (Royal Society of Tropical Medicine and Hygiene, UK, 2008-03) Fawibe, AE
    Despite the fact that acute chest syndrome contributes immensely to morbidity and mortality in patients with sickle cell anaemia, its exact aetiopathogenesis is very complex and not yet well understood. Therefore, a high index of suspicion is needed in its diagnosis, and appropriate treatment should be commenced as soon as possible to prevent lethal complications of this condition, especially in Nigeria where appropriate diagnostic and therapeutic facilities may not be readily available. This is very important, as it may even develop on hospital admission. There is a need to further investigate preventive measures such as the use of hydroxyurea and the newly introduced Nicosan, especially in those people with recurrent disease, in order to reduce both short- and long-term complications of this syndrome among sickle cell patients in Nigeria.
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    The pattern and outcome of adult tetanus at a sub-Saharan tertiary hospital in Nigeria.
    (College of Physicians and Surgeons Pakistan., 2010) Fawibe, AE
    Though tetanus is a major cause of preventable morbidity and mortality in Nigeria, there is a paucity of data on the pattern and outcome of the disease among the sub-urban and rural populations. This retrospective study of adult tetanus at a suburban tertiary hospital in Nigeria reports a high case fatality rate of 57.1% in 35 patients with a mean age of 33.0+/-14.8 years. Severity of disease (p=0.02), presence of complications (p=0.001) and length of hospital stay (p<0.001) were significantly associated with fatality. Preventive measures for control of tetanus should be extended to the inaccessible suburban and rural areas of Nigeria.
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    Prevalence and Characteristics of Cigarette smokers among Undergraduates of the University of Ilorin, Nigeria
    (Medical and Dental Consultants Association of Nigeria., 2011) Fawibe, AE; Shittu, AO
    Background: Smoking control is urgently needed to prevent the epidemic of tobacco-related diseases and deaths in developing countries. This requires data on smoking, especially among vulnerable groups like students. We have surveyed cigarette smoking among undergraduates of the University of Ilorin, in the North Central region of Nigeria. Materials and methods: This was a questionnaire-based survey among undergraduates of the University of Ilorin. A total of 1800 students were selected by multistage random sampling. Results: A total of 1754 students (234 medical and 1520 non-medical students) completed the questionnaires. They were 1148 (65.5%) males and 606 (34.5%) females with a mean age of 21.6 ± 3.1 years. The prevalence rate of current smoking was 5.7% (males 7.7%, females 2.0%) and of ever smoking was 17.1% (males 22.9%, females 6.2%). Smoking was more common in non-medical students. Eighty-three (83.8%) of the smokers had already started smoking by their eighteenth birthday. Fifty-one (51.5%) of them smoked ≤ 5 sticks of cigarettes daily. Most of them were influenced into smoking by peer pressure and commercial advertisements. Sixty-seven (67.6%) of them believed that smoking could never have a negative impact on their health status and quality of life and just 39 (39.4%) smokers were willing to quit. Conclusions: Despite the low prevalence rate of smoking in the studied population, a majority of them were not willing to quit because of a low perception of the negative effects of smoking on their health and quality of life. Comprehensive antismoking campaigns were urgently needed to control cigarette smoking among University undergraduates in Nigeria.
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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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    A Retrospective Five Year Review of Snakebite in Bida, Nigeria.
    (College of Health Sciences, University of Ilorin, 2009) Fawibe, AE; Ibok, IO
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    Sickle Cell Chronic Lung Disease among Young adult Nigerians.
    (West Africa College of Physicians and Surgeons, 2010) Fawibe, AE; Oluboyo, PO; Salami, AK
    Background: Sickle cell chronic lung disease (SCLD) is often underappreciated by health care providers because its exact prevalence and methods of diagnosis have not been well studied. Objective: To describe the pattern of SCLD among young adult Nigerians with sickle cell anaemia (SCA).its exact prevalence and methods of diagnosis have not been well studied. Objective: To describe the pattern of SCLD among young adult Nigerians with sickle cell anaemia (SCA). Methods: Ninety (43 males and 47 females) patients with SCA who were selected by balloting and 90 (54 males and 36 females) healthy subjects with normal adult haemoglobin were studied. Their ventilatory function test (spirometry and peak expiratory flow rates), radiological and electocardiographic parameters were obtained and analyzed for SCLD. Results: Seventeen (18.9%) of the patients had SCLD. Majority (94.1%) of them were in stage1 disease, 5.9% in stage two, and none in the more advanced stages3 and 4. The number of patients with SCLD increased with increasing age. SCLD was associated with more than five previous hospital admissions: 82.4%, (OR of 10.02; CI:4.51 to 22.22) and presence of symptoms suggesting previous acute chest syndrome: dyspnoea in 58.8% (OR of 33.33, CI 7.39 to 150.30); chest pain in 94.1%, (OR of 81.33, CI 9.83 to 672.85); and cough in 47.1%, (OR of 64.00, CI 7.15 to 572.60). Conclusion: SCLD may not be a rare event in Nigeria. Therefore efforts should be made to diagnose it in the early asymptomatic stage so as to offer effective intervention therapy to halt progression to the more disabling advanced stages.
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    Sickle cell chronic pulmonary disease among Africans: the need for increased recognition and treatment
    (Pan African Thoracic Society, 2008) Fawibe, AE
    The pulmonary complications of sickle cell disease (SCD) among adults are expected to increase since more of them are expected to survive into adulthood with improved healthcare delivery systems. Such complications, especially the chronic ones, which are usually collectively referred to as SCCLD (sickle cell chronic lung disease), are often under-appreciated by healthcare providers in sub-Saharan Africa. However, results of recent work in Nigeria show that SCCLD might not be as uncommon as previously thought. It is very important to detect SCCLD at an early stage, which is usually asymptomatic; the late stages are not usually responsive to conventional treatment. In Africa, outline spirometry can be used as a screening test for asymptomatic SCCLD in the follow-up of SCD. Patients with asymptomatic SCCLD should be offered measures that can prevent further deterioration of their condition, while those with more advanced symptomatic disease are treated symptomatically.
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    Unilateral post-tuberculosis lung destruction and massive haemoptysis in pregnancy with successful outcome.
    (Faculty of Medicine, Alexandria University, Egypt., 2015-04) Adeniran, AS; Ijaiya, M.A.; Fawibe, AE; Adeoye, PO; Abdulkadri, ZA
    Post-tuberculosis destroyed lung is a fatal complication of pulmonary tuberculosis which can manifest with severe life-threatening haemoptysis. Its occurrence during pregnancy is rare and challenging because of the significant risk to both the mother and the foetus. We present an unbooked 36 year old G6P4 +1 (4 alive) woman who presented with chronic cough, massive haemoptysis and multiple pregnancy (twin) at 35 week gestation. She had completed anti-tuberculosis treatment twice at and over nine years prior to presentation. On evaluation, there were clinical and radiological evidences of unilateral (right) destroyed lung but no evidence of active tuberculosis; resuscitation was with antibiotics, blood transfusion and oxygen therapy followed by an emergency caesarean delivery due to significant maternal compromise. The symptoms resolved following antibiotic therapy and she was subsequently discharged home. Post-tuberculosis destroyed lung is a fatal uncommon condition that may present during pregnancy and requires a multi-disciplinary specialist care to ensure good maternal and foetal outcome