Prevalence and pattern of psychiatric morbidity among people living with human immunodeficiency virus in Kano

Background:Human immunodeficiency virus/ Acquired immunodeficiency syndrome (HIV/AIDS), has remained a disease of public health concern, with the largest burden being found in sub Saharan Africa. The advent of anti-retroviral therapy (ART) has significantly reduced the mortality of the disease, thereby transforming it to a chronic disorder, with significant co-morbid psychiatric sequalae.Objectives:To determine the prevalence and pattern of psychiatric morbidity among PLWHAattending Aminu Kano Teaching Hospital, Kano.Materials and methods:This was a cross sectional study of adult patients with HIV/AIDS attending outpatient clinic at the S.S. Wali Virology Centre of Aminu Kano Teaching Hospital who gave informed consent. Systematic random sampling technique was used.Patients aged 18years and above who had been on ARVdrugs for at least one year were included, while those who had a medical emergency and needed immediate attention were excluded.Socio demographic characteristics were obtained using a socio-demographic questionnaire and psychiatric morbidity was assessed with the MINI International Neuropsychiatry Interview.Results:Atotal of 420 participants were recruited in the study with a male to female ratio of 1:1.5 and mean age of 40.4±10.0 years. The prevalence of a psychiatric disorder was 22.1% out of whom 5.0% had more than one psychiatric diagnosis. Major depression was the most common (11%) psychiatric disorder. Generalized Anxiety disorder, substance abuse, post-traumatic stress disorder and alcohol abuse accounted for 7.6%, 5.5%, 2.4% and 1.7% of psychiatric disorders respectively.Conclusion:Psychiatric disorders are common in PLWHA, with major depression being the commonest.

ACCEPTANCE AND UTILIZATION OF MODERN FAMILY PLANNING METHODS AMONG WOMEN OF CHILD BEARING AGE IN RURAL COMMUNITIES OF NORTH-EASTERN NIGERIA.

Introduction: Modern family planning is one of the most "health-promoting" and cost-effective activities in public health promotion and has the potential to avert approximately 30% of maternal and 10% of child deaths. Family planning is an important preventive measure against maternal and child morbidity and mortality. It is an essential component of primary health care and reproductive health. It confers important health and development benefits to individuals, families, communities, and the nation at large. Objectives: The study examined the acceptance and utilization of modern family planning methods among women of childbearing age in Potiskum town of Yobe State, North-eastern Nigeria. Methodology: A descriptive cross-sectional study design was adopted for the study. A semi-structured questionnaire was used to collect data from 271 respondents comprising women of childbearing age (15-49 years) residing in Bolewa 'B', Yerimaram, and DogoNini wards of Potiskum town, Yobe State. A multi-stage sampling technique was used to select the participants for the study. Results: The findings of the study revealed that the women of child-bearing age in Potiskum town, Yobe State have a high level of knowledge on modern family planning methods (88.6%) with friends and relatives as the predominant source of information (60.4%). More than half of the respondents (54.2%) have good utilization of modern family planning with cultural and religious misconceptions playing vital roles. The unmet needs were found to be (37.4%). Established determinants of utilization of modern family planning services among the respondents include male noninvolvement, side effects, religion, and distance beyond 5km to a health facility. Conclusion: In conclusion, despite a good level of knowledge of modern contraceptives among the respondents, only half utilize the services. It is recommended among others that, there is a need for the government, through the Ministry of Health, to revive and support family planning education at both household and community levels that targets the woman and her partner. This could be undertaken through community mobilization and engagement using print and mass media, traditional leaders, community resource groups, market places as well as newsletters, posters, and social media.

KNOWLEDGE, ATTITUDE AND PRACTICE OF PREMARITAL SCREENING FOR HIV/AIDS AMONG RESIDENCE OF RURAL AREAS IN NORTH-EASTERN NIGERIA.

