RESUMO
Anticholinergic medications are frequently prescribed for gastrointestinal and genitourinary spasms. Psychosis, when present, results from anticholinergic overdose or toxicity. In the literature, anticholinergic-induced psychosis at therapeutic doses in patients with normal cognition is extremely uncommon. Here, we describe the case of a 28-year-old female who presented with auditory and visual hallucinations, stereotypy, and agitation after receiving a single intramuscular injection of 20 mg hyoscine butylbromide for dysmenorrhea. Even though it is rare for a therapeutic dose of hyoscine butylbromide to cause psychosis, clinicians should maintain a high index of suspicion and be cautious when administering or prescribing anticholinergics.
RESUMO
Background: Fibromyalgia is not an uncommon cause of chronic musculoskeletal pain, and despite its rising prevalence, it remains a diagnostic challenge for physicians. This study aimedto assess the knowledge and awareness of fibromyalgia among Nigerian physicians.Methods: This was a cross-sectional, self-reported online survey. A total of 502 physicians participated in the study. The data was collected using a semi-structured questionnaire. The questionnaire comprised of sociodemographic data and questions related to fibromyalgia. A scoring system was developed to stratify knowledge of fibromyalgia into very low, low, average, high, and very high. The level of significance was set at p<0.05.Results: Responses were obtained from 502 physicians with a mean age of 36�02 years. Most of the respondents (41.3%) had low fibromyalgia knowledge levels.Only 15.2% of the respondents obtainedtheir knowledge of fibromyalgia during their undergraduate training, and 33.5%were familiar with at least one diagnostic criteria. Physical exercise (79.2%),opioids (65.6%), and non-steroidal anti-inflammatory drugs (63.8%) were the most selected treatment options. Theyears in clinical practice, type of health facility, respondents� cadre, and specialty were significantly associated with fibromyalgia knowledge levels(p<0.001). The number of years in clinical practice was found to be a predictor of fibromyalgia knowledge (p=0.001).Conclusions: This study found low levels of fibromyalgia knowledge among Nigerian physicians. The survey emphasizes the importance of improving Nigerian physicians' training modules for the diagnosis and treatment of fibromyalgia.