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

Reshaping maternal services in Nigeria: any need for spiritual care?

BACKGROUND:High maternal and perinatal mortalities occur from deliveries conducted in prayer houses in Nigeria. Although some regulatory efforts have been deployed to tackle this problem, less attention has been placed on the possible motivation for seeking prayer house intervention which could be hinged on the spiritual belief of patients about pregnancy and childbirth. This study therefore seeks to determine the perception of booked antenatal patients on spiritual care during pregnancy and their desire for such within hospital setting.METHOD:A total of 397 antenatal attendees from two tertiary health institutions in southwest Nigeria were sampled. A pretested questionnaire was used to obtain information on socio-demographic features of respondents, perception of spiritual care during pregnancy and childbirth; and how they desire that their spiritual needs are addressed. Responses were subsequently collated and analyzed.RESULTS:Most of the women, 301 (75.8%), believe there is a need for spiritual help during pregnancy and childbirth. About half (48.5%) were currently seeking for help in prayer/mission houses while another 8.6% still intended to. Overwhelmingly, 281 (70.8%) felt it was needful for health professionals to consider their spiritual needs. Most respondents, 257 (64.7%), desired that their clergy is allowed to pray with them while in labour and sees such collaboration as incentive that will improve hospital patronage. There was association between high family income and desire for collaboration of healthcare providers with one's clergy (OR 1.82; CI 1.03-3.21; p?=?0.04).CONCLUSION:Our women desire spiritual care during pregnancy and childbirth. Its incorporation into maternal health services will improve hospital delivery rates

Processing Effects on Chemical, Functional and Pasting Properties of Cowpea Flour from Different Varieties

Cowpea varieties (IT88D-867-11, IT89KD-288 and MALA) were boiled, roasted, dehulled and later milled into powder. The proximate composition, functional and pasting properties as well as anti-nutritional contents (Tannin) of the product was subsequently determined. The result of the study revealed significant increase (P < 0.05) in the crude protein, crude ash, swelling power and water absorption capacity. Conversely, significant decrease (P < 0.05) was observed in crude fat, starch content, moisture content, solubility and peak viscosity. Boiled samples have significantly higher (P < 0.05) crude protein, swelling power, water absorption capacity, with concomitantly lower solubility and tannin content. Crude ash, moisture, solubility and tannin content of dehulled samples decreased significantly with an increase in protein, swelling power and water absorption capacity. However, IT89KD-288 has the highest protein content irrespective of the processing used. But raw IT89KD-288 showed highest percentage of swelling power, solubility, water absorption capacity and Tannin content. The result revealed that both boiling and dehulling willgreatly reduce tannin content of cowpea

Profile and causes of mortality among elderly patients seen in a tertiary care hospital in Nigeria

Background: Old age is one of the factors associated with increased risk of dying when admitted to hospital. Therefore, aim of this study was to  examine causes and pattern of death among elderly patients managed in a tertiary care hospital in Nigeria with scanty mortality records.Materials and Methods: This prospective study was on deaths that occurred in patients 60 years and above admitted to University of Ilorin Teaching Hospital (UITH), Ilorin, between January 2005 and June 2007. Excluded were all brought-in-dead during the study period. Information obtained included demographic data, duration on admission, and diagnosis. Causes of death were determined from clinical progress notes and diagnosis.Results: A total of 1298 deaths occurred during the study period, of which 297 occurred in persons 60 years and above with crude death rate of  22.8%. The mean age at death was 68 ± 9 years (ranged 60-100 years). This consisted of 59% males and 41% females. Mean age at death for females was 69.7 ± 8.7 years and for males 68.1 ± 9.8 years (P=0.05).Mean values of serum chemistry were sodium 137 ± 8 mMol/l, potassium 3.6 ± 1 mMol/l, urea 11 ± 8 mMol/l, and creatinine 126 ± 91 μmol/l. The value of mean haemogram concentration was 10.5 ± 3 gm/dl and white  cell count was 12 ± 2 × 109/ mm3. The three most common diagnoses at deaths were stroke (19.8%), sepsis (16.5%), and lower respiratory tract disease (8.1%). Infectious diseases accounted for 38.2% of all diagnoses. Collective mean length of hospital stay (LOS) at death was 6.8 ± 8.6  (ranged 15 minutes-60 days). Close to 27.4% of the deaths occurredwithin 24 hours and neurological disorder had shortest hospital stay (4.6 ±  6.3 days), followed by endocrine disorders (6.8 ± 8.4 days) and respiratory diseases (8.4 ± 5.6 days) [P=0.001].Conclusion: Hospital mortality is high amongst older people. Stroke and infectious diseases are leading causes of death. Efforts should be geared toward reducing risk for cardiovascular diseases and improvement on level of personal and community hygiene

