The role of spirituality and religiosity in psychoactive substance use among adolescents in a Nigerian Hospital

Objective: Adolescence is a transition period where drug experimentation is common. Spirituality and religiosity have been recognized by literature as having a possible role in stabilizing good physical and mental health. To compare the religiosity and spirituality among adolescents abusing a psychoactive substance and those not abusing psychoactive substances in a Nigerian hospital Methods: This was a cross-sectional descriptive study conducted among adolescent patients admitted to the drug rehabilitation unit and adolescents attending the General Outpatient Department of the ABUAD Multisystem Hospital, Ado-Ekiti. The Daily Spiritual Experience Scale and Centrality of Religiosity Scale were used Results: The prevalence of high religiosity and spirituality among the respondents was 57.9% and 56.1%. The prevalence of high religiosity and spirituality among respondents not abusing psychoactive substances was 62.9% and 62.6% respectively, while the level of high spirituality and religiosity among respondents abusing psychoactive substances was 53.0% and 49.1% respectively. A significant proportion of the respondents who had a low level of religiosity (55.9%) abused psychoactive substances than respondents who do not abuse psychoactive substances (45.7%) (X2=7.694 p=0.006). Similarly, more proportion of respondents who had a low level of spirituality (57.4%) abused psychoactive substances than respondents who do not abuse psychoactive substances (44.2%). The observation is statistically significant (X2=11.1, p<0.001). In addition, there was a significant positive correlation between the spirituality and religiosity scores among the respondents (r =0.50, p<0.001) Conclusion: Psychoactive drug use among the respondent was associated with both low religiosity and spirituality. Therefore, religious activities should be encouraged among adolescents.

Prevalence and clinical characteristics of headaches among undergraduate students in three tertiary institutions in Ilorin, Nigeria.

OBJECTIVE: Headache is a common chronic neurologic disorder with huge economic and psychosocial impact. In comparison with other neurological disorders, there is limited data on primary headache, especially from sub-Saharan Africa. This study was done to fill in the gap and provide recent information on headache among Nigerian undergraduate students. METHODOLOGY: Quota sampling was used to select students from three tertiary educational institutions within Ilorin, the capital of Kwara state. Two-stage self-administered questionnaires developed from the guideline of the International Society of Headache were used to harvest information. RESULTS: A total of 1500 students participated in the study. The mean age of the students was 20.9 ± 3.1 years, with male:female ratio of 1.6:1. A total of 356 students have frequent headache within previous 1 year, given the headache frequency of 23.7%. Fifty-three students (3.5%) had headaches on almost daily basis, 84 (5.6%) had ≥4 attacks/week, 145 (9.7%) had ≤2-3 attacks/month, and 123 (8.2%) had 1-3 attacks every 3 months. Close to 75% indicated that it limits their daily activity frequently. One hundred and eighty-seven (12.5%) students fulfilled the criteria for tension-type headache, 36 (2.4%) for migraine headache, and 133 (8.9%) had nonclassified headaches. The most frequent headache-associated symptoms are photophia - 100 students (6.7%), phonophobia - 159 students (10.6%), while 62 students (4.1%) had nausea and vomiting. None of the students had seen a physician for proper headache diagnosis. Majority (90.2%) used none prescription over-the-counter analgesia (acetaminophen) for symptomatic treatment of their aches. CONCLUSION: Headache is a common complaint among Nigerian undergraduate students and it limits the daily activity of majority of the sufferers. Students need proper education regarding treatment to alleviate their suffering and forestall complication, especially those associated with analgesic overuse.

Tetanus remains a formidable health challenge in Nigeria: The experience from a single Teaching Hospital in Osun State, Nigeria.

