Stroke in Sokoto, Nigeria: A five year retrospective study

Background: Morbidity and mortality from stroke is increasing in Africa. The focus now is on prevention. Effective preventive strategies in any locality will depend on the knowledge of the local pattern of the disease. Methods: A retrospective study of 93 adult patients with stroke, seen at Usmanu Danfodiyo University Teaching Hospital, Sokoto between January 1994 and December 1998 was carried out, aimed at highlighting the local pattern. Results: Ninety-three cases of stroke made up of 54 males and 39 females were seen. Stroke constituted 0.36% of total hospital admissions and 1.9% of the total hospital mortality within the period. People most commonly affected were between 41 and 70 years. The major cause of stroke was hypertension (83.9%) The mortality rate was 37.6% and among those who died 74.3% died within the first two weeks of admission. Conclusion: Those affected by stroke in this study fall mainly within the active segment of the society. There is urgent need to establish effective preventive measures to stem the depletion of the local workforce from the disease. Key Words: Stroke, adults, Sokoto Annals of African Medicine Vol.3(2) 2004: 73-7

Self-reported adherence to treatment: A study of socioeconomic factors and psychiatric morbidity among male and female patients with HIV infection in Sokoto, Nigeria

Objective: Adherence to treatment is important and relevant in HIV  treatment. Previous studies in sub Sahara Africa and south western Nigeria reported that psychiatric morbidity influence treatment adherence.The present study was to examine treatment adherence among the male and the female patients with HIV infection and the effect of socioeconomic factors and psychiatric morbidity on treatment adherence .Methods: A total of 159 patients which comprised of 48 male and 111  female who were eligible for this cross sectional prospective study were  included having given their consent to participate. Questionnaire relating to socioeconomic factors and treatment adherence were administered. Psychiatric morbidity was assessed using HADS. Data was analyzed with SPSS for windows version 16.0.Results: Treatment adherence was poor in 5.3% of the patients. The male patients had slightly better adherence than the female patients. Factors associated with poor treatment adherence include poor clinic attendance, presence of anxiety symptoms in males and poor education attainment in females.Conclusion: Treatment adherence is related to socioeconomic factors and psychiatric morbidity. Treatment protocol in which mental health and  detailed socioeconomic circumstance of patient is an integral part should be encouraged.Keywords: Adherence, HIV, infection, Patient, Treatmen

Secondary Structures Associated With Alkaline Transition of Horse Heart Ferricytochrome C: An FTIR Study

The spectra of amide I region (1700-1600cm-1) of horse heart ferricytochrome c at 20oC are reported at low ionic strength at of pH values between 7.0 and 11.5 encompassing the alkaline transition. The mid-infrared spectra can probe the protein secondary structures. The Fourier transform infrared spectroscopic technique is used to investigate the changes in the conformationally sensitive amide I band of cytochrome c with pH and ionic strength. Analysis of these results supports the hypothesis that an increase in the non-repetitive secondary structure during alkaline transition is at the expense of regular secondary structures. These strongly suggest that structural switching and ligand exchange behaviour of ferricytochrome c is accompanied by conformational change in the protein backbon

Prevalence and specific psychosocial factors associated with substance use and psychiatric morbidity among patients with HIV infection at Usmanu Danfodiyo University Teaching Hospital, Sokoto State, Nigeria

In this study we set out to determine the prevalence of depression and anxiety disorders among HIV infected persons, prevalence of substance use among these patients, effect of active and inactive use of substance on drug compliance and clinic attendance, and psychosocial correlates of substance use among these patients. This cross sectional study was conducted among patients who had been diagnosed with HIV disease in a teaching hospital in Sokoto, Nigeria. A questionnaire relating to socio-demographic variables, substance use and psychiatric morbidity was administered to the patients. Information obtained were analyzed using SPSS version 11 with the test of significance set at p<0.05. Our study showed that more male patients used substance than the female patients. In addition, the presence of psychiatric morbidity and substance use had implications for clinic attendance and drug compliance. In the overall management of HIV infected patients, regular screening for substance use and psychiatric morbidity should be carried out and referrals made appropriately

