Community reintegration in stroke survivors: Relationship with motor function and depression

Stroke survivors show a variety of physical and psychosocial problems, which can affect their reintegration into the community. This study explored the association of community reintegration with motor function and post-stroke depression (PSD). Ninety community-dwelling stroke survivors with mean age of 58.3 ± 7.8 years participated in this study. Participants were 56 men and 34 women attending the physiotherapy clinics of selected hospitals in southwestern Nigeria. Motor function was assessed using the Motor Assessment Scale (MAS), PSD by the Hamilton Depression Scale, and community reintegration by the Reintegration to Normal Living Index (RNLI). The mean RNLI, MAS, and PSD scores were 57.3 ± 23.5, 34.9 ± 10.9, and 9.4 ± 4.8, respectively. RNLI scores were significantly associated with MAS (r = 0.584, p = 0.001) and PSD (r = ?0.373, p = 0.006) scores. Multiple regression analysis showed that age, depression, and motor function were associated with RNLI scores, which accounted for 41% of the variance. This study concluded that the higher the community reintegration, the higher the motor function, and the lower the PSD. Motor function and depression are factors that influence community reintegration and should be properly assessed and adequately treated before stroke survivors return to the community.     

Carbamazepine-induced Diabetes mellitus

Diabetes Mellitus was observed in a patient given carbamazepine. The diabetes improved when the treatment was discontinued and worsened on re-introduction.     

Antipsychotic effects and tolerance of crude Rauvolfia vomitoria in Nigerian psychiatric inpatients

The dried root of Rauvolfia vomitoria administered orally to 10 psychiatric patients at doses up to 800 mg/day, in divided doses, showed antipsychotic effects. The overall side effects were minimal, without serious incidence of extrapyramidal symptoms. Physical examination and laboratory parameters tend to correlate with the theory that Rauvolfia vomitoria accumulates in the plasma. The antipsychotic effects of Rauvolfia vomitoria were shown to be dose dependent when given three-times a day, with minimal side effects.     

Suicide and sermon reference in schizophrenia--a case report

A case of a 28-year old married Nigerian woman who castrated in response to a sermon reference is presented. Possible import of psychological and socio-cultural influences are discussed. Drawbacks in the effective management of such patients are highlighted.     

Efficient production of bioactive insulin from human epidermal keratinocytes and tissue-engineered skin substitutes: implications for treatment of diabetes

Despite many years of research, daily insulin injections remain the gold standard for diabetes treatment. Gene therapy may provide an alternative strategy by imparting the ability to secrete insulin from an ectopic site. The epidermis is a self-renewing tissue that is easily accessible and can provide large numbers of autologous cells to generate insulin-secreting skin substitutes. Here we used a recombinant retrovirus to modify human epidermal keratinocytes with a gene encoding for human proinsulin containing the furin recognition sequences at the A-C and B-C junctions. Keratinocytes were able to process proinsulin and secrete active insulin that promoted glucose uptake. Primary epidermal cells produced higher amounts of insulin than cell lines, suggesting that insulin secretion may depend on the physiological state of the producer cells. Modified cells maintained the ability to stratify into 3-dimensional skin equivalents that expressed insulin at the basal and suprabasal layers. Modifications at the furin recognition sites did not improve proinsulin processing, but a single amino acid substitution in the proinsulin B chain enhanced C-peptide secretion from cultured cells and bioengineered skin substitutes 10- and 28-fold, respectively. These results suggest that gene-modified bioengineered skin may provide an alternative means of insulin delivery for treatment of diabetes.