Elevated plasma homocysteine in association with decreased vitamin B12, folate, serotonin, lipids and lipoproteins in depressed patients

Objective: Increased plasma homocysteine, decreased vitamin B12 and folic acid levels have been implicated in depressive mood. Plasma homocystine, vitamin B12, folic acid tryptophan, lipids and lipoproteins were determined in depressed patients and controls. Method: Sixty subjects consisting of 30 depressed patients and 30 apparently healthy volunteers, who served as controls, were selected for this study. Anthropometric indices and biochemical parameters were determined using standard procedures. Results: The results showed a significantly higher plasma homocysteine level amongst depressed patients when compared with the corresponding controls (p<0.001), the percentage increase was 116%, while the plasma vitamin B12 (p<0.01), total cholesterol, high density lipoprotein cholesterol and low density lipoprotein cholesterol levels (p<0.001) were markedly lower when amongst depressed patients when compared with the corresponding controls; the percentage differences were 21%, 42% and 42% respectively. Plasma triglyceride, folic acid and tryptophan levels amongst depressed patients were not significantly different from the controls. The male subjects had significantly higher plasma tHcy levels than the female counterparts (p<0.001). Conclusion: This study showed a significant increase in plasma tHcy coexisting with a decrease in plasma vitamin B12 TC, LDLC and HDLC, in depressed patients. Increased plasma homocysteine could be a sensitive indicator of plasma B vitamin deficiency.Keywords: Cholesterol; Depression; Homocysteine; Tryptophan; Vitamin

Postpartum depression in a maternity hospital in Nigeria

Objective: To explore the recognition and management of postpartum depression (PPD) by the obstetric team in a maternity hospital concomitantly, was to find the rate of PPD in the centre. Design: A descriptive cross-sectional study. Setting: Island Maternity Hospital, Lagos, Nigeria; a moderately large obstetric facility with 68 beds and 42 paediatric cots. Subjects: The medical staff including doctors and nurse midwives in the study centre. Concomitantly, a sample of women that delivered in the hospital during the study period. Results: Seventy two (65.5%) of the total 110 obstetric staff in the hospital consented to the study; made up of 10 doctors and 62 midwives of varying cadres. 43.1% of them admitted their difficulty to recognise PPD with X2 of 25.8, while 19.4% expressed doubt in the obstetric team's ability to manage PPD. 86.1% would rather refer PPD cases to the psychiatrists, but saw stigma as a militating factor. Hence 77.8% with X2 of 65.3 would want consultation-liaison psychiatric services established in the centre. Concomitantly, of the 252 women assessed with EPDS, 23% were depressed with scores>12. Conclusion: It is concluded that there is need to update the obstetric team's knowledge on the management of PPD through Continuous Medical Education (CME) to which 97.2% of them agreed. East African Medical Journal Vol.81(12) 2004:616-61

Physical Activity Level, Nutritional Intake, Functional Status and Quality of Life of Geriatric Individuals in Lagos, South-West, Nigeria: A Cross Sectional Survey

Background: Participation in physical activity (PA) and healthy nutrition are important factors that affects muscle and bone strength and the resultant functioning in the activities of daily living (ADL) skills including the overallquality of life (QoL) of geriatric individuals. However, the relationships between all these parameters are yet to be fully documented and studies from developing countries are lacking.Objective: This study was designed to investigate the relationships between PA level, frequency of nutritional intake of food rich in calcium, magnesium, phosphorus, vitamin D and the basic ADL, instrumental ADL and QoL of geriatric individuals in Lagos, Nigeria.Methods: A cross-sectional study involving 394 geriatric individuals. A combination of standardized questionnaires which assessed the socio-demographic parameters, PA level, frequency of intake of food rich in calcium, magnesium, phosphorus, vitamin D, ADL skills, and QoL ofthe geriatric individuals was used. Data was analyzed using descriptive statistics and Pearson’s chi-square. Results: The highest proportion (35.5%) of participating geriatric individuals was at the active PA level. PA level was statistically associated with QoL, basic and instrumental ADL, (X2 = 199.57, p = 0.001; X2= 87.07, p = 0.000; and X2=164.53, p= 0.001 respectively). There was also anassociation between frequency of intake of food rich in calcium, magnesium, phosphorus, vitamin D and the basic ADL (X2 = 97.43, p = 0.001), instrumental ADL (X2 = 151.56, p = 0.001) and QoL (X2 = 250.21, p = 0.001) of the studied geriatric individuals.Conclusion: The study demonstrated that an increase in PA level and regular intake of food rich in calcium, magnesium, phosphorus, vitamin D were associated with optimal functional status and better QoL in geriatricindividuals. Educational programmes on the importance of participation in regular PA and healthy nutrition are imperative and recommended for geriatric individuals. Key Words: Physical Activity, Geriatrics, Nutrition, Activitiesof daily living, Quality of life

