Functional neurological disorder (FND) occasionally known as dissociative seizure or pseudo-genic non epileptic seizure. It resembles epileptic seizures in symptoms and signs as it is accompanied by transient focal/global neurologic symptoms and signs seen in seizures but lack electrophysiological correlates. The episodes of altered movement, sensation and behavior that resemble epileptic seizures. Functional neurological disorder (FND) seizures episodes involves altered movement, sensation, or behaviour that resemble epileptic seizures which are not caused by abnormal epileptic form electrical activity in the brain but rather often due to intentional deception as in factitious disorder or malingering. In some people with developmental or intellectual disabilities, non- epileptic events are behavioural or attention-seeking. However, PNES is distinctly different in that it is not conscious or intentional. We present case reports of 4 patients: A 24 year old female medical student who presented with recurrent seizure-like episodes, initially misdiagnosed as epilepsy and was treated in a peripheral hospitals until she was presented to a neurologist. Through comprehensive evaluation, including video-electroencephalogram (vEEG), the diagnosis of FND was confirmed. These cases highlights the need for a multidisciplinary approach to diagnosis and management, highlighting impact of psychological intervention in the treatment of FND.

Tuberculosis is a chronic infection and a common cause of chronic pericardial effusion. Approximately 1-2% of patients with pulmonary tuberculosis (PTB) develop tuberculous pericarditis (TBP) and it is less common in the developed world than in developing countries where active tuberculosis is endemic. In these countries with high endemicity, TBP is the most common form of pericarditis and is often associated with HIV. The clinical picture is usually that of a chronic systemic illness in a patient with pericardial effusion. The index case is that of a 24 year old male, who had presented to our medical outpatient clinic with a history of cough and chest pain of 9 and 2 days duration respectively. Diagnosis was made following echocardiography, electrocardiography (ECG), Chest X-ray (CXR) and culture findings which showed features in keeping with tuberculous pericarditis. His clinical condition improved significantly following pericardiocentesis and TB treatment was subsequently instituted. He was discharged for outpatient follow-up 5 days after pericardiocentesis. TBP can be difficult to diagnose and often goes undetected especially in resource poor countries. Accurate and early diagnosis is important as it is a dangerous disease if left untreated.

Gordon Holmes Syndrome is a rare inherited disease characterized by both neurological and reproductive signs and symptoms. Most patients develop neurologic challenges in early adulthood and cerebellar ataxia occurs as the disease progresses. In the majority of patients, hypogonadism is hypogonadotropic but rarely hypergonadotropic. We report a case of a 26-year-old female in Nigeria, with hypergonadotropic hypogonadism and cerebellar atrophy from a non-consanguineous marriage and no family history.

Amitraz is a pharmacological product widely used in the veterinary setting, in the control of ectoparasites (e.g., ticks and mites), in the treatment of demodicos in dogs, cattle etc, and in the agricultural setting as a pesticide. There have been a limited number of cases of amitraz poisoning published in the literature, as it is often under-recognised and mistaken for organophosphate poisoning (OPP). So far, there has been no specific antidote for its management. However, case reports on successfully managed patients are available and may assist doctors and other medical practitioners in the management of such cases. This index case is that of an 18-year-old male secondary school leaver who ingested an unknown quantity of an amitraz containing insecticide in a suicidal attempt and was brought to Enugu State University Teaching Hospital about 3.5 hours later, following a prior visit to a clinic close to his home. He received both symptomatic and supportive treatment, recovered fully within 3 days and was discharged on the sixth day and referred to psychiatric department for further supportive management. It is pertinent to avoid misdiagnosis as it may lead to respiratory failure, necessitating the use of ventilators which are not available in a significant number of hospitals in Nigeria.

Hypertension is a leading cause of non-communicable morbidity in Sub Saharan Africa. Recent studies suggest and increase in the prevalence of hypertension in rural Sub-Saharan Africa. Using a three-phase approach, a structured questionnaire was used to determine the prevalence of hypertension in a rural settlement is Enugu State, Southeast Nigeria. Blood pressure measurement was done according to the guidelines of the European Society of Hypertension. Out of 1576 participants aged 18 years and above, 1082 (68.7%) completed the full survey, their blood pressure was measured, and data analyzed. The prevalence of hypertension in this study was 27.6%, (95%CI 25–30.4), similar in males 29.2, (95%CI 24.7–30.4) and females 26.8%, (95%CI 23.5–30.2). p = 0.39. The prevalence of hypertension increased with age reaching a peak of 32.8% (95%CI 26.2–40) in the 40–49 age group, however this was not statistically significant P = 0.22. This age-related increase in the prevalence of hypertension tended towards significance in males (p = 0.05) but not in females (p = 0.44). Awareness of hypertension was 7.2%. Systolic blood pressure positively correlated with older age, higher blood glucose levels and waist-hip ratio. Diastolic blood pressure correlated with the type of work the patients is involved in and blood glucose levels. In conclusion, the prevalence of hypertension in a rural southeastern Nigeria community was 27.6%, however awareness was very low (7.9%). Most participants had mild hypertension thus offering a window of opportunity for public health educators in preventing the complications of hypertension. There is therefore the need for awareness campaigns to be intensified in rural communities.

