Background: Maternal mortality and severe maternal morbidity are pressing global health issues, especially in low- and middle-income countries. Prognostic tools in the intensive care unit (ICU) are crucial for guiding timely interventions. While general severity scoring systems such as Acute Physiology and Chronic Health Evaluation II and SAPS II are widely applied, their accuracy is limited in pregnancy. This review focuses on the Sequential Organ Failure Assessment (SOFA) score, particularly the delta SOFA (DeltaSOFA), as a prognostic indicator for maternal outcomes in obstetric ICU settings. Methods: Published literature was retrieved from electronic databases, including PubMed, Scopus, and Google Scholar, using key terms related to “SOFA score,” “DeltaSOFA,” “maternal mortality,” and “obstetric ICU.” Peer-reviewed original articles, reviews, and clinical studies examining the prognostic value of SOFA or DeltaSOFA scores in obstetric ICU patients were included. Studies lacking obstetric-specific data or prognostic outcomes were excluded. Relevant information was systematically extracted regarding score components, predictive performance, advantages over static scoring systems, limitations, and clinical applicability in maternal critical care. Results: Evidence indicates that the DeltaSOFA score provides a dynamic, sensitive prediction of maternal mortality compared to static systems. It reflects organ dysfunction trends over time, aiding decision-making and resource allocation. However, limitations exist, including non-adapted parameters for pregnancy physiology and inconsistent application across studies. Conclusions: DeltaSOFA emerges as a promising prognostic tool for maternal outcomes in ICUs, though standardized obstetric-specific modifications and further research are needed to optimize its clinical use.
Background: Diabetic retinopathy (DR) is a leading cause of preventable visual impairment. Comparative evidence from rural and urban secondary care settings in Nigeria is limited. We evaluated prevalence, pattern, awareness, screening uptake, and clinical correlates of DR among adults with diabetes attending rural and urban secondary health facilities in Lagos. Methods: A comparative hospital-based cross-sectional study recruited 288 adults with diagnosed diabetes (144 rural and 144 urban). Data collection included structured questionnaires, clinical records review, and comprehensive ocular examination with clinical DR grading. Associations were examined using Chi-square tests and multivariable logistic regression; the adjusted model included age, sex, duration of diabetes, blood-pressure status, and area of residence. Statistical significance was set at P < 0.05. Results: Mean age was 60.4 +/- 10.8 years; 64.2% were female. Overall awareness of DR was 16.3% (47/288), markedly lower in rural (0.7%, 1/144) than urban participants (31.9%, 46/144). Overall DR prevalence was 29.5% (85/288), 28.5% in rural and 30.6% in urban participants. Non-proliferative DR accounted for 90.6% (77/85) of cases; diabetic macular edema occurred in 10.6% (9/85). Prior retinal examination uptake was low (rural 35.4%; urban 38.2%). HbA1c results were available for only 17 participants (5.9%). In multivariable analysis, longer diabetes duration (adjusted odds ratio [AOR] per year 1.10; 95% confidence interval [CI] 1.04-1.16; P = 0.000623) and poor glycemic status (random blood glucose >= 200 mg/dL; AOR 2.93; 95% CI: 1.64-5.21; P = 0.000267) were independently associated with DR. Conclusion: DR is common among clinic-attending adults with diabetes in Lagos, while awareness and screening uptake are low, particularly in rural settings. Longer disease duration and clinic-based glycemic measures were associated with DR. Given the cross-sectional, hospital-based design and limited HbA1c data, these findings indicate priorities for service strengthening and should be confirmed in prospective, population-based studies.
