Orient Journal of Medicine

Sleep Health: The Under-Rated Determinant of Brain Health

Chukwuemeka Eze — 2024-10-05

This is a review of sleep health as an often-undervalued determinant of brain health. It implores current research on the intricate relationship between sleep and cognitive function, emotional stability, and the prevention of neurological disorders. Neglecting sleep not only compromises daily functioning but poses long-term risks to neurological health, including an increased vulnerability to neurodegenerative diseases, mental health disorders, and other systemic diseases. Sleep health measurement involves assessing various sleep domains that are measurable and independently associated with overall well-being. They include sleep regularity, satisfaction, alertness, timing, efficiency, and duration (RU SATED). Optimal sleep health could be achieved by maintaining consistent sleep schedules, creating a conducive sleep environment, and addressing relevant lifestyle factors. The undervalued impact of sleep health on brain health can be improved by raising public awareness of the importance of sleep, integrating sleep education into the school curricula at different levels, and advocating for policies that prioritize sleep. The above recommendations could lead to profound improvements in individual and societal well-being and lasting benefits for cognitive vitality and overall health. This would culminate in the transformation of societal attitudes toward sleep and elevate its status as a cornerstone of brain health.

Prevalence of Chronic Kidney Disease in Anambra State, Nigeria: Results of a Community Survey

Chidozie Ndulue — 2024-10-05

Background: Chronic kidney disease (CKD) is a global epidemic but its burden is more pronounced in sub-Saharan Africa (SSA). Within regions of SSA, there is paucity of data on the epidemiologic characteristics of CKD in these communities. These population-based studies are required to better describe the epidemiologic characteristics of the disease and also to aid in designing holistic prevention and treatment programs within the community. Objective: To determine the prevalence of CKD among adults residing in a rural setting in Anambra State, Nigeria. Methodology: This was a descriptive cross-sectional study of 391 adult residents of Ukpor, Anambra State, Nigeria who were selected using multi-stage sampling technique. Albuminuria and estimated glomerular filtration rate used to estimate CKD prevalence. Data analysis (Kruskal-Wallis H test and Chi square test) were done using Epi Info^TM version 7.2.2.16 software. Results: The prevalence of CKD was 10.7% (95% CI: 8.0-14.2%). The prevalence of decreased kidney function and albuminuria were 6.6% (95% CI: 4.6-9.6%) and 7.9% (95% CI: 5.6-11.0%) respectively. Although there was a significant decline in eGFR with increasing age (p<0.001), the association between increasing age and reduced kidney function, albuminuria and CKD was not significant (p>0.05). Conclusion: The prevalence of CKD in rural Anambra State is high. There is need to institute regular screening programs for CKD in order to detect people at earlier stages of CKD when appropriate measures can be taken to prevent or retard their progression to kidney failure.

Quality Assurance and Blood Security in Blood Transfusion Practice in Nigeria: A Multi-Centre Study

Garba Umar — 2024-09-12

Introduction: Safe Blood is an indispensable resource in preventing morbidity and mortality in modern clinical practice either as supportive or as standalone therapy care. Providing safe blood requires a secured system that is standard in its operations, effectiveness and efficiency. Aim: This study aimed to conduct a baseline audit of the Quality Management System (QMS) and security in the provision of blood transfusion services in some government-owned Tertiary Hospitals (THs) in Nigeria. Methodology: This was a descriptive cross-sectional study carried out between October 2019 and June 2020. Data was collected from Haematologists or Laboratory Scientists working in the blood bank of the THs using a pretested electronic questionnaire. Data were analyzed using SPSS software (version 21.0). Results: Fifty THs in Nigeria responded to the survey. Fifty two percent (26/50) of them lack blood transfusion policy. Although 54.0% have blood transfusion committee, only 18.0% have regular meetings. Fifty two percent have National Blood Service Comission (NBSC) Centres in their State and only 16.0% receive regular blood supply from NBSC. The majority (72%) have their blood bank as a separate structure, 68% have no blood component production unit, 50% have no system for validating equipment, 90% have blood inventory system and 88.0% of the THs blood bank do experience materials running out of stock. Conclusion: Majority of the THs lack blood transfusion management system in virtually all the components of quality assurance system.

Dermatopathological Spectrum of Alopecias in Lagos Nigeria

Ehiaghe ANABA — 2024-10-05

Background: Dermatopathological evaluation is the gold standard in hair loss management. It allows for specific diagnosis, precise therapies and prognosis. However, reports of dermatopathology based diagnoses of scalp hair loss are few in Nigeria. A study of the dermatopathological spectrum of scalp hair loss will reveal the commonly encountered types of hair loss and this will in addition aid in health care planning. Objectives: The study aimed to document and to correlate with clinical diagnoses, the dermatopathology diagnoses of hair loss. Methodology: This was a retrospective case review of 331 scalp biopsies evaluated for hair loss from 2015-2022 in Lagos, Nigeria. Standard laboratory processing, hematoxylin and eosin staining with relevant special stains and clinicopathologic correlation when necessary were done. Data was analyzed using SPSS version 23. Results: Three hundred and thirty one scalp biopsy samples from 251 patients were evaluated. The commonest dermatopathological diagnoses were central centrifugal cicatricial alopecia in 14.7%, folliculitis decalvans in 13.5%, alopecia areata in 13.5%, psoriasis in 12.8%, discoid lupus in 12.7%, lupus non-scarring alopecia in 4.2%, lichen planopilaris in 4% and androgenetic alopecia in 4%. The correlation between dermatopathological diagnosis with provisional clinical diagnosis was concordant in 75.7% of cases. Conclusion: Central centrifugal cicatricial alopecia and folliculitis decalvans are the commonest reasons for scalp biopsies. Clinicopathologic correlation is high for scalp hair loss. Dermatopathological evaluation is important in the definitive evaluation and management of hair loss. Age and gender influence the types of hair loss.