BACKGROUND: Tetanus, though an eminently preventable disease still ranks as a leading cause of death in Nigeria as well as in other developing countries. Reported mortality for severe tetanus varies from 20-60% and depends on the availability and quality of intensive care. Farmers and artisans are mostly affected. OBJECTIVES: This retrospective study was carried out to determine the pattern of clinical presentation of tetanus, the immunization status, case fatality rate and factors influencing mortality. METHODS: Case notes of patients (age > 10 and above) managed for tetanus from 2004-2008 at LAUTECH Teaching Hospital Osogbo were retrieved. Demographic, clinical data, laboratory investigation results and response to treatment were collated. The data obtained were analysed using the SPSS version 15 Statistical package. RESULTS: Over the 5-year period,80 cases of tetanus were managed in the medical wards of LAUTECH Hospital Teaching Osogbo. However, the medical records of 12 of them could not be retrieved, leaving 68(85%) for analysis. This comprised of 45 males and 23 females. Tetanus was highest in the third decade of life. The commonest portal of entry was the lower limb (n = 43). Only one subject was fully vaccinated and received booster dose of vaccine. Thirty-one (31)out of the 68 patients died giving a case fatality rate of 51.5%. CONCLUSION: The mortality of tetanus is still very high from this retrospective study. The rate of immunization against tetanus was dismally low. Active immunization should be given to all Nigerians particularly those in the vulnerable group.

The prevalence and subjective handicap of epilepsy in Ilie--a rural riverine community in South West Nigeria: a door-to-door survey.

BACKGROUND: The prevalence of epilepsy is high in tropical countries, particularly in Africa with an estimated mean prevalence of 15 per 1000. There is lack of recent data on epilepsy prevalence in Nigeria. The main objective of this study was to determine the prevalence of epilepsy in Ilie in South West (SW) Nigeria, and the secondary objectives were to determine the clinical characteristics, the seizure types with electroencephalography (EEG) recording, the pattern of treatment, and to evaluate the subjective handicap of people with epilepsy (PWE). MATERIALS AND METHODS: The study, which was descriptive cross-sectional, was carried out in Ilie, a rural community in South West Nigeria, using a simple random sampling technique. The survey was done in 2 phases from January 2013 to April 2013. Phase 1: Door-to-door screening using the WHO Neuroscience Research Protocol to detect neurological disorders by health workers. Phase 2: Individuals with positive screening had complete neurologic examination by neurologists as well as an EEG recording. The questionnaires for survey of epilepsy in tropical countries and subjective handicap of epilepsy were administered to all PWE. RESULTS: Two thousand two hundred twelve individuals from 231 households were screened during the first phase, and 33 cases of neurologic diseases were detected. During the second phase, 10 cases were confirmed to be epilepsy by neurologists, thus giving a crude lifetime prevalence of 10/2212=4.5/1000 population (95% CI=2.30-8.04). CONCLUSIONS: The prevalence of epilepsy in Ilie in South West Nigeria is rather low compared with previous figures from studies in rural Africa.

Knowledge, attitudes and perceptions of epilepsy among secondary school teachers in Osogbo South-West Nigeria: a community based study.

BACKGROUND: The attitudes toward people with epilepsy are influenced by the degree of knowledge of the condition. The social problems encountered by school children with epilepsy as a result of negative attitude and beliefs are quite enormous. OBJECTIVES: The study therefore looked at the knowledge, attitudes, and perceptions of teachers, who see a lot of epileptics, relate to them on a daily basis and have influence on them. MATERIALS AND METHODS: A cross-sectional survey, using a self-administered questionnaire obtained from the author of a similar study in the United States, was carried out among 269 school teachers randomly selected from various secondary schools in Osogbo, the Osun State capital in South-West Nigeria. The questionnaire included the scale of attitudes toward persons with epilepsy and knowledge about epilepsy as well as demographic and teaching experience survey among others. RESULTS: Despite the high level of education of the teachers ranging from Masters Degree to National Certificate in Education, there were significant deficits in terms of general knowledge about epilepsy (70% of the respondents reported their general knowledge about epilepsy in the lower half of the scale). There was also poor knowledge of the first aids measures in the classrooms. Below one-third (29.2%) felt it was contagious and 40% of respondents reported that sufferers should not be kept in regular classes. However, their attitudes toward epilepsy were generally positive. CONCLUSIONS AND RECOMMENDATIONS: We concluded that teachers need to have health education courses on common disease conditions such as epilepsy that are prevalent in school age; this might help to reduce the prejudice and increase the acceptance of epileptic individuals in the classrooms. Also, generally public health campaigns should be encouraged in this field.