Introduction: One of the biggest health challenges threatening the human race in recent times is the HIV/AIDS pandemic. To know one's HIV status is a part of the human right to health. The disease has continued to be on the front burner for many years now, despite initial denials and cover-ups by some countries. Sub-Saharan Africa with just over 10 percent of the world's population has the greatest burden of this disease. It is estimated that close to two-thirds of all people living with HIV are in sub-Saharan Africa with South Africa having the highest number. Objective: This study assessed the knowledge, attitude, and practice of premarital screening of HIV/AIDS among residents of rural areas of Itas Gadau local government area of Bauchi state, North-eastern Nigeria. Methodology: A descriptive cross-sectional design was used for the study. A semi-structured questionnaire was used to collect data from 379 eligible respondents comprising residents of Itas and Gadau towns of Bauchi State. A multi-stage sampling procedure was used to select the participants for the study. Pearson's chi-square test was used in testing for the association between educational status and premarital screening for HIV/AIDS in rural areas. Results: The results show that all (100%) of the respondents have heard of HIV/AIDS and the dominant source of information was from friends (77.6%) followed by healthcare workers (17.4%). In addition, 90% of participants have good knowledge of premarital screening for HIV/AIDS. Majority of the study respondents had undergone premarital screening for HIV/AIDS (64.4%). The result also shows that there is a statistically significant relationship between educational status and the practice of premarital screening for HIV/AIDS in Itas/Gadau, Bauchi State with p-value of 0.001. Conclusion: The study found that there was a very high level of knowledge, good attitude, and practice for HIV/AIDS among the study respondents. Thus we recommend that the community should maintain the mandatory premarital screening and continue with regular health education on premarital screening for HIV/AIDS.

Educational Interventions for Antibiotics Misuse and Self-Medication in Africa: A Systematic Review and Meta-Analysis [Protocol].

BACKGROUND: Antibiotics misuse and self-medication remains one of the most serious public health challenges globally. Persistent rise in resistant bacterial infections has been attributed to high prevalence of antibiotics misuse and self-medication. Large volume of literature has emerged describing studies that evaluate the effectiveness of various types and combinations of educational and behavior-modification techniques to reduce antibiotics misuse and self-medication. No previous systemic review has attempted to assess the quality of evidence in public domains on educational strategies aiming to reduce prevalence and improve knowledge, attitude and practice on antibiotics misuse and self-medication in Africa. This study, therefore, intends to assess the quality of evidence presented and determine the effectiveness of health education as an intervention tool for reducing prevalence and improving knowledge and attitude on antibiotics misuse and self-medication among adults in Africa. METHODS: This study will include published papers on effectiveness of health education in reducing antibiotics misuse and self-medication from 2011-2021. Systematic search for literature will be conducted according to the Preferred Reporting Item for Systematic Reviews and Meat-analysis (PRISMA) guidelines to identify published studies based on our predetermined inclusion and exclusion criteria in PubMed, EMBASE, PsychINFO, CINAHL and Web of Sciences. Two independent reviewers will assess all identified studies and another set of reviewers will extract data for analysis and evidence synthesis.

CONTEXTE: Le mauvais usage des antibiotiques et l'automédication restent l'un des plus graves problèmes de santé publique dans le monde. L'augmentation persistante des infections bactériennes résistantes a été attribuée à la prévalence élevée de l'abus d'antibiotiques et de l'automédication. Un grand nombre de publications décrivent des études qui évaluent l'efficacité de divers types et combinaisons de techniques d'éducation et de modification du comportement pour réduire l'abus d'antibiotiques et l'automédication. Aucun examen systémique antérieur n'a tenté d'évaluer la qualité des preuves dans les domaines publics sur les stratégies éducatives visant à réduire la prévalence et à améliorer les connaissances, l'attitude et la pratique sur le mauvais usage des antibiotiques et l'automédication en Afrique. Cette étude a donc pour but d'évaluer la qualité des preuves présentées et de déterminer l'efficacité de l'éducation à la santé comme outil d'intervention pour réduire la prévalence et améliorer les connaissances et l'attitude sur le mauvais usage des antibiotiques et l'automédication chez les adultes en Afrique. MÉTHODES: Cette étude comprendra les articles publiés sur l'efficacité de l'éducation sanitaire dans la réduction de la mauvaise utilisation des antibiotiques et de l'automédication entre 2011 et 2021. Une recherche systématique de la littérature sera effectuée conformément aux directives PRISMA (Preferred Reporting Item for Systematic Reviews and Meat-analysis) afin d'identifier les études publiées en fonction de nos critères d'inclusion et d'exclusion prédéterminés dans PubMed, EMBASE, PsychINFO, CINAHL et Web of Sciences. Deux examinateurs indépendants évalueront toutes les études identifiées et un autre groupe d'examinateurs extraira les données pour l'analyse et la synthèse des preuves. Mots clés: Education à la santé, Mauvaise utilisation des antibiotiques, Automédication, Examen systématique et méta-analyse, Systématique et méta-analyse.