The study investigated socioeconomic and psychological wellbeing on somatic symptoms among public servants in Enugu. Civil servants are the front liners in carrying out government duties and for efficient and effective delegating of these duties; they may be exposed to somatic symptoms. Participants in this study were one hundred and sixty (160) public servants selected through convenient sampling technique in two primary schools: the Command Children School and the Police Children School, University of Nigeria Teaching Hospital and Nigeria Civil Defense Corps, which are aged between 18 and 60 years. The participants were assessed with three instruments namely: the Ryff psychological wellbeing, interviewer rated multivariate assessment of socioeconomic-wellbeing and clinical symptom inventory; the results were analyzed using Pearson Product’s Moment correlation analysis at 0.05. The distribution of questionnaires lasted for two months. The study concluded that workers with inappropriate socioeconomic and psychological wellbeing could predispose somatic symptoms among workers.. The researcher therefore recommends that workers should be exposed to important life skills like ability self tolerance and stress inoculation exercise; apart from that, motivation of workers and payment of their benefits on time are advocated for public servants in Enugu Urban. Keywords: Socioeconomic, Psychological Wellbeing, Somatic Symptoms, Public Servants

Screening patients for psychotic features can pose a problem when using verbal based tests.Establishment of validity of non-verbal psychotic screening scale can enhance diagnostic specificity and address challenges associated with verbal based tests.The goal of this study is to check whether Bender Visual Motor Gestalt Test-II will serve as a diagnostic specific tool for distinguishing between psychotic patients and healthy population.A total of 40 participants 22 males and 18 females were employed in the study.They were made of 10 patients diagnosed with schizophrenia, another 10 with depressions associated with psychotic features, 10 with substance/medication induced disorders and 10 healthy adults as the control.Their ages ranged from 20 -65 with a mean age of 35.70 and standard deviation of 6.04.The healthy control group was staff of the hospital that was comparable to the patients in terms of age, gender and studies.All participants available who met the inclusive criteria who were willing to participate were selected.The instruments were (BVMGT-II) and (WHODAS 2.0).The design of the study was between group designs and One Way ANOVA was employed for data analysis.The findings of the study showed that BVMGT-II discriminated between patients with psychotic disorder and healthy population.It is recommended that BVMGT-II should be employed as screening instrument by the clinical/neuropsychologists in clinical psychological assessment for distinguishing psychotic patients from healthy population.

Background and Objective: Vocal cord paralysis results in impairment of breathing and/or speech.One of the causes of vocal cord paralysis is the disruption of vagus nerve innervation to the vocal cords by the mass effect of a neighbouring structure.We report a rare case of vocal cord paralysis secondary to internal carotid artery dissection.Method: The diagnosis was based on clinical history, physical examination and imaging studies.Literature review was done.Case Report: This was a 53-year-old female with a history of unremitting, progressive hoarseness and mild dysphagia to liquid, who was clinically found to have impaired left vocal cord mobility, a left-sided pulsatile neck mass and left carotid artery dissection based on imaging studies.Symptoms abated after conservative treatment with Aspirin and she has remained symptom free since two years of follow-up.Conclusion: Vocal cord paralysis can be a consequence of carotid artery dissection causing mass effect on the vagus nerve.Thus, carotid artery dissection should not be forgotten as a possible cause of vocal cord paralysis in some cases of vocal cord paralysis of uncertain etiology.Treatment with anti-platelet drug can bring about resolution of symptoms and return of vocal cord mobility.