Knowledge; Attitudes and Perceptions of Epilepsy among Secondary School Teachers in Osogbo South-West Nigeria: A Community Based Study

Background: The attitudes toward people with epilepsy are influenced by the degree of knowledge of the condition. The social problems encountered by school children with epilepsy as a result of negative attitude and beliefs are quite enormous. Objectives The study therefore looked at the knowledge; attitudes; and perceptions of teachers; who see a lot of epileptics; relate to them on a daily basis and have influence on them. Materials and Methods: A cross-sectional survey; using a self-administered questionnaire obtained from the author of a similar study in the United States; was carried out among 269 school teachers randomly selected from various secondary schools in Osogbo; the Osun State capital in South-West Nigeria. The questionnaire included the scale of attitudes toward persons with epilepsy and knowledge about epilepsy as well as demographic and teaching experience survey among others. Results Despite the high level of education of the teachers ranging from Masters Degree to National Certificate in Education; there were significant deficits in terms of general knowledge about epilepsy (70 of the respondents reported their general knowledge about epilepsy in the lower half of the scale). There was also poor knowledge of the first aids measures in the classrooms. Below one-third (29.2) felt it was contagious and 40 of respondents reported that sufferers should not be kept in regular classes. However; their attitudes toward epilepsy were generally positive. Conclusions and Recommendations: We concluded that teachers need to have health education courses on common disease conditions such as epilepsy that are prevalent in school age; this might help to reduce the prejudice and increase the acceptance of epileptic individuals in the classrooms. Also; generally public health campaigns should be encouraged in this field

Stroke among young adults at the LAUTECH Teaching Hospital, Osogbo, Nigeria.

BACKGROUND: Stroke in young adults is relatively rare and there are very few hospital reports about it in Nigeria. The aetiologic mechanisms of stoke among young adults are quite distinct from those of the adults' populations. OBJECTIVE: The purpose of this retrospective study was to determine the frequency, aetiologic mechanisms and prognosis of stroke among young adults at the LAUTECH Teaching Hospital Osogbo Nigeria. METHODS: The study was both retrospective and descriptive. Case notes of stroke patients aged 16-45 years managed at the LAUTECH Teaching Hospital Osogbo from June 2005 till February 2008 were retrieved. Demographic data, clinical profile of stroke, laboratory investigation results and treatment outcomes were collated. Clinical diagnosis and classification of stroke was mainly clinical using the WHO clinical criteria. Only 3 patients had cranial CT scan. RESULTS: Out of the total number of 208 stroke patients managed during this period, 27(12.9%) were aged 45 years and below. This comprised of 17 males and 10 females. The age range was between 23-45 years. Using the WHO clinical criteria, there were 14 cases of heamorrhagic CVD and 13 cases of ischaemic CVD. The three cranial CT scan that were done revealed cerebral infarction which was consistent with the clinical diagnosis. Severe hypertension was found in 16 (59.2%) patients on admission. 3 patients had clinical and electrocardiographic evidence of rheumatic heart disease with infective endocarditis. Other risk factors included Sickle cell disease, cardiac arrhythmias etc. 8 out of the 27 patients died giving a percentage mortality of 29.6% and 7 patients were discharged against medical advice. CONCLUSION: Heamorrhagic stroke was slightly more frequent than ischaemic CVD. Systemic hypertension was also found to be prevalent among these young Nigerian adults with stroke. However, it was difficult to unravel the aetiologic mechanisms of stroke in this study because of paucity of investigations.

Cranial computerised tomographic assessment of cerebrovascular disease in Osogbo, Nigeria.

