Psychiatric morbidity in stroke patients attending a neurology clinic in Nigeria

Back ground

Stroke produces a wide range of mental and emotional disorders. Neuropsychiatric complications associated with stroke may have negative effects on the social functioning, overall quality of life and the recovery of motor functioning of stroke survivors.

Objective

To determine the prevalence and nature of psychiatric morbidity among stroke patients attending neurology outpatient clinic of the University of Ilorin Teaching Hospital (UITH), Ilorin-Nigeria.

Methods

All patients with stroke aged 18 years and above at an outpatient neurology clinic in Ilorin, Nigeria were assessed for mental and emotional disorders using the Schedule for Clinical Assessment in Neuropsychiatry (SCAN) over one year (March 2009 to February 2010).

Results

Overall prevalence of psychiatric morbidity was 36.0% (30/83) among 83 patients who constituted the study population. Specific diagnoses recorded were depression (19.2%), generalised anxiety disorder (9.6%), harmful alcohol use (2.4%); dementia, somatoform disorder, phobia and delusional disorder each had a prevalence of 1.2%. Clinical and sociodemographic variables were not significantly associated with psychiatric morbidity.

Conclusion

Psychiatric disorders are often associated with stroke. Identifying and treating stroke patients with these psychiatric co-morbidities could thus help to improve the overall quality of life of these patients.     

Seroprevalence of cytomegalovirus among pregnant women attending Murtala Mohammed Specialist Hospital Kano,Nigeria

Background

Primary Cytomegalovirus (CMV) infection during pregnancy is a frequent and serious threat to the fetus. As there is no vaccine alternative measures are needed to prevent congenital CMV infection.

Objective

This study determined CMV Immunoglobulin G (IgG) antibody among pregnant women in order to ascertain the immune status of mothers to guide policy makers.

Methods

A semi-structured questionnaire was initially administered to obtain information on demographic details, stage of pregnancy and risk factors. Blood was collected by venipuncture from 180 women attending the antenatal clinic in Murtala Mohammed Specialist Hospital Kano, Kano State, Nigeria. Sera samples were screened using CMV IgG ELISA kit (Dialab, Austria).

Results

Out of 180 pregnant women, 164 (91.1%) were seropositive. Based on stages of pregnancy 6/6(100%), 52/60(86.7%) and 106/114(93.0%) were seropositive among women in the first, second and third trimesters respectively.

Conclusion

Seroprevalence of pregnant women to CMV Ig G is high, hence the need for CMV - IgM screening to know the extent of active infection. There is also need for public enlightenment on the methods of transmission, effective prevention and control strategies.     

Overweight and obesity among patients attending a Nigerian oral surgery clinic: implications for oral surgical practice in Nigeria

Aim

To determine the prevalence of overweight and obesity among patients attending oral and maxillofacial outpatient clinic of the Lagos University Teaching Hospital, Nigeria; and discuss the clinical and surgical implications that obesity has on the delivery of oral and maxillofacial surgical and anaesthetic care.

Methods

Consecutive patients presenting to the oral and maxillofacial surgery outpatient clinic at the Lagos University Teaching Hospital, Nigeria over a 4-month period (May–August 2004) were screened for age, sex, height and weight. All of the patients were treated for dentoalveolar surgical procedures (routine and surgical extractions), incisional and excisional biopsies, and enucleation under local anaesthesia.

Results

The BMIs of the studied patients ranged from 16.7 to 39.8 kg/m², with a mean of 24.6 ± 4.5 kg/m². Prevalence of excess weight was 39.1%. Thirty-one (11.4%) patients were obese and 75 (27.7%) patients were overweight. A significant difference was observed in the BMIs of male and female patients (P=0.000). The age groups < 30 years had mean BMIs that were considered normal; whereas other age groups above 30 years had mean BMIs that were considered overweight. Prevalence of obesity increases with increasing age. Obese individuals were seen in all the age groups except those < 20 years.

Conculsions

The prevalence of excess weight (overweight and obesity) in patients presenting in the studied oral and maxillofacial outpatient setting was 39.1%. Oral and maxillofacial surgeon needs to be aware of obesity-/overweight-related medical and surgical issues and take them into consideration when treating these patients.     

Pneumomediastinum as a complication of asthma in teenage and young adult patients

The characteristics of 11 patients (age range, 13 to 31 yr) with asthma complicated by pneumomediastinum are presented. Nine of 11 patients were male. Cough and chest pain were prominent symptoms in the affected individuals. Subcutaneous emphysema was noted in all but 1 patient who presented with an unusual radiographic finding: a radiolucent rim surrounding the pulmonary artery. Hamman's sign was detected in 7 patients. None of the patients required specific therapy for pneumomediastinum. The pathophysiology of pneumomediastinum was reviewed.     

Ear-related problems among children attending the paediatric and otorhinolaryngology out-patients clinics of the University of Nigeria Teaching Hospital,Enugu

BackgroundEar related diseases are commonly seen in clinics worldwide especially among children. They are associated with significant morbidity and frequent hospital visits. Limited data exists regarding the burden of ear disease among Nigerian children.ObjectiveTo determine the prevalence of ear-related problems among children presenting at the Paediatric and Otorhinolaryngology clinics of the University of Nigeria Teaching Hospital, Enugu.ResultsThree thousand and twenty-one children were seen during the study period. Out of these, 248 children (8.2%) presented with ear-related problems. Chronic otitis media (30.5%), acute otitis media (29.9%), cerumen auris (11.3%), otitis externa (10.1%), hearing impairment (7.3%) and foreign body in the ear (5.7%) were the most commonly diagnosed ear-related problems.ConclusionEar-related problems among children presenting at the UNTH Enugu were not uncommon. However, otitis media was the most commonly diagnosed ailment affecting the ears in children.     

