Musculoskeletal Pain after Stroke: Prevalence, patterns and distribution among survivors in Maiduguri, North Eastern Nigeria

Background: Musculoskeletal pain is one of the factors that limit movements at a joint and impede functional use of the limb as well as rehabilitation activities after stroke. Objective: This study determined the prevalence, pattern and distribution of musculoskeletal pain among stroke survivors receiving physiotherapy care in Maiduguri. Methods: A cross-sectional study design was used to recruit 94 stroke survivors from the physiotherapy clinics of two randomly selected tertiary hospitals in Maiduguri. In addition to sociodemographic and clinical characteristic information, musculoskeletal pain was assessed with the Box-Numerical Rating Scale. Prevalence, pattern and distribution of musculoskeletal pain were computed with frequency and percentages. Chi-square test was employed to compare the difference in the prevalence of musculoskeletal pain among participants with various socio-demographic and clinical characteristics. Results: The mean age, post-stroke duration and duration of physiotherapy intervention of the participants were 54.2±12.5 years, 18.27±23.98 months and 13.04±15.09 months, respectively. Majority of the participants experienced musculoskeletal pain within the first 3 months after stroke. The most commonly affected body region was the shoulder (80.7%) followed by the wrists/hand (60.2%) and the least affected body region was the elbow (38.5%). The overall prevalence of musculoskeletal pain was 88%. The prevalence was significantly (χ2 =4.5, p-value=0.034) higher among males (57.8%) than females (42.2%). Conclusion: The study found high prevalence of musculoskeletal pain among stroke patients with males more commonly affected than females, and the shoulder being the most commonly affected joint. Assessing musculoskeletal pain and effective interventions for improving pain should constitute an integral part of a stroke rehabilitation plan

Clinico­microbial profile of diabetic foot infections in Zaria, North­West Nigeria

Background: Diabetic foot infection (DFI) is a dreaded complication of diabetes mellitus, which usually occurs following foot ulceration. It may starts as a monomicrobial infection and end up as a polymicrobial infection. Antimicrobial regimens are usually selected empirically initially, based on local epidemiological and antimicrobial susceptibility pattern. Objective: The aim is to investigate the microbiological profile of patients admitted with DFIs in our institution and determine the antimicrobial susceptibility pattern of the isolates. Materials and Methods: A 2­year retrospective observational study of patients admitted with DFI into our institution. The microbiological culture and antimicrobial susceptibility results of swab specimens from the patients were retrieved and reviewed. These were correlated with the clinical stage of the disease. Results: Fifty­six patients' medical records were reviewed. There were 35 males and 21 females. The mean age of the patients was 56.2 years (range 48­75 years). Three patients had bilateral lesions. The Wagner grades of the lesions were Grades II­V, with Grade IV being predominant. Eight bacteria species and a fungus were isolated from the 59 swab specimens studied. Four specimens yielded no growth, whereas 7 specimens yielded contaminants. Monomicrobial cultures were predominant, with Gram­negative bacteria being preponderant.Staphylococcus aureus was the most common isolate, followed by Proteus species. The isolates showed greater susceptibility to levofloxacin and ciprofloxacin. Conclusion: The findings suggest that either levofloxacin or ciprofloxacin should be the anchor antimicrobial agent in empirical treatment of DFI in our locality