BACKGROUND: cerebrovascular disease (CVD) is a leading cause of morbidity and mortality in Nigeria. Non-contrast computerized axial tomography (CT) is the routine imaging modality of choice for acute stroke evaluation, because it is widely accessible, convenient, has a short imaging time, and is sensitive for detection of haemorrhage. OBJECTIVE: to evaluate the pattern of stroke by computerised tomography (CT) and to relate the clinical diagnosis of stroke to the radiological features. METHODS: a retrospective study of 86 patients with suspected stroke who had CT of the brain from October 2005 to December 2008 were studied. The type and location of the stroke were documented and correlated with the age and sex. RESULTS: Sixty-five (75.6%) out of the 86 patients had CVD. Normal study was noted in 7(8.12%) patients and 14(16.3%) patients had other intracranial conditions wrongly diagnosed clinically as stroke. Ischaemic CVD was the most common [43(66.2%)], haemorrhagic CVD [21(32.3%)] and combined ischaemic and haemorrhagic, one(1.5%). Most [26(60.5%)] of the ischaemic stroke lesions were localized to the region of the middle and anterior cerebral arteries. There were no differences based on gender in the distribution of stroke pattern within the brain or the type of cerebrovascular disease. CONCLUSION: ischaemic CVD is the most common stroke. The rate of misdiagnosis of stroke is high in the Osogbo environment.

Cervical disc herniation and Brown-Sequard syndrome: a case report.

Brown-Sequard syndrome caused by herniated cervical disc is relatively rare. We report a 45 year old female patient who presented with weakness of the right extremities and absent pain and temperature sensation on the left below the C4 dermatome. CT myelogram revealed disc herniation between C3/C4, C4/C5 and C5/C6 disc spaces but was worst at C4/C5 with anterior cord compression and evidence of posterior osteophytes on the C5 and C6 cervical vertebrae. Patient responded well to symptomatic and supportive therapy including physiotherapy. She declined surgical intervention which is usually recommended in discogenic Brown-Sequard syndrome.

Intracardiac tumor: a risk factor for stroke in the young--a case report.

BACKGROUND: Stroke occurs commonly in individuals above 65 years, especially in the background of atherosclerosis and other risk factors. In young persons below 45 years it is a rare disorder with devastating sequelae on the affected individual. OBJECTIVE: Presently there are few reports on the aetiology/risk factors for stroke in young adults in Nigeria. This is due to limited facility for thorough investigation; therefore management of such cases poses a diagnostic challenge. In this report we present a case of embolic stroke in a male undergraduate that began with two brief episodes of transient left sided weakness before a completed stroke four hours later. 2-D echocardiography showed that the likely source of emboli to be a non-pedunculated left atria tumour attached to the root of posterior mitral valve leaflet. CONCLUSION: Intracardiac mass should be considered a possible risk factor for ischemic stroke in young adult, especially in the absence of other risk factors such as connective tissue disorders, HIV/AIDS, hemoglobinopathy or use of recreational drugs. High index of suspicion is required in order not to overlook such source of emboli. Early diagnosis offers the best panacea for a definitive therapy and prevention of stroke recurrence with its devastating sequelae.

Knowledge and perception of stroke among adults in Osogbo, Nigeria.

Stroke is a major cause of neurological admission in Nigeria. Its prevention has been reported to be dependent on public knowledge of stroke warning signs and risk factors. Ignorance of stroke risk factors and inability to control such risk factors may contribute to high prevalence of stroke among blacks. This cross-sectional descriptive study therefore investigated knowledge and perception of stroke among adults living in Osogbo, Nigeria. Multistage sampling technique was used to select a sample of 900 adults aged between 18 and 80 years as at their last birthday. Data were collected using a pretested modified version of instrument used in a previous study. Data collected from the final survey instrument were analyzed using both descriptive and inferential statistics. A total of 900 adults with male to female ratio of 1.4:1 and mean age 43.6+/-17.63 years participated in this study. Four hundred and seven (45.2%) of the interviewees reported that they were hypertensive. Heart was incorrectly identified by 54% of the respondents as injured organ during stroke. Majority (83.0%) of the respondents indicated that stroke was preventable whereas only 37.1% of them were aware of stroke recurrence. The most common stroke risk factors listed by the respondents were hypertension (78.2%) stress (59.9%) and old age (58.3%). Stroke survivors were perceived by 68.7% of the respondents as being able to return to activities of daily living but with diminished quality of social life. Knowledge of stroke warning signs and risk factors was good among the respondents. However, their baseline knowledge about stroke was poor. Stroke survivors were perceived as being unable to return to pre-stroke's quality of social life. Development of educational strategies to enlighten the public about stroke is therefore recommended.