Preliminary study of Hepatitis B surface antigen on mental health care workers at federal neuropsychiatric hospital Barnawa, Kaduna Nigeria

Background: This study was designed to determine retrospectively, HBsAg status, marker of HBV infection, among Mental Health Care Workers (MHCWs) at Federal Neuropsychiatric Hospital (FNPH), Barnawa Kaduna, North West, Nigeria. Two hundred and fifty one, apparently healthy HBV vaccine naïve, MHCWs, who voluntarily participate prior to HBV-vaccination. Materials and Methods: The screening was carried out using atlas latex haemagglutination test kit, between the months of December, 2000 through March, 2001. The MHCWs were categorized into senior and junior staff. Their ages, years of service, occupation, and department were obtained from year 2000 staff nominal roll. Prior to the study ethical approval was obtained from the hospital ethical committee. Two hundred and fifty one, participant were tested for HBsAg in a pre-HBV-vaccination exercise. Results: The number and percentages of participants by gender were 127 (50.6%) males and 124 (49.4%) females, respectively. The age range was 19-60 years with a mean age of 37 ± 2 years. The Number and percentages of junior and senior staff were 163 (65.0%) and 88 (35.0%), respectively. The incidence of HBsAg was 72 (28.7%). Incidence rates was highest among the males 41 (32.3%) compared to females 31(25.0%) and51-60yrs (50.0%), the incidence among Junior Staff was 52 (31.9%), while in Senior staff was 20 (22.7%) respectively. MHCWs who served between 26-30 years were 2 (66.7%) and those within 21-25 years were 6 (26.1%). Medical Record Staff were 3 (60.0%) and staff from other departments were Pharmacy 3 (50.0%), Artisans 7 (46.7%), Security 15(42.9%), Occupational Therapy Staff 2 (40.0%), Account Staff 6 (30.0%), Social Welfare 1 (25.0%), Hospital Maids 14 (23.7%), Administration Staff 11 (23.4%), Nurses 8 (17.0%), Medical Laboratory Staff 0 (0.0%), respectively. Statistical analysis obtained using Chisquare (x2) test showed no statistically significant association (p >0.05) between incidence of HBV-infection and years of service, Sex, Age, Cadre and Occupation. Conclusions: Due to a high prevalence of HbsAg, a marker of HBV infection, among MHCWs, Pre-vaccination screening should be instituted in Nigeria’s mental health facilities for early detection of HBV-infection and selective treatment. Key words: Hepatitis B virus; HbsAg; neuropsychiatric; vaccination; screening; Barnawa; Kaduna; Nigeria

Pilot Study of [18F] Fluorodeoxyglucose Positron Emission Tomography (FDG-PET)/Magnetic Resonance Imaging (MRI) for Staging of Muscle-invasive Bladder Cancer (MIBC)

Introduction: Computed tomography (CT) has limited diagnostic accuracy for staging of muscle-invasive bladder cancer (MIBC). [18F] Fluorodeoxyglucose positron emission tomography (FDG-PET)/magnetic resonance imaging (MRI) is a novel imaging modality incorporating functional imaging with improved soft tissue characterization. This pilot study evaluated the use of preoperative FDG-PET/MRI for staging of MIBC. Patients and Methods: Twenty-one patients with MIBC with planned radical cystectomy were enrolled. Two teams of radiologists reviewed FDG-PET/MRI scans to determine: (1) presence of primary bladder tumor; and (2) lymph node involvement and distant metastases. FDG-PET/MRI was compared with cystectomy pathology and computed tomography (CT). Results: Eighteen patients were included in the final analysis, most (72.2%) of whom received neoadjuvant chemotherapy. Final pathology revealed 10 (56%) patients with muscle invasion and only 3 (17%) patients with lymph node involvement. Clustered analysis of FDG-PET/MRI radiology team reads revealed a sensitivity of 0.80 and a specificity of 0.56 for detection of the primary tumor with a sensitivity of 0 and a specificity of 1.00 for detection of lymph node involvement when compared with cystectomy pathology. CT imaging demonstrated similar rates in evaluation of the primary tumor (sensitivity, 0.91; specificity, 0.43) and lymph node involvement (sensitivity, 0; specificity, 0.93) when compared with pathology. Conclusions: This pilot single-institution experience of FDG-PET/MRI for preoperative staging of MIBC performed similar to CT for the detection of the primary tumor; however, the determination of lymph node status was limited by few patients with true pathologic lymph node involvement. Further studies are needed to evaluate the potential role for FDG-PET/MRI in the staging of MIBC. © 2020 Elsevier Inc.In this pilot study, preoperative staging with [18F] fluorodeoxyglucose-positron emission tomography/magnetic resonance imaging in muscle-invasive bladder cancer detected the primary bladder tumor; however, the determination of lymph node status was limited by few patients with pathologic lymph node involvement. Additional studies are needed to evaluate the potential role for [18F] fluorodeoxyglucose-positron emission tomography/magnetic resonance imaging in the staging of bladder cancer