Snake Envenoming: A Disease of Poverty

Every year snake envenoming kills more people in the tropics than some of the world's recognised neglected tropical diseases (NTDs), including schistosomiasis and leishmaniasis. While lacking the epidemic potential of an infectious/vector-borne disease, snake envenoming in rural tropical communities has as great a medical mortality, if not morbidity, as the NTDs. The recent categorisation of snake envenoming as an NTD is an important advance that hopefully will result in the wider recognition and allocation of resources, particularly since death from snake envenoming is preventable; antivenom is very effective when the appropriate antivenom is correctly administered. Snake envenoming urgently requires international support to instigate the epidemiological, health education, and effective treatment initiatives that proved so potent in addressing the medical burden of NTDs such as leprosy and dracunculosis. All the global estimates of snake envenoming and deaths from snakebite indicate that mortality is highest in the world's tropical countries. Here we examined associations between the globally available data on (i) snakebite-induced mortality and (ii) socioeconomic markers of poverty. Our data unequivocally establishes that snake envenoming is globally associated with poverty, a distinctive characteristic of the neglected tropical diseases

Obesity measurement and management: a review

Obesity, which often results from excess intake of calories (through overfeeding) without commensurate energy expenditure (through activities), has long been known to be a public health problem in the developed world. In the developing countries, it is commonly associated with the higher socio economic class, who can afford to overeat and over drink. The lower socio economic class is not entirely left out. It is by far easier to gain weight than to loose weight. Obesity is associated with numerous medical complications. It is therefore of public interest to stimulate interest towards it's prevention since attempts at curing it may be disappointing. Keywords: obesity, measurement, managementNigerian Medical Practitioner Vol. 49(6) 2006: 144-14

The Story Of Tuberclosis: A Reason For Hope For The HIV/AIDS Patient

Before the discovery of specific antibiotics for the treatment of tuberculosis, there was no cure. It took several millennia before the specific organism was uncovered and appropriate drug therapy discovered. The initial euphoria of this discovery was dashed by early occurrence of drug resistance. This was overcome, but not completely so, by the use of multi drug therapy. The issue of multi-drug resistant tuberculosis which was a growing concern, even in advanced countries, became more intense by the advent of the Human Immun Deficiency Virus (HIV) infection. However, due to growing scientific knowledge, the lessons learnt from the handling of mycobacterium tuberculosis and the disease caused by it, the war against the HIV and Acquired Immunodeficiency Sydrome (AIDS) which it causes, is being fought in all fronts. The delays experienced with the old disease has been overcome by increased knowledge and interest since the effect of the later on the population has been found to be devastating. A co-infection of both diseases or a super-infection of one upon the other presents more complex management problems that have stimulated more intense research. It is hoped that the results of these research works may unearth the solution to the problems of both diseases. Sahel Medical Journal Vol.7(1) 2004: 1-

Hyponatraemia: A Practical Approach to Management

Hyponatraemia, an electrolyte disorder is not an infrequent occurrence in hospitalized patients. Low sodium levels from the laboratory are frequently regarded as laboratory error instead of as a stimulus to seek for the clinical feature with a view to correcting the imbalance. Some of the patients lost on the wards may have died from undetected and untreated hyponatraemia which has a mortality of 5% - 10% depending on severity and rapidity of onset. The asymptomatic cases may not require immediate correction of their sodium levels. Attempts should be made to identify and treat the causes(s). The acute symptomatic cases may require immediate and aggressive correction of the imbalance within 48hours. Careful and slow correction is the norm for the chronic symptomatic cases to avoid neurological and other complications of treatment. Nigerian Medical Practitioner Vol.46(3) 2004: 46-4

Bronchial Asthma in Sokoto: A Study of 128 Adult Asthmatic Patients Over a Six Year Period

128 adult asthmatics, made up of 62 males and 66 females were seen at Usmanu Danfodiyo University Teaching Hospital, Sokoto between the 1st of January 1993 and 31 st of December 1998. The mean age of presentation for the males was 34.8 years while for the females it was 28.2 years. Those between the age of 20 and 39 year constituted the majority of the patients. Cold weather and upper respiratory tract infection were the commonest recorded precipitating factors. Only 12.5% of the patients had a family history of asthma. Recovery was the norm in a vast majority of patients. Only 2 patients were lost within the period due to asthma. Key Words: Bronchial Asthma, Adults, Sokoto. Nig. Medical Practitioner Vol. 44(3) 2003: 59-6