Exploring the Essential Stroke Care Structures in Tertiary Healthcare Facilities in Rivers State, Nigeria.

This study evaluated the essential stroke care structure available in the two Tertiary Health Facilities in Rives State, Nigeria. This was a descriptive survey involving the Stroke Care Survey and Assessment Tool (checklist/questionnaire) developed by the World Stroke Organisation to obtain information about the available essential stroke care structure (facilities, equipment, personnel and management protocol) at the two tertiary health facilities (RSUTH & UPTH). The study gathered relevant information, which was summarised into tables and graphs using Microsoft Excel 2016. From the results, although facilities had A and E departments, dedicated stroke units (fixed or mobile) were unavailable, and there was no locally developed protocol to support rapid triage of stroke patients. The facilities and equipment were either unavailable or insufficient. Only one health facility (RSUTH) provided 24 hrs/7 days laboratory services. The workforces were a mix between regular clinical staff and some specialists. Tissue plasminogen activator (tPA) use was non-existent, though specialists were trained on its administration. There was no locally developed or adopted stroke-specific clinical guidelines. In conclusion, the structural services available for stroke care within the studied tertiary health facilities were poor, unavailable or grossly insufficient. The state facility (RSUTH) suffered the most in terms of unavailable national support and staff development.

COVID-19-Related Mental Health Burdens: Impact of Educational Level and Relationship Status Among Low-Income Earners of Western Uganda.

Objective: The study aimed to investigate the relationship between mental health with the level of education, relationship status, and awareness on mental health among low-income earners in Western Uganda. Methods: This was a cross-sectional descriptive study carried out among 253 participants. Anxiety, anger, and depression were assessed using a modified generalized anxiety disorder (GAD-7), Spielberger's State-Trait Anger Expression Inventory-2, and Beck Depression Inventory item tools, respectively. Results: The majority of our respondents were male (n = 150/253, 59.3), had a secondary level of education (104/253, 41.1), and were single (137/253, 54.2). No formal education and primary education (r2 = 47.4% and 6.4%, respectively) had a negative correlation with awareness of mental health care. In addition, no formal education had a positive correlation with anger and depression (r2 = 1.9% and 0.3%, respectively). Singleness in this study had a negative correlation with awareness of mental health care, anger, and depression (r2 = 1.9, 0.8, and 0.3%, respectively), and a positive correlation with anxiety (r2 = 3.9%). Conclusion: It is evident that education and relationship status influenced awareness on mental health care and mental health state among low-income earners in Western Uganda during the first COVID-19 lockdown. Therefore, policymakers should strengthen social transformation through the proper engagement of low-income earners in this COVID-19 era.

Anxiety, Anger and Depression Amongst Low-Income Earners in Southwestern Uganda During the COVID-19 Total Lockdown.

Background: Low-income earners are particularly vulnerable to mental health, consequence of the coronavirus disease 2019 (COVID-19) lockdown restrictions, due to a temporary or permanent loss of income and livelihood, coupled with government-enforced measures of social distancing. This study evaluates the mental health status among low-income earners in southwestern Uganda during the first total COVID-19 lockdown in Uganda. Methods: A cross-sectional descriptive study was undertaken amongst earners whose income falls below the poverty threshold. Two hundred and fifty-three (n = 253) male and female low-income earners between the ages of 18 and 60 years of age were recruited to the study. Modified generalized anxiety disorder (GAD-7), Spielberger's State-Trait Anger Expression Inventory-2 (STAXI-2), and Beck Depression Inventory (BDI) tools as appropriate were used to assess anxiety, anger, and depression respectively among our respondents. Results: Severe anxiety (68.8%) followed by moderate depression (60.5%) and moderate anger (56.9%) were the most common mental health challenges experienced by low-income earners in Bushenyi district. Awareness of mental healthcare increased with the age of respondents in both males and females. A linear relationship was observed with age and depression (r = 0.154, P = 0.014) while positive correlations were observed between anxiety and anger (r = 0.254, P < 0.001); anxiety and depression (r = 0.153, P = 0.015) and anger and depression (r = 0.153, P = 0.015). Conclusion: The study shows the importance of mental health awareness in low resource settings during the current COVID-19 pandemic. Females were identified as persons at risk to mental depression, while anger was highest amongst young males.

Morton's Toe: Prevalence and Inheritance Pattern among Nigerians.

BACKGROUND: Anatomical variations have been genetically linked and the difference in the length of the big toe relative to the second toe (Morton's toe) is not an exception; however, its prevalence and inheritance pattern has been a scientific debate. Therefore, this study investigated the prevalence and inheritance pattern of Morton's toe among Nigerians in Rivers State. MATERIALS AND METHODS: A total of 101 families comprising of 101 parents (fathers and mothers) and 135 offspring were conveniently sampled for this study. The observed big toe pattern was described as "LBT" and "SBT" representing big toe longer than the second toe and big toe shorter or equal to the second toe, respectively. The offspring trait was tabulated alongside the parental combination patterns (i.e., when both parents had LBT, both parents SBTand a combination of LBTand SBT). XLSTAT 2012 (version 4.2.2) Chi-square analysis tested the association between sex and Morton's toe. Mendelian Chi-square gene distribution model evaluated the conformance to simple dominance-recessive pattern, while the Hardy-Weinberg (H-W) equation for allele frequency compared the parental allele frequency to that of the offspring. RESULTS: LBT(218; 64.7%) was more in the studied population than SBT(119; 35.3%); with males (63; 18.7%) having slightly higher proportion of SBT (Morton's toe) than females (56; 16.6%), which was without sexual preference (χ2 = 0.141, P > 0.932). The test of offspring gene distribution in conformance to Mendelian simple dominant-recessive monohybrid cross had rather weak result. The H-W equation showed a deviation of offspring allele distribution (1:3:2.5 [2:6:5]) from the parents (1:3:2). CONCLUSION: Morton's toe could be said to be genetically linked, however, its inheritance pattern does not conform to the simple dominant-recessive model, but a more complex pattern. It should be noted that the large frequency of a trait in a population does not make it dominant.