The Prevalence and Factors Associated with Depression among Patients with Pulmonary Tuberculosis at the Federal Medical Center, Owo, Nigeria.

BACKGROUND: Co-morbid depression poses a challenge to the successful management of pulmonary tuberculosis (TB). This study assessed the prevalence of depression and its associated factors among patients receiving treatment for TB in a tertiary health care facility in southwestern Nigeria. MATERIALS AND METHODS: A descriptive cross-sectional study was conducted among all the pulmonary TB patients presenting in the initiating or continuous phase of treatment and they were consecutively recruited between January and December, 2017. The Mini International Neuropsychiatric Interview (MINI) tool was used for the diagnosis of depression. The severity of depression was assessed using Hamilton Rating Scale for Depression (HAMD). RESULTS: Of the 152 patients, 85 (55.9%) were males with a mean age of 41.7 ±15.5 years and 71 (46.7%) had depression of which 64(90.1%) had mild depression and 2 (2.8%) had severe depression. Among female 38(56.7%) were depressed compared to 33 (38.8%) male (p=0.028). Fifty-nine (55.1%) of those on continuous phase of treatment were depressed compared to 12 (27.3%) initiating treatment (p=0.002). In those with HIV co-morbidity 36 (66.7%) were depressed while 35 (35.7%) were depressed among those without HIV co-morbidity (p <0.001). Among those who had poor perception of treatment outcome, 7 (87.5%) were depressed compared to 64 (44.4%) with good perception, p=0.018. Overall, predictors of depression were having poor perception about outcome of treatment (AOR: 12.9; CI 95%: 1.4-118.4), having HIV co-morbidity (AOR: 2.9; CI 95%: 1.4-6.3) and being on continuous phase of TB treatment (AOR: 2.5; CI 95%: 1.1- 5.9). CONCLUSION: The care of patients with TB should be more comprehensive. Health care workers should actively seek for evidence of depression among patients diagnosed with Tuberculosis and appropriate help offered to them.

The value of plain abdominal radiographs in management of abdominal emergencies in Luth.

OBJECTIVE: The plain abdominal x-ray is still the first imaging modality in diagnosis of acute abdomen. The aim of this study was to find the value of plain abdominal x-ray in the management of abdominal emergencies seen in Lagos university teaching hospital. BACKGROUND: The accurate diagnosis of the cause of acute abdominal pain is one of the most challenging undertakings in emergency medicine. This is due to overlapping of clinical presentation and non-specific findings of physical and even laboratory data of the multifarious causes. Plain abdominal radiography is one investigation that can be obtained readily and within a short period of time to help the physician arrive at a correct diagnosis The relevance of plain abdominal radiography was therefore evaluated in the management of abdominal emergencies seen in Lagos over a 12 month period (April 2002 to March 2003). METHOD: A prospective study of 100 consecutively presenting patients with acute abdominal conditions treated by the general surgical unit of Lagos University Teaching Hospital was undertaken. All patients had supine and erect abdominal x-ray before any therapeutic intervention was undertaken. The diagnostic features of the plain films were compared with final diagnosis to determine the usefulness of the plain x-ray RESULTS: There were 54 males and 46 females (M:F 1.2:1). Twenty-four percent of the patients had intestinal obstruction, 20% perforated typhoid enteritis; gunshot injuries and generalized peritonitis each occurred in 13%, blunt abdominal trauma in 12%, while 8% and 10% had acute appendicitis and perforated peptic ulcer disease respectively. Of 100 patients studied, 54% had plain abdominal radiographs that showed positive diagnostic features. Plain abdominal radiograph showed high sensitivity in patients with intestinal obstruction 100% and perforated peptic ulcer 90% but was less sensitive in patients with perforated typhoid, acute appendicitis, and blunt abdominal trauma and generalized peritonitis. CONCLUSION: In conclusion, this study shows that abdominal radiographs are useful when appropriate criteria are followed in requesting for the investigation. The investigation should be requested for all patients with moderate to severe abdominal tenderness, those with gunshot injuries, blunt abdominal trauma and generalized peritonitis. It should be an integral part of management of patients with clinical suspicion of bowel obstruction and gastrointestinal perforation.