Acute Rapid QTc Changes Following Chloroquine Overdose With No Suicidal Intent

We report a 39 year-old male with unintentional chloroquine overdose without any suicidal intention. Marked QTc prolongation of 0.508sec was observed acutely though patient’s total ingested dose was lower than most fatal doses reported in literature. This range of QTc carries a predisposition to potentially fatal ventricular arrhythmias. Serial electrocardiograms (ECGs) demonstrated gradual return of QTc towards normal while patient was on observation without any indication for active intervention. We recommend that in the event of chloroquine overdose, close monitoring of the cardiovascular system should be done even in apparently stable individuals

Self-reported symptoms of uninvestigated dypepsia among University staff in Ilorin, Nigeria

Objectives: Dyspepsia is a common gastrointestinal (GI) symptom which impacts negatively on quality of life, workplace efficiency and overall productivity. Many studies on dyspepsia in our environment are hospital based, but being a complaint frequently treated first by self-medication before presentation to the hospital, such studies may underestimate its prevalence. The objective of the study was to determine the prevalence of the dyspepsia and its associated factors among administrative staff of the College of Health Sciences, University of Ilorin, Nigeria.Methods: This was a cross-sectional study. Pretested structured, close-ended, interviewer-administered questionnaires were administered to 53 administrative staff selected across the different units by stratified random sampling. The questionnaire obtained information about subject's experiences of dyspeptic symptoms and presence of associated factors such as family history, non-steroidal anti-inflammatory drugs (NSAIDS), tobacco and alcohol use, and presence of diabetes mellitus (DM).Results: The prevalence of uninvestigated dyspepsia among the respondents was 37.5%. Age was significantly predictive of the occurrence of dyspepsia among the subjects Odds Ratio- 1.46, 95% Confidence Interval (1.042-2.045) P=0.03. Use of NSAIDS, presence of DM, family history and tobacco use were not predictive of occurrence of dyspepsia.Conclusion: The prevalence of dyspepsia is high among respondents in the study.Keywords: Dyspepsia, prevalence, university, Nigeri

PATTERN AND EXPLANATORY FACTORS FOR MEDICATION ADHERENCE AMONG PATIENTS WITH HYPERTENSION, DIABETES MELLITUS AND THEIR COMORBIDITY IN A NORTH CENTRAL STATE OF NIGERIA

Introduction: Hypertension and diabetes are the two most common non-communicable diseases seen in outpatient clinics in Sub-Saharan Africa. Promoting medication adherence is a major clinical hurdle to be crossed in reducing the premature morbidity and mortality associated with these diseases. This study explored factors that predict medication adherence among hypertensive and diabetic patients in Ilorin, Nigeria. Methods: This cross-sectional study was carried out among hypertensive and diabetic patients in outpatient clinics of a teaching hospital in Ilorin, Nigeria. Data was collected from 1,203 patients using a validated Morisky 8-item medication adherence questionnaire. Multivariate ordinal logistic regression was used to model the medication adherence explanatory factors with SPSS version 22. Result: Less than half (43.3%) of the patients were highly adherent to their medication. The relative proportion for high adherence was 42.7%, 35.6% and 49.2% for hypertension, diabetes and both diseases respectively. The odds of medication adherence improving from either low to medium level or from medium to high level was explained by; age, symptoms count, absence of disease complication and absence of drug side effect among the patients. Blood pressure, gender and disease duration did not explain medication adherence among hypertensive and diabetic patients. Conclusion: It is concluded that the discomfort experienced due to the disease condition and the medication regimen are important explanatory factors for patient’s medication adherence in the study setting. This study recommends strategies to reduce multiple drug combinations and promote medication adherence counselling and education among patients

PREDICTIVE FACTORS OF MEDICATION ADHERENCE AMONG HYPERTENSIVE AND DIABETICS PATIENTS IN A NORTH CENTRAL STATE OF NIGERIA

Introduction: Hypertension and diabetes are the two most common non-communicable diseases seen in outpatient clinics in Sub-Saharan Africa. Promoting medication adherence is a major clinical hurdle to be crossed in reducing the premature morbidity and mortality associated with these diseases. This study explored factors that predict medication adherence among hypertensive and diabetic patients in Ilorin, Nigeria. Methods: This cross-sectional study was carried out among hypertensive and diabetic patients in outpatient clinics of a teaching hospital in Ilorin, Nigeria. Data was collected from 1,203 patients using a validated Morisky 8-item medication adherence questionnaire. Multivariate ordinal logistic regression was used to model the medication adherence explanatory factors with SPSS version 22. Result: Less than half (43.3%) of the patients were highly adherent to their medication. The relative proportion for high adherence was 42.7%, 35.6% and 49.2% for hypertension, diabetes and both diseases respectively. The odds of medication adherence improving from either low to medium level or from medium to high level was explained by; age, symptoms count, absence of disease complication and absence of drug side effect among the patients. Blood pressure, gender and disease duration did not explain medication adherence among hypertensive and diabetic patients. Conclusion: It is concluded that the discomfort experienced due to the disease condition and the medication regimen are important explanatory factors for patient’s medication adherence in the study setting. This study recommends strategies to reduce multiple drug combinations and promote medication adherence counselling and education among patients

