A survey of perceived stress, intimidation, harassment and well-being of resident doctors in a Nigerian Teaching Hospital

No Abstract

Gilles de la Tourette Syndrome Co-existing with Attention Deficit Hyperactivity Disorder in a 9-Year Old Nigerian Boy

Tourette disorder is an uncommon neuropsychiatric disorder characterised by involuntary tics and behavioural disturbances. The disorder is most prevalent in childhood. Only a few cases of Gilles disorder had been reported in Nigeria. The disorder shares some characteristics and association with many neuropsychiatric disorders hence, the diagnosis can be easily missed. This is a report of a 9-year old school boy with Tourette disorder with co-existing Attention Deficit Hyperactive Disorder (ADHD). The diagnosis in this child was missed on initial assessment, hence this report highlights the need for high index of suspicion when children present with involuntary tics

Vesicouterine fistula: A case report of successful repair

The increasing rate of cesarean deliveries especially in previous scars is a major cause of vesicouterine fistula (VUF). The incidence of VUF is on the rise because of the increasing incidence of cesarean deliveries. VUF is a pathological communication between the uterus and the bladder. VUF presents in various ways, the main symptoms are urinary incontinence with or without hematuria. There could be depression or psychological distress, which may culminate in reduction in quality of life. The precise and early diagnosis of vesicouterine fistula may be difficult; thus necessitating myriad of investigations such as retrograde cystography, cystoscopy, contrast‑enhanced CT scan, MR urogram, and transvaginal ultrasound with or without Doppler. Examination under anaesthesia (EUA) is crucial to the diagnosis of VUF and this includes methylene blue test. We report a case of VUF.Key words: Urinary bladder; urogenital fistula; uterus; vesicouterine fistula

Quality of Sleep and Psychological Distress in Glaucoma

Background: People living with glaucoma are psychologically burdened because of the threat of visual loss. Therefore, understanding the psychosocial issues and quality of sleep holds important implications for the recognition, prevention, and treatment of emotional problems among people with glaucoma. This study investigated the quality of sleep and psychological distress among people with glaucoma. Methods: This was a cross-sectional study of adults recruited over a period of 12 weeks from a glaucoma clinic of a Teaching Hospital in south-west Nigeria. The quality of sleep and psychological distress were evaluated using the Pittsburgh Sleep Quality Index and General Health Questionnaire respectively. Results: Ninety-three adults with glaucoma participated in the study. The mean age was 62.33 ± 15.25 years. Fifty-seven (61.3%) of the subjects were poor sleepers while 27 (29.0%) were psychologically distressed. Psychological distress correlated with global sleep score (r = 0.399, p = 0.000), subjective sleep quality (r = 0.341, p = 0.001), sleep latency (r = 0.245, p = 0.018) and sleep disturbance (r = 0.279, p = 0.007). Conclusion: Psychological distress and sleep disturbances were common among patients with glaucoma. Concerns about these issues should be incorporated into routine clinical evaluations of patients with glaucoma

Attitudes of Pre-Clinical and Clinical Medical Students to Psychiatry

Medical training provides an environment in which proper and professional attitudes towards psychiatric patients can be acquired. The purpose of this study was to assess the attitudes of medical students to psychiatry by comparing those of clinical students that have had exposure to psychiatric postings with the pre-clinical students who have not had rotations in psychiatry. A questionnaire was administered to a sample of randomly selected preclinical and clinical medical students studying at Olabisi Onabanjo University, Ogun state. The items on the questionnaire were designed explicitly to collect information on attitude to psychiatry. A total of 152 students took part in the study. Sixty six (43.4%) of them were males. Seventy eight (51.3%) of the respondents were preclinical students. About 60% of the students agreed that psychiatry is a rapidly advancing field of medicine. More than two-thirds of the respondents felt psychiatry has a high status and aura of wisdom within medicine. A large percentage of the students disagreed with the statement that entering psychiatry is a waste of medical education and that it is not a challenging career. The clinical students showed more positive attitudes toward psychiatry compared to the preclinical students. They agreed more that psychiatry is a rapidly advancing field in medicine compared with the preclinical students (χ2 = 4.537, p = 0.033). The clinical students were favourably disposed to choosing psychiatry as a field of specialty compared with the preclinical students (χ2 = 12.659, p = 0.000). Appropriate psychiatric education of medical students may do much to reduce the stigma directed towards psychiatry. Keywords: Attitude to psychiatry, Medical students, Medical education, Stigma Nigerian Hospital Practice Vol. 2 (4) 2008: pp. 88-9

Prevalence of diastolic hypertension among ophthalmic patients in Sagamu, Ogun State

