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Biomedical subjects

O O Famuyiwa

Publications and source records attributed to O O Famuyiwa.

At least 19 recordsLinked to original sources
PubMed2003

Emotional reactions of relatives to schizophrenic patients in Lagos, Nigeria.

Unlike what obtains in the developed countries, not much is known about the expressed emotions (EE) of the family to mental illness in developing nations, including Nigeria. Therefore, the objective of this study is to investigate the EE among family members to schizophrenics in Lagos, Nigeria. The Camberwell Family Interview was conducted with Nigerian family members of 19 schizophrenics whose symptoms were further ascertained using the Present State Examination. Sixty-three percent of the family sample showed high expressed emotions (HEE). The proportion of HEE families increased progressively with the number of previous hospitalization (r = 1, p = 0.000). The mean ratings of Critical Comment, Warmth and Positive Remarks were, respectively, 6.1 (+/- 3.8), 2.6 (+/- 0.9) and 2.2 (+/- 0.9) and 2.2 (+/- 1.3). The proportions of relatives showing Emotional Over-Involvement and Hostility were, respectively, 26.3% and 31.6%. The correlation between Warmth and Critical Comment was -0.39. The findings were compared with those of a key cross-cultural study of EE and the implications highlighted.

Adolescent↗
PubMed2000

Reliability and validity of a psycho-social problem inventory for childhood epilepsy.

In response to the need for formal psychosocial assessment in childhood epilepsy, a 25-question inventory was constructed from raw items based on multidisciplinary inputs and tested for practicality, and psychometric attributes. Weighted inter-rater and test-retest reliability estimates were 61.8% and 63.9% respectively. A measure of concurrent validity was satisfactory though a modest discrepancy was observed between two raters (P = 0.019 and 0.0064). Discriminant validity was very satisfactory (average P 0.001) based on compared means of ratings from two groups of subjects with disparate prognosis. The inventory should be useful in the assessment of similar chronic childhood disabilities but interpretations of data should be in a wider clinical context including inputs of informant and school authorities as indicated.

Child↗
PubMed1998

Serious hand sepsis and diabetes mellitus: specific tropical syndrome with western counterparts.

Infection in the extremities of diabetic patients most commonly involves the feet and, at least in western societies, is often associated with chronic complications of diabetes. Severe hand infection, often culminating in amputation and even death, is, however, well-described in tropical countries, where it may not be associated with any evidence of neuropathy or arterial insufficiency. Similar cases are described in the western literature but are more often associated with more severe antecedent trauma. The literature describing hand sepsis in diabetic patients both in tropical and in western practice is reviewed and we draw some conclusions about pathogenesis and treatment from the literature and from original data documenting the varying experience of hand sepsis in diabetic practice throughout Africa.

Adult↗
PubMed1997

Psychosocial assessment methods in childhood epilepsy: focus on sub-Saharan Africa.

The scale of evidence tilts towards the contention that epileptic children as a group are at a disadvantage regarding intellectual and emotional development and have higher rates of behavioural abnormalities than their non-epileptic peers. Differentiating factors logically point to the problem areas which should be enquired into in a comprehensive assessment of a child with epilepsy and should facilitate formulation of viable intervention stratagems. A critical review of the literature reveals that, of five major assessment methods, the use of a standardised and valid questionnaire is likely to yield the most reliable clinical information. However, a complete assessment package should include drug use monitoring, evaluation of cultural milieu and family psychodynamics.

Africa South of the Sahara↗
PubMed1996

Intra-city differences in psychotropic drug use: a Nigerian scene.

In a study of prescribing practice in 3 psychiatric institutions in Lagos, Nigeria, patterns of psychotropic drug use were generally unsatisfactory in terms of poly-pharmacy, high frequency of daily multiple administrations and prolonged use of minor tranquillisers. These deficiencies were noticeable in one of the hospitals that had the lowest doctor:patient ratio with consequent greatest workload, employed the 'medical model' as its main practice-orientation and that bore responsibility for a large part of community psychiatric morbidity. The widespread use of anti-parkinsonian agents had some rationality in view of the grossly inadequate community-based facilities needed to control drug induced extra-pyramidal side-effects. Improving psychiatric services, through personnel training, sufficient funding and the realisation of the need for therapists to conform to acceptable rules of drug prescribing, would help tremendously to minimise the vagaries and anomalies of drug use observed.

