Objectives: Respiratory disease is a leading cause of morbidity and mortality worldwide. Most of the deaths will occur in low resource countries like Nigeria. There is limited data on the burden of these respiratory diseases. Methods: A retrospective study of three hundred and seventy-seven (377) cases was carried out. Case selection was based on review by at least a specialist pulmonologist. Other data were retrieved with the help of questionnaire for analysis. Results: Respiratory diseases accounted for about 10.4% of hospital admissions at the medical emergency of the hospital. Pulmonary tuberculosis (PTB) (40.3%) and acute lower respiratory tract infections (ALRTI) (27.9%) were the major presentation. More deaths occurred from PTB (51.6%), with HIV and diabetes mellitus been the major comorbidities commonly associated with the disease presentation. Conclusion: The burden of respiratory diseases is substantial, with communicable diseases such as PTB and ALRTI are leading in terms of inpatient presentation. HIV disease is the main condition commonly associated with morbidity and mortality.
Methods: In a single-center, retrospective, observational study, data of renal transplant patients was screened to identify patients treated with ATLG. ATLG was administered with a mean dose 5 mg/kg in three divided doses on a day before transplant and day 1 and day 2 post-transplant with. Blood samples were collected in EDTA vial on day 1 and day 5 for immunodeficiency panel testing. Changes in absolute lymphocytes count (aLC), absolute CD3 (aCD3), absolute CD4 (aCD4), absolute CD8 (aCD8) counts, CD4:CD8 ratio and serum creatinine were noted. Also, the incidence of bacterial, viral or any other infections as well as graft dysfunction or rejection were noted. Results: In 30 patients treated with ATLG, mean age was 42.0AE14.1 years and 80% were males. Etiology of chronic kidney disease was unknown in majority (86.7%) patients. HLA mismatch of 3 or more was seen in 61% patients. Significant reductions in aLC (1068.9AE488.4 to 472.6AE443.2, p<0.0001), aCD3 (790.8AE405.8 to 249.5AE305.4, p<0.0001), aCD4 (476.8AE293.6 to 141.4AE168.3, p<0.0001) and aCD8 (282.2AE145.8 to 102.0AE134.2, p<0.0001) counts were seen in post-transplant period. Change in CD4:CD8 ratio was also significant (p¼0.046). Mean serum creatinine at discharge was 0.98AE0.36 mg/dL, which changed to 1.06AE0.31 at 1 month (n¼29, p¼0.109), 1.1AE0.39 at 2 month (n¼24, p¼0.210), 1.26AE0.49 at 3 months (n¼18; p¼0.040) and 1.33AE0.31 at 6 months (n¼8; p¼0.081). Urinary tract infection (majority due to Escherichia coli) was observed in 30% patients. One patient each had delayed graft function and mild acute cellular rejection (at 5 th month). No complications of viral infections were noted. Conclusions: Pre-transplant use of ATLG is associated with significant reduction in absolute counts of lymphocytes, CD3, CD4, CD8 cells, change in CD4:CD8 ratio and with preservation graft function over 6 months. There is no increase in incidence of viral infections. Larger, prospective studies are necessary to confirm the findings.
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