Frequency of complementary and alternative medicine utilization in hypertensive patients attending an urban tertiary care centre in Nigeria

Background  

To study the frequency and pattern of use of complementary and alternative medicine (CAM) in patients with essential hypertension attending a tertiary hypertension clinic.     

Prevalence of venous thromboembolism risk factors in hospitalized patients at the University of Nigeria Teaching Hospital,Enugu Nigeria

BackgroundVenous thromboembolism (VTE) is a common and lethal disease. Assessing the risk factors will help to modify exposures.AimThis study, assessed VTE risk factors in hospitalized patients at the University of Nigeria Teaching Hospital, Enugu.Patients and MethodsThis was an observational, case-control study. Three hundred and fifty (350) patients were recruited for the study: This comprised 150 medical patients, 140 surgical patients and a population of 60 healthy control group. Subjects were evaluated once using the Caprini risk assessment model (RAM).ResultsOver 50% of all hospitalized patients, were at risk for VTE. Surgical patients were at a higher risk than medical patients. Hemoglobin concentration was associated with the risk of VTE in surgical patients, while d-dimer was associated with VTE risk in medical patients.ConclusionThis study shows a high prevalence of VTE risk factors among hospitalized patients at the University of Nigeria Teaching Hospital.     

The importance of empathy in the enablement of patients attending the Glasgow Homoeopathic Hospital.

BACKGROUND: Patient enablement in general practice is known to be limited by consultation length. However, the processes within the consultation that lead to enablement are not well understood. AIMS: To investigate patient enablement in a setting where time is less of a constraint than in primary care, in order to determine the importance of other factors in enablement. DESIGN OF STUDY: Exploratory questionnaire-based study. SETTING: Two hundred consecutive outpatients attending four doctors at the Glasgow Homoeopathic Hospital, an NHS-funded integrated complementary and orthodox medicine unit. METHOD: Information was collected on enablement and a range of other factors, including the patients expectations, their perception of the doctors empathy, and the doctors own confidence in the doctor-patient relationship. RESULTS: Although there were many factors that correlated with enablement, multi-regression analysis showed patients expectation, doctor's empathy (as perceived by the patient), and doctor's own confidence in the therapeutic relationship to be the three key factors. Together they accounted for 41% of the variation in enablement, with empathy being the single most important factor (66% of the explained variation in enablement). CONCLUSION: Patient enablement at the Glasgow Homoeopathic Hospital is mainly related to the patients perception of the doctor's empathy.     

Sarcomatoid renal cell carcinoma in a young adult

Sarcomatoid renal cell carcinoma (SRCC) is an uncommon, aggressive renal cell carcinoma (RCC) accounting for 1.2% to 12.3% of renal cell carcinomas. SRCC may arise from any RCC subtype as it probably results from the de-differentiation of any renal epithelial malignancy. SRCC is characterised by a rapid progression and high metastatic rate. Currently there is no specific effective treatment for it. We report a new case of a 32-year-old man presented with two months backache. Ultrasound revealed a 7.5 cm heterogeneous mass at the inferior pole of the left kidney. A nephrectomy was performed. Histological study diagnosed a sarcomatoid renal cell carcinoma. The patient was doing well 6 months after initial surgery and then was lost to follow-up.     

Evaluation of a community treatment program for young adult schizophrenics

To evaluate a program of intensive case management for young adult chronic schizophrenics released from a large urban state mental health facility, several interrupted time series analyses were conducted over an 18-month period on 64 patients. Findings indicate that the intensive, active, and reactive role of case managers contributes significantly to the effectiveness of an aftercare, community-based treatment program.     

Psychological mindedness in relation to personality and coping in a sample of young adult psychiatric patients

Psychological mindedness (PM) is a relevant but rarely studied construct in clinical psychology. The aim was to examine the relationships among PM, personality, and coping in young adults with psychological difficulties. Sixty‐three young women and 32 young men who were admitted for intake at a Dutch mental health institute completed relevant questionnaires. PM showed positive associations with the putatively adaptive personality characteristics of extraversion, openness, agreeableness, and conscientiousness and a negative correlation with neuroticism. In addition, PM was associated with problem‐focused coping independently of the effect of personality characteristics. PM seems to be related to adaptive person characteristics in young adults with psychological difficulties. Longitudinal studies are needed to examine the issue of causality. © 2009 Wiley Periodicals, Inc. J Clin Psychol 66:1–12, 2010.     

DNAJC21-related thrombocytopenia in a young adult female

Bone marrow failure type 3 (BMFS3) (MIM:617052) is a subtype of inherited bone marrow failure syndromes (IBMFS) caused by homozygous pathogenic variants in DNAJC21. It was first defined in 2016, and to date, 19 patients have been reported. Here we report the first adult patient; a 20-year-old female with a novel frameshift variant in DNAJC21 presents with thrombocytopenia, dysmorphic findings, and ovarian agenesis. Our patient expands the clinical spectrum to the milder end and suggests that DNAJC21-related disorders can have relatively mild presentations. Investigation of DNAJC21 variants in both childhood and adult patients with persistent, non-progressive thrombocytopenia will allow to broaden the gene-related phenotypic and genotypic spectrum and elucidate the pathophysiology. Therefore, we encourage revisiting undiagnosed patients to offer whole exome sequencing (WES) in adulthood.