Adolescent↗
PubMed1995

Carbohydrate tolerance in patients with tropical ataxic neuropathy--A human model of chronic cyanide intoxication.

Patients with tropical ataxic neuropathy (TAN) have been shown to have chronic cyanide intoxication. Glucose tolerance test data in a group of 88 patients with TAN and 88 matched controls who were studied several years ago were analysed. A standard glucose tolerance test (SGTT) with 50 gm dextrose preceded by 50 mgs cortisone acetate orally 8 1/2 and 2 hours before the tests were performed. The SGTT was considered abnormal if the capillary blood glucose at 0.60 and 120 were greater than 120, 200 and 140 mg/100 ml (6.6, 11.1, 7.8 mmol/l) respectively. Capillary blood glucose considered abnormal for CGTT were 205 and 155 mg/100 ml at 60 and 120 (113 and 8.6 mmol/I) respectively. The SGTT was abnormal in 1 of the TAN patients and 2 controls while CGTT was abnormal in 9 TAN patients and 7 controls. However, all controls with abnormal CGTT were older than 50 years while only 1 TAN patient was older than 50 and 6 were 30 years or younger (p = 0.0105), Fischer's probability test. The results suggest a greater statistical risk for subjects with TAN 30 years or younger to have an abnormal CGTT. While this does not predict the future development of diabetes, our observation indicates the need for better designed prospective studies among such patients in developing countries.

Adolescent↗
PubMed1993

The effects of chronic cassava consumption, cyanide intoxication and protein malnutrition on glucose tolerance in growing rats.

Intraperitoneal glucose tolerance tests were performed at 4-week intervals in groups of weanling rats before and after feeding with maize- or cassava-based diets with and without adequate protein and sublethal cyanide supplementation. Weaning weights were doubled (increase of about 50 g) after 4 weeks on control (maize-based with adequate protein) and protein-replete diets. Weight gain on the protein-deficient diets was much less (22 g or 50%), a pattern maintained by the rats on these diets until the age of 12 weeks. Plasma thiocyanate levels were identical at weaning and after 8 weeks of the control diet but increased by 200-300% after 4 weeks intake of the cassava or cyanide-supplemented feeds. Levels returned to normal in all groups after a further 4 weeks feeding with the control diet. Glucose tolerance (as assessed by the area under the 2 h glucose v. time curve) was impaired to a varying extent in the rats after 4 weeks on the various diets: protein-replete cassava and protein-deficient maize diets by 50% protein-deficient cassava diet by 300%, and cyanide-supplemented protein-deficient maize diet by 150%. The derangement in the rats on the protein-replete cassava diet was unaffected by a further 4 weeks intake of the control diet, unlike in the other groups where there was significant improvement in the glucose tolerance indices at the same time. It is concluded that in growing rats: (1) cassava intake and protein malnutrition may have independent and additive effects on the genesis of glucose intolerance, (2) cyanide supplementation of a cassava-free protein-replete diet has no effect on glucose tolerance.

Animals↗
PubMed1993

The efficacy of traditional medicine in the management of diabetes mellitus in southwestern Nigeria.