Sociodemographic and clinical correlates of sexual dysfunction among psychiatric outpatients receiving common psychotropic medications in a Neuropsychiatric Hospital in Northern Nigeria

Background: Sexual dysfunction is common in patients receiving psychotropic medications and may reduce their quality of life and medication adherence with resultant negative impact on treatment outcomes.Objectives: In this study, we described the various types of sexual dysfunction among psychiatric outpatients receiving psychotropic medications and the sociodemographic and clinical correlates associated with it.Settings and Design: A descriptive, cross‑sectional study conducted in a Neuropsychiatric Hospital in Northern Nigeria.Methodology: The participants were made up of a consecutive sample of 255 outpatients attending psychiatric clinic from January to March 2014. Data were collected on sociodemographic items, patient’s clinical diagnosis, psychotropic medications received, and duration of treatment. Information about sexual functioning was obtained using the International Index of Erectile Function Questionnaire for the male participants and the Female Sexual Function Index for the female participants.Results: The mean age of the patients studied was 34.7 years (standard deviation [SD] =5.9), with a mean duration of treatment of 3.8 (SD = 6.5) years. Males constituted 47.8% and patients with schizophrenia constituted 43.1%; other diagnoses include bipolar affective disorder, recurrent depressive disorder, and substance use disorder. The prevalence of sexual dysfunction was 64.3%. Age, employment status, and psychotropic medication use were significantly associated with sexual dysfunction; however, only employment status and psychotropic medication use significantly predicted sexual dysfunction.Conclusions: We concluded that sexual dysfunction is highly prevalent among patients receiving psychotropic medication; as such inquiries about sexual function should be routinely carried out by clinicians as this may negatively impact on adherence and quality of life.Keywords: Psychiatric outpatients, psychotropic medications, sexual dysfunctio

Severe depression following á-interferon usage in a patient with chronic myeloid leukemia

Background: Chronic myeloid leukaemia (CML), with a median age of 40 years, is one of the commonest haematological malignancies in Nigeria. Cytoreductive agents, which were hitherto the mainstay of treatment, neither induce cytogenetic nor haematologic remission. Alpha-interferon (á-IFN), an endogenous glycoprotein with cytotoxic and natural killer cell enhancer effects has been found to induce haematologic and cytogenetic remission in patients with CML, but neuro- psychiatric complications of á -interferon (á-IFN) usage were not reported in Nigeria. Objective: To report a case of deliberate self-harm in University Lecturer as a side effect of á-IFN in the treatment of CML Method: Clinical and laboratory follow up of a patient receiving á-IFN in the management of CML from the time of diagnosis of CML to the point of loss of contact. Result: Severe depression is a complication that may adversely influence the clinical outcome of á-IFN usage Conclusions/Recommendations: Although interferon related depression is uncommon, it is suggested that pre-therapy interferon assays and neuro-psychiatric assessment are carried out in prospective users of á-IF

Assessment of Perceived Family Psychological Support among Depressed Patients in two Psychiatric Hospitals Kaduna State

A family member experiencing mental illness or any other challenge usually finds the family as the first point of support. Family members supply the required psychological support and care for the affected family member.  This study assessed the perceived family psychological support among depressed patients in Psychiatric Hospitals, Kaduna State Nigeria.  The study adopted a descriptive cross sectional research design. One hundred and forty-four (144) depressed patients were randomly selected from Ahmadu Bello University Teaching Hospital and Federal Neuro-Psychiatric Hospital (FNPH) both in Kaduna State. Statistical package social sciences (SPSS) version 22, was used to analyse the data. The results showed that 40% of the 144 participants claimed to be psychologically supported by their families.  This means that less than half of the depressed patients under review, had high level of perceived psychological support from their family members. Females received more family psychological support than their male counterparts. Recovery rate, using the Hospital Anxiety Depression Scale (HADS), was significantly correlated with the level of family members’ psychological support. It is therefore, recommended that more focus should be placed on enhancing more family psychological supports for depressed patients most especially in the areas of encouragement towards health education, religious and / or spiritual activities, brightening the moods of their patients, and  more moral support. Also, family focused psycho education should be provided to family members of depressed patients by the professional care givers. Keywords: Psychological Support, Family, Care, Depression, Tertiary Hospital