Hypertension a common non communicable disease is often symptom less. It is not uncommon to discover it during a routine medical checkup. Many eye surgeries had to be cancelled because of raised blood pressure. This prospective hospital based study was carried out to determine the prevalence of hypertension in patients attending the eye clinic. It was found that prevalence of hypertension was 37.1%, and affects mainly people above 50years. A total of 66.7% of the known hypertensive patients who were on antihypertensive medications still had elevated blood pressure. Hypertensive retinopathy was found in only 12.8% of the hypertensive. We conclude that routine check of the blood pressure should be an integral part of eye examination; this may help in the long term by reducing the morbidity and mortality from this disease.Nigerian Hospital Practice Vol. 2 (3) 2008: pp. 58-5

Churg-Strauss's Syndrome; Review of literature

Churg – Strauss Syndrome (CSS) is a rare idiopathic, multisystemic, autoimmune disease, characterized by diffuse eosinophilic infiltration and necrotizing vasculitis of small to medium sized vessels. Late onset asthma and/or allergic rhinitis are frequent clinical manifestations with fever and loss of weight as systemic symptoms at presentation. Mononeuritis multiplex, myalgia, skin involvement (purpura, skin nodules, urticarial rash, livedo reticularis), arthralgia, gastro intestinal tract (GIT) involvement, pericardial, myocardial, central nervous system (CNS) and renal involvements are other manifestations of CSS. Diagnostic hallmarks include Blood and tissue eosinophilia, histology revealing eosinophilic granulomas and/or necrotizing vasculitides in tissue biopsy. Although not a criterion of CSS diagnosis, presence of Antineutrophil Cytoplasmic Antibodies (ANCA), especially antimyeloperoxidase (ANCA MPO), is associated with CSS. This is present in more than 40% (40 - 66 - 73%) of CSS patients. Pathogenesis varies from ANCA activation of neutrophils and resultant systemic endothetial damage (in ANCA positive CSS), on one hand, and tissue infiltration by eosinophils with resultant tissue damage by toxic products of eosinophils (in ANCA negative CSS), on the other hand. There are also the varying B and T cell dysfunctions. Diffuse organ involvement, especially cardiovascular (CVS), GIT, rare involvement of CNS and renal system suggest poorer prognosis and possible fatal outcome. Patients with these poor prognostic outlooks, especially cardiac, receive aggressive treatment using corticosteroids combined with immunosuppresants (chiefly cyclophosphamide). Patients with refractory CSS have been successfully treated, adding TNF – alpha blockers to a combination of glucocorticoids and cyclophosphamide. Antithymocyte globulin or pooled intravenous globulin have been found effective alternative therapy in resistant cases and most especially in pregnant patients. Keywords: Churg-Strauss syndrome, Eosinophilia, Antineutrophil Cytoplasmic Antibodies, Immunosuppressant

Quality of Sleep among Adults in Sagamu, Southwest Nigeria

Sleep plays an essential restorative function and is essential for good health, good quality of life and well-being. This study aimed to assess quality of sleep in a southwestern community within Nigeria.Participants were recruited using a multi-stage random sampling technique from Sagamu community. Four hundred and sixteen participants were interviewed using a socio-demographic questionnaire, Pittsburgh Sleep Quality Index and the 12-item General Health Questionnaire. Poor sleep quality was reported by 25.7% (n=107) of the respondents. There was a significant difference in the average hours of sleep across gender (male = 7.166 ± 1.385; female = 7.640 ± 1.201, t = 3.710, p = 0.000). Respondents that were 65 years and above were likely to be poorer sleepers compared to other age groups (X2 = 5.416, p = 0.067). Respondents who were separated or divorced (52.4%), widowed (46.7%) and married (31.2%) were significantly poorer sleepers compared with those that were single or never married (14.6%) (X2 = 25.926, p = 0.000) The overall sleep quality correlated positively with age (r = 0.220, p = 0.000) and psychological morbidity (r = 0.211, p = 0.000).A good proportion of the community dwellers were poor sleepers. Sleep disturbance might represent a significant and unrecognized public health issue within the community. Keywords: Quality of Sleep, Sleep Duration, Psychiatric Morbidity and Pittsburgh Sleep Quality inde

Sexual Risk Behavior, Sexual Violence, and HIV in Persons With Severe Mental Illness in Uganda: Hospital-Based Cross-Sectional Study and National Comparison Data.

We investigated prevalence of past-year sexual risk behavior and sexual violence exposure in persons with severe mental illness (SMI) in Uganda, and compared results to general population estimates. We also investigated whether persons with SMI reporting sexual risk behavior and sexual violence exposure were more likely to be HIV-infected