Effect of an Antidepressant on Medication Adherence among Type 2 Diabetic Patients with Depression Accessing Care in GOPC of FETHI.

Comorbid depression among diabetes mellitus (DM) patients is on the increase. This has been linked with poor glycaemic control, greater risk of complications, high burden of medical cost and health care utilisation, and worsening prevalence of other comorbidities resulting in decreased life expectancy. This study determined the antidepressant effect of amitriptyline on depression and glycaemic control among the depressed type 2 DM patients attending Federal Teaching Hospital, Ido-Ekiti (FETHI), Nigeria. It was an interventional study involving 51 depressed type 2 DM patients randomly screened using Patient Health Questionnaire-9 (PHQ-9). They had health education and oral amitriptyline 50mg at night for two months. Postintervention assessment was done using the same tool. Respondents' age ranged between 44 and 78 years with a mean age of 58±8.4 years. Post-intervention assessment showed improved depressive symptoms; 50% of the respondents had significantly improved glycaemic control with a statistically significant effect on depression (the median score of PHQ-9 reduced from 6.0 to 3.0).

La dépression comorbide chez les diabétiques est en augmentation. Elle a été associée à un mauvais contrôle de la glycémie, à un risque accru de complications, à une charge élevée en termes de coûts médicaux et d'utilisation des soins de santé, ainsi qu'à un taux de mortalité plus élevé chez les personnes souffrant de comorbidité. Cette étude a déterminé l'effet de l'antidépresseur (Amitriptyline) sur la dépression et le contrôle de la glycémie chez les patients dépressifs atteints de diabète de type 2 qui fréquentent l'hôpital universitaire fédéral d'Ido-Ekiti (FETHI). Il s'agit d'une étude interventionnelle portant sur 51 patients atteints de diabète de type 2 et déprimés, sélectionnés au hasard à l'aide du questionnaire sur la santé des patients 9 (PHQ-9). Ils ont bénéficié d'une éducation à la santé et ont pris 50 mg d'amitriptyline par voie orale pendant deux mois. L'évaluation post-intervention a été réalisée à l'aide du même outil. L'âge des personnes interrogées était compris entre 44 et 78 ans, avec un âge moyen de 58± 8,4 ans. L'évaluation postintervention a montré une amélioration des symptômes dépressifs, 50% des personnes interrogées ont eu un contrôle glycémique significativement amélioré avec un effet statistiquement significatif sur la dépression (le score médian du PHQ est passé de 6,0 à 3,0). Mots clés: Diabète sucré, dépression, contrôle glycémique, observance thérapeutique.

[Profile of immune and allergic dermatoses among children at the outpatient dermatology clinic in Cotonou (Benin)]. / Profil des dermatoses immunoallergiques chez les enfants dans le service de dermatologie du CNHU-C (Bénin).

OBJECTIVE: The aim of this work was to study the profile of immune and allergic dermatoses (IAD) in children consulting at the outpatient dermatology clinic at the National University Hospital in Cotonou (Benin). METHOD: This retrospective descriptive study examined records of children consulting with this diagnosis over a 10-year period. RESULTS: IAD (902 cases, 37%) were the most common pediatric dermatosis, followed by infectious dermatosis (24%). The sex ratio of children was 0.78. The age groups most strongly affected were those aged 1-30 months (25.39%) and 150-180 months (19.73%). The main IAD were: eczema (47.9%) and prurigo simplex (40.7%). Other IADs included lichen planus (5.1%), toxicoderma (3.8%), urticaria (1.5%), and erythrodermic eczema (1%). The incidence of eczema increased from 13.5% in 2000 to 21.5% in 2009, an increase of 62.2% over 10 years. CONCLUSION: IADs are common at the Cotonou hospital clinic and are dominated by eczema, the incidence of which has increased significantly over time.

Predictive factors for psychiatric morbidity among women with infertility attending a gynaecology clinic in Nigeria.