A survey of traditional healers in Ibadan, Nigeria, demonstrated that fewer than 10% of them were involved in the treatment of patients with diabetes mellitus and the total number of such patients under their care was less than 100, compared to those receiving western-type of medical treatment (up to 1000 at the University College Hospital, Ibadan, alone). An interview of 20 native practitioners revealed that they had little understanding of the nature of diabetes mellitus. Their diagnosis of diabetes was based largely on intuition and the disease was often confused with other medical problems like urinary tract infection or venereal disease. In a parallel study, 10 diabetic patients being treated exclusively by traditional healers were followed up on an ambulatory basis for periods of up to 16 weeks and another group of 8 patients had a hospital-based trial of traditional anti-diabetic medicines for about 4 weeks. Most of the patients reported improvement in their symptoms with less polyuria and improved sense of well-being. However, no objective improvement in the blood glucose was demonstrated. For the hospitalized group, n = 8, pre and post-treatment blood glucose respectively were, mean (+ SD), 13.9 (3.5) mmols/l and 14.9 (4.3) mmols/l, P > 0.50. It is concluded that the effectiveness of traditional anti-diabetic drugs in lowering blood glucose still remains to be demonstrated. Any claims of "cure" of diabetes using native medicines can be firmly rejected. However, further studies into the potential usefulness of native herbs in the treatment of diabetes must be pursued.

Adult↗
PubMed1992

Pattern of adrenocortical response to the stress of severe illness in Nigerians.

Twenty-eight severely ill, hospitalized Nigerian patients, 18 males and 10 females with a median age of 41 years (group I) and 20 stable ambulatory patients, 11 males and 9 females with a median age of 42.5 years (group II), had early morning plasma cortisol measurements. Ten healthy young Nigerian males with a mean age of 22.1 years (group III) had plasma cortisol estimations during insulin tolerance test. The mean (+/- SD) cortisol values for the three groups in nmols/l were as follows: group I--389.3 (202.4), group II--267.1 (67.4), group III-624.5 (81.1). The results for the group III healthy controls represent the peak (60 mins) value during insulin induced hypoglycemic stress. A one way analysis of variance (ANOVA) demonstrated a statistically significant difference between the three mean cortisol values, P < 0.001. A pair-wise comparison using the t-test also showed significant differences between the groups, P < 0.05 in each case. An important observation was the variable pattern of cortisol stress response in different types of illnesses. Cases of stroke appeared to be associated with increased cortisol stress values (Z-score + 5.67) while patients with hypotension (B.P. < or = 90/60) and those on Rifampicin had reduced cortisol responses (Z-scores - 3.66 and 3.51 respectively). However, no firm recommendations can as yet be made regarding the usefulness of corticosteroids in life-threatening illnesses among Nigerians, other than those for which steroids are known to beneficial.

Adolescent↗
PubMed1992

Sheehan's syndrome in a developing country, Nigeria: a rare disease or problem of diagnosis?

Over a five year period, 11 cases of Sheehan's syndrome were seen in the Endocrinology Unit of a teaching hospital in Ibadan, Nigeria. The mean age at diagnosis was 35.1 years; the mean parity was four and the average interval between the obstetric injury and diagnosis was 6.9 years. Four patients were in middle socio-economic class and seven were in low socio-economic class. The most frequent presenting symptoms were failure of lactation (11 out of 11 patients) and amenorrhoea (9 out of 11 patients). Seven patients had multiple endocrine insufficiency involving essentially all pituitary cell types. Six out of 8 patients were lost to follow-up. In a review of autopsy records over a 5-year period at the same institution, out of 1,951 post-mortem examinations, no additional cases of Sheehan's were found. With an average of about two clinical cases per year, it would seem that Sheehan's syndrome is still a relatively rare entity in this part of the world in spite of the poor level of obstetric care generally available. There is a need for increased awareness about this disease on the part of practitioners in developing countries in order to establish whether this rarity is real or it is due to missed diagnosis.

Adult↗
PubMed1991

Stress among factory workers in a developing country.