Narcolepsy is a chronic sleep-wake disorder usually diagnosed by polysomnography, multiple sleep latency testing, and laboratory assessment. One such laboratory approach involves measuring hypocretin-1 in cerebrospinal fluid. Deficiency of this neuropeptide is characteristic of narcolepsy. However, reliance on its measurement has limitations related to invasiveness, restricted availability, and variable sensitivity across disease phenotypes. Reliance on a single biomarker for the diagnosis of any disease has several drawbacks, including the limited availability of that biomarker and variability in disease outcomes. Emerging biomarkers beyond hypocretin-1 span genetic, immune, molecular, neurophysiological, and neuroimaging domains. Genetic associations, particularly HLA-related risk and T-cell receptor variants, support an autoimmune contribution to disease pathogenesis. Autoantibodies and molecular biomarkers, on the other hand, are still in their early stages due to inconsistent replication and poor validation. Neurophysiological and imaging data provide essential mechanistic insights, but their diagnostic specificity is limited. The integration of numerous biomarkers may increase diagnostic accuracy and disease subtype identification. Heterogeneity in study design, assay methodology, and cohort characteristics continues to impede clinical translation. Future research should target longitudinal validation, assay standardization, and collaborative registries to help establish clinically relevant biomarker-driven diagnostic frameworks.
Heart failure with preserved ejection fraction (HFpEF) is a growing clinical challenge, particularly in patients with obesity, where metabolic dysfunction, systemic inflammation, and endothelial impairment drive disease progression. Traditional therapies have shown limited benefit in this subgroup, highlighting the need for novel, phenotype-specific treatments. Tirzepatide, a dual glucose-dependent insulinotropic polypeptide and glucagon-like peptide-1 receptor agonist, has demonstrated significant weight loss, improved insulin sensitivity, and potential cardiovascular benefits in recent clinical trials. This narrative review explores the pathophysiological overlap between obesity and HFpEF, summarizes key findings from the SURMOUNT and SURPASS trial programs, and examines emerging evidence from ongoing studies such as SUMMIT-HFpEF. The review also discusses tirzepatide’s potential mechanisms of action in improving diastolic function and vascular health, its safety profile, and its role in future multidrug strategies. Tirzepatide may represent a promising new direction in the metabolic management of HFpEF with obesity.
Background: Dental plaque is the primary etiological factor in the causation of periodontal disease, whereas the main aim of all preventive programs is directed towards the control of dental plaque. Furthermore, mastic is a resinous exudate obtained from the stem and leaves of Pistacia lentiscus, which is known for its potent antibacterial, anti-inflammatory, and antiulcer properties. The aim of the present study was to evaluate the anti-plaque effects of mastic chewing gum as an adjunct to routine oral hygiene procedures. Methods: The present double-blind randomized controlled trial included 60 male and female patients, aged between 21 and 40 years, diagnosed with chronic generalized gingivitis, who were divided into two groups including mastic chewing gum group (Group A) and placebo group (Group B) with 30 patients in each group based on simple random sampling. Again, clinical parameters such as plaque index and gingival index, and microbiological parameters including the mean anaerobic colony forming units in the supragingival plaque samples obtained from patients, were taken at baseline and subsequently, at 15th and 21st day and the data obtained, subjected to statistical analysis. Results: The findings of the present study revealed a significant reduction in clinical and microbiological parameters in both the groups, though, the differences observed were more marked in Group A as against Group B with statistically significant results (P < 0.05). Conclusions: Mastic chewing gum exhibited significant antiplaque, antigingivitis and antibacterial activity compared with the placebo and thus, it can be used as a significant adjunct to the routine oral hygiene procedures.
Bilateral optic disc edema is most commonly associated with raised intracranial pressure, but systemic causes such as severe anemia can occasionally mimic this presentation. Identifying these reversible causes is essential to avoid unnecessary neurological interventions. A 21-year-old female presented with headache, vertigo, and diplopia for 10 days. Ophthalmic examination revealed bilateral optic disc edema, while neuroimaging showed no intracranial pathology. Laboratory investigations demonstrated severe iron-deficiency anemia with markedly low ferritin and elevated total iron-binding capacity. A detailed menstrual history revealed chronic irregular cycles with prolonged heavy menstrual bleeding, prompting pelvic ultrasonography, which showed polycystic ovarian morphology as the underlying cause of chronic blood loss. The patient was managed with intravenous iron therapy, acetazolamide, hormonal treatment, and dietary modification. Her visual symptoms and optic disc edema resolved completely on follow-up. Severe anemia can cause optic nerve head hypoxia and venous congestion, leading to disc swelling. Coexisting polycystic ovarian disease may exacerbate anemia through menorrhagia and metabolic dysregulation. Correction of anemia results in the rapid resolution of ocular manifestations. Bilateral optic disc edema secondary to iron-deficiency anemia is a rare but reversible condition. Comprehensive evaluation for systemic causes, particularly in young women with menstrual irregularities, is vital for timely diagnosis and effective management.
