Health-related quality of life and its determinants in HIV patients with post herpetic neuralgia.

BACKGROUND: Postherpetic neuralgia is a neuralgia caused by the varicella zoster virus. Its natural history involves slow resolution of the pain syndrome. A subgroup of patients may develop severe, long-lasting pain that does not respond to medical therapy. It also accounts for 11-15% of all referrals to pain clinics but little is known about the quality of life of patients with this condition in our locality Nigeria. METHOD: Fifty three Post herpetic Neuralgia patients aged between 25 and 56 years (mean = 37.47 +/- 8.29 years) receiving antiretroviral therapy/treatment at the University of Maiduguri Teaching Hospital, Maiduguri, Nigeria participated in this study. The short-form 36 (SF-36) generic health-related Quality of Life questionnaire was used to assess the QoL. Spearman rank correlation procedure was used to evaluate the relationship of HRQoL outcomes with medical and socio-demographic factor. RESULT: Physical functioning), Role limitations due to physical health (LPH), Role limitations due to emotional problems (LEP), Social functioning (SF), General health perceptions (GH) scores were below average (35.59 +/- 19.85, 34.28 +/- 33.16, 33.70 +/- 23.26, 49.07 +/- 17.04, 44.09 +/- 9.72 respectively) while Emotional well being/Mental health (EM) was above average (50.13 +/- 11.56). An average (moderate) symptom scale score was Energy/Fatigue (EF) (51.32 +/- 12.87) while Bodily pain (BP) was severe (31.09 +/- 20.46). Age and sex had no significant influence on any of the functional and symptom scale scores as well as the overall QOL. Inverse relationship was observed between age and each of the LPH, LEP, SF, GH, overall QoL and the entire symptom scales. The overall QoL and each of the symptom scale scores were significantly related (P > 0.05). The functional scale score PF, RPH, REP EM and GH were significantly related to overall QoL while SF was not significantly related (P > 0.01). CONCLUSION: This study has shown that the overall QoL of PHN in HIV positive patients undergoing adjuvant therapy is below average. The predictor factors of the overall QoL of this group of patients have been brought to light. These patients would require ways to improve the QoL, there is the need for health care provider to address the factors uncovered by this study. Four of the determinant factors (PF, LP, BP and EF) are issues that fall within the corridor of physical therapy. Physical therapist should arise to address these significant aspects of the management this group of patients.

Reliability of physiological cost index measurements.

The reliability of physiological cost index (PCI) measurements under steady state, non-steady state and post-exercise conditions was evaluated. Thirty volunteers (15 male and 15 female) aged 20-30 years participated in the study. None of the volunteers had a history of smoking, respiratory disorder or locomotor abnormalities. Each subject walked at his/her preferred walking speed on an electronic treadmill (Weider TM 2000) and pulse rates (radial pulse) were monitored by the palpatory method. The test was performed twice with an interval of one week between tests. The gender effect on PCI values was evaluated using the independent t-test while the test-retest reliability was determined by the Pearson product-moment correlation method. Results showed no consistent gender difference in PCI. It also revealed a high test-retest reliability (r = 0.843-0.944) for the non-steady state PCI (NSSPCI), the steady state PCI (SSPCI) and post exercises PCI (PEPCI). Analysis of variance showed that the correlation coefficient were significantly different from zero (p < 0.001). It is concluded that PCI is an easy to-use, valid and reliable measure of energy expenditure and it is recommended as a useful tool for physiotherapist in the assessment and evaluation of functional performance.

Health related quality of life and its determinants in Nigerian breast cancer patients.

Breast cancer, the commonest malignancy in women, is now the most common cancer in Nigeria, but little is known about the quality of life (QOL) of Nigerian women breast cancer survivors and the predictive factors that may influence their QOL. Health-related QOL (HRQOL) was evaluated in 35 Nigerian women receiving radiotherapy for breast cancer at the University College Hospital, Ibadan by using the European Organization for Research and Treatment of Cancer (EORTC) quality of life questionnaire (QLQ - C30 version 3). Linear regression procedures were used to evaluate the association of HRQOL outcomes with medical and socio-demographic factors. Physical functioning (PF), Emotional functioning (EF) and Cognitive functioning (CF) scores were above average (76.9 +/- 20.6, 61.9 +/- 30.3 and 60.0 +/- 32.1 respectively) while Role functioning (RF) and Social functioning (SF) scores were below average (46.2 +/- 36.6 and 40.9 +/- 42.8 respectively). High symptom scale scores were recorded for fatigue, pain and financial difficulties (52.7 +/- 32.8, 59.1 +/- 34.4 and 71.4 +/- 38.8 respectively). Age had no significant influence on any of the functional and symptom scale scores as well as the overall QOL. The overall QOL was significantly related to PF, CF and SF. It was also significantly and inversely related to the scores of fatigue, nausea and vomitng, pain, insomnia and financial difficulty. The findings of this study provide important information on QOL and their correlates among Nigerian women undergoing radiotherapy for breast cancer and are helpful in developing treatment strategies accordingly.