Symptomatology and comorbidity of somatization disorder amongst general outpatients attending a family medicine clinic in south west Nigeria

Background: Individuals with somatization may be the most difficult tomanage because of the diverse and frequent complaints across many organ systems. They often use impressionistic language to describe circumstantial symptoms which though bizarre, may resemble genuine diseases. The disorder is best understood in the context “illness” behaviour, masking underlying mental disorder, manifesting solely as somatic symptoms or with comorbidity.Objective: To evaluate somatization symptoms and explore its  comorbidity in order to improve the management of these patients.Methods: A cross-sectional survey of 60 somatizing patients who were partof a case-control study, selected by consecutive sampling of 2668 patientswho presented at the Family Medicine Clinic of University College HospitalIbadan, Nigeria between May-August 2009. Data was collected using theICPC-2, WHO- Screener and Diagnostic Schedule and analysed with SPSS16.Results: There were at least 5 symptoms of somatization in 93.3% of thepatients who were mostly females. Majority had crawling sensation, “headache”, unexplained limb ache, pounding heart, lump in the throat and insomnia. The mean age at onset was 35yrs with 90% having recurrence of at least 10yrs.Approximately 54% had comorbidity with cardiovascular disease being the most prevalent.Conclusions: The study revealed that somatization is not a specific diseasebut one with a spectrum of expression. This supports proposition thatfeatures for the diagnosis of somatization could be presence of three ormore vague symptoms and a chronic course lasting over two years. It isimportant to be conversant with pattern of symptoms and possible comorbidity for effective management of these patients.Keyword: Somatization, Bizarre Symptoms, Comorbidity, Crawling sensatio

Perception of Nurses about Palliative Care: Experience from South-West Nigeria

Background: Nurses play a major role all over the world in the palliative care team.Aim: The aim of this study was to investigate the knowledge and attitude of nurses toward palliative care in a tertiary level hospital in Nigeria. Subjects and Methods: Setting: This cross-sectional questionnaire-based study was carried out among nurses at a tertiary health care facility inAdo-Ekiti, South-West Nigeria. Design: A cross-sectional questionnaire-based study was carried out. The questionnaire sought information about the sociodemographic profile of respondents, their knowledge of definition and philosophy of palliative care among other things. Descriptive statistics was used to obtain the general characteristics of the study participants, while Chi-square was used to determine the association between categorical variables. A two-sided P < 0.05 was considered as significant.Results: A total of 100 questionnaires were returned with a female preponderance among the respondents with F: M ratio of 9:1. Regarding the definition of palliative care, 71.8% (48/66) of the respondents  understood palliative care to be about pain medicine, 55% (33/60) thought it to be geriatric medicine, while 90.2% (83/92) felt palliative care is about the active care of the dying. Exactly 80.5% (66/82) respondents agreedthat palliative care recognizes dying as a normal process while 84.1% (74/88) respondents were of the opinion that all dying patients would require palliative care. The use of morphine would improve the quality of life of patients according to 68.9% (42/61) of respondents.Conclusion: There are gaps in the knowledge of healthcare workers in the area of palliative care and this call for a review of the current nursing curriculum and practice guidelines in Nigeria.Keywords: End of life, Nursesf attitude, Pain management, Palliative car

Cervical screening with Luviva machine for early detection of cervical dysplasia: experience from Ekiti state, Nigeria

