Background: This study compared the effects of anti-seizure medication (ASM) monotherapy and polytherapy on hematological parameters in patients with epilepsy (PWE).Objective To compare hematological parameters and derived inflammatory indices in patients with epilepsy receiving ASM monotherapy versus polytherapy and determine independent predictors and discriminatory performance of these parameters. Methods: A hospital-based cross-sectional study was conducted between January and June 2024 at the Neurology Clinic of Olabisi Onabanjo University Teaching Hospital, Sagamu, Nigeria. Two hundred adult PWE were enrolled and classified into monotherapy or polytherapy groups. Sociodemographic and clinical data were collected. Venous blood samples were analyzed using the Sysmex XN-1000 hematology analyzer. Statistical analyses included independent t-tests, chi-square tests, logistic regression, and receiver operating characteristic (ROC) analysis (p < 0.05). Results: Males predominated in the monotherapy group (58.8%), while females predominated in the polytherapy group (84.1%; p < 0.001). Monotherapy showed significantly higher neutrophils, hemoglobin, mean corpuscular volume, mean corpuscular hemoglobin concentration, and neutrophil-lymphocyte ratio, but lower mean platelet volume. Neutrophils, hemoglobin, MCV, MCHC, and MPV independently predicted treatment pattern. ROC analysis showed moderate discrimination for MPV, while others performed poorly. Conclusion: ASM polytherapy is associated with greater hematological alterations. Monotherapy should be prioritized when feasible, with routine hematological monitoring recommended.

METHOD:This cross-sectional study recruited 940 PWE attending outpatient clinics of selected tertiary hospitals in southwestern Nigeria, with diagnosis confirmed clinically and supported by electroencephalography (EEG), aged ≥15 years, with no history of psychogenic non-epileptic seizures. Zung Self-Rating Depression Score (ZSRDS) was used to assess depression, and Liverpool Adverse Event Profile (LAEP) was used to assess the adverse effects of ASM. RESULTS:The prevalence of depression was 44.5%. In multivariable logistic regression, independent predictors of depression included younger age (OR 0.94, p < 0.001), higher age of seizure onset (OR 1.09, p < 0.05), seizure duration < 2 years (OR 1.76, p = 0.032), lower mean LAEP score (OR 0.90, p < 0.001), not being on an ASM (OR 2.12, p = 0.001), and ASM duration < 2 years (OR 4.15, p < 0.001). CONCLUSION:While depression is prevalent among PWE, adverse events, non-use of ASM, and duration of ASM use were among the predictors of depression. Health care providers should work towards preventing adverse events and achieving early seizure control with appropriate pharmacotherapeutic intervention.

BackgroundThe prevalence of epilepsy is highest in the Central Africa subregion most especially in rural settlements. This is further compounded by a high prevalence of treatment gap, from poor drug adherence, and poor road network. One approach to overcoming this burden is to leverage Video-based Directly Observed Therapy (ViDOT) use for stable patients living with epilepsy, harnessing the advancement in mHealth technologies, and widespread adoption of smartphones. ViDOT is a form of telemedicine that is a smartphone-based, treatment approach for monitoring and evaluating remote patients.ObjectiveWe performed a narrative review of the existing literature using electronic databases from PubMed and Google Scholar to identify relevant publications related to ViDOT and chronic diseases, in particular epilepsy.MethodsThe selected articles were assessed for relevance, and key findings were synthesized to provide an overview of the role of ViDOT in addressing the challenges of drug adherence in epilepsy.ResultsThe review shows that poor drug adherence is a major risk for poor outcomes in patients living with epilepsy. ViDOT has the potential to significantly contribute to improved drug adherence in patients living with epilepsy. Other benefits of ViDOT include the elimination of prolonged waiting times, improvement in access to specialized care, eradication of self-induced stigma and discrimination, diminishing neurologists' workload, and cost-effectiveness. Challenges include poor network coverage and unstable internet service.ConclusionGiving a brief psychoeducation about epilepsy, anti-epileptic drug (AED) side effects, and the importance of sticking with the recommended drug use can improve AED adherence and epilepsy outcomes. Information dissemination through ViDOT to people with epilepsy and their caregivers at large is important to promote a healthy life.