Effect of constraint-induced movement therapy on persons-reported outcomes of health status after stroke: a systematic review and meta-analysis.

Constraint-induced movement therapy (CIMT) is used for the rehabilitation of motor function after stroke. The aim of this review was to investigate its effect on persons-reported outcomes of health status (PROsHS) compared with conventional therapy. The study was a systematic review and meta-analysis registered in PROSPERO (CRD42019142279). Five databases PubMED, PEDro, OTSeeker, CENTRAL and Web of Science were searched. Randomized controlled trials were included if they assessed PROsHS. Mean scores of PROsHS, sample size and dose of CIMT and control groups interventions were extracted. The result was analyzed using qualitative and quantitative syntheses. Nine studies (n = 558) were included in the review. From the result, CIMT significantly improved PROsHS postintervention. However, postintervention, there was no statistically significant difference between groups for the upper limb [Mean difference (MD) = 6.67, 95% confidence interval (CI) = -2.09 to 15.44, P = 0.14] and the lower limb (MD = -1.86, 95% CI = -16.29 to 12.57, P = 0.80). Similarly, there was no statistically significant percentage of variation across studies, upper limb (I2 = 0%, P = 0.92) and lower limb (I2 = 0%, P = 0.86). For the lower limb at follow-up, there was no statistically significant difference between groups (MD = 0.97, 95% CI = -13.59 to 15.53, P = 0.90). When upper and lower limbs studies were pooled, there was no statistically significant difference between groups postintervention (MD = 0.22, 95% CI = -0.15 to 0.58, P = 0.24) and at follow-up (MD = 0.03, 95% CI = -0.43 to 0.49, P = 0.90). CIMT improves PROsHS after stroke. However, it is not superior to conventional therapy based on the current literature.

Assessment of Factors Affecting Quality of Life in Oral Squamous Cell Carcinoma Patients Using University of Washington Quality of Life Questionnaire.

Introduction Post-treatment Quality of Life (QOL) is considered an important outcome in cancer patients. A number of questionnaire tools have been designed for its assessment. University of Washington Quality of Life (UW QOL) questionnaire version four is a reliable tool for assessment of post-treatment QOL in oral squamous cell carcinoma (OSCC) patients. Our aim was to identify the post-treatment problems faced by OSCC patients and to assess the impact of clinical factors affecting post-treatment QOL by using UW QOL (version four) questionnaire. Methods The study was conducted on 59 patients with OSCC who were treated with curative intent at Patel Hospital, Karachi from August 2015 to September 2015. Patients were asked to fill the UW QOL questionnaire (version four) on their follow-up visit. Results Overall mean composite QOL score was 66.59 ± 16.98. Chewing and saliva (dryness of mouth) had the lowest scores (38.98 ± 37.2 and 56.78 ± 41.4, respectively) among all domains while pain and anxiety had the highest scores (80.93 ± 20.4 and 79.66 ± 29.8, respectively). Patients having tumors of the tongue, late stage (III and IV) tumors, and restricted mouth opening had significantly lower mean composite QOL scores. Patients with tongue tumors revealed significantly lower scores for pain, swallowing, mood, and anxiety. Patients with late-stage tumors showed significantly lower scores for chewing, swallowing, taste, saliva, appearance, anxiety, and recreation. Patients with restricted mouth opening had significantly lower scores for pain, speech, appearance, recreation, and anxiety domains. Conclusion Different clinical features have different impacts on QOL in terms of problems faced by the patients. Features having a significant effect should be identified, and measures focused on most relevant problems should be employed in order to improve the post-treatment QOL.