Traditional Birth Attendants' Understanding and Perceived Roles in the Prevention of Mother to Child Transmission of HIV in Ogun State, Nigeria

Background: About 3.2 million people and 400,000 children live with HIV in Nigeria. Over 60% of deliveries take place outside health facilities and are often supervised by Traditional Birth Attendants (TBA). It is expedient that TBAs have good knowledge and perception of prevention of mother to child transmission (PMTCT) of HIV. Methods: This is a cross-sectional study of TBAs in two randomly selected LGAs in Ogun State. All consenting TBAs registered with the TBA association in the selected LGAs were included in the study. Result: There were 142 respondents in all. Most TBAs (97.2%) were aware of HIV and the mode of transmission. They acquired the knowledge from Government hospitals (35.2%) and the media (32.4%). The respondents were aware mothers could transmit HIV to their children during pregnancy (67.6%), labour/delivery (74.6%) and breastfeeding (62%). The perceived roles of the TBAs in PMTCT included counseling of pregnant women (95.8%), ensuring screening for HIV (95.8%), accompanying HIV positive pregnant women to centers where they can obtain care (97.2%), referral of HIV positive women (97.2%), use of universal precaution during delivery (94.4%), use of sterile instruments for delivery (98.6%) and not taking delivery of HIV positive pregnant women by themselves (78.9%). Conclusion: The TBAs in this study had a good perception of their role in PMTCT. Persistent training and supervision will ensure compliance with the principles of PMTCT and thus reduce the burden of mother-to-child transmission of HIV

Measured effect of some socio-demographic factors on depression among breast cancer patients receiving chemotherapy in Lagos State University Teaching Hospital (LASUTH)

Background: Breast cancer is a disease predominantly found amongst women. It is a disease which threatens an organ that is intimately associated with a woman's self image, sexuality, as well as her reproductive and nurturing capacity. These threats have serious psychological implications for women living with breast cancer. Objective: To examine the pattern and predictors of depressive symptoms among breast cancer patients receiving chemotherapy in the Lagos State University Teaching Hospital (LASUTH). Methods: Ethical approval was obtained for an ongoing multi-centre study. The data used in this study are pre-test scores from breast cancer patients in the Lagos State University Teaching Hospital. The 21-item Becks Depression Inventory II (BDI-II) was administered on 33 purposively sampled breast cancer patients who read and signed informed consent forms before taking part in the study. Results: Analysis of data using simple percentages showed that the 33 participants indicated varying degree of depressive symptoms: 13 (39.4%) of the respondents had minimal depression, 12 (36.4%) of them had mild depression, 3 (9.1%) had moderate depression, and 5 (15.2%) had severe depression. The average BDI-II score yielded 16.09 indicating mild depression. Multiple regression analysis results showed that being informed about breast cancer, average monthly income, cancer stage and educational level significantly predicted participants' level of depression. Conclusion: This study confirmed the presence of depressive symptoms in cancer patients in Nigeria. It was recommended that intervention programs to help reduce these depressive symptoms be developed

Psychiatric morbidity in stroke patients attending a neurology clinic in Nigeria

Back ground: Stroke produces a wide range of mental and emotional disorders. Neuropsychiatric complications associated with stroke may have negative effects on the social functioning, overall quality of life and the recovery of motor functioning of stroke survivors. Objective: To determine the prevalence and nature of psychiatric morbidity among stroke patients attending neurology outpatient clinic of the University of Ilorin Teaching Hospital (UITH), Ilorin- Nigeria. Methods: All patients with stroke aged 18 years and above at an outpatient neurology clinic in Ilorin, Nigeria were assessed for mental and emotional disorders using the Schedule for Clinical Assessment in Neuropsychiatry (SCAN) over one year (March 2009 to February 2010). Results: Overall prevalence of psychiatric morbidity was 36.0% (30/83) among 83 patients who constituted the study population. Specific diagnoses recorded were depression (19.2%), generalised anxiety disorder (9.6%), harmful alcohol use (2.4%); dementia, somatoform disorder, phobia and delusional disorder each had a prevalence of 1.2%. Clinical and sociodemographic variables were not significantly associated with psychiatric morbidity. Conclusion: Psychiatric disorders are often associated with stroke. Identifying and treating stroke patients with these psychiatric co- morbidities could thus help to improve the overall quality of life of these patients