Psychosocial characteristics of infertile women in a Nigerian tertiary hospital

Introduction: High premium is placed on childbirth particularly after marriage in our society. Sub‑Sahara Africa is known to have the high incidence of infertility and the woman is usually blamed for the problem. Stress is known to have effect on ovulation and therefore conception thereby forming a vicious cycle. The study was to determine the psychosocial problems and psychiatric morbidity among infertile women and to determine the difference in psychosocial problems in primary and secondary infertility patients.Method: The Satisfaction with Life Scale (SWLS) questionnaire, the 12 ‑item General Health Questionnaire (GHQ‑12) and the HADS (Hospital Anxiety and Depression Scale) were administered to 111 patients.Result: The mean age for the respondents was 33.6 ± 5.8 years. There were more cases of secondary infertility 58 (52.3%) compared to primary fertility 53 (47.7%). The study revealed a fairly high degree of psychological morbidity among the respondents, a depressive rate of 39.6%, anxiety rate of 48.6% and psychiatry morbidity of 39.6%.There was no significant difference in prevalence of these morbidity between the patients with primary and secondary infertility.Conclusion: Both primary and secondary infertility are associated with significant psychosocial and psychiatric morbidity. Psychological strain itself can also be a cause or aggravate infertility therefore psychological assessment and co‑management with the psychiatrist should be encouraged.Keywords: Anxiety; depression; infertility; primary; psychosocial; secondar

The psychological impact of intensive care unit admission on relatives of critically ill patients

Introduction: It is recognized that ICU patients are exposed to massive stresses both from their life-threatening illness and the necessary intensive medical procedures they are subjected to. These stresses may lead to psychological problems like depression, anxiety and post-traumatic stress disorder. However, the psychological demands and impact of the ICU on the relatives of these patients are often not appreciated. We aimed to determine the prevalence of anxiety and depression and the influence of ICU specific interventions on the development of psychological symptoms in relatives of ICU patients. Methods: This prospective, descriptive, questionnaire-based study was conducted on all consenting primary caregivers of patients on admission in the intensive care unit during the study period. The Hospital Anxiety and Depression Scale and the General Health Questionnaire were used to determine the presence of psychological disorders during this study.Result: In this study, GHQ demonstrated a 72.5% prevalence of psychological illness in relatives of ICU patients. The prevalence of psychological illness using Hospital Anxiety and Depression Scale (HADS) was 56.3% on the anxiety scale and 55% on the depression scale.Conclusion: Critical care can result in the development of psychological disorders among primary caregivers of ICU patients. Intensive care physicians need to pay more attention to their care's impact on the psychological health of their patients’ relatives

Knowledge, attitude and prescription practice of menopausal hormone replacement therapy by doctors in UITH, Ilorin Nigeria

Objective: This study aimed to evaluate the knowledge, attitude and prescription practice of menopausal-HRT (mHRT) by doctors in UITH, Ilorin.Method: All consenting doctors in O&G, Internal Medicine, Family Medicine, Public Health and Interns at the UITH completed a structured questionnaire. SPSS software version 22 was used for analysis. Associations between categorical variables were tested using the chi-square (x2) while the student-t test was used for the continuous variables (p <0.05).Results: Eighty doctors, 56 males and 24 females responded. Majority (63.8%) rated their knowledge of mHRT average; (17.5%) believed they had good knowledge, while (18.7%) had poor knowledge. Gynaecologists had the highest mHRT Knowledge Score (72.4) while public health doctors had the lowest (33.7), (83.7%) had no formal training on the use of mHRT. Fifty-five percent did not think menopause should be treated. Just 25% prescribed mHRT where 58.8% had no reason for not prescribing. Only 18.8% had ever referred menopause patients to specialists. Forty percent use alternative therapies for menopausal symptoms, majorly vitamins and herbs.Conclusion: The knowledge, attitude and prescription practice of the studied doctors was poor. Trainings are still needed in this area.Keywords: Menopause; hormone replacement therapy; doctor