OBJECTIVE: To determine the psychosocial and clinical factors that are associated with psychiatric morbidity among women with infertility attending a Nigerian gynaecology clinic. METHOD: Over a four month period, 320 respondents (160 in the study group and 160 in the control group) were interviewed using a proforma (designed by the authors) and a screening instrument, General Health Questionnaire version 30 (GHQ-30). All probable cases with a score of 5 or more on GHQ-30 were interviewed using the Present State Examination (PSE). Psychiatric diagnosis was made in accordance with the diagnostic criteria of the 10th edition of the International Classification of Diseases (ICD-10). RESULTS: The infertility rate among the study group was found to be 25.8% with primary and secondary infertility rates constituting 21.9% and 78.1% respectively. The prevalence of psychiatric morbidity among women with infertility (48.8%) was significantly more than that in the control group (11.2%) (chi(2) = 51.80, p < 0.0001). Lack of support from husband (chi(2) = 15.31, p < 0.001), lack of support from husband's relatives (chi(2) = 39.60, p < 0.0001), discrimination (chi(2) = 69.91, p < 0.0001) and history of induced abortion (chi(2) = 30.40, p < 0.0001) were found to be significantly associated with psychiatric morbidity among patients with infertility when compared with the fertile control population. There was no significant difference in the rate of psychiatric morbidity between women with primary infertility and those with secondary infertility (chi(2) = 0.03; p = 0.87). CONCLUSION: Psychiatric morbidity is significantly more common among patients with infertility as compared with those without. There was a significant association between psychiatric morbidity and absence of support from husband and his relations, presence of discrimination, and a history of induced abortion. We suggest more public enlightenment on the need for moral/psychosocial support to women with infertility. In addition, more efforts should be made towards early screening and identification of cases of psychiatric morbidity among patients with infertility.

Predictive factors for psychiatric morbidity among women with infertility attending a gynaecology clinic in Nigeria

Objective: To determine the psychosocial and clinical factors that are associated with psychiatric morbidity among women with infertility attending a Nigerian gynaecology clinic. Method: Over a four month period, 320 respondents (160 in the study group and 160 in the control group) were interviewed using a proforma (designed by the authors) and a screening instrument, General Health Questionnaire version 30 (GHQ-30). All probable cases with a score of 5 or more on GHQ-30 were interviewed using the Present State Examination (PSE). Psychiatric diagnosis was made in accordance with the diagnostic criteria of the 10th edition of the International Classification of Diseases (ICD-10). Results: The infertility rate among the study group was found to be 25.8% with primary and secondary infertility rates constituting 21.9% and 78.1% respectively. The prevalence of psychiatric morbidity among women with infertility (48.8%) was significantly more than that in the control group (11.2%) (c2 = 51.80, p < 0.0001). Lack of support from husband (c2 = 15.31, p < 0.001), lack of support from husband's relatives (c2 = 39.60, p < 0.0001), discrimination (c2 = 69.91, p < 0.0001) and history of induced abortion (c2 = 30.40, p < 0.0001) were found to be significantly associated with psychiatric morbidity among patients with infertility when compared with the fertile control population. There was no significant difference in the rate of psychiatric morbidity between women with primary infertility and those with secondary infertility (c2 =0.03; p = 0.87). Conclusion: Psychiatric morbidity is significantly more common among patients with infertility as compared with those without. There was a significant association between psychiatric morbidity and absence of support from husband and his relations, presence of discrimination, and a history of induced abortion. We suggest more public enlightenment on the need for moral/ psychosocial support to women with infertility. In addition, more efforts should be made towards early screening and identification of cases of psychiatric morbidity among patients with infertility

Human metabolism of the experimental cancer therapeutic agent d-limonene.

d-Limonene has efficacy in preclinical models of breast cancer, causing > 80% of carcinomas to regress with little host toxicity. We performed a pilot study on healthy human volunteers to identify plasma metabolites of limonene and to assess the toxicity of supradietary quantities of d-limonene. Seven subjects ingested 100 mg/kg limonene in a custard. Blood was drawn at 0 and 24 h for chemistry-panel analysis and at 0, 4, and 24 h for limonene-metabolite analysis. On-line capillary gas chromatography/mass spectrometry (GC/MS) analysis indicated that at least five compounds were present at 4 h that were not present at time zero. Two major peaks were identified as the rat limonene metabolites dihydroperillic acid and perillic acid, and two minor peaks were found to be the respective methyl esters of these acids. A third major peak was identified as limonene-1,2-diol. Limonene was a minor component. At a dose of 100 mg/kg, limonene caused no gradable toxicity. Limonene is metabolized by humans and rats in a similar manner. These observations and the high therapeutic ratio of limonene in the chemotherapy of rodent cancers suggest that limonene may be an efficacious chemotherapeutic agent for human malignancies.