Post-stroke depression among stroke survivors attending two hospitals in Kampala Uganda

Background: The burden of stroke worldwide is increasing rapidly. There is paucity of data on post-stroke depression (PSD) among stroke survivors in Uganda, despite the high prevalence of PSD reported elsewhere.Methods: In a cross-sectional study, we assessed adult participants with confirmed first stroke with a standardized questionnaire. The Patient Health Questionnaire-9 was used to assess for depression among non-aphasic patients while the Aphasic Depression Rating Scale was administered to aphasic patients. Univariable and multivariable analyses performed to describe associations with PSD.Results: Forty three females (58.9%) and 30 males (41.1%) who had a stroke participated. Fifty eight (79.5%) had ischemic strokes and 12 participants (16.4%) were aphasic. The prevalence of PSD among the study participants was 31.5%. PSD was higher among patients assessed within 6 months after the onset of stroke. PSD was strongly associated with the total Barthel index of activities of daily living (BIADL) score; p=0.001. There was no significant association between demographic characteristics and PSD.Conclusion: There is a high prevalence of unrecognized post-stroke depression. Post-stroke depression was strongly associated with the patient’s inability to undertake activities of daily life. There is urgent need for integration of screening for and management of post-stroke depression among stroke survivors.Keywords: Stroke, post-stroke depression

Post-stroke depression among stroke survivors attending two hospitals in Kampala Uganda

Background: The burden of stroke worldwide is increasing rapidly. There is paucity of data on post-stroke depression (PSD) among stroke survivors in Uganda, despite the high prevalence of PSD reported elsewhere. Methods: In a cross-sectional study, we assessed adult participants with confirmed first stroke with a standardized questionnaire. The Patient Health Questionnaire-9 was used to assess for depression among non-aphasic patients while the Aphasic Depression Rating Scale was administered to aphasic patients. Univariable and multivariable analyses performed to describe associations with PSD. Results: Forty three females (58.9%) and 30 males (41.1%) who had a stroke participated. Fifty eight (79.5%) had ischemic strokes and 12 participants (16.4%) were aphasic. The prevalence of PSD among the study participants was 31.5%. PSD was higher among patients assessed within 6 months after the onset of stroke. PSD was strongly associated with the total Barthel index of activities of daily living (BIADL) score; p=0.001. There was no significant association between demographic characteristics and PSD. Conclusion: There is a high prevalence of unrecognized post-stroke depression. Post-stroke depression was strongly associated with the patient\u2019s inability to undertake activities of daily life. There is urgent need for integration of screening for and management of post-stroke depression among stroke survivors

A rare case of multi‐drug resistant Raoultella ornithinolytica‐induced sepsis in a healthy young man in Uganda

Key Clinical Message Antimicrobial resistance (AMR) is a public health challenge. It causes unresponsiveness to treatment with antimicrobials, leads to sepsis, septic shock, and increased hospital mortality. This is compounded by new multidrug resistant organisms. We present and discuss a case of sepsis caused by a rare multi‐drug resistant bacterium Raoultella ornithinolytica. Abstract Antimicrobial resistance is a major public health concern worldwide, associated with nearly 5 million deaths. The highest mortality attributed to AMR is seen in sub‐Saharan Africa. Escherichia coli, Staphylococcus aureus, Klebsiella pneumoniae, Streptococcus pneumoniae, Acinetobacter baumannii, and Pseudomonas aeruginosa contribute to most deaths attributed to AMR globally. However, other uncommon microorganisms have been implicated. Few cases of resistant, extended‐spectrum beta‐lactamase (ESBL) producing Raoultella ornithinolytica have been reported to cause sepsis worldwide. To our knowledge, no case of R. ornithinolytica‐induced sepsis has been reported in our settings. We report a case of sepsis due to R. ornithinolytica in an injured young adult. We received a 36‐year‐old man, a professional banker involved in a road traffic accident 2 h before admission. He sustained a deep degloving wound on the right ankle with exposure of the lateral malleolus and presented with severe pain, and bleeding at the injury site. x‐Rays confirmed a comminuted intra‐articular distal tibia and fibular fracture. Surgical debridement and external fixation were aseptically done on the same day. Below knee amputation was done on the 7th day post‐admission due to extensively injured and infected limb with sepsis. Local pus culture isolated ESBL‐positive R. ornithinolytica susceptible only to meropenem, ciprofloxacin, and amikacin. Introducing these antibiotics on the 11th post‐admission day averted sepsis and enhanced patient recovery. With the threat of AMR, newly emerging highly resistant microbes should be expected and suspected. Early recognition of sepsis and its focus and precise intervention with antimicrobials guided by specimen culture and susceptibility profile is highly recommended and should be standard practice. It highly reduces morbidity and mortality due to sepsis

A pilot experience of common European infectious diseases curriculum for medical students: the IDEAL summer school

We demonstrated our ability as European medical educators to overcome language and organizational barriers moving towards a paradigm of Euorpean-wide teaching that better addresses students' needs and underpins high quality, safe exchange of information across the continents; thereby promoting excellent patient care by tomorrow's physicians