Anaesthesia for patients with Treacher Collins syndrome (TCS) can be challenging due to their craniofacial abnormalities and potential difficult airway. TCS presents with micrognathia and retrognathia, a small oral aperture, and severe temporomandibular joint abnormalities. Its association with cleft palate increases the difficulty in airway management. A 16-month-old male patient with TCS and bilateral cleft of palate presented for primary palatorrhaphy. Our airway management plan and the difficulties we encountered at 1st attempt with fiber optic intubation and a subsequent successful 2nd attempt are described. The insertion of an improvised nasopharyngeal airway ensured that postoperative airway obstruction did not occur. We review the literature of various techniques described for the airway management of children with TCS. Airway management of patients with TCS is challenging. A difficult airway management plan should be discussed by the team before the induction of anesthesia. Proficiency in the use of fiber optic bronchoscope for intubation of patients with TCS can reduce the perioperative risk associated with their airway management.
Introduction: Single-sided deafness (SSD) is defined as complete deafness in one ear while the other ear has normal hearing, up to mild hearing loss. Patients with SSD experience various hearing difficulties, including problems locating the source of a sound, its intensity, reduced spatial awareness, and difficulty understanding speech in noise. Cochlear implants remain the standard treatment, providing an effective way of restoring binaural function. Other methods include CROS hearing aids and bone conduction implants. This study evaluated the effectiveness of the Bonebridge bone conduction device for people with SSD who did not meet the criteria for cochlear implantation. Methods: The study included 52 patients aged between 8 and 58 years who were diagnosed with SSD and underwent Bonebridge implantation surgery. Prior to the procedure, the anatomical condition of the temporal bone was examined using computed tomography. To assess speech understanding in noise, three Matrix tests were performed: Before surgery, at processor activation, and 6 months later. Patients also completed the Abbreviated Profile of Hearing Aid Benefit (APHAB) questionnaire. Results: Implant surgery was successful in all cases, and postoperative healing proceeded without any major complications. As measured by the APHAB questionnaire, there were significant improvements in the Matrix test results and reductions in hearing difficulties. Some 73% of patients said they would choose a Bonebridge implantation again. Conclusions: The Bonebridge system is an effective and safe alternative to traditional hearing aids. It is particularly useful for understanding speech in noisy environments and is ideal for patients with SSD who do not meet the criteria for cochlear implantation.
Background:Stroke significantly leads to altered lung mechanics, irregular respiratory rhythms, and compromised breathing control, thereby impacting pulmonary functions. However, the impact on diaphragmatic function remains underexplored.Aim:Enhanced impact of diaphragmatic facilitation methods on respiratory muscle strength in patients with chronic stroke: a randomized controlled trial (RCT).Methods:Overall, 60 patients with chronic stroke were involved for this single-blinded RCT that was allocated to Group A (n = 30; all males), which received conventional therapy, while Group B (n = 30; 28 males, and 2 females) received diaphragmatic facilitation techniques combined with conventional exercise intervention for 4 weeks. Participants were randomly allocated using computer-generated randomization in a 1:1 ratio. An independent administrator prepared opaque, sequentially numbered, sealed envelopes to ensure concealed allocation and minimize selection bias. Outcome assessors and data analysts were blinded to group allocation. Outcome measures included chest expansion at the xiphisternum level, maximum respiratory pressures (Micro RPM), and diaphragmatic thickness (ultrasonography [USG]), that were assessed at baseline and postintervention. For normality evaluation, the Shapiro-Wilk test was applied, and the Mann-Whitney U-test and Wilcoxon paired test were performed for between-group and within-group comparisons.Results:In comparison to Group A, Group B showed enhanced improvements in chest expansion (P = 0.001), inspiratory pressure (P = 0.001), and expiratory pressure (P = 0.001), with no USG changes. Moreover, between-group analysis favored Group B in posttreatment chest expansion (P = 0.005) and inspiratory pressure (P = 0.003).Conclusion:The study concluded that diaphragmatic facilitation techniques, combined with conventional therapy, significantly enhance the strength of the respiratory muscles in chronic stroke patients.