Glioblastoma Multiforme Involving Conus Medullaris in a Child.

Primary spinal cord glioblastoma multiforme involving the conus medullaris is an uncommon entity with poor outcomes. An aggressive multimodality treatment approach has been used, but prognosis remains same. There are no guidelines for the treatment of patients with spinal glioblastoma multiforme (GBM). We highlight the case of a child diagnosed with conal GBM. He was treated with definitive surgery followed by adjuvant concurrent chemoradiation. After completion of treatment, he showed a temporary symptomatic improvement, but later on his condition deteriorated. We elaborate the stepwise treatment approach employed in this patient.

Torsion of Ovarian Dysgerminoma in a Child: Role of Computed Tomography.

Dysgerminomas are malignant germ cell tumors of the ovary that most commonly occur in the adolescent population. Ovarian dysgerminoma presenting with complications like torsion is a rare entity in the pediatric age group. Cross-sectional imaging plays a crucial role in diagnosis, tumor staging before surgical resection, and for planning adjuvant chemotherapy. We report a case of a nine-year-old female who presented to the emergency room (ER) with abdominal distention and abdominal pain. Computed tomography scan revealed a large right-sided pelvic mass with areas of low attenuation, speckled calcification, peritumoral free fluid, and a twisted vascular pedicle that was likely originating from the left adnexa. The right ovary was normal in appearance. Suspicion of a left-sided ovarian tumor with torsion was raised, which was later confirmed on surgery and histopathology of the resected specimen.

Molecular Characterization and Phylogenetic Analysis of Listeria monocytogenes Isolated from Milk and Milk Products in Kaduna, Nigeria.

In this study, Listeria (L.) monocytogenes isolated from milk and milk products in Kaduna, Nigeria, were subjected to a multiplex PCR assay to identify virulence-associated genes (such as prf A, inl A, hly A, act A, and iap). Of the 36 isolates, 9 (25%) were positive for one or two virulence-associated genes. Based on the sample type, 6 (16.9%) of the isolates that possessed virulence-associated genes were obtained from raw milk, 2 (3.2%) from "Manshanu," and 1 (2.8%) from "Kindrimo." Sequence and phylogenetic analysis based on the 16S rRNA revealed that Nigerian L. monocytogenes isolates (NGA 34A, NGA 35A, NGA 41A, and NGA 38A), when compared with reference L. monocytogenes, were grouped into two distinct clusters, A and B, with sequence (NGA 34A, NGA 35A, and NGA 41A) phylogenetically closer to J1776; N1-011A; R2-502; J1816; and J2-031, whereas L. monocytogenes isolate (NGA 38A) clustered with EDG; J1-220; J1926; J1817; and J2-1091. The separation of the Nigerian L. monocytogenes isolates into linage A (responsible for epidemic listeriosis) and lineage B (responsible for sporadic cases of listeriosis) is of public health concern and that local isolates might have potentials for human food borne listeriosis based on the virulence factors so far identified.

Tardive dyskinesia in a South Asian population with first episode psychosis treated with antipsychotics.