Injury prevention in football: Knowledge and behaviour of players and availability of medical care in a Nigerian youth football league

Background. Exposure to competitive football is increasing among male youth football players in Nigeria. However, medical support to abate the impact of injuries appears inadequate and there is limited literature to show whether youth football players are knowledgeable about, and practise effective measures for injury prevention in football (IPF).Objective. To assess the knowledge and behaviour of male youth football players regarding IPF and the availability of medical care for players.Methods. We conducted a cross-sectional study among all registered first-division players of a male youth football league in Lagos, Nigeria. Using a self-administered questionnaire, we assessed players’ knowledge regarding IPF, awareness of the Fédération Internationale de Football Association (FIFA) 11+ injury-prevention programme, injury-prevention behaviour and availability of medical attendants during training and competitive matches.Results. The mean age of the players was 18.5 years (standard deviation (SD) ±1.7; range 12 - 19). Their overall mean knowledge score regarding IPF was 4.40 (SD ±1.92) from a total score of 9, with the majority falling into the poor (39.1%) and fair (43.9%) knowledge categories. Most (79.3%) players were not aware of the FIFA 11+ programme. Less than half (40.5%) wore shin guards during training sessions, while 52.5% reported wearing shin guards during matches. Less than two-thirds always warmed up or cooled down at training or matches. About three-quarters (73.1%) and over half (52.1%) reported not having medical attendants working with their teams during matches and training, respectively.Conclusion. There is a clear deficiency in the knowledge and behaviour of injury-prevention measures among Nigerian male youth football players, and adequate medical care is lacking. There is a need for injury-prevention advocacy and implementation of effective interventions to bridge the identified deficiencies in youth football in Nigeria

Violence Against Mental Health Staff in Nigeria: Some Lessons from Two Mental Hospitals

Background: Psychiatric patient violence against staff is frequentlyencountered in mental health settings. Studies from Africa and Nigeria inparticular are few.Aim: The study aimed at comparing the frequency and type of physicalassaults by individuals with mental illness against staff working in twomental hospitals in Nigeria with a view to identifying some staff contextualvariables that could predispose them to these assaults.Methods: The study was a crosssectional descriptive report by questionnaire survey of physical assaults on 189 staff members(doctors and nurses) working at the Federal Neuropsychiatry Hospital,Yaba (FNHY), Lagos and Federal Neuropsychiatry Hospital Calabar(FNHC), Nigeria.Results : One hundred and twelve participants from the two hospitalswere victims of 202 assaults. Staff of FNHC experienced more assaults(70.4%) than staff of FNHY (49.5%), and this was significant. Nursing staffwere more frequently assaulted than doctors for the two hospitals. Eventhough staff of FNHC attended fewer courses on management andprevention of violence than staff of FNHY, not having received training inmanaging patient violence and gender were not significant risk factors forexposure to patient violence in a multivariate analysis.Conclusion. There is a need to formulate policies and guidelines forthe management and prevention of psychiatric patient violence againststaff in our mental health institutions

Post traumatic stress disorder among injured road traffic accident victims in Lagos, Nigeria

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Clinico-Pathologic Features and Outcome of Chronic Lymphocytic Leukemia In Ilorin, North Central Nigeria.

A retrospective analysis of all patients that were diagnosed and managed for Chronic lymphocytic Leukemia (CLL) in the Department of Haematology of University of Ilorin Teaching Hospital, Ilorin between 1st January 2005 and 31st December 2018 was carried out with the aim of characterizing the clinical, haematological and prognostic features as well as outcome in the patients. A total of 39 patients were reviewed consisting 25 (64.1%) males and 14 (35.9%) females giving a M:F ratio of 1.6:1. The median age of patients at diagnosis was 65.5 years and the highest prevalence was found in the 60 – 69 years age group. The commonest symptoms at presentation were night sweats (59.0%), Body weakness (51.3%), fever (41.0%), and weight loss (41.0%) while the commonest signs included lymphadenopathy in all patients (100%), splenomegaly (87.2%), pallor (53.9%) and hepatomegaly (46.2%). The mean values of haematological parameters were: Packed cell volume (28.6%), Haemoglobin concentration (9.4g/dL), Total white blood cell count (87.6 x 109/L), Absolute lymphocyte count (55.8 x 109/L) and platelet count (134.8 x 109/L). The majority of the patients (94.9%) were diagnosed with advanced disease (Rai stage III and IV) while only 2(5.1%) had Rai stage II and none in Rai stage 0 – I. Chlorambucil-based regimen was used in 71.8% of patients, and only 2 patients had Rituximab as part of their treatment regimen. The clinical presentation, haematological features and disease outcome observed in our study was similar to what had been reported in Nigeria and other parts of the world. Keywords: Clinical, Haematological, Features, Chronic lymphocytic leukemia, Ilori

Determinants of the disposition of patients attending a psychiatric emergency department in Nigeria

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