Background:Central venous catheters are frequently used in the acute care settings but are associated with a significant risk of central line-associated bloodstream infections (CLABSIs). Despite the availability of evidence-based CLABSI prevention bundles, knowledge gaps and inconsistent adherence among nurses remain common contributors to rising infection rates. The study aims to evaluate the effectiveness of an educational intervention in improving nurses' knowledge of central line care and CLABSI prevention.Methods:This quasi-experimental one-group pretest-posttest study was conducted among registered nurses working on two medical-surgical units in a teaching hospital. A voluntary educational program on CLABSI prevention was delivered over 2 days. Participants completed a 10-item multiple-choice pretest before the session and the same posttest was administered immediately after. Scores were compared using paired t-test analysis, with statistical significance set at P < 0.05.Results:Forty nurses participated in the program. The mean pretest score was 64.19 (standard deviation [SD] =13.02), which increased significantly to a mean posttest score of 81.38 (SD = 10.96) after the intervention (P = 0.000). The proportion of participants achieving a passing score (>= 70%) increased from 35% at baseline to 82.5% postintervention.Conclusion:The educational program significantly improved nurses' knowledge of central line care and CLABSI prevention. Regular, structured training may enhance adherence to evidence-based practices, strengthen patient safety, and reduce CLABSI-related morbidity and healthcare costs. Further research should evaluate long-term knowledge retention and the impact of such educational interventions on actual CLABSI rates.
Charles Bonnet syndrome (CBS) is characterized by complex, well-formed visual hallucinations in individuals with visual impairment and preserved insight, often leading to diagnostic uncertainty when comorbid conditions exist. We report the case of a 48-year-old man with chronic alcohol dependence who developed vivid, recurrent hallucinations initially attributed to alcohol-related psychosis. Careful evaluation revealed preserved orientation and insight, the absence of withdrawal symptoms, and critical ophthalmologic findings of cilioretinal artery occlusion with retinal ischemia, establishing the diagnosis of CBS. This case highlights the diagnostic challenge of differentiating CBS from substance-related hallucinosis and underscores the importance of targeted ophthalmologic assessment. It also illustrates the rarity of vascular causes of CBS and the need for clinicians to consider ocular pathology in patients presenting with complex visual hallucinations, even in the presence of confounding factors such as alcohol use.
Adnexal masses in reproductive-age women can pose diagnostic challenges due to overlapping imaging findings. We present the case of a 34-year-old woman with chronic lower abdominal pain and a right adnexal mass on imaging, initially interpreted as an ovarian fibroma or uterine myoma. Pelvic examination revealed no uterine or adnexal abnormalities. Intraoperative exploration identified an 8 cm firm mass arising from the cecal wall. Colonoscopy confirmed external compression of the cecum without mucosal involvement. The lesion was excised via right hemicolectomy, and histopathology with immunohistochemistry confirmed a benign cecal leiomyoma. The tumor showed diffuse H-caldesmon positivity and was negative for CD117, DOG1, CD34, and S100. This case highlights the diagnostic limitations of imaging alone and emphasizes the importance of pelvic examination and multidisciplinary collaboration in evaluating adnexal masses. Considering rare gastrointestinal tumors in the differential diagnosis may help prevent unnecessary gynecologic procedures and improve clinical outcomes. This case underscores the need to consider nongynecologic origins in adnexal mass evaluation.