BACKGROUND: Tardive dyskinesia (TD) is a side effect of antipsychotic treatment that often only appears after months or years of treatment. A systematic review of randomized controlled trials lasting more than 1 year showed that second-generation antipsychotics (SGAs) were associated with an approximately fivefold lower risk of TD compared to haloperidol in patients with chronic schizophrenia. In contrast, there is little research on the risk of TD with other first-generation antipsychotics (FGAs), and this applies especially to their use in the treatment of patients with first episode psychosis (FEP). OBJECTIVES: To determine the severity and point prevalence of TD in a naturalistic sample of patients with FEP in Pakistan treated with FGAs or SGAs. METHODS: This was an observational study. TD was assessed by trained clinicians using the Abnormal Involuntary Movement Scale. RESULTS: In the total sample (number =86) the mean age of patients was 26 years and the prevalence of TD (Schooler Kane criteria) was 29% with no significant difference between those treated with FGAs and SGAs (31% FGAs versus 26% SGAs; P=0.805). The Abnormal Involuntary Movement Scale total score (items 1-7), a measure of the severity of TD, was significantly higher for patients treated with FGAs versus those treated with SGAs (P=0.033). Scores on specific items showed that this reflected higher scores for dyskinesia affecting the muscles of facial expression, as well as of the upper and lower limb, whereas scores did not differ significantly in other body areas. CONCLUSION: FGAs were associated with greater severity, though not prevalence, of TD than SGAs. The study highlights the relatively high rate of TD in Asian FEP patients and the need for clinicians to monitor for this and other potential antipsychotic side effects during treatment.

Mesial prefrontal cortex degeneration in amyotrophic lateral sclerosis: a high-field proton MR spectroscopy study.

BACKGROUND AND PURPOSE: Frontotemporal lobar degeneration is responsible for the cognitive abnormalities seen in patients with ALS. We sought to evaluate the in vivo neurochemical changes associated with this pathology indicative of neuronal loss and gliosis. MATERIALS AND METHODS: Twenty-four patients with ALS (2 with ALS-FTD) and 15 healthy controls were studied. High-field proton MR spectroscopy of the mesial prefrontal cortex was used to determine concentrations of NAA and mIns, markers of neuronal integrity and gliosis, respectively. Metabolite concentrations were correlated with cognitive tests (verbal fluency, ACE). RESULTS: NAA/mIns was decreased 17% (P =.002). Abnormalities were present to a lesser degree in the individual metabolites NAA (decreased 9%; P =.08) and mIns (increased 11%; P =.06) than the ratio of the 2 metabolites. These measures did not correlate significantly with verbal fluency or the ACE. CONCLUSIONS: Prefrontal lobe degeneration exists in patients with ALS as indicated by an abnormal mesial prefrontal cortex neurochemical profile. Further study is necessary to determine the potential utility of the NAA/mIns ratio as a biomarker for frontal lobe degeneration in ALS.

Transjugular intrahepatic cavoportal shunt for Budd-Chiari syndrome.

Budd-Chiari syndrome (BCS) is characterized by obstruction of the hepatic venous outflow tract. Therapeutic options for BCS are limited. We report a case of a 21-year-old woman with protein S and C deficiency with gross ascites. Treatment with transjugular intrahepatic portosystemic shunt (TIPS) was attempted, which revealed occluded hepatic veins, so transcaval TIPS was performed. No serious procedure-related complication occurred. After successful shunt creation, the patient's symptoms subsided and she was discharged and followed up for 6 months.

Radiologic feeding gastrostomy placement: experience in 23 patients.

OBJECTIVE: To evaluate the safety, efficacy and complications of percutaneous gastrostomy catheter placementunder flouro guidance for long-term enteral feeding. MATERIALS AND METHODS: Between April 1998 to May 2002, 23 patients who had percutaneous gastrostomy catheter placement were retrospectively reviewed. Clinical indications for catheter placement included patients with neurologic disease, head and neck malignancy, and pulmonary disease patients. Placement of 12 - 14 Fr gastrostomy catheter was then accomplished with the Seldinger technique. The technical success, procedural complications were recorded. RESULTS: Twenty seven procedures, including revisions, were performed. The success rate for catheter placement was 100%. Revision was necessary in 7 (30%) instances in 7 patients. There was one (3.8%) major and 4 (14.8%) minor complications. CONCLUSION: Fluoroscopically directed percutaneous placement of gastrostomy catheters is a safe and effective procedure.