This study investigated the predictive roles of experiential avoidance on the relationship between death anxiety and health-related quality of life among diabetic patients. A total of one hundred and five (105) participants (62; 58.5% females) participated in the study. The participant ages ranged from 21-75 years with a mean age of 53.45 and a standard deviation of 14.44. Participants were drawn using the convenience sampling technique and were administered the questionnaires before their consultations. Three instruments were used in data collation namely; the Death Anxiety Inventory-Revised (DAI-R), the Acceptance and Action Questionnaire (AAQ), and the Diabetes Quality of Life Questionnaire (DQOLQ). Four hypotheses were tested and the results showed that there was no significant correlation between death anxiety and HRQoL (r=-.036), also, experiential avoidance didn’t significantly predict HRQoL (.411, p<.05), experiential avoidance didn’t significantly predict death anxiety (.534, p<.05), while experiential avoidance didn’t predict the relationship between death anxiety and HRQoL (.757, p<.05). The researchers suggest that medical professionals in charge of diabetic patients should look beyond HRQoL and death anxiety in investigating whether there will be an occurrence of experiential avoidance.

Background: Lassa fever is a viral haemorrhagic fever associated with several complications which include hearing loss.Hearing loss in Lassa fever may become residual with its negative impact on the quality of life.Purpose: This paper is a review of various studies on Lassa fever related hearing loss.Methods: Systematic literature review was done on articles on Lassa fever patients and Lassa fever survivors.Relevant articles published in English between 1969 and 2021 were searched for using Google Scholar and PubMed databases.Eight studies which met the inclusion criteria were finally selected and included in the review.The variables of interest were extracted from the full-text articles.Results: Lassa fever related hearing loss occurs in both sexes and in all age groups.The incidence of self-reported hearing loss ranged from 12.5% to 30% with a mean of 17.6%.The incidence of audiometrically determined sensorineural hearing loss ranged from 13.5% to 29% with a mean of 22.1%.Hearing loss persisted in 64% of those that were followed up.Cases of hearing loss varied in severity, ranging from mild to profound.No successful specific treatment for Lassa fever related hearing loss was reported apart from hearing rehabilitation.Conclusion: Hearing loss among Lassa fever patients remains a major challenge.Lack of effective treatment for Lassa fever related hearing loss is a serious gap in the management of Lassa fever patients which should be addressed in future research.

Background: Lassa fever cases outside Africa are seen as imported cases of Lassa fever. Timely diagnosis of imported Lassa fever is important for timely intervention necessary to reduce the morbidity and mortality associated with Lassa fever, and this requires the knowledge of the clinical manifestations of Lassa fever. Purpose: This review was done to see how clinical diagnosis of imported Lassa fever can be facilitated based on the clinical presentations of imported cases of Lassa fever in Lassa fever non-endemic region. Methods: The relevant articles for the review were obtained from the databases of PubMed and Google Scholar. Results: The clinical presentations of the imported Lassa fever cases consisted of multisystem involvement and were similar to those of Lassa fever patients who were treated in the Lassa fever endemic region. Conclusions: History of recent travel to, or residence in, Lassa fever endemic region is an important clue for clinical diagnosis of Lassa fever. The 2011 CDC surveillance case definition and the modified Khan case definition for Lassa fever may aid clinical diagnosis of Lassa fever. Any clinically suspected case of Lassa fever should have a laboratory confirmation.

This study investigated the role of social support on mental wellbeing during COVID-19 Pandemic among internet users in Nigeria. A total of one hundred and six (106) participants (55 (51.9%) females, and 51 (48.9%) males participated in the study. The participant ages ranged from 19-29 years with a mean age of 28.68 and standard deviation of 8.14. Participants were drawn using convenience sampling technique and data were collated using the online Google form method. The link to the survey was shared across different platforms such: as Facebook, Whatsapp, and email list. The participants gave their consent and willingness to participate by checking a box in the online survey. Two instruments were used in data collection namely; a 15-item COVID-19 social support questionnaire (COVID-19- SSQ) and Warwick-Edinburgh Mental Well-being Scale (AWEMWBS). Two hypotheses were tested. The study adopted cross sectional design, while regression was employed for data analysis. The findings indicate that the presence of social support has significant influence on existence of mental wellbeing. It is recommended that social support factor should be sustained because of its buffer effect on mental wellbeing during COVID-19 Pandemic among internet users in Nigeria.

