An investigation into the relationship between first-degree relatives of bipolar affective disorder and (idiopathic) epilepsy in a sub-Saharan African population.

OBJECTIVE: Phenomenological, neuro-biological and pharmacological investigations linked bipolar affective disorders with epilepsy. Similarly, a large community-based epidemiological study of epileptic patients reported that 12% of the participants had bipolar symptoms, a rate 7× higher than in control. Bipolar and epileptic disorders are epiphenomena of an underlying genetic susceptibility. This study aimed to determine the relationship between first-degree relatives of bipolar and epileptic patients in a sub-Saharan African population. METHOD: In this case-control study, we used a socio-demographic and clinical variables questionnaire to assess random convenient samples of 50 control, 40 and 60 first-degree relatives of bipolar and epileptic patients, respectively at Federal Neuro-psychiatric Hospital (FNPH), Maiduguri. Relatives of epileptic patients and the control completed the mood disorder questionnaire (MDQ). Two consultant psychiatrists made the diagnosis of epilepsy using the ILAE criteria, in relatives of bipolar patients and the control. Participants in both groups had no EEG. We analysed the data obtained, using EPI-info 7 to report averages and associations between categorical variables with Chi-square test, and analysis of variance (ANOVA) for parametric data(statistical significance set at p=0.5, two-tailed). RESULTS: The rate of epilepsy among relatives of bipolar disorder compared with control was 15.2% vs. 2.0% (χ(2)=46.08, p<0.001), and that of bipolar among relatives of epileptics compared with control was 14.5% vs. 2.1% (χ(2)=31.2, p<0.001). Educational status showed significant relationship across two groups (χ(2)=24.19, p=0.0001). Using ANOVA, age showed significant relationship among relatives of bipolar and epileptic patients (F=5.769, p=0.0039). CONCLUSION: Despite its limitations, this preliminary study contributes to literature on the relationship between epilepsy and bipolar affective disorder in sub-Saharan Africa.

Attitude towards psychiatric treatment and referral pattern in the University of Maiduguri Teaching Hospital - a preliminary report.

OBJECTIVE: There is a paucity of literature on consultation-liaison psychiatry, in northern Nigeria. This study aimed to determine both the pattern of psychiatric referrals, and the attitudes of doctors toward the treatment of mental disorders in a teaching hospital, in northeast Nigeria. METHOD: In this cross-sectional survey, we used a modified version of the self-rated Kumar 12-item questionnaire and a basic socio-demographic questionnaire to assess a non-random convenient sample of 100 postgraduate resident doctors (with a response rate of 70%) from the University of Maiduguri Teaching Hospital (UMTH). We subjected the data obtained to descriptive statistical analysis, using EPI info (2003), to report averages. RESULTS: A relatively low percentage (57.1%) of doctors acknowledged treating patients with mental disorders in their practice, with a higher proportion acknowledging referral (75%). Nearly one in five (17.6%) of the respondents were unaware that patients with functional illness could have psychological disorders. We found more awareness for psychotherapy (44.1%) than other non-pharmacological treatment interventions, while 10.3% were ignorant of non-pharmacological forms of treatment for psychological problems. CONCLUSION: Although this is a preliminary report, the research reported here demonstrated that doctors in the teaching hospital concerned recognized the need for psychiatric consultation and referral. It is difficult to draw further conclusions because of the limitations of this study.

Overview of somatization-diagnosis and management.

BACKGROUND: Neurologists and general practitioners frequently encounter patients with inexplicable, unintentionally produced somatic complaints otherwise known as somatoform disorders. METHODS: A literature search was performed including MEDLINE, as well as local and intemrnational journals using the following keywords/ phrases and crossreferencing: somatoform disorder, somatization, medically unexplained physical symptoms. RESULTS: Illness with excessive somatic preoccupation is difficult to diagnose or categorize reliably due to rigid diagnostic criteria that often overlap with several psychiatric disorders. CONCLUSION: Management of patients with dysfunctional somatoform disorders is complex and challenging, particularly when initiated in a neurology outpatient or inpatient setting. The acronym CARE-MD represents a comprehensive treatment regimen that can be used to decrease physician and patient frustration, dramatically minimise health care over utilization, and improve overall well-being for patients with somatoform disorders.

Overview of Somatization-Diagnosis and Management

Background: Neurologists and general practitioners frequently encounter patients with inexplicable; unintentionally produced somatic complaints otherwise known as somatoform disorders. Methods: A literature search was performed including MEDLINE; as well as local and international journals using the following keywords/ phrases and cross referencing: somatoform disorder; somatization; medically unexplained physical symptoms. Results: Illness with excessive somatic preoccupation is difficult to diagnose or categorize reliably due to rigid diagnostic criteria that often overlap with several psychiatric disorders. Conclusion: Management of patients with dysfunctional somatoform disorders is complex and challenging; particularly when initiated in a neurology outpatient or inpatient setting. The acronym CARE-MD represents a comprehensive treatment regimen that can be used to decrease physician and patient frustration; dramatically minimise health care over utilization; and improve overall well-being for patients with somatoform disorders

Production of adventitious root primordia on hypocotyls of castor bean seedling, infected with Agrobacterium tumefaciens.

The development of sterile secondary tumours on hypocotyls of castor bean seedlings, inoculated with any of the ten isolates of Agrobacterium tumefaciens tested, were observed below the site of the primary tumours. Histopathological studies performed in the present work indicate that the observed secondary tumours were adventitious root primordia and not the ordinary type of secondary tumours. According to the available literature such findings are reported here for the first time. All the tested isolates of the present study were also able to initiate well defined roots in conjunction with crown gall (teratomas) on Bryophyllum crenata and Kalanchoe marmorata, but not in tomato.