Background: Cervical cancer is a preventable and potentially curable cancer when detected early, yet it continues to be among the leading causes of cancer death in developing countries. Screening for cervical dysplasia is critical for early detection in order to reverse this trend. Several traditional screening methods such as pap smear test, HPV-DNA screening test, visual inspection with acetic acid or lugol iodine are in vogue with different specificity and sensitivity. LuViva advanced cervical scan is a new automated screening tool that has great promise for the detection of the disease in itsearliest form both in developing and developed countries.Objective: This study was designed to describe our experience with the use of LuViva advanced cervical scan as a primary screening tool for cervical dysplasia.Method: This is a descriptive cross-sectional study, whose data was obtained from the free health screening for civil servants in Ekiti State conducted between 11th and 21st February, 2014. Screening for Cervical dysplasia was conducted using the LuViva advanced cervical scan for women 40 years old and above. The result was automatically recorded and transferred to an Excel sheet for analysis.Result: A total sum of 254 patients was screened during the study period. Only one patient had a prior pap smear done. The automated self-reporting LuViva scan presented the result of the benign changes on the cervix as low risk in 143 patients (56.3%), moderate risk in 52 patients  15%) and high risk in 59 patients (11.5%). The machine further classified the dysplastic changes of the low, moderate and high risk categories as Atypical glandular cell (AGC), Atypical glandular cell favouring neoplasia (AGC-FN), Atypical g l a n d u l a r c e l l o f u n d e t e r m i n e d significance(AG-US), Atypical squamous cell of undetermined significance (ASC-US), Atypical squamous cell where high grade cannot be excluded (ASC-H) and Low grade squamous Intraepithelial lesion (LSIL). The proportion of moderate and high risk AGC (31.2%) was just slightly lower than the moderate and high risk of ASC-US (35.2%) while a higher percentage of43.9% in low grade squamous intraepithelial lesion was recorded among the patients.Conclusion: Our experience suggests that there is a place for the use of luViva scan in the primary screening for cervical dysplasia and there is a correlation between LuViva scan high risk result and histological diagnosis of cervical dysplasia.Keywords: Cervical screening, cervical dysplasia, civil servants, LuViva Scan, Ekiti State Nigeri

Team approach concept in management of oro-facial clefts: a survey of Nigerian practitioners

<p>Abstract</p> <p>Background</p> <p>Cleft palate craniofacial teams have evolved across the globe in the last 20 years in compliance with the interdisciplinary concept of management of oro-facial clefts. An interdisciplinary care allows a coordinated treatment protocol for the patient. The objective of this study was to evaluate oro-facial cleft care in Nigeria with particular emphasis on the compliance of the practitioners to the team approach concept.</p> <p>Methods</p> <p>A snapshot survey was conducted among specialists that attended the Pan African Congress on Cleft Lip and Palate, at the International Institute of Tropical Agriculture, Nigeria in February 2007.</p> <p>Result</p> <p>Sixty three respondents successfully completed and returned the questionnaire for analysis. Mean age of respondents was 43.5 years and the range was 38–62 years.</p> <p>Male to female ratio was 2.7:1. Oral and Maxillofacial Surgeons and Plastic Surgeons constituted the majority of respondents (38.1% and 22.2%) respectively. Only 47.6% (n = 30) of the specialists belonged to cleft teams. Majority of Oral and Maxillofacial Surgeons and Plastic Surgeons belonged to cleft teams (70% and 63.3% respectively) while speech pathologists and orthodontists were less represented (20% and 36.7% respectively) in teams.</p> <p>Conclusion</p> <p>Findings from this study suggests that interdisciplinary care for the cleft patient does not appear to have been fully embraced in Nigeria. This may be a result of several reasons ranging from non availability of the requisite specialists, the relatively young age of cleft care practice in this part of the world to the poor state of infrastructure.</p

An audit of impacted mandibular third molar surgery

Background: Mandibular third molar impaction is a major oral health burden globally. The associated morbidity and increasing public awareness necessitate the need for more researches into the subject of third molar impaction.Objective: To audit cases of third molar impaction and its management in our institution.Methodology: We carried out a descriptive clinical study involving patients who presented for management of impacted third molar between January 2010 and December 2011. Demography of the patients including third molar spatial relationship, indications for surgery and pre- and post-operative visual analogue score for pain, were analysed.Result: Demography of the patients revealed a mean age of 27.67&#177;7.19 (range 19-56 years) and male to female ratio of 1:1.15. The most common indication for surgery was peri-coronitis, and the mesio-angular variety was the most common form of impaction in our series (46.5%, N=40). Analysis of mean pre-operative and post-operative pain perception with paired t-test revealed statistically significant difference (p=0.00 &amp; 0.01, respectively). Only 14% of the patients developed post-operative infection.Conclusion: Management of impacted mandibular third molar constitutes a sizeable workload of oral surgeons and dental practitioners globally. Early surgery for symptomatic impacted third molar tooth is hereby advocated

The influence of workplace stress on family functioning of resident doctors at university college hospital Ibadan