Background: When a disease is associated with stigma, there may be attendant negative consequences.Purpose: This review was to show how stigmaassociated diseases impact negatively on the psychological and social wellbeing of the affected persons.Methods: The relevant articles for the review were obtained through PubMed and Google Scholar search on the internet using relevant keywords.Results: Several infectious and non-infectious diseases are associated with stigma.The causes of stigma in these diseases include fear of contracting the disease and dying from it, disfiguring caused by the disease and ignorance and misconception concerning the cause, nature and infectivity of the disease.Those suffering from stigma-associated diseases are usually discriminated against and denied the privileges and opportunities available for those not suffering from stigma-associated diseases.This often leads to psychosocial or psychiatric complications such as social isolation, depression or even suicidal ideation.Conclusions: Stigma-associated diseases still remain a very important health problem with attendant psychosocial consequences.Multi-disciplinary and multi-level efforts are required for its effective mitigation.

Zika virus disease is a disease of public health importance and was declared a “Public Health Emergency of International Concern”, by the World Health Organization on February 1, 2016. It is mostly transmitted through the bite of Aedes aegypti and Aedes albopictus mosquitos. Transmission can also occur through blood transfusion and sexual intercourse. It could cause microcephaly and other neurological problems in newborns and adults, such as Guillain-Barre syndrome. It could also lead to abortion and stillbirth in pregnant women. Prevention methods are essentially targeted at transmission routes, which are mosquito bite, sexual intercourse, and blood transfusion. The study was of observational, descriptive, cross-sectional design, and conducted in a tertiary health institution in the Southeast geopolitical zone of Nigeria. Two hundred and fifty-six female caregivers participated in the study, with most of them being within the childbearing age group, and educated up to tertiary level. The objective was to assess the knowledge of Zika virus infection prevention methods, among female caregivers that bring babies for immunization in a Teaching Hospital, Southeast Nigeria. Out of the eight questions that sought to assess the knowledge level of the respondents, they scored 50% and above only in three, which were on prevention through protection against mosquito bite (60.5%), avoiding unnecessary blood transfusion in endemic areas (53.9%), and avoidance of oily meals not being a preventive measure (51.2%). Respondents in the childbearing age group, and those with higher educational qualifications, generally exhibited higher knowledge level than the other respondents. Scores on questions that sought to assess their knowledge on prevention aspects related to sexual behavior, and vaccination were poor. Sensitization, or awareness creation activities for persons in this study area, ought to be designed to address the observed gaps.

: This study investigated the moderating role of psychological breach of contract and violation on the relationship between mental wellbeing and sense of humour among workers of T-Man Nigeria LTD, Enugu state. A total of one hundred and seven (107) participants (44; 41.1 % males and 63; 58.9% females) participated in the study. Participants were drawn using convenience sampling technique and were administered questionnaire during their break period. Three instruments were used in data collation namely; the Coping Humour Scale (CHS), Warwick-Edinburgh Mental Well-being Scale (AWEMWBS) and Psychological Contract Breach and Violation Scale (PCBVS). Two hypotheses were tested and the results showed that sense of humor significantly and positively correlated with psychological well-being at r=1.00, while psychological contract significantly moderated the relationship between sense of humor and psychological wellbeing (f-change= .000, p< .05). The findings indicate that the presence of sense of humour will always increase the levels of psychological well-being and existence of psychological contract breach will always influence the relationship between sense of humor and psychological well-being.

Background: Lassa fever is a disease of public health importance because of its morbidity and associated mortality and also because of its potential for residual morbidity such as hearing loss and social stigma. Knowledge of the mortality among Lassa fever patients is one way of assessing the effectiveness of the current strategies employed in Lassa fever management. This article is aimed at reviewing mortalities among Lassa fever patients. Methods: The relevant articles for the review were searched and obtained through the PubMed database. Data of interest were confirmed cases of Lassa fever, number of deaths and case fatality rates. Findings: All the studies reviewed were carried out in the Lassa fever endemic zone of West Africa. The case fatality rates in Lassa fever ranged from 24% to 61%, with a mean of 36%. More cases of Lassa fever and more deaths occurred during Lassa fever outbreaks. Patient’s age, co-existing medical conditions as well as complications arising from Lassa virus infection were the determinant factors for patients’ survival. Conclusion: The case fatality rate in Lassa fever was very high among hospitalized patients. Timely therapeutic intervention, infection prevention and control measures and well-coordinated response during Lassa fever outbreaks are necessary for favourable outcomes in Lassa fever management.