Background: Medication error has been shown to be a common occurrence during anesthesia. However, in Nigeria, the incidence and causes of medication error during pediatric anesthesia have not been documented. Methods: This is a descriptive study conducted virtually with the use of Google Survey. A Google Survey form was distributed to members of the Nigerian Society of Anesthetists using the social media platform Whatsapp over a period of 7 days. The form was completed anonymously by respondents. Filling of the form was restricted to respondents who anesthetised or sedated at least one child weekly in the preceding 6 months. Descriptive analysis was done using Microsoft Excel, and data were presented in prose, tables, and figures. Results: One hundred and forty-two physician anesthetists responded. Most (88.7%) were from tertiary institutions. About half (52.1%) were resident doctors, 44.4% were consultants/postresidency, and 3.5% were diplomates. Over a third (36.6%) of respondents reported a medication error in the preceding 6 months. Common errors were overdosing (27.5%), underdosing (25.4%), and overdilution (15.5%). Seven (4.9%) respondents reported serious/life-threatening errors, of which one (0.7%) led to a mortality. Medication errors were reported to likely occur during a critical event (51.4%), during emergency procedures (50%) and at induction/airway control (36.6%). Weighing of children, proper labeling/dilution of drugs, and good team communication were suggested to prevent medication error. Conclusion: Medication error can lead to catastrophe in pediatric anesthesia. There is a high prevalence of medication errors in pediatric anesthesia in Nigeria. Measures and protocols to prevent and report medication errors are needed in Nigeria.
Antimicrobial resistance (AMR) poses a growing global threat, diminishing the effectiveness of existing antibiotics and demanding innovative solutions for new drug discovery. Traditional antibiotic discovery methods are often time-consuming and inefficient, rendering them inadequate in keeping pace with the rapid evolution of pathogens. Machine learning (ML) has emerged as a transformative approach in this domain, offering enhanced computational power to analyze complex biological datasets with unprecedented speed and accuracy. This review explores the application of ML in identifying novel antibiotic targets, emphasizing its role in genomic analysis, protein function prediction, metabolic network modeling, phenotypic data integration, and drug-target interaction (DTI) prediction. ML algorithms such as support vector machines, deep learning networks, and graph-based models enable the prediction of essential genes, protein functions, and metabolic chokepoints critical for bacterial survival. These models also integrate high-throughput phenotypic screening data to identify resistance mechanisms and druggable targets. Furthermore, ML enhances the prediction of DTIs by leveraging structural and chemical data, facilitating the development of precision-targeted antibiotics. By integrating diverse datasets and continuously adapting to new information, ML-driven approaches significantly accelerate the drug discovery pipeline. This narrative review highlights the potential of ML to revolutionize antibiotic discovery and its promising role in addressing the pressing challenge of AMR.
Background: Overt lower gastrointestinal bleeding (LGIB) is a common encounter in general surgical practice. The pattern of clinical presentation of LGIB is largely influenced demographic indices, which vary globally. LGIB is the most common indication for colonoscopy in Nigeria. The objective of this study is to determine the association of age and gender characteristics on colonoscopy findings of patients with LGIB. Methods: Between December 2010 and June 2025, the colonoscopy records of all patients who had colonoscopy performed by the surgeons in our institution were reviewed. Gender, age, and characteristics of the patients and results of their colonoscopy were analyzed. Data analysis was performed using IBM SPSS version 23. Results: LGIB was the primary indication for colonoscopy in 70 patients. There were 26 females (37.1%) and 44 males (62.9%) with a male-to-female ratio of 1–1.7. In all cases, the diagnostic yield of colonoscopy for LGIB in this study was obtained in 59 out of 70 colonoscopies (84.2%). The mean age of all patients was 52.6 ± 16 years. The most positive findings on colonoscopy were in patients between 50 and 59 years. Seventeen patients (24.3%) were found within this age group. Hemorrhoids were the most common finding at colonoscopy. Neoplastic lesions of the colon accounted for 14.3% of abnormal colonoscopy findings and are most common in the middle-aged male gender. Conclusion: this study highlights some disparities in abnormal colonoscopy findings in LGIB by age and gender. Regardless of gender, benign colorectal lesions were most frequently diagnosed. Neoplastic lesions accounted for 14% of the colonoscopy findings and are most common in middle-aged males. Targeted colonoscopy screening programs for Nigerians in the middle-aged may be considered for future studies.