Prevalence of Glaucoma Among Secondary School Teachers in Onitsha, Nigeria

Adanma Ezenwa — 2025-03-14

Background: Glaucoma an optic neuropathy and is the leading cause of irreversible and functional vision in Nigeria. It is a disease of significant public health interest. Aim: To determine the prevalence of glaucoma among secondary school teachers in Onitsha North Local Government Area (LGA) Anambra state. Materials and methods: Secondary school teachers from randomly selected schools in Onitsha North LGA had their eyes examined for glaucoma using the International Society of Geographical and Epidemiological Ophthalmology (ISGEO) and the Nigerian normative data for defining glaucoma in prevalence studies. Those with evidence of glaucoma further had the following measurements: visual acuity, intraocular pressure (IOP), central corneal thickness (CCT), gonioscopy and central visual fields. Results: 171 teachers, made up of 158(92.4%) females and 13(7.6%) males participated. The age range was 20 – 72 years, mean 45.7±10.36 years. The prevalence of glaucoma was 5.9% with half of those affected with glaucoma been females. The mean CCT was 529.9±26.7, mean IOP 23.3±7.1mmHg, mean cup – to – disc ratio 0.8± 0.6 – 0.9. Gonioscopy showed 9(90%) had open angles and 2 on perimetry had an eye with advanced glaucomatous damage. Only one participant had been previously diagnosed for glaucoma. Conclusion: Prevalence of glaucoma among this cohort of teachers is high. Most of those participants with glaucoma were previously undiagnosed. The results of this study suggest the need for creating awareness on glaucoma and also the need for regular eye check among teachers.

Haematological profiles of children with sickle cell anaemia in steady state and vaso-occlusive crisis: a comparative study.

Chinenye MaryQueen Uju — 2025-03-14

Background: Sickle cell anaemia (SCA) is a major health problem in many parts of the world particularly in Sub-Saharan African countries with Nigeria having the highest disease burden. The disorder is characterised by chronic haemolytic process; with subsequent marrow hyperactivity resulting in higher levels of leucocytes and platelet counts in SCA patients compared to normal population. Aims: This study aimed to compare the haematological profiles (leucocyte counts, absolute neutrophil count, platelet counts, haemoglobin concentration and haematocrit level) of SCA children (in steady state or in vaso-occlusive crisis) aged one year to 17 years with age- and gender- matched children with haemoglobin genotype AA. Methods: A cross-sectional study was conducted among 50 children with SCA grouped into subjects in steady state (36) and those having vaso-occlusive crisis (14) and age- and gender- matched controls (50) with haemoglobin genotype AA. Physical examination of the participants was conducted and blood samples collected for haematological tests. Data analyses were carried out using SPSS statistical package version 21. P value ≤ 0.05 set as significant level. Results: The leucocyte count, neutrophil count and platelet counts of children with SCA were higher (particularly for those in vaso-occlusive crisis) than matched controls (P-value < 0.05) whereas the haemoglobin concentration and haematocrit level were lower among children with SCA compared to the controls (P-value < 0.01). Conclusion: Strategies targeting on reduction of leucocyte and platelet count as well as improving the haemoglobin concentration could reduce the disease severity and improve wellbeing of children with SCA.

Pattern of Referrals to Psychiatrist in a Multi-specialty Tertiary Hospital in Nigeria: A Retrospective Study.

Sunday O ORIJI — 2025-03-14

Background: Consultation-liaison psychiatry (C-LP) plays a crucial role in integrating mental health care in tertiary care hospitals, yet the referral pattern to psychiatric services is inadequately documented in Nigeria. Methods: This cross-sectional retrospective study examined the referral patterns to the psychiatry department at Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria, over a two-year period (2022-2024). Data from 263 in-hospital referrals were analysed with SPSS version 23, focusing on referral departments, sub-specialties, reasons for psychiatric consultation, and psychiatric diagnoses. Results: The study indicated that Internal Medicine (46.8%) and Surgery (27.4%) were the predominant sources of referrals, with frequent requests originating from Neuro-surgery and Cardiology sub-specialties. The majority of referrals were prompted by confusion and irrelevant speech (50.1%) or disturbing behaviours such as restlessness and aggression (41.9%). Notably, 57.0% of referrals did not specify a psychiatric diagnosis. Schizophrenia/psychosis and major depression were the most commonly diagnosed conditions. Conclusion: Despite the benefits of C-L Psychiatry as reported in the literature, there was underutilization of psychiatric consultations, as evidenced by the relatively low referral rates from diverse specialties. This underscores a critical necessity for increased awareness and integration of psychiatric services throughout all medico-surgical departments.