Nutritional knowledge, dietary habits and nutritional status of adults living in urban Communities in Lagos State.

Background: Malnutrition is a major threat to the world's public health. While under-nutrition and micronutrient deficiencies persist, obesity is increasing worldwide. Although malnutrition has been extensively researched among children, it has become of increasing concern among adults because of the relative increase in the prevalence of diet-related non-communicable diseases (NCDs). Objectives: This study was conducted to determine the nutritional knowledge, dietary habits and nutritional status of adults in an urban community in Lagos State. Methods: This was a descriptive cross-sectional study involving 320 adults selected using a multi-stage sampling technique. Data was obtained using interviewer-administered questionnaires and standard anthropometric measurements. Chi-square analysis was used to compare prevalence between categories. Results: Only 15.9% of respondents had good nutritional knowledge. The dietary habits and estimated nutrient intake showed a deficiency of fiber, energy and most micro-nutrients with the exception of zinc, iron and vitamin A. Dietary carbohydrate, protein as well as sodium levels were elevated. BMI findings estimated the prevalence of overweight at 24.8% and obesity at 17.3%. However, there was no statistically significant association observed between nutritional knowledge and status of respondents. Conclusion: Nutritional knowledge was poor and obesity was relatively high among participants. Improved nutrition education intervention is necessary to increase knowledge and reduce obesity among adults living in urban communities in Lagos, Nigeria.

Physicians' compliance with malaria treatment guidelines of under-five children in a secondary maternal and child care centre in Lagos State

Background: The global malaria agenda has the ultimate goal of eliminating malaria in all countries of the world by 2030 through universal access to malaria prevention, diagnosis and treatment. Presumptive treatment of malaria with Artemisinin Combination Therapy (ACT) has been associated with the development of resistance, therefore parasitological confirmation of all fevers is crucial in the context of eliminating malaria. This study assessed physicians' compliance with the national guidelines in the treatment of malaria among under-five (U-5) children and their prescription pattern in a Maternal and Child Care (MCC) centre in Lagos State. Methods: This was a descriptive cross-sectional study conducted as an exit interview among 427 mothers/caregivers of febrile U-5 children who were consecutively sampled.The data was collected using a pre-tested interviewer-administered questionnaire and a proforma. Epi-info version 7.2.1 was used to analyze the data and the level of significance was set as p<0.05. Results: Malaria Rapid Diagnostic Test (mRDT) was done for 75 17.6%) of the children and 37 (49.3%) was positive. Anti-malarial drugs were prescribed at consultation to 400 (93.7%) of the febrile children. Artemisinin Combination Therapy (ACT) was prescribed for 364 (91.0%) of the children. The most prescribed ACT was Artemether-Lumefantrine (AL) in 222 (60. 9%).Conclusion: The physician's compliance with malaria treatment guidelines for febrile illnesses in U-5 children was poor with regards to parasitological confirmation before treatment. However, the use of ACTs was adhered to in almost all cases. Regular training workshops are recommended for health workers to improve adherence to parasitological confirmation before treatment

Physicians' compliance with malaria treatment guidelines of under-five children in a secondary maternal and child care centre in Lagos State

Background: The global malaria agenda has the ultimate goal of eliminating malaria in all countries of the world by 2030 through universal access to malaria prevention, diagnosis and treatment. Presumptive treatment of malaria with Artemisinin Combination Therapy (ACT) has been associated with the development of resistance, therefore parasitological confirmation of all fevers is crucial in the context of eliminating malaria. This study assessed physicians' compliance with the national guidelines in the treatment of malaria among under-five (U-5) children and their prescription pattern in a Maternal and Child Care (MCC) centre in Lagos State. Methods: This was a descriptive cross-sectional study conducted as an exit interview among 427 mothers/caregivers of febrile U-5 children who were consecutively sampled.The data was collected using a pre-tested interviewer-administered questionnaire and a proforma. Epi-info version 7.2.1 was used to analyze the data and the level of significance was set as p<0.05. Results: Malaria Rapid Diagnostic Test (mRDT) was done for 75 17.6%) of the children and 37 (49.3%) was positive. Anti-malarial drugs were prescribed at consultation to 400 (93.7%) of the febrile children. Artemisinin Combination Therapy (ACT) was prescribed for 364 (91.0%) of the children. The most prescribed ACT was Artemether-Lumefantrine (AL) in 222 (60.9%). Conclusion: The physician's compliance with malaria treatment guidelines for febrile illnesses in U-5 children was poor with regards to parasitological confirmation before treatment. However, the use of ACTs was adhered to in almost all cases. Regular training workshops are recommended for health workers to improve adherence to parasitological confirmation before treatment

Health-Related Quality of Life of the Elderly in Institutional Care and Non-Institutional Care in Southwestern Nigeria: A Comparative Study.