Male infertility continues to pose a significant clinical issue, and sperm DNA fragmentation (SDF) has also been established as a key marker of fertilization success, embryo viability, and pregnancy outcomes. The assessment of sperm DNA integrity using conventional semen analysis proves inadequate, creating the imperative for implementing innovative therapeutic approaches. This review examines the impact of SDF on reproductive outcomes and pharmacologic management through the use of antioxidants, hormone treatments, and amino acid therapies for preventing DNA damage. Antioxidants such as Vitamins C and E, coenzyme Q10, selenium, and L-carnitine are essential in countering oxidative stress. At the same time, hormonal agents such as clomiphene citrate and gonadotropins regulate endocrine function to facilitate spermatogenesis. Amino acids such as L-arginine and N-acetylcysteine also contribute to sperm metabolism and antioxidative defense mechanisms. In addition, novel technologies such as nanotechnology-based drug delivery systems, enhanced sperm selection methods, and gene editing tools offer new pathways for enhancing sperm DNA integrity. However, their clinical efficacy requires further validation. Despite the potential benefits of pharmacologic interventions, inconsistencies in treatment effectiveness, dosing regimens, and study methodologies necessitate the development of standardized protocols and large-scale clinical trials. Integrating these therapeutic approaches with innovative technologies is essential for optimizing treatment and improving reproductive outcomes.
Background: Approximately one-third of pregnant women in the world are estimated to have anemia with 50% in Nigeria. This study compared the pattern of Doppler velocimetry umbilical artery (UA), middle cerebral artery (MCA), and perinatal outcomes in the third trimester of anemic and nonanemic women. Methods: There was a prospective cohort study involving 336 low-risk booked antenatal care attendees with gestational age of 34 weeks till term with anemia/study and without anemia/reference group. Data were collected and analysed using the Statistical Package for the Social Sciences for Windows version 20. Results: Sociodemographic characteristics of both the groups were similar. Among the participants, 28.6% had mild anemia, 17.8% had moderate anemia, and 53.6% were nonanemic. Biometric characteristics of foetuses in the anemic group were lower than the nonanemic group (P < 0.001) except for abdominal circumference. The UA pulsatility index was lower in the anemic group (0.69 ± 0.3) compared to the nonanemic group (0.70 ± 0.3) (P < 0.001), while the systolic/diastolic (S/D) ratios and resistance indices (RIs) revealed no significant differences for both the groups. The MCA velocimetric parameters showed no significant differences in the S/D ratios and pulsatility and RIs between both the groups. The mean birth weight of newborns (3.1 ± 0.3 kg) and Apgar score at 5 min (9.0 ± 0.6) were similar in both the groups. Conclusion: Maternal anemia was linked to reduced fetal biometry, but mild-to-moderate anemia showed no significant Doppler or perinatal differences. Further studies are recommended to determine whether a risk-based approach to fetal Doppler monitoring, focused on women with additional risk factors, can better predict adverse outcomes and guide targeted interventions.
