Predictive factors for psychiatric morbidity among women with infertility attending a gynaecology clinic in Nigeria

Objective: To determine the psychosocial and clinical factors that are associated with psychiatric morbidity among women with infertility attending a Nigerian gynaecology clinic. Method: Over a four month period, 320 respondents (160 in the study group and 160 in the control group) were interviewed using a proforma (designed by the authors) and a screening instrument, General Health Questionnaire version 30 (GHQ-30). All probable cases with a score of 5 or more on GHQ-30 were interviewed using the Present State Examination (PSE). Psychiatric diagnosis was made in accordance with the diagnostic criteria of the 10th edition of the International Classification of Diseases (ICD-10). Results: The infertility rate among the study group was found to be 25.8% with primary and secondary infertility rates constituting 21.9% and 78.1% respectively. The prevalence of psychiatric morbidity among women with infertility (48.8%) was significantly more than that in the control group (11.2%) (Χ 2 = 51.80, p < 0.0001). Lack of support from husband (Χ2 = 15.31, p < 0.001), lack of support from husband’s relatives (c 2 = 39.60, p < 0.0001), discrimination (Χ2 = 69.91, p < 0.0001) and history of induced abortion (Χ2 = 30.40, p < 0.0001) were found to be significantly associated with psychiatric morbidity among patients with infertility when compared with the fertile control population. There was no significant difference in the rate of psychiatric morbidity between women with primary infertility and those with secondary infertility (Χ2 = 0.03; p = 0.87). Conclusion: Psychiatric morbidity is significantly more common among patients with infertility as compared with those without. There was a significant association between psychiatric morbidity and absence of support from husband and his relations, presence of discrimination, and a history of induced abortion. We suggest more public enlightenment on the need for moral/ psychosocial support to women with infertility. In addition, more efforts should be made towards early screening and identification of cases of psychiatric morbidity among patients with infertility.Key words: Predictive factors; Psychiatric morbidity; Infertility; Nigeri

Characteristics of clients accessing HIV counseling and testing services in a tertiary hospital in Sagamu, Southwestern Nigeria

Introduction: Client-initiated HIV testing and counseling has helped millions of people learn their HIV status. Nevertheless, global coverage of HIV testing and counseling programs remains low. This study describes the characteristics of clients who accessed HIV counseling and testing (HCT) services in Olabisi Onabanjo University Teaching Hospital, (OOUTH)Sagamu.Materials and Methods: A retrospective study of the clients accessing HCT services in OOUTH. Data was collected from clients using a client intake form. Pre-test counseling, HIV screening and post-test counseling were carried out. Informed consent and confidentiality were ensured. Data obtained were analyzed using SPSS 10.0.Results: A total of 2607 clients accessed our HCT services between May 1st 2008 and April 30th 2010. The clients were between the ages of 1 year and 90 years. The mean age was 33.3 ± 15.26. The median age was found to be 32.0 years, with the modal age being 30.0 years. 73.7% (1828) were non-reactive (negative result), 25.9% (643) were reactive (positive result), while 0.3% (8) were indeterminate. Among the reactive results, 9.3% (242) were males while 15.1% (394) were females.Conclusion: A fair uptake of HCT services was noted. More females accessed services than males. More positive results were seen among females than males (P&lt;0.05).Recommendations: Upscale of HCT services to involve Sexually transmitted infections clinics and free-standing, client-initiated testing centers is necessary. Continuous AIDS education and risk reduction should be promoted

Effect of soil depth and topography on physical and chemical properties of soil along federal college of forestry, Ibadan North West, Oyo State

Soil properties along a toposequence is a key to sustainable crop and soil productivity, hence the need to study the effect of toposequence and soil depth on physical and chemical properties of soil around Federal College of Forestry, Ibadan, Oyo-State. Four profile pits were dug along the toposequence in Federal College of Forestry, Ibadan, Oyo-State. Soil samples were collected from three soil depth (0 - 30 cm, 30 - 45 cm, and 45 - 60cm) from four profile pits that was dug along the toposequence, (crest, sedentary, middle and valley bottom) for analysis of physical, morphological and chemical properties following standard procedures at the laboratory. The results showed that the consistency of the soil in profile pit 1 (crest) is slightly sticky and slightly plastic compared to soil in profile pit 2 (sedentary) that is predominantly nonplastic while profile pit 3 and 4, (middle/creep and valley bottom) are non-plastic, non-sticky, slightly sticky. The highest total porosity values was recorded at the valley bottom of the forest (57.74 %), followed by middle of the forest (53.21 %) while the least was by crest of the forest (51.7 %). The highest saturated hydraulic conductivity was recorded at the crest of the forest (15.91 cm hr-1) and the least by valley bottom of the forest (8.44 cm hr-1). Likewise bulk density values at the crest of the forest (1.28 g cm-3) was the highest compared to valley bottom of the forest (1.12 g cm-3). The highest (52 mg kg-1) and the lowest (1 mg kg-1) available P values were recorded at the valley bottom layers of the forest land soils and sedentary of the forest land soils, respectively. The highest exchangeable Ca was found in the valley bottom of forest soils (4.44 cmol kg-1) at the upper topographic position, whilst the lowest values were recorded at the crest layers of forest soils (1.2 cmol kg-1) at the middle topographic positions. Thus, it was concluded that the soils position on the topography affects the composition of the soil at each sampling point. This indicated that landscape in the study area affects the process of soil formation. Therefore, integrated soil fertility management and soil conservation measures are required in all topographic positions to maintain soil physicochemical properties. Key words: Toposequence, soil profile, physical properties, chemical propertie