This study examined Influence of career, education and pious organisational membership on marital satisfaction on Roman Catholic couples. Two hundred and twenty-seven participants were employed in the study. They all consist of couples who were random sampling procedure. Their age ranged from 18- 60, with a mean age of 3.39and standard deviation of .889.The instrument adopted for the study consists of 25 items which measures marital satisfaction, developed by Hudson (1982). The study adopted 10x7x8 factorial design for the study while 3 way Analysis of Variance (ANOVA) was used to test the hypotheses. The first hypothesis which stated that Career will significantly influence Marital satisfaction among Roman Catholic couples was rejected at (F=1.059, sig.400). The second hypothesis which stated that Education will significantly influence marital satisfaction among Roman Catholic couples was also rejected at (F=1.395, sig.233).The third hypothesis which stated that Pious organisational membership will significantly influence marital satisfaction among Roman Catholic couples was accepted at (f=1.939, sig.072). Based on the findings of this study, the researcher, therefore, recommended that marriage class instructors as well as all whose responsibility it is to instruct those going into marriage should advice couples to join any of these pious organisations. Also couples who are currently experiencing challenges in marital relationship should be counselled to join any of the extant pious organisations.

This study investigated the relationship between personality traits using the Big Five personality trait and post traumatic stress disorder among displaced people from select areas of Anambra State.Forty eight (48) participants comprising of 30 males and 18 females selected from three Governments Areas of the State participated in the study.All the participants were recently displaced and suffered huge losses from different tragic occurrences within the country including terrorist attacks and fire disasters.The participants' ages ranged from 26 to 56 years with mean age of 37.7 and standard deviation of 9.1.Posttraumatic Stress Disorders (PKS) and Big Five Inventory (BFI) were used to assess the PTSD and the five dimensions of personality.Cross-sectional survey design was employed while Pearson's Product-moment the area to enhance knowledge and improve management of correlation was used as the appropriate statistics.Five hypotheses were tested on whether PTSD is related to personality traits.The result indicated that only hypothesis 4 which states that "Agreeableness trait of personality would not correlate with PTSD among displaced people", was rejected at(r= -.393, p< .05).The other hypotheses were all accepted.The result was discussed in line with the findings.The researcher recommended that more effort be directed by health workers and therapists to other areas than personality, to unearth the underlying influences on PTSD, for better management.Broader research is recommended in PTSD.

Background: Resting heart rate is related to cardiovascular mortality as well as to all-cause mortality. It is therefore important to know whether resting heart rate changes with age in adults. The aim of this study was to determine the relationship between heart rate and age in adult Nigerians. Methods: It was a retrospective study on adult Nigerians attending a University Teaching Hospital in Nigeria. All the needed data were retrieved from the medical records. Heart rate was calculated from the electrocardiogram and correlated with age. Results: There were 99 cases aged between 20 and 54 years and comprised of 60 males and 39 females. The mean heart rate was 73.40±13.16 beats/minute. Across the various decades, the mean heart rate in beats per minute was 73.46±10.70 in the third decade, 75.52±12.16 in the fourth decade, 72.38±13.91 in the fifth decade, and 71.60±18.77 in the sixth decade of life (p=0.770). Heart rate correlated negatively and weakly with age (r=- 0.034, p=0.736). There were more cases of sinus bradycardia than sinus tachycardia, but the proportion of cases with heart rate outside 60 beats per minute to 100 beats per minute was small. Conclusion: This study showed that resting heart rate did not change with age in young adult and middle-aged Nigerians who had no clinical evidence of heart disease. A greater proportion of them were in normal sinus rhythm.

Background: P wave axis, QRS axis, T wave axis and QRS-T angle have prognostic values on cardiovascular morbidity and mortality, yet the effect of age on these important electrocardiographic parameters has not been well studied in adult Nigerians, knowing that some electrocardiographic parameters are affected by age. Objectives: This study was aimed at determining the effect of age on P frontal axis, QRS frontal axis, T frontal axis and frontal QRS-T angle among adult Nigerians. Methods: This was a retrospective study in which P frontal axis, QRS frontal axis and T frontal axis of adult patients who attended a university teaching hospital were determined from 12-lead ECG. Frontal QRS-T angle was calculated as the absolute difference between the QRS frontal axis and T wave frontal axis. The electrical axes and QRS-T angle were correlated with age. Results: There were 85 cases aged between 20 and 66 years, which included 42 males and 43 females. P frontal axis correlated positively and non-significantly with age (r = -0.032, p = 0.773), QRS frontal axis correlated negatively and significantly with age (r = -0.295, p = 0.006), T frontal axis correlated negatively and non-significantly with age (r = -0.002, p = 0.984), while frontal QRS-T angle correlated negatively and significantly with age (r = -0.266, p = 0.014). Conclusion: There were significant age related changes in both QRS frontal axis and frontal QRS-T angle. No significant age related changes were found in P frontal axis and T frontal axis.