Background: Soft-tissue sarcomas (STSs) are heterogeneous malignancies whose outcomes depend on histologic subtype, grade, and stage. We described demographics, frontline treatment patterns, and metastatic profiles of histologically confirmed STS managed at a tertiary oncology center in Lagos, Nigeria to identify the service gaps and inform quality-improvement priorities. Methods: Retrospective consecutive case series of all histologically confirmed STS seen at Medserve–LUTH Cancer Center from June 1, 2019 to December 31, 2024. Demographic, histologic, staging, and treatment data were abstracted from the electronic records; 10%–15% were re-abstracted for quality control. Metastatic status and site(s) were recorded; descriptive statistics used SPSS v27. Results: One hundred and three patients (mean age 33.8 years, standard deviation 22.6); 34 (33.0%) <18 years; 56 (54.3%) male. Rhabdomyosarcoma predominated (53/103; 51.5%), then leiomyosarcoma (14/103; 13.6%), liposarcoma (11/103; 10.7%), and angiosarcoma (11/103; 10.7%). Primary sites: Extremity 34/103 (33.0%) and head-and-neck 27/103 (26.2%). Distant metastasis was in 23 (22.3%); lung commonest (16/103; 15.5%). Multimodality care: Surgery 61 (59.2%), chemotherapy 60 (58.2%)-vincristine–actinomycin–cyclophosphamide 31.7%, doxorubicin–ifosfamide 20.0%, and radiotherapy 47 (45.6%) (three-dimensional conformal radiotherapy 53.2%, intensity-modulated radiotherapy 27.7%, and volumetric-modulated arc therapy 10.6%); mean radiotherapy dose ≈ 43.2 Gy (median 50 Gy). Sixteen (15.5%) received no cancer-directed therapy, largely for financial reasons. Conclusion: This single-center, descriptive study highlights a young, pediatric-skewed case mix with rhabdomyosarcoma over-representation, notable baseline metastatic burden and heterogeneous treatment delivery. Priorities to improve the outcomes include strengthening early detection/referral, financial protection, pathology/staging capacity and access to histology-directed therapies in similar low-resource settings and workforce training for multidisciplinary teams.
Background: Stroke is a leading cause of mortality and long-term disability worldwide. Beyond physical impairment, psychiatric co-morbidities such as depression, anxiety, and cognitive disturbances are increasingly recognized as major determinants of quality of life and functional recovery. However, limited data are available from rural Indian populations. Aim: To assess the prevalence of psychiatric co-morbidities in adult poststroke patients and examine their relationship with functional outcomes. Methods: This cross-sectional, hospital-based study was conducted among 73 adult poststroke patients attending the Psychiatry and Neurology Departments at Acharya Vinoba Bhave Rural Hospital, Wardha. Data were collected using a socio-demographic pro forma, the National Institutes of Health Stroke Scale (NIHSS), the Present State Examination, and the Brief Psychiatric Rating Scale (BPRS). Descriptive statistics, Chi-square tests, and correlation analyses were performed using SPSS version 28. P < 0.05 was considered statistically significant. Results: The mean age of the participants was 42.3 ± 12.1 years, with a male predominance (58.9%). The most common psychiatric co-morbidities were depressive mood (87.7%), anxiety (63.0%), cognitive difficulties (68.5%), and appetite loss (72.6%). Suicidal ideation was present in 27.4% of patients. Hypertension (65.8%) was the most frequent medical comorbidity. Stroke severity was predominantly moderate (63.0%). No significant correlation was found between overall psychiatric symptom severity (BPRS) and stroke severity (NIHSS) (ρ = –0.037, P = 0.76). Conclusion: Psychiatric co-morbidities are highly prevalent in poststroke patients and occur largely independent of stroke severity. These findings highlight the importance of routine psychiatric screening and timely intervention as an integral component of stroke rehabilitation to improve the long-term outcomes.
Background: The psychosocial issues surrounding having a cleft lip/palate (CL/P) as an adult, especially in low- and middle-income countries, are a key area for research in cleft management that requires attention. This study aims to explore the lived experiences related to CL/P of a sample of adults with CL/P receiving orofacial cleft care at our institution. Methods: This is a qualitative study in which in-depth interviews were conducted for adult individuals not <18 years of age with CL/P in Lagos, Nigeria. Interviews were recorded on an audio device and transcription was done using an edited intelligent verbatim transcription approach. Data analysis was done using a thematic analysis approach. Results: Fifteen individuals were recruited into the study, 11 females and 4 males. The averagee age was 28.3 (standard deviation 9.9) years. Nine were single, never married, and 13 had a tertiary level education. Participants described their experience of living with CL/P as limiting, mainly due to a feeling of not being understood by others due to their speech impairment. This limitation also extended to their ability to have stable romantic relationships and form close bonds outside their family. This limitation did not extend to their overall educational attainment, although there were experiences of bullying, especially during primary and secondary schooling, due mainly to their looking different. Conclusion: The psychosocialwell-being of individuals with CL/P should be considered an important treatment outcome. The result of this study has highlighted the need for this gap to be filled in comprehensive cleft care.