Comparative study on the effect of Thaumatococcus daniellii (Benn) Benth sweetener on the Physicochemical and Sensory Properties of Sorghum based Kunun-zaki Drink

Effect of a natural sweetener (Thaumatococcus danielli) on the physicochemical properties and sensory evaluation of kunun-zaki was determined. Proximate and mineral compositions of the natural sweetener, physicochemical properties and sensory evaluation of kunun-zaki using Thaumatococcus danielli and sucrose were determined. Proximate composition of the aril showed that protein had (33.03%), crude fibre (5.20%), ash content (4.79%), moisture content (12.20%), fat content (0.16%), and carbohydrate (44.17%). The result of mineral obtained for the aril showed the following values potassium (190.00ppm), sodium (167.66ppm), calcium (132.96 ppm), iron (21.59 ppm) and magnesium (14.40 ppm). Physicochemical composition of kunun-zaki varied with concentrations of Thaumatococcus danielli aril and sucrose pH ranged between (3.90-4.90), total solid (4.95-13.49 %) and titatable acidity (0.78-0.39 %) for Thaumatococcus danielli while kunun-zaki sweetened with sucrose had pH (3.51-4.90), total Solids (4.95-7.43%) and titratable acidity (0.74-0.85) respectively. The sensory evaluation showed that the samples sweetened with Thaumatococcus daniel aril compared favorably with sucrose in terms of colour, taste, aroma and overall acceptability. Keywords: Kunun-zaki, Proximate, Mineral, Sensory properties, Thaumatococcus danielli

Psychosocial impairments among adults with epilepsy in a neurology clinic in Nigeria

Objective: Psychosocial problems unattended to may compromise adequate control of seizures and elevate the risk of psychopathology. We assessed for psychosocial impairments and associated psychopathology in patients with epilepsy, with the hope that findings will help initiate formal psychosocial care for patients attending the neurology clinic.Methods: Consecutive patients with epilepsy seen at the neurology clinic that met the inclusion criteria and gave consent were interviewed in a 2 stage procedure. In the first stage patients were assessed with a semi-structured questionnaire containing psychosocial variables while probable psychiatric morbidity was assessed with General Health Questionnaire (GHQ-12). In the second stage psychiatric diagnoses were assessed with Schedule for Clinical Assessment in Neuropsychiatry (SCAN).Results: Many of the patients reported difficulties in at least one or more of the psychosocial domains assessed; areas of difficulty included: physical activity (52.4%), occupational activity (46.8%); finances (41.3%); stigma (33.3%); inadequate social support by relatives (31.7%), and perceived inadequate general adjustment (34.9%). Psychosocial factors significantly associated with increased rate of psychopathology included: being a woman, having low education; financial difficulties and limitations in physical activities while significant clinical factors included: having frequent fits and partial epilepsy. Multiple logistic regression analyses indicated that being a woman and having partial seizures were the most important predictors of psychopathology among the patients.Conclusion: This study has provided evidence of the need to introduce routine psychosocial care in our neurology clinic which hitherto did not carry out structured routine assessment of psychosocial problems in order to reduce risk of psychopathology.Keywords: Psychosocial impairments, adults, epilepsy, neurology clinic, Nigeri

Estimating the Number of Male Sex Workers with the Capture- Re-capture Technique in Nigeria

Estimating the size of populations most affected by HIV such as men who have sex with men (MSM) though crucial for structuring responses to the epidemic presents significant challenges, especially in a developing  society. Using capture-recapture methodology, the size of MSM-SW in  Nigeria was estimated in three major cities (Lagos, Kano and Port Harcourt) between July and December 2009. Following interviews with key informants, locations and times when MSM-SW were available to male clients were  mapped and designated as “hotspots”. Counts were conducted on two  consecutive weekends. Population estimates were computed using a  standardized Lincoln formula. Fifty-six hotspots were identified in Kano, 38 in Lagos and 42 in Port Harcourt. On a given weekend night, Port Harcourt had the largest estimated population of MSM sex workers, 723 (95%CI:  594-892) followed by Lagos state with 620 (95%CI: 517-724) and Kano  state with 353 (95%CI: 332-373). This study documents a large  population of MSM-SW in 3 Nigerian cities where higher HIV prevalence  among MSM compared to the general population has been documented. Research and programming are needed to better understand and address the health vulnerabilities that MSM-SW and their clients face. Afr J Reprod Health 2013 (Special Edition); 17[4]: 83-89).Keywords: Male sex worker, Capture-recapture, size estimation,   population estimates, Men who have sex with men, Nigeria, Lagos, Kano, Port Harcourt