Background: This study aimed to evaluate factors associated with adverse drug reaction (ADR) among people with epilepsy (PWE) on Levetiracetam (LEV) monotherapy. Method: This descriptive, cross-sectional study, utilized a total purposive sampling method, to recruit 102 consenting participants on LEV monotherapy. Seizure classification was determined using the 2017 International League against Epilepsy (ILAE) guideline. Liverpool Adverse Events Profile (LAEP) was employed to evaluate ADR in individuals on LEV monotherapy. Result: There were 44 (43 %) had ADR [single 21(20.59 %) vs multiple 23(22.55 %)], while 58 (56.86 %) had No Adverse Drug Reaction (NADR) respectively. The most common ADRs were headaches 20 (19.6 %), disturbed sleep (18.6 %), and dizziness 16 (15.7 %). Demographic and clinical characteristics were comparable among ADR, and NADR, except for marital status (p0.043), lower age at onset [23.89 ± 13.30 vs 32.32 ± 20.34 (p0.027)], and higher LAEP score [24.48 ± 5.55 vs 19.00 ± 0.00 (p < 0.001)]. The parameters were also comparable in single and multiple reactions except for marital status (p0.035), and etiology (p0.012). Furthermore, lower age at onset (p0.027), and higher LAEP score (p < 0.001) were identified factors associated with ADR among participants. However, none of these predicted ADR. Conclusion: Nearly half of the participants had ADR, with neurological ADRs being the commonest, and 23 % of them had multiple ADRs. Furthermore, lower age at onset and higher LAEP scores were significantly associated with ADR. Healthcare providers should focus on identifying and mitigating these ADRs to improve the quality of care in PWE.

Objectives Body image dissatisfaction and anthropometry-related issues are a growing public health concern in Nigeria, particularly among young adults. Tertiary students, including those in Nigerian university campuses, may be susceptible to sociocultural influences that promote unrealistic body ideals. This study investigates the relationship between perceived body size and anthropometric measurements among this population. Material and Methods A cross-sectional study was conducted among 232 female university students in a selected tertiary educational institution in Ibadan, southwestern Nigeria. Participants completed a demographic questionnaire and the Silhouette Rating Scale (SRS) to assess their perceived body size. Height and weight were measured to calculate the Body Mass Index (BMI). Descriptive statistics were used to summarise demographics and body image scores. Correlations were conducted to examine the relationship between perceived body size, anthropometry, and gender. Statistical significance was set at 0.05. Results The average age of the participants was 21.4 years. The participants reported a significant discrepancy between their perceived and actual body size. Most of them (65%) overestimated their body size, regardless of gender or BMI category. Correlations revealed a negative association between perceived body size and BMI, indicating that participants with higher BMI tended to perceive themselves as larger in body size. Conclusion This study found a significant body image discrepancy among Nigerian university students. Despite variations in BMI, a substantial portion of the sample overestimated their body size. These findings highlight the need for culturally sensitive interventions to promote healthy body image and aid effective anthropometry interventions among young adults.