BACKGROUND: The world population is rapidly ageing and people aged 60 years and above are growing faster than any other age group. In Africa, the most rapid growth of older persons is expected in Western and Northern Africa. STUDY DESIGN: This was a comparative cross-sectional study of a total of 360 respondents. A multi-stage sampling method was used in selecting 240 respondents in the non-institutional group while all the respondents (120) in the institutional group were included in the study. The data was collected using a pre-tested, semi-structured, interviewer administered quality of life questionnaire (SF-36). Data analysis was done using SPSS version 17. RESULTS: The respondents in the institutional group were older with a mean age of 78.7±8.8 years as compared to 70.1±8.2 years in the non-institutional group. The mean Health-Related Quality of Life (HRQOL) score was higher (64.5±15.6) in the non-institutional group than in the institutional group (52.6±15.7) and this was statistically significant (p<0.001). After controlling for the effect of other variables, the respondents who belonged to the non-institutional group (OR=2.37, p=0.018); who were female (OR=2.00, p=0.019); engaged in work (OR=4.93, p=0.009) and had no co-morbid condition (OR=7.58, p<0.001) were significantly more likely to have good HRQOL. CONCLUSION: The non-institutional group had better HRQOL than the institutional group in all the domains except in the body pain domain. It is recommended that programs are tailored to the needs of the elderly in institutions and should be targeted towards improving their quality of life and well-being.

Visual acuity, safe/unsafe practices and self-reported road traffic crash experiences among commuter bus drivers from two motor parks in Lagos, Nigeria.

BACKGROUND: Road Traffic injuries remain a significant public health problem with serious health and economic implications. This study was conducted to determine visual acuity, safety practices and road traffic crash (RTC) experiences of commercial bus drivers in Lagos, Nigeria. METHODS: This cross-sectional study involved visual acuity screening and interviewer- administered questionnaire survey. Participating motor parks were selected by simple random sampling and all intercity, commercial minibus drivers were included. Data was analyzed with Epi info version 3.5.1. RESULTS: A total of 407 drivers participated with a mean age of 43.4 ± 10.8 years. A total of 68 (16.7%) of the drivers did not meet the minimum VA standard required for driving; 8.6% of them use mobile phones while driving; 97% fasten their seatbelt, out of which almost 98% do so always. Fourteen percent also admitted eating while driving. Sixty two (15.2%) of drivers had been involved in RTC in the past 5 years prior to interview. CONCLUSION: A proportion of commercial minibus drivers did not meet the minimum VA required for driving. Some of them also practiced distracted driving. Free visual acuity screening within the motor park is recommended for commercial drivers at least once a year. There should be awareness campaigns to enlighten commercial drivers on the dangers of distracted driving in addition to strict enforcement of regulations and Highway Code.

Occipital paroxysmal discharges suppressed by eye opening: variability in clinical and seizure manifestations in childhood.

The EEG in childhood epilepsy with occipital paroxysms (CEOP) was termed "distinctive" by Gastaut (1985) and Talwar et al. (1992) and "characteristic" by Herranz Tanarro et al. (1984), which suggests that the EEG is specific and diagnostic for CEOP. However, this hypothesis has been challenged (Newton and Aicardi, 1983; Beaumanoir and Grandjean, 1987). To test this, we reviewed 5,291 EEG reports made in 5 1/2 years in the only tertiary pediatric center in Newfoundland and Labrador. We identified 31 children who had one or more EEGs with occipital spike/sharp waves showing suppression of discharges with eye opening and normal background activity. Six had CEOP, 17 had benign nocturnal childhood occipital epilepsy, 5 had symptomatic epilepsy, 3 had unusual complex partial seizures (CPS), 4 had only provoked seizures, and 2 had no definite seizures. Overlap between seizure types was common. The EEG criteria for CEOP are not very specific.