Psychiatric morbidity in a Nigerian neurology clinic

Objective: The objective of the study was to determine the prevalence and nature of psychiatric morbidity among patients attending a neurology outpatient clinic.Design: A two-stage screening procedure with General Health Questionnaire (GHQ-12) and Schedules for Clinical Assessment in Neuropsychiatry (SCAN) was used to assess psychological disorders over a one year period. Psychiatric diagnosis was based on ICD-10 criteria.Setting: University of Ilorin Teaching Hospital (UITH), Ilorin- NigeriaSubjects: Two hundred and thirty-five (235) patients aged 18 years and above attending the neurology outpatient clinic.Results: Overall prevalence of psychiatric morbidity was 26.0% (61/235). The most frequent diagnoses were depression (14.9%), generalised anxiety disorder (5.5%), dementia (2.6%) and substance use disorder (1.3%). Significantly more patients with stroke had psychiatric morbidity.Conclusion: The study supports previous reports that psychiatric disorders are quite common among patients with neurological disorders. Efforts should, therefore, be directed at identifying and treating neurological patients with psychiatric morbidity since this will ensure improved outcome. In this regard, mental health professionals would need to provide liaison services for the neurologists and train them in the use of simple screening instruments for detecting associated psychiatric disorders with appropriate referral where necessary

Prevalence and Correlates of Common Mental Disorders among Mothers of Young Children in Kilimanjaro Region of Tanzania.

Although poor maternal mental health is a major public health problem, with detrimental effects on the individual, her children and society, information on its correlates in low-income countries is sparse. This study investigates the prevalence of common mental disorders (CMD) among at-risk mothers, and explores its associations with sociodemographic factors. This population-based survey of mothers of children aged 0-36 months used the 14-item Shona Symptom Questionnaire (SSQ). Mothers whose response was "yes" to 8 or more items on the scale were defined as "at risk of CMD." Of the 1,922 mothers (15-48 years), 28.8% were at risk of CMD. Risk of CMD was associated with verbal abuse, physical abuse, a partner who did not help with the care of the child, being in a polygamous relationship, a partner with low levels of education, and a partner who smoked cigarettes. Cohabiting appeared to be protective. Taken together, our results indicate the significance of the quality of relations with one's partner in shaping maternal mental health. The high proportion of mothers who are at risk of CMD emphasizes the importance of developing evidence-based mental health programmes as part of the care package aimed at improving maternal well-being in Tanzania and other similar settings

Born to yawn? Understanding yawning as a warning of the rise in cortisol levels: Randomized trial

Background: Yawning consistently poses a conundrum to the medical profession and neuroscientists. Despite neurological evidence such as parakinesia brachialis oscitans in stroke patients and thermo-irregulation in multiple sclerosis patients, there is considerable debate over the reasons for yawning with the mechanisms and hormonal pathways still not fully understood. Cortisol is implicated during yawning and may link many neurological disorders. Evidence was found in support of the Thompson cortisol hypothesis that proposes cortisol levels are elevated during yawning just as they tend to rise during stress and fatigue. Objectives: To investigate whether saliva cortisol levels rise during yawning and, therefore, support the Thompson cortisol hypothesis. Methods: We exposed 20 male and female volunteers aged between 18 and 53 years to conditions that provoked a yawning response in a randomized controlled trial. Saliva samples were collected at the start and again after the yawning response, or at the end of the stimuli presentations if the participant did not yawn. In addition, we collected electromyographic data of the jaw muscles to determine rest and yawning phases of neural activity. Yawning susceptibility scale, Hospital Anxiety and Depression Scale, General Health Questionnaire, and demographic and health details were also collected from each participant. A comprehensive data set allowed comparison between yawners and nonyawners, as well as between rest and yawning phases. Collecting electromyographic data from the yawning phase is novel, and we hope this will provide new information about neuromuscular activity related to cortisol levels. Exclusion criteria included chronic fatigue, diabetes, fibromyalgia, heart conditions, high blood pressure, hormone replacement therapy, multiple sclerosis, and stroke. We compared data between and within participants. Results: In the yawning group, there was a significant difference between saliva cortisol samples (t = -3.071, P = .01). Power and effect size were computed based on repeated-measures t tests for both the yawning and nonyawning groups. There was a medium effect size for the nonyawners group (r = .467) but low power (36%). Results were similar for the yawners group: medium effect size (r = .440) and low power (33%). Conclusions: There was significant evidence in support of the Thompson cortisol hypothesis that suggests cortisol levels are elevated during yawning. A further longitudinal study is planned to test neurological patients. We intend to devise a diagnostic tool based on changes in cortisol levels that may assist in the early diagnosis of neurological disorders based on the data collected. Trial Registration: International Standard Randomized Controlled Trial Number (ISRCTN): 61942768; http://www.controlled-trials.com/ISRCTN61942768/61942768 (Archived by WebCite at http://www.webcitation.org/6A75ZNYvr)