Hormonal disruptions due to seizures and antiseizure medications (ASMs) might be responsible for the cognitive dysfunction in people with epilepsy. This study investigated the association between reproductive hormones and Cognitive Impairment (CI) in women with epilepsy (WWE).  A cross-sectional study was conducted on 150 WWE aged 18-45 years. Epilepsy diagnosis was clinical and supported by electroencephalography (EEG). Cognitive function was evaluated using the Community Screening Instrument for Dementia (CSID). Serum levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH), progesterone, estradiol, prolactin, and testosterone were measured during the follicular and luteal menstrual phases. Analyses included Age group, which examined CI distribution across different age ranges, Mann-Whitney U tests for group comparisons, logistic regression for predictors, and receiver operating characteristic (ROC) curve analysis for diagnostic accuracy (p < 0.05). Of the participants, 28% had CI. The CI group exhibited higher follicular-phase LH (p = 0.002) and testosterone (p < 0.001), as well as luteal-phase LH (p = 0.039) and LH/FSH ratio (p = 0.046), but lower luteal-phase progesterone (p = 0.039), estradiol (p = 0.042), and prolactin (p = 0.023) compared to the non-CI group. Logistic regression identified testosterone as the sole significant predictor (p = 0.004; odds ratio = 0.555; 95% confidence interval, 0.373-0.825), indicating a 44.5% reduction in CI odds per unit increase. ROC analysis demonstrated moderate predictive accuracy for testosterone (area under the curve = 0.708; p < 0.001). Elevated follicular-phase LH and testosterone, luteal-phase LH alongside LH/ FSH, are associated with CI in WWE, with testosterone emerging as a key predictor. These findings indicate that hormonal factors play a role in cognitive impairment among individuals with epilepsy and suggest that focusing on hormone-based therapies might augment ASMs to improve treatment outcomes. Keywords: Cognitive impairment, women with epilepsy, luteinizing hormone, testosterone, Mann-Whitney U test, logistic regression.

Background:There is a growing concern about the prevalence of high blood pressure among young adults, but its epidemiological profile remains poorly explored.Objective: This cross-sectional study described the pattern of blood pressure and its correlates among young adults aged 16-35years recruited under the TERRACE study, in two major metropolises in South Western Nigeria.Methods:Basic socio-demographic, anthropometric, and clinical data were collected using a structured questionnaire. Blood pressure and anthropometric parameters were measured using standardised methods. Data analysis was done using SPSS version 23 software and a pvalue <0.05 was used to determine the level of statistical significance.Results: In a total of 803 participants; 66.5% were females, mean age was 21.2 ± 3.4 years. 74.8% had optimal (BP), 15.6% normal, 5.9% had high-normal BP, while 3.1% and 1.0% had grades 1 and 2 hypertension, respectively. The mean Systolic Blood Pressure (SBP) andDiastolic Blood Pressure (DBP) was 110.29 ± 11.54 mmHg and 70.80 ± 9.64mmHg, with mean SBP higher in males 113.3 ± 11.5mm Hg vs females 108.8 ± 11.2mmHg (p= 0.001) while mean DBP slightly higher among females 71.89 ± 9.35mmHg vs males 69.64 ±10.11mmHg (p= 0.018). The pattern of hypertension status showed hypertensive to be 3.7% and more of isolated diastolic hypertension phenotype, 20(2.5%). On multivariate analysis, only body mass index (BMI) showed an independent association with elevated blood pressure.Conclusion: This study highlights blood pressure profiles among Nigerian young adults, about one out of four don't have optimal category of blood pressure with isolated diastolic hypertension, an important phenotype and BMI was identified as a key determinant. There is need for early preventive interventions and lifestyle modifications to reduce hypertension as risks, targeting modifiable risk factors like BMI.