Seroprevalence of syphilis among blood donors in Ilorin

Background: One of the greatest values of serological test for syphilis is as a surrogate marker for lifestyle known to be associated with high risk of HIV and HCV infections. This study was designed to determine the prevalence of syphilis among blood donors in Ilorin and also the relationship between seropositivity and lifestyle known to be associated with high risk for HIV and Hepatitis infection.Method: This was a hospital based cross sectional study involving 350 consenting blood donors. The socio-demographic details (e.g., age, sex, occupation, risk behavior etc) were obtained using a structured questionnaire designed for the study. Screening for syphilis was carried out using the DiaSpot Rapid Diagnostic Test kit (DS 401- Syphilis test strips; lot: SYP2070028) according to the manufacturer's (Sam Tech Diagnostics) instructions.Result: The seroprevalence of syphilis among the blood donors was 1.1%. None of the seropositive donors was a homosexual, commercial sex worker or intravenous drug user. None of them had history of blood transfusion. Only one out of the 4 seropositive donors engaged in extramarital sex.Conclusion: The seroprevalence of syphilis among blood donors in Ilorin was low and therefore the relationship between syphilis seropositivity and high risk lifestyle could not be determined. A prospective study design where cases and controls are appropriately matched to exclude confounders would be more appropriate. The relationship of syphilis seropositivity and high risk lifestyle can therefore be better studied among patients attending Sexually Transmitted Infection clinic and using seronegative patients as controls.Keywords: syphilis, blood donors, risky lifestyl

Assessment of Markers of Depression and CD4 Cell Count among Adult HIV-Positive Patients on Anti-Retroviral at a Nigerian University Teaching Hospital

Objective: Depression is a common mental health problem among people living with HIV/AIDS (PLWHA); because low count of lymphocytes with  cluster of differentiation 4 (CD4 cell count) is associated with severe symptoms of HIV infection, there are thoughts that low CD4 cells count can provoke depressive illness. This study was conducted to determine the relationship between CD4 count and depression among adult HIV positivepatients attending Family Medicine clinics at University of Ilorin Teaching Hospital (UITH), Ilorin, Nigeria.Method: A hospital based descriptive cross-sectional study was done over a period of 6 months among 350 systematically randomly selected adult HIV-positive patients. PHQ-9 was used to obtain information on depression and the CD4 count was determined using a flow-cytometric method. Data were obtained and analyzed using SPSS-17. Chi-square was used to determine degree of association between the depression and the level of CD4 count. P-value of < 0.05 was considered statistically significant.Results: The prevalence of depression among the respondents was 33.4%. The prevalence of depression was highest among respondents with low CD4 count (≤349cells/ul), 37.0%, and least among those with high CD4 count (≥500cells/ul), 28.3%. This relationship was however not statistically significant.Conclusion: The overall prevalence of depression was high among the respondents (33.4%) suggesting the need for routine depression screening among HIV positive patients. There was no statistically significant association between presence of depression and level of CD4 count (p-value=0.302). Keywords: Depression, CD4count, PLWHA, Family Medicine, UITH

Psychotropic Medications and QTc Parameters in a Nigerian Cohort

Aims: Evidence is increasing to indicate that individuals with mental illness may be at risk of premature death. We studied the prevalence of QTc prolongation, QT dispersion (QTd) and cardiac arrhythmias in patients on psychotropic drugs. Study Design: Cross-sectional study. Place and Duration of Study: Department of Medicine and Department of Behavioral Sciences, University of Ilorin Teaching Hospital, Nigeria Between Januaryand June 2010. Methodology: One hundred and ninety-one consecutive patients on psychotropic medications with 121 controls were studied. All the subjects had detailed clinical examination and resting electrocardiogram (ECG) at 25mm/sec. QTc was determined using Bazett formula and QTd by subtracting shortest from longest QTc in 12-lead ECG. Results: Mean QTc of the patients (450±46msc) was longer (p=0.0001) than that of the controls (390±27msc) but mean QTd was similar (p=0.13) in both groups. QTc was prolonged in 68(35.6%) patients compared to 11(9.1%) controls, p=0.0001. LVH, arrhythmias and abnormal T-wave morphology occurred more (p=0.01, 0.01 and 0.001 respectively) in the patients than controls. Age, duration of treatment and total daily doses of antipsychotics were independent predictors of QTc. Cardiac arrhythmias were seen in 24.1% of the patients but none had ventricular arrhythmias. Conclusion: Psychotropic drug use is a risk factor for QTc prolongation and cardiac arrhythmias. We suggest periodic electrocardiography, discourage polypharmacy and recommend drug holiday in stable patients

Family correlates of depression among hiv positive patients attending family medicine clinic at University of Ilorin Teaching Hospital, Ilorin, Nigeria