Migraine with prolonged aura: correlation of clinical and EEG features.

Migraine with prolonged aura has rarely been examined with regard to the sequence of the neurological symptoms and the associated EEG changes. This report describes five patients who underwent clinical assessment and EEG recordings during attacks of migraine with prolonged aura. CT scan of the brain was obtained in four of them. Follow-up EEG was also obtained. The aura symptoms either preceded the headache or were coincident with it. The aura symptoms evolved in a manner consistent with posterior-to-anterior dysfunction of the cerebral cortex. The EEG abnormalities were non-epileptiform and consisted of focal delta slow waves or theta slow waves. The EEG abnormalities showed good correlation with the patients' aura symptoms and resolved when the patients became symptom free. The posterior-to-anterior sequence of the aura symptoms is in accord with the findings during cerebral blood flow studies in patients having migraine with aura. Also the symptoms and EEG changes in our patients indicate dysfunction of the cerebral cortex, consistent with the notion that spreading cortical depression may be the underlying pathophysiological event in migraine with aura.

Seizures induced by music.

Musicogenic epilepsy is a rare disorder. Much remains to be learned about the electroclinical features. This report describes a patient who has been followed at our institution for 17 years, and was investigated with long-term telemetered simultaneous video-EEG recordings. She began to have seizures at the age of 10 years. She experienced complex partial seizures, often preceded by elementary auditory hallucination and complex auditory illusion. The seizures occurred in relation to singing, listening to music or thinking about music. She also had occasional generalized tonic clonic seizures during sleep. There was no significant antecedent history. The family history was negative for epilepsy. The physical examination was unremarkable. CT and MRI scans of the brain were normal. During long-term simultaneous video-EEG recordings, clinical and electrographic seizure activities were recorded in association with singing and listening to music. Mathematical calculation, copying or viewing geometric patterns and playing the game of chess failed to evoke seizures.

Complex partial status epilepticus provoked by "crack" cocaine.

A 53-year-old woman with a history of chronic abuse of "crack" cocaine developed isolated complex partial status epilepticus after 3 days of frequent cocaine use. The electroencephalogram demonstrated focal epileptiform activity. Follow-up for 1 year during which she reported continuous abstinence from cocaine and anti-convulsants revealed no recurrence of seizures.

Validity of the GHQ-30 in a Nigerian medical outpatient clinic.

Basic mental health vital statistics are scarce in developing countries. Scarcer still are validated psychological survey instruments which can be used in these settings. A method of dealing with such scarcity is through the validation of instruments developed elsewhere. One such instrument is Goldberg GHQ-30. The 30-item General Health Questionnaire was used by the authors as a screening instrument for emotional disorder in a general medical outpatient clinic. The GHQ-30 misclassified 32.3% of the respondents, a majority of whom were false-positives. There is a tendency for the misclassified respondents to suffer from chronic physical ailments, and to be older. The GHQ-30 appears not to have high specificity (65%) and sensitivity (73%). The predictive value (53.3%) of a positive finding by this screening instrument in this population is also low. Informed consent was obtained from participating subjects.

Syndromes of epilepsy in childhood and adolescence.

This report concerns the more commonly recognized epileptic syndromes that have their onset or entire clinical course in childhood and/or adolescence. It hopes to demonstrate the close relationship between the classifications of epileptic syndromes. It will also discuss how knowledge of the epileptic syndromes will enhance the management plan for the patient with epilepsy.

Seizures induced by exercise.

Three patients had a clinical history of epileptic seizures during exercise. In all three patients, generalized epileptiform EEG abnormalities were activated by exercise, whereas none had paroxysms during resting wakefulness or during hyperventilation, and only one had a paroxysmal discharge during sleep. Advice to epileptic patients about physical activity should be based on a careful history of individual tolerance. In doubtful cases, an EEG recorded during exercise can provide evidence for an epileptic mechanism.

The clinical recognition of subacute tetanus.

The clinical features of a modified form of tetanus, termed 'subacute tetanus', occurring in non-immune patients are presented as manifested in five patients. Subacute tetanus has a good prognosis and favourable outcome. Trismus and abdominal rigidity may be minimal or absent. Nocturnal, brief generalized muscle spasms, palpably contracted sternomastoid muscles and spastic limbs are common features of the disease. The pathophysiology of the nocturnal muscle spasms requires elucidation.