IntroductionSex steroid hormones are emerging significant biomarkers of depression among Women with Epilepsy (WWE) with promising prognostic potential and therapeutic end point. Therefore, the study is aimed at exploring the association between sex steroids hormones, Anti-seizure Medication (ASM) and depression among WWE.MethodologyA baseline questionnaire was used to obtain socio-demographics and clinical characteristic from one hundred and twelve (112) WWE and 50 age matched healthy control. The diagnosis of epilepsy and Electroencephalography (EEG) description was based on 2017 International League Against Epilepsy (ILAE) criteria. Blood samples were collected from cases and control during Luteal Phase (LP) and Follicular Phase (FP). The Zung Self-Rating Depression Scale (ZSRDS) was used to assess depression.ResultThe prevalence of depression among WWE is 18.8%, with a significant difference between the level of formal education (p0.000), age (p0.000), and mean ZSRDS (p0.000) among cases and control. There is a statistical difference in hormonal levels between cases and control with regards to higher testosterone [3.28 ± 9.99 vs. 0.31 ± 0.30; p0.037], lower FP prolactin [16.37 ± 20.14 vs. 17.20 ± 7.44; p0.778], and lower LP prolactin [15.74 ± 18.22 vs. 17.67 ± 7.27; p0.473]. Testosterone (p0.024), FP Follicle Stimulating Hormone (FSH) (p0.009), FP Estradiol (p0.006), LP FSH (p0.031), LP Progesterone (p0.023), and LP Prolactin (p0.000) were associated with depression. However, only prolactin (p0.042) and testosterone (p0.000) predicts depression among WWE.ConclusionThere was higher mean depression score, lower prolactin and higher testosterone level among cases compared to control. Furthermore, there was lower prolactin and higher testosterone level in Carbamazepine (CBZ) group compared to Levetiracetam (LEV) groups.

Background Teleneurology has been in existence for decades, and the COVID-19 pandemic has escalated its widespread usage. Neurological conditions are a leading cause of death globally, with sub-Saharan Africa bearing the bulk of the burden. Nigeria has few trained neurologists with the few available concentrated in an urban region. The adoption of teleneurology will help close this treatment gap. Despite evidence of its advantage, the adoption and state of teleneurology in Nigeria are very low. This study aims to determine the state and perception of teleneurology in the care of neurological patients in Nigeria and identify challenges to its wide usage. Methods The primary research method was a descriptive cross-sectional survey among 48 neurologists in Nigeria across the six geo-political zones of the country. Descriptive statistics such as frequency and percentage were used to summarize and present the results. Results A total of 48 neurologists participated, of which 46 (95.8%) specialized in general neurology. Videoconferencing is the most preferred means of telemedicine (24, 50%), followed by phone calls (16, 33.3%) and short messages (6, 12.5%). Three-quarters of the respondents are concerned about legal actions from telemedicine use. The majority (34, 70.9%) are not familiar with telemedicine tools, and 40 (83.3%) indicate low telemedicine seminar attendance. More than 90% (46) of neurologists believe that it is a viable approach and can save time and money. Barriers to telemedicine included the lack of incentive to use the technology (38, 79.2%), poor Internet connectivity (36, 75%), and the lack of exposure to telemedicine (36, 75%). Conclusions It is important to overcome the existing barrier to teleneurology in order to fully harness its potential in addressing the shortage of health professionals in Nigeria as most neurologists are open to using it.

Background and Objective: Inter-arm blood pressure differences (IABPD) are linked to higher cardiovascular mortality and morbidity. Unfortunately, the profile and associated risk factors of IABPD in sub-Saharan Africa, particularly Nigeria are poorly studied. This study aims to determine the profile and associated correlates of systolic IABPD among the participants in the profile of anthropometry and psychosocial issues on campus (TERRACE) study, a cohort of young persons on selected tertiary educational campuses in Abeokuta metropolis aged 16-35years. Methods: This was a cross-sectional study. Basic demographic, anthropometric, and clinical data were collected. Brachial Blood Pressure (BP) were recorded in both arms, using validated electronic devices. Three standard measurements were performed on both arms. The IABPD was defined as the absolute value of the difference in systolic blood pressure(SBP) between the left and right arms of BP averages. Significant IABPD ≥10 mmHg. Data was analysed using Statistical Package for the Social Sciences (SPSS) version 23. The level of statistical significance was set at <0.05. Results: A total of 301 participants with age, 21.8±4.9 years and female proportion of 65.1%. The mean±SD of neck circumference, weight, height, right SBP, left SBP were 26.2 ± 3.6 cm, 58.0 ± 10.0 kg, 164.1 ± 10.4 cm, 112.9± 11.6mmHg and 112.0 ± 11.1 mmHg respectively. The median systolic IABPD was 0.6 mmHg, and the prevalence of significant systolic IABPD is 9.0% (11.4% in males and 7.7% in females, p- value: 0.275). Among our participants, there were 6.0%, 2.3% and 0.7% with a systolic IABPD in the ranges: 10-14.9mmHg, 15-19.9mmHg and ≥ 20mmHg respectively. The proportion with dominantly high right SBP was 54.4% in males compared to females (41.9%), p- value: 0.209. There was a correlation between height and IABPD (r2=0.177, p-value=0.002) Conclusion: Our study found that this young population have high IABPD, suggesting increased cardiovascular risk. Routine measurement in both arms is advised.