Background: Work and family are very important aspects of life, and for medical doctors, workplace stress may be inevitable during residency training. Resident doctors should have a balanced work-family life because it contributes to their overall family functioning.Objectives: The specific objectives were to determine the prevalence of workplace stress, evaluate the family functioning, and assess the influence of workplace stress on the family functioning of the resident doctors working in the University College Hospital (UCH), Ibadan, Nigeria.Setting:&nbsp;The study was conducted at the University College Hospital, Ibadan located at the south-western part of Nigeria.Methods: The study was a cross-sectional study, conducted among resident doctors across all the specialties at UCH, Ibadan over a period of 3 months. Two hundred and thirty-two eligible and consenting resident doctors were selected by stratified random sampling and data was collected using a structured self-administered questionnaire. Data was analyzed using the Statistical Package for the Social Sciences (SPSS) version 23.Results: The prevalence of workplace stress among the resident doctors was 62.1%, and 27.6% had problematic family functioning. There was a significant association between workplace stress and the family functioning of the resident doctors. Workplace stress could independently predict problematic family functioning of the resident doctors.Conclusion: Workplace stress should not be underestimated, as it has significant influence on the family functioning of the residentdoctors working at the UCH, Ibadan, Nigeria. Keywords: workplace; stress; family; functioning; influence; work-family

Profile, clinical correlates and anxiety symptoms among adult hypertensive patients attending the family medicine clinic, University College Hospital, Ibadan

Introduction: Hypertension and anxiety are both common conditions in primary care. Hypertension is a chronic disease and is often accompanied by anxiety. The co-existence of both conditions results in treatment barriers, poor quality of life and increased utilization of health facilities which constitute a public health problem. Recognition and treatment of anxiety in patients with hypertension can result in significant improvement in self-care and effectiveness of therapeutic interventions. The aim of this study was to determine the profile, clinical correlates and anxiety symptoms among adults with hypertension attending Family Medicine clinic, University College Hospital, Ibadan.Methods: This was a hospital based cross-sectional study of consenting hypertensive adults presenting to the Family Medicine Clinic of College Hospital, Ibadan, Oyo State, from September-November 2019. The study utilized interviewer-administered questionnaire on 231 participants, selected by systematic random sampling. Data on sociodemographic status and clinical variables were collected. Generalized Anxiety Disorder Scale (GAD-7) was used to assess anxiety among participants and anxiety was defined as a GAD-7 of ten and above. Data collected was analysed using Statistical Package for Social Sciences (SPSS) version 23.Result: The mean age of the respondents was 54.9 ±9.9 years, with a male: female ratio of 1: 1.6. Majority of the respondents were married (81.8%), Yoruba (86.1%), employed (81%) and of the Christian faith (62.3%). The mean duration of hypertension was 6.06±5.80 years and mean body mass index was 29.0±5.6kg/m². The mean systolic blood pressure was 136.6 ± 17.8mmHg while the mean diastolic blood pressure was 85.3± 13.2mmHg. The prevalence of anxiety was 30.3%.Conclusion: This study revealed that a third of hypertensive adults had anxiety symptoms, which would have been missed because hypertensives are not routinely screened for anxiety. There is a need for Family Physicians who are frontline doctors to actively explore anxiety in hypertensive patients, because these will support holistic therapeutic intervention and improve their medical outcome. Keywords: Anxiety, Hypertension, Family Medicine, Prevalence, Blood pressur

Relationship between Unhealthy Sexual Behaviour and Urinary Infections among Adolescents Presenting in a Tertiary Hospital in South West Nigeria

Adolescent is an important segment of the world population accounting for about one fifth. It is a transition state between childhood and adulthood and characterized with the development of behaviours with lifelong consequences. Such behaviours include unhealthy sexual practices with its associated risks like unwanted pregnancy and sexually transmitted diseases. This was a cross sectional descriptive study of 321 adolescents who presented at the general outpatient clinic of a tertiary health institution. The diagnosis of urinary infection was by the use of rapid dipstick test to detect the presence of nitrites, while the presence of pus cells, white blood cells greater than 5 per high power fluid, epithelial cells and trichomonal vaginalis were identified microscopically. Their HIV status was also determined. The fifty three (16.25) of the respondents who had coital experience were screened for evidence of urinary infection. The prevalence of urinary infection was 24.5% among the respondents with 10% and 5% of the sexually exposed females reported homosexual and bisexual experience. Parental higher socioeconomic class was protective against sexual exposure among the adolescents. In view of the high level of poverty with a large part of the population belonging to low socioeconomic class, it is necessary to research into possible interventional study on how to prevent unhealthy sexual behavior among adolescents from low socioeconomic class.Key words: sexual behavior; Urogenital Infection; Adolescent