COVID-19 and mental health in Nigeria: Three proposals for integration mental health services into COVID-19 response

The COVID-19 disease is a global pandemic which in its over twelve months of known existence has affected over 89 million people worldwide leading to psychological and social sequelae in the affected individuals, their caregivers, health workers and the general public. Nigeria seems to have at best, a skeletal and non-structured integration of mental health professionals into her COVID-19 response team, both at the state and the federal levels. This article proposes three (3) models for integrating a multidisciplinary mental health team into the management of infected individuals, their caregivers as well as health care workers, while taking into consideration, the human and material resources available for mental health in the country as well as the already existing pressure on the available resources.  These models include a mental health team participatory model, a multi-level training model and a multi-sectoral collaboration model. It is hoped that a careful and strategic integrating of these three models will help to create a sustainable framework for tackling the mental health consequences of the COVID-19 pandemic` in a developing country like Nigeria. &nbsp

Structural echocardiographic abnormalities seen in HIV/AIDS patients are independent of CD4 count

Introduction: The human immunodeficiency virus (HIV) infection remains one of the most daunting public health challenges today. Cardiac involvement in HIV/acquired immune deficiency syndrome (AIDS) is frequent and has been recognized on autopsy since the emergence of the pandemic. The objective of the study was to assess the pattern of structural echocardiographic (echo) findings in HIV/AIDS patients and compare this to the echo findings in apparently healthy HIV-negative controls.Materials and Methods: One hundred and fifty HIVpositive patients were recruited consecutively from the HIV patients attending the University of Ilorin Teaching Hospital, Ilorin, North Central, Nigeria. One hundred and fifty age- and sex-matched controls were also recruited from the surrounding community. All the individuals had clinical examination, electrocardiography (ECG) and echocardiography (echo) done.Results: ECG abnormalities were seen in 55.3% of the HIV-positive patients compared with 2.7% of controls (P < 0.001). The overall prevalence of echo abnormalities among the patients was 54%, against 15.3% (P < 0.001) of the controls. All the structural dimensions of the cardiac chambers were significantly greater than the cardiac chamber dimensions in the controls except for left atrial dimension (LAD). When the patients were considered in two groups of those with CD4 count less than 200 cells/mm3 than those with CD4 count more than 200 cells/mm3, the structural chamber dimensions were similar between both groups.Conclusions: Echo is an important tool for detecting cardiac abnormalities in HIV/AIDS patients. There is a high prevalence of echo abnormalities among HIV patients seen in our centre. The HIV infection was associated with increased structural dimensions of cardiac chambers compared with HIV-negative controls. This however did not seem to be related to disease severity as the chamber dimensions were similar between those with CD4 count below and above 200 cells/mm3.Keywords: Echocardiography, CD4 count, human immunodeficiency virus/ acquired immune deficiency syndrom

Characteristics of patients with acute heart failure in North Central Nigeria

Objectives: Heart failure (HF) is an important cause of hospital admission in Nigeria. HF is increasingly prevalent because the population is aging and HF epidemiology is changing. We aimed at profiling the socio-demographic, clinical and echocardiographic (Echo)  characteristics of patients admitted for acute HF. This is one of the largest cohorts of HF patients profiled in Nigeria so far. Methods: Cross sectional design. Socio-demographic, clinical and Echo data were collected from 455 patients admitted for AHF at University of Ilorin Teaching Hospital, North central, Nigeria. Results: Mean age of patients was 58.9± 15.7years, (men were older than women, P= 0.006). 265(58.2%) were males, most patients were aged >60 years, 4.8% had pre-existing Type2 Diabetes mellitus. 53.2% of patients presented in New York Heart Association Stages III and IV. Median duration of admission was 11days (IQR, 6-17), intrahospital mortality- 11.6%. Hypertension was the commonest aetiological factor (62.4%), followed by dilated cardiomyopathy 17.6%, rheumatic heart disease (6.6%), Peripartum cardiomyopathy (5.3%), and others. Conclusion: AHF patients in our study are older than those in previous studies in Nigeria and sub-Saharan Africa. Hypertension is main driver of AHF, and patients largely present with clinically advanced disease necessitating stronger public health education about risk factors and early presentation. &nbsp

Benefits, disadvantages and challenges of virtual conferencing in the COVID-19 era: Adjusting to the new normal

Objective: The COVID-19 pandemic has had tremendous effect on the medical and scientific community. Measures instituted to curb the spread of the disease such as physical distancing and ban on large gatherings have significantly altered conferencing activities of medical professional associations. With no end in sight to the pandemic, it is certain that medical professional associations may have to make do with purely virtual or hybrid conferencing for some time to come. The objective of this paper is to highlight the benefits, disadvantages and challenges of virtual conferencingMethods: We searched Pubmed, Embase, Scopus, and AJOL databases from January 1, 2021 to December 31, 2021 for publications describing the benefits, disadvantages and challenges of virtual conferencing during the pandemic. This, together with authors' experience formed the resource base for this work.Conclusion: We propose ways the scientific community in Nigeria can maximize the virtual conferencing while the pandemic lasts. We also advocate increased discussion about how to improve the virtual conferencing culture and the development of guidelines for purely virtual or hybrid scientific conferences

The Impact Of HIV/AIDS On The Cardiovascular System - A Review Of Current Trends

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