Introduction: Pharmacotherapy with antiseizure medications (ASMs) has been a cornerstone for achieving long-term remissions in persons with epilepsy (PWEs). This study aims to determine the prescription patterns and treatment gaps (TGs) among PWEs.Methods: Accordingly, a descriptive cross-sectional study was conducted with 940 PWEs aged ≥18 years having clinically confirmed diagnosis of epilepsy based on the International League Against Epilepsy (ILAE) criteria. At a scheduled interview with each participant, a previously established questionnaire was used to obtain clinical information relating to epilepsy in terms of the age of onset, etiology, duration of epilepsy, frequency, types, and number of ASMs used.Results: There were fewer male participants [445 (47.4%) vs. 495 (53.6%)] than females, with a higher mean age of onset [(35.19 ± 21.10 vs. 31.58 ± 20.82 years; p = 0.009]. The medication characteristics showed that 336 (35.7%) of the 940 PWEs recruited were not on any ASMs, whereas the remaining 604 (64.3%) patients were on ASMs, with 504 (83.4%) on monotherapy vs. 100 (16.6%) on polytherapy. The PWEs on ASM monotherapy had a higher mean age [40.92 ± 19.40 vs. 33.61 ± 16.51 years; p < 0.001] and higher mean age of onset [34.47 ± 21.80 vs. 25.39 ± 19.78 years; p < 0.001] than those on polytherapy. Furthermore, there were more persons on ASM monotherapy among the participants with seizure duration < 2 years [251 (87.5%) vs. 36 (12.5%)] and seizure duration > 2 years [253 (79.8%) vs 64 (20.2%)].Conclusion: The majority of the participants receiving ASMs were on monotherapy, with carbamazepine being the most frequently prescribed medication. Furthermore, about a third of the participants had TGs; therefore, healthcare providers should focus on alleviating the TGs among PWEs.

Objective: This study is aimed at comparing differential effect of Levetiracetam (LTC) monotherapy and Carbamazepine (CZP) monotherapy in W omen with epilepsy (WWE) on gonadal hormone. Methods: 87 WWE were recruited comprising randomly of 46 and 41 on CZP and LTC group respectively with diagnosis and classification based on International League Against Epilepsy (ILAE). Reproductive hormones (Luteinizing Hormone (LH), Follicle stimulating hormone, progesterone, estradiol and testosterone) were assayed. National Hospital Seizure Severity Scale (NHSS) and Zung self-reporting depression scale (ZSRDS) were used to assess the seizure severity and the mood respectively. Data was analyzed using Statistical Package for Social Sciences (SPSS) version 20. The Chi-square test was used to compare categorical variables while Student's t-test or its non-parametric equivalent where appropriate were used to compare continuous variables. Results: Clinical characteristics were comparable in both groups except for ZSRDS (p = 0.048), NHSS (p = 0.012) and hip circumference (p = 0.037). The CZP group had a higher ASEX score and proportion of WWE with clinically significant sexual dysfunction (p < 0.001). WWE on LTC had similar hormonal profiles with those on CZP except for a higher median serum testosterone level (p = 0.004), and lower median serum LH (p = 0.006). Age was negatively associated with serum testosterone level for the 25th, 50th, and 75th quartile. However, the differential effect for AED type was only significant for the 25th quartile; with higher values in LTC. Conclusion: The therapeutics implication of lower LH and testosterone levels in the LTC group compared to CZP group need to be explored.