Background information: HIV infection may impact negatively on family relationship and vice versa. Members of the family of HIV positive patients may become  frustrated because of the stigma of having a family member with HIV infection, and the burden of having to care for the patient. This can result into the family members becoming unsupportive and taking out their angers on the patients which in turn can lead to psychosocial problems such as depression in the patients. This study determined the prevalence of depression and its association with family factors (family functioning, family member awareness of HIV status, support for HIV treatment and satisfaction with the support for treatment) among adult HIV positive patients attending Family Medicine Clinic at University of Ilorin Teaching Hospital (UITH), Ilorin, Nigeria.Subject, material and method: A hospital based descriptive cross-sectional study was done among 350 systematically randomly selected adult HIV patients over a period of 6 months. Interviewer administered structured and semi-structured questionnaires were used to obtain information. Information on prevalence and severity of depression was obtained using Patient Health Questionnaire-9 (PHQ-9) while Family APGAR questionnaire was used to determine the family functioning. Data were obtained and analysed using SPSS-17. Chi-square and Fisher's Exact test were used to determine the degree of association between the variables.  P-value of < 0.05 was considered statistically significant.Result: The prevalence of depression among the respondents was 33.4%. There was statistically significant association between depression prevalence and dysfunctional family (p-value=0.006).Conclusion: Family dysfunction is a risk factor for depression among HIV positive patients. Therefore family members should be properly involved in management of HIV positive patients

Prevalence of depression and socio-demographic characteristics of HIV infected patients seen by family physicians at university of Ilorin Teaching Hospital, Ilorin, Nigerian

Background information: Various studies across the world have shown that depression is of high prevalence among people living with HIV/AIDS (PLWHA), and that it has lots of adverse effects on them. Diagnosis of depression among this group of people is however still very low in sub-Sahara Africa, particularly at primary care level. This was what led to this local study which determined the prevalence and socio-demographic characteristics of depression among PLWHA seen by family physicians at University of Ilorin Teaching Hospital (UITH) in order to sensitize the primary care physicians on importance of depression among their patients with HIV-infection so as to improve the care they provide to them.Study design: The study was conducted as a descriptive cross-sectional hospital based study among 350 systematically randomly selected adults (18 years and above) HIV infected patients attending Family Medicine Lenti-viral clinic at UITH over a period of 6 months (October 2012- March 2013). A semi-structured questionnaire was used to determine the socio-demographic characteristics of the patients. The prevalence and severity of depression among the respondents were determined using Patient Health Questionnaire-9 (PHQ-9), a depression screening tool recommended for primary care physicians. The tool was administered by theinterviewers. Data were entered and analysed using SPSS-17 software package. Chi-square and Fisher's exact test were used to determine the degree of association between variables. P-value of less than 0.05 was considered statistically significant.Result: About one-third (33.4%) of the respondents were depressed. Slightly above half (52.1%) of them had mild depression, 27.4% had moderate depression, 14.5% had moderately severe depression and 6.0% had extremely severe depression. There was statistically significant association between depression and: age above 47 years; not being currently married; and educational status of primary school and below.Conclusion: A large number of HIV infected patients seen by primary care physicians are at risk of developing depression; therefore, routine screening for depression should be encouraged and incorporated into the normal care of HIV-infected patients.Keywords: Depression prevalence, socio-demographic characteristics, HIV infected patients, family physicians, Ilori

Clinical Presentations and Characteristics of Confirmed Covid-19 Patients over a 1-Year Period in a Private Health Facility in Ilorin, North-Central Nigeria

The first case of COVID-19 in Nigeria was confirmed on February 27, 2020.  Since then, many studies from government designated isolation centers have described the characteristics of patients with Covid-19. Even though COVID-19 testing and management are exclusively carried out at the NCDC-approved centers, majority of patients are referred from primary care facilities, both public and private owned. To our knowledge, there has been no studies regarding Covid-19 disease among the patients served by these centers. Our aim is to describe the clinical characteristics and outcome of COVID-19 cases seen at Olanrewaju Hospital, Ilorin, North Central Nigeria. This is a descriptive retrospective study of patients with confirmed COVID-19 seen over a one-year period. Records of all patients that tested positive using the real-time reverse-transcriptase-polymerase-chain-reaction (RT-PCR) were retrieved to extract relevant information. Data was analyzed using Epi Info 7.48 patients were analyzed. The mean age (standard deviation) was 50.0 years (17.89). Male sex predominates (58.3% vs 41.7%). Majority of patients were symptomatic (93.7%). Fever was most common presentation (75.6%). Shortness of breath was experienced by 11 patients (24.4%). Co-morbidities were found among 75% of the patients with hypertension being the commonest (45.9%). There were 6 deaths (12.5%), 5 of which occurred in the older age patients. Case fatality rate was significantly higher during the first wave than during the second wave 40% vs 5.6%, p < 0.05. The male gender, co-morbidities and older age groups are particularly prone to severe covid-19 infection with poorer outcome