Analysis of Nigerians with Apparently Sporadic Parkinson Disease for Mutations in LRRK2, PRKN and ATXN3

Several genetic variations have been associated with Parkinson disease in different populations over the past few years. Although a considerable number of worldwide populations have been screened for these variants, results from Sub-Saharan populations are very scarce in the literature. In the present report we have screened a cohort of Parkinson disease patients (n = 57) and healthy controls (n = 51) from Nigeria for mutations in the genes PRKN, LRRK2 and ATXN3. No pathogenic mutations were found in any of the genes. Hence, common pathogenic mutations in these genes, observed in several different populations, are not a frequent cause of Parkinson disease in Nigeria

Managing Patients with Diabetes Mellitus and Mental Health Problems: Administrative and Clinical Challenges

Diabetes mellitus is the subject of a great many case management programs around the world as it is a prevalent disease with modifiable risk factors and potentially preventable severely disabling complications. Diabetes mellitus represents even greater challenges in the context of mental illness. Patients with psychological complications of diabetes mellitus or with psychiatric disease and comorbid diabetes mellitus present a unique set of problems with which the physician and other care providers must contend. These challenges include: problems with treatment regimens; inability to manage self-care programs; difficulties with negotiating appointments, referrals, and follow-up care; confusion over competing care instructions; potential drug interactions and/or complications which exacerbate diabetes mellitus; and many social difficulties which undermine the effective care of diabetes mellitus. Lack of control of either diabetes mellitus or mental health problems may complicate or exacerbate one or the other of these diseases. Case management for these individuals is one potential way of improving care. Management needs to be team based, coordinated between specialties, simplified, and in one location of care when possible. Excellent coordination and communication is paramount and social factors and supports require special attention.Diabetes mellitus, Diabetic complications, Pharmacoeconomics, Psychiatric disorders