Background The study is aimed to identify the predictors of Quality of Life (QOL) in women with epilepsy (WWE) on carbamazepine (CBM) and levetiracetam (LTM) monotherapy. 100 WWE were recruited (50 each on CBM and LTM), after clinical diagnosis of epilepsy supported by Electroencephalography (EEG) features and seizures classification by 2017 International League Against Epilepsy (ILAE) criteria, the Quality of Life Inventory Scale 31(QOLIE-31) and Zung Self-Rating Depression Scale (ZSRDS) were used to assess QOL and depression, respectively. Result Higher QOLIE-31 scores was seen in the LTM group across all domains except seizure worry ( p = 0.051) compared to CBM group . Logistic regression showed that the use of CBM ( p = 0.000), fast frequency on EEG ( p = 0.005), longer duration of epilepsy ( p = 0.017), presence of depression ( p = 0.008) and lower level of education (p = 0.003) were predictors of QOL. Progesterone ( p = 0.040), oestradiol ( p = 0.011) and prolactin ( p = 0.002) in follicular phase showed significant association with QOLIE-total score. In the luteal phase, luteinizing hormone–follicle stimulating hormone (LH–FSH) ratio ( p = 0.009) and testosterone ( p = 0.015), FSH ( p = 0.015), prolactin ( p = 0.000), showed significant association with QOL. None of the hormones independently predicts QOL. Conclusion LTM group appears to have better QOL than CBM group. Healthcare providers should focus on addressing these identified predictors which include medication effect, depression, Level of education, EEG background and duration of epilepsy with aim of improving QOL.

Background: There is growing evidence that inflammation plays a specific role in the pathogenesis of epilepsy and seizures also induce inflammation. The Neutrophil/Lymphocyte ratio (NLR) is an emerging inflammatory biomarker of epilepsy. Objectives: To determine the association between epilepsy and Neutrophil /Lymphocyte Ratio among adults. Methods: Adults with epilepsies the attending outpatient neurology clinics at two Nigerian tertiary health facilities, were recruited. One hundred cases and one hundred age-matched, healthy controls were recruited. The total white blood cell (WBC) and its differential counts were extracted from Full Blood Count (FBC) results and NLR was calculated. The predictors of the association between WBC parameters and epilepsy were established using a linear regression model derived from WBC parameters associated with epilepsy. Results: Out of 100 cases and controls, there was no gender-related statistical difference between the cases and controls (p = 0.777). There was no difference between the mean ages of cases and control (p = 0.058). The total mean white blood cell count among the cases was 8.80±9.84×109 cells/L compared to was 6.30±1.90 ×109 cells/L in the controls, (p = 0.013). The mean neutrophil count in the cases was 59.00±17.89 ×109 cells/L compared to 49.50±15.44 ×109 cells/L among the controls (p < 0.001). The mean NLR for the cases was 4.24±10.44 compared to 1.84±2.26 in the controls (p = 0.026). The Neutrophil/Lymphocyte Ratio (p = 0.013) and Basophil (p < 0.001) predicted epilepsy on linear regression analysis. Conclusion: This study shows a clear difference in the TWBC and NLR with between adults with epilepsies and health controls.

