Electroencephalographic Findings, Antiepileptic Drugs and Risk Factors of 433 Individuals Referred to a Tertiary Care Hospital in Ethiopia

Little is known about the characteristics of electroencephalogram (EEG) findings in epileptic patients in Ethiopia. The objective of this study was to characterize the EEG patterns, indications, antiepileptic drugs (AEDs), and epilepsy risk factors. METHODS: A retrospective observational review of EEG test records of 433 patients referred to our electrophysiology unit between July 01, 2020, and December 31, 2021. Results: The age distribution in the study participants was right skewed unipolar age distribution for both sexes and the mean age of 33.8 (SD=15.7) years. Male accounted for 51.7%. Generalized tonic clonic seizure was the most common seizure type. The commonest indication for EEG was abnormal body movement with loss of consciousness (35.2%). Abnormal EEG findings were observed in 55.2%; more than half of them were Interictal epileptiform discharges, followed by focal/or generalized slowing. Phenobarbitone was the commonest AEDs. A quarter (20.1%) of the patients were getting a combination of two AEDs and 5.2% were on 3 different AEDs. Individuals taking the older AEDs and those on 2 or more AEDs tended to have abnormal EEG findings. A cerebrovascular disorder (27.4%) is the prevalent risk factor identified followed by brain tumor, HIV infection, and traumatic head injury respectively. CONCLUSION: High burden of abnormal EEG findings among epileptic patients referred to our unit. The proportion of abnormal EEG patterns was higher in patients taking older generation AEDs and in those on 2 or more AEDs. Stroke, brain tumor, HIV infection and traumatic head injury were the commonest identified epilepsy risk factors

Effect of Standard Versus Patient-Targeted In-Patient Education on Patients' Anxiety about Self-Care after Discharge from Cardiovascular Surgery Clinics : Cardiovascular Topic

Abstract: We compared standard and patient-targeted in-patient education in terms of their effect on patients' anxiety. One hundred and ninety-eight patients who were hospitalised for coronary artery bypass surgery were given standard education (group 1) or individualised education (group 2) on the management of their healthcare after discharge. Patients in group 2 were assessed on the patient learning needs scale and were given education according to their individual needs. The level of anxiety was measured by the state-trait anxiety inventory. Anxiety scores were significantly lower in group 2 than group 1 after education (p 0.001). While state anxiety did not change after education in group 1 (p

Patient and social work factors related to successful placement of long-term psychiatric in-patients from a specialist psychiatric hospital in South Africa

Objective: The slow discharge of long-term psychiatry patients from Weskoppies Hospital into the community has not matched the national and international drive towards deinstitutionalisation. This article investigates patient and social work factors related to successful community placement; in the context of limited community care facilities. Method: Thirty-six long-term patients who were successfully placed outside of the hospital during a seven month period were compared to 235 unplaced long-term patients in terms of demographic and clinical variables. Social work services were analysed in terms of which patients received the most interventions; and the most common type of interventions. Results: The most significant patient factors associated with successful placement were: female patients; medium-to-high level of functioning; having involved relatives living far away; a low frequency of behavioural problems (especially of cannabis abuse; verbal or physical aggression; uncontrolled sexual activity); and agitation or restlessness. These patient factors were mirrored in the social work services rendered to the long-term patients during the study period: The recipients were mostly female; in open wards (higher-functioning); and the social services utilised were mostly related to planning for placement and patient support. Conclusion: The lack of community care facilities in the Pretoria area that are able to care for the more difficult long-term psychiatry patients; limits successful placement and increases the burden of hospital based social workers. The problem cannot be resolved at a hospital level and needs to be addressed in the context of provincial and national health departments

Long stay patients in a psychiatric hospital in Lagos, Nigeria

Objective: In the face of recently introduced government health reform and the dwindling number of available beds for acutely ill patients, a cross sectional study was carried out on long-stay patients at the 100 years old psychiatric hospital Yaba, Lagos, Nigeria with a view to discharging most of them. Method: Necessary consent was obtained from the Hospital Research and Ethical Committee. All the long-stay patients were evaluated with a specially designed proforma to elicit socio-demographic, clinical and long-stay variables. Further more, each of them had clinical assessment to make diagnosis in accordance with ICD - 10 and finally, the subjects were also assessed with the Brief Psychiatric Rating Scale (BPRS). Results: Fifty-one (51) subjects; that is, occupying 10.7% of the hospital functional beds fulfilled the criteria of long-stay. They included 36 (70.6%) males and 15(24.4%) females. The mean age was 47.3±16.5 years with age range of 18-92 years. The average length of stay was 11.4±15.0 years and range of 0.5 to 57 years; with significant gender difference (males higher than females) (t =3.51, p<0.02). The vast majority of the subjects were diagnosed with schizophrenia (84.3%), followed by mental retardation with seizure disorder (5.9%). One-third (33.3%) of the subjects had co-morbid physical pathologies most especially epilepsies, hypertension, Koch/'s disease, HIV/AIDS. Despite being on high doses of antipsychotics (conventional and/or atypical) the majority of the subjects (86.3%) exhibited poor mental state with BPRS scores of ≥10. The mean BPRS score was 23.6±22.0 and range of 4-56 with a significant gender difference (t = 3.66, p< 0.02). Conclusion: These patients would continue to require long-stay hospitalization despite been a burden to the study center; or, in the alternative provision of mid­way facilities for their rehabilitation

Distribution of Male Urethral Discharge among the Patients in Primary Health Care Centres of Jos North L.G.A.; Jos; Nigeria

Objectives: The study was to determine the distribution of male urethral discharge among the patients seen in primary health care centres of Jos North Local Government Area. Methods: Male patients with urethral discharge were recruited during their clinic days; from September 2004 to May 2006. A structured questionnaire was administered to the patients who gave their consent. Pre-treatment and post-treatment urethral samples were collected and processed according to standard laboratory procedures. Results: One hundred and seventy-six out of 200 patients completed the study. The age range and mean age of the patients were 11-60 years and 30.7 years respectively. The age decade 21-30 years constituted 100 (56.8) of 176 patients; commercial motorcyclists contributed 80 (45); the single marital status recorded 106 (60.2) while primary and secondary education status had 141 (80). Conclusion: Commercial motorcyclists recorded the highest risk of male urethral discharge; and the peak was among young adults of age decade 21-30 years; especially among the single and less educated