Background: The objective of this study was to assess the effect of psychoactive substance use on academic performance among university students of Lagos undergraduates. Methods: This is a descriptive cross-sectional study to assess psychoactive substance use and its relation to academic performance among undergraduate students of the University of Lagos. A multi-stage sampling technique was used to select the participants. Data was collected using a self-administered semi-structured questionnaire adapted from WHO model core questionnaire self-administered format. Data was collected and analyzed using the free-liscence software package Epi-Info, version 7.2.2.16. Chi square and Fisher's exact were used to test for any significant association between psychoactive substances use and academic performance of the respondents. Level of significance (p) was set at 0.05. Result. Prevalence of psychoactive substance use was 28.6%. Male and female respondents were270 (69.77%) and 117(30.23%) respectively, with age range between 14 and 30 and mean age of 20.51 (SD)(±2.91) year. Alcohol was the most abused substance with 68.99%, this was followed by cigarette with 20.67% ever use prevalence. The mean age of first use of psychoactive substance was 16.31±3.89. Using the Grade Point Average system from the previous semester, majority of the respondents (87.08%) had GPA >2.50. Both frequency of studying and mean CGPA was statistically better among non-life time users and non-current users of alcohol, tobacco and cannabis in the male group. However there was no statical significance among female group. Using fischer exact test to assess the effect of age of first substance use and mean CGPA. The age of first substance use was statistically significant for tobacco p = 0.007. Conclusion. Psychoactive substance use among students was common and negatively associated with students’ academic performance especially among male gender.

Background Every minute, six indigenous Africans develop new strokes. Patient-level and system-level contributors to early stroke fatality in this region are yet to be delineated. We aimed to identify and quantify the contributions of patient-level and system-level determinants of inpatient stroke fatality across 16 hospitals in Ghana and Nigeria. Methods The Stroke Investigative Research and Educational Network (SIREN) is a multicentre study involving 16 sites in Ghana and Nigeria. Cases include adults (aged >= 18 years) with clinical and radiological evidence of an acute stroke. Data on stroke services and resources available at each study site were collected and analysed as system-level factors. A host of demographic and clinical variables of cases were analysed as patient-level factors. A mixed effect log-binomial model including both patient-level and system-level covariates was fitted. Results are presented as adjusted risk ratios (aRRs) with respective 95% CIs. Findings Overall, 814 (21 center dot 8%) of the 3739 patients admitted with stroke died as inpatients: 476 (18 center dot 1%) of 2635 with ischaemic stroke and 338 (30 center dot 6%) of 1104 with intracerebral haemorrhage. The variability in the odds of stroke fatality that could be attributed to the system-level factors across study sites assessed using model intracluster correlation coefficient was substantial at 7 center dot 3% (above a 5% threshold). Stroke units were available at only five of 16 centres. The aRRs of six patient-level factors associated with stroke fatality were: low vegetable consumption, 1 center dot 19 (95% CI 1 center dot 07-1 center dot 33); systolic blood pressure, 1 center dot 02 (1 center dot 01-1 center dot 04) for each 10 mm Hg rise; stroke lesion volume more than 30 cm3, 1 center dot 48 (1 center dot 22-1 center dot 79); National Institutes of Health Stroke Scale (NIHSS) score, 1 center dot 20 (1 center dot 13-1 center dot 26) for each 5-unit rise; elevated intracranial pressure, 1 center dot 75 (1 center dot 31-2 center dot 33); and aspiration pneumonia, 1 center dot 79 (1 center dot 16-2 center dot 77). Interpretation Studies are needed to assess the efficacy of interventions targeting patient-level factors such as aspiration pneumonia in reducing acute stroke fatality in this region. Policy directives to improve stroke unit access are warranted. Funding US National Institutes of Health. Copyright (c) 2023 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 license.

Objectives: There is a need for early identification and intervention of Adverse Drug Reaction (ADR) to alleviate the unacceptably growing burden, morbidity, and mortality associated with People With Epilepsy (PWE). This study is aimed at identifying associated factors and predictors of ADR among PWE. Methods: It is an interviewer-administered questionnaire-based study consisting of 940 consenting participants aged 16 years and above attending epilepsy clinics for 5 years with diagnosis confirmed by International League against Epilepsy (ILAE) criteria and supported by Electroencephalography (EEG). Twenty-one-item Liverpool Adverse Effect Profile (LAEP) and 8-item Morinsky Medication Adherence Scale (MMAS) were used to assess ADR and adherence respectively. Results: The highest reported ADR in PWE were nervousness (34.3%), aggression (33.6%), and weight gain (32.3%). Specifically, 20.1% of the participants complained of memory problems. On the other hand, ADR associated with skin, mouth/gum and hair loss was 9.3%, 8.9%, and 7.2% respectively, and these were the lowest reported ADRs. Using the MMAS, 545(90.2%), 28(4.6%), and 31(5.1%) of PWE in this study were classified as having high, medium, and low adherence, respectively. Duration of Anti-Seizure Medication (ASM) use and duration of epilepsy were the major determinants of ADR in PWE on the regression model. Conclusion: Duration of ASM use and duration of epilepsy are the major determinants of ADR in PWE. Effective strategies to identify and reduce ADR should be incorporated into the management of PWE by Health Care Providers (HCPs) to improve their quality of life.

Background:Many anthropometric measures have been developed in the last two decades to evaluate cardiovascular health and disease. However, the relationship between these measures and blood pressure is not commonly explored among young population. Objective:This study sought to explore the relationship between selected traditional and novel anthropometric metrics and blood pressure among young people as part of ThE profile of anthRopometRy And psyChosocial issuEs on campus (TERRACE) study. Methods:A total of 375 participants were included in the study. Basic demographic details, standard methods were used to measure blood pressure, and anthropometric measures Height, weight, waist circumference, hip circumference, and neck circumference were measured. Derived waist and hip indices included the waist-hip ratio, waist-to-height ratio, weight-adjusted waist index, abdominal volume index, neck-to-height ratio, and conicity index. The linear relationships between the anthropometric parameters and systolic blood pressure, diastolic blood pressure, and pulse pressure were explored. Those that were strongly correlated, moderately correlated, weakly correlated, and effectively uncorrelated were graded 0.50-1.0, 0.30-0.49, 0.10-0.29, and less than 0.10, respectively. The analysis was done using SPSS version 23. A p-value <0.05 was considered significant. Results:The mean age ±standard deviation(SD) and proportion of females were 21.1±3.5 years and 245 (65.3%), respectively. The mean ±SD systolic blood pressure, diastolic blood pressure, and pulse pressure were 109.2 11.2 mmHg, 67.5±8.8 mmHg, and 41.6±11.1 mmHg, respectively. Most of the variables have a statistically significant relationship with the blood pressure parameters; however, all are neither moderately nor strongly correlated. Conclusion:Most of the anthropometric indicators, including the novel ones, are correlated with BP parameters in this young population. However, further research is needed to unravel newer one with better correlations in this population.

Objective: The study assessed the profile and factors associated with fast food consumption among young people in tertiary educational institutions in Ibadan, Nigeria.Materials and Methods: This was a cross-sectional study carried out among 300 eligible undergraduates in four campuses in Ibadan, Nigeria. Socio-demographic characteristics and information on fast food consumption and other relevant data were collected using a self-administered questionnaire. Statistically significant p-value was set at <0.05. SPSS version 23 was used for data analysis.Results: The mean ± standard deviation (SD) age was 21.6 ± 3.7 years and females constituted 66% of the participants. Nine out of ten participants had never married, majority were fulltime students and holiday jobs were noted in less than a third. About three out of five participants consumed fast food, which was usually flour-based. The commonest pattern of fast food consumption was lunch, with the commonest frequencies of once a day and thrice a week. The strongest reasons for consumption include being considered nutritious, being readily available, claiming it provides value for money, and being accessible.Conclusion: Fast food consumption was high in this study and this potentially has serious implications on the cardiovascular health of the participants. There is need for concerted efforts by the relevant stakeholders in stemming this tide by encouraging health education for healthy eating among young persons.