This cross-sectional study reveals that a significant proportion (35%) of the sampled population of factory workers experienced measurable health problems in the form of anxiety, sleep disturbance, depression, somatic complaints and other clinical indicators of stress. Job stress and social support levels experienced by the group of workers judged 'sick' were significantly different from the control group, particularly so for employees in the lower levels of work hierarchy. In consonance with findings from the literature, job stress has a significant impact on mental health, with all the job stress parameters accounting for 41% of the variation in the general health. Those job stress variables that were significant predictors of health were job pressure, namely security and job tension, and interpersonal rewards. Extrinsic rewards i.e. those factors relating to income and status were not significant predictors of health. Perceived social support tended to increase at the higher levels of occupational status and at the work place it appeared to exert a positive influence on health presumably by counteracting the adverse effects of job stress. This study stresses the need for industrial organizations of the emergent nations to initiate measures which would enhance health status of workers as a cardinal factor in organizational growth [corrected].

Adult↗
PubMed1991

The objective structured clinical examination in undergraduate psychiatry.

Inadequate attention has been given to verifying the psychometric attributes of the objective structured clinical examination (OSCE), yet its popularity has been increasing in recent years. Our 6 years' experience in Nigeria showed that OSCE is practicable in undergraduate psychiatry assessment and there is evidence over consecutive years that it has satisfactory reliability and criterion-based validity. The importance of students' feedback in assessing the quality of examination is reinforced, and subtle, less tangible elements which determine students' performance, such as social interactional mystique and some personality traits, are worthy of evaluative research.

Clinical Competence↗
PubMed1991

Diagnosing childhood depression who should be interviewed--parent or child? The Newcastle Child Depression Project.

The extent of the similarities and discrepancies in the reporting of depressive symptomatology by children and their mothers was examined. Child-parent agreement was not always impressive, particularly for more subjective symptoms. It is suggested that direct psychiatric assessment of children provides a more accurate picture of their mental state regardless of presenting disorder, but particularly where depression is suspected.

Adolescent↗
PubMed1991

The context of childhood depression. The Newcastle Childhood Depression Project.

This paper examines the family background, premorbid personality traits and adverse life events preceding childhood depression. The non-depressed group proved more likely to have experienced pre-school bereavement and familial disturbance, and to come from the more deprived background; there was also an excess of premorbid anxiety and hysterical personality traits in this group. School phobia and premorbid obsessional traits were associated with the depressed group. Although there was an association between depression and the total number of adverse life events, this was more substantial when the perceived impact of the events was taken into account. Of the individual classes of life event, only illness and a change in social relationships were associated specifically with depression.

Adaptation, Psychological↗
PubMed1991

Reliability and validity of two self-rating scales in the assessment of childhood depression.

A comparison was made of the reliability and validity of two self-rating scales, the Children's Depression Inventory (CDI) and Depression Self-Rating Scale (DSRS), in the diagnosis of depression in 93 children (aged 8-16 years) attending a university child psychiatry department. The two scales were of comparable merit but had only moderate discrimination between depressed and non-depressed children, with each scale having a misclassification rate of 25%. Better agreement was obtained in more verbally intelligent children, irrespective of age. Girls scored higher on the instruments than boys. No significant relationship was found between teacher assessment of classroom behaviour and the two self-rating depression instruments.

Adolescent↗
PubMed1991

The Newcastle Child Depression Project. Diagnosis and classification of depression.

A total of 275 successive referrals to a university child psychiatry unit out-patient department were examined using the Child Depression Inventory. Of these, 95 children were examined further by a structured clinical interview, and the relationship between different instruments for the assessment of depression in childhood was investigated. Just over one-third of the children (35%) had significant depression, and it was found that depression may be missed unless children with other psychiatric diagnoses are examined closely. Multivariate analyses of the clinical data provided factorial validation of diagnoses when employing different clinical diagnostic schemas.

Adolescent↗
PubMed1991

A standardized schedule for burden on the family of sickle-cell anaemia sufferers.

The chronicity and incurability of sickle cell anaemia reinforce the need to give particular attention to the psychosocial effect of the illness on the family. A 22-item schedule of burden with very high inter-rater reliability and modest validity is constructed and should be useful in the assessment of other similar chronic disorders. The phylogenetic origin of sickle-cell anaemia makes it essential that a psychological understanding of the disorder should be a component of the therapy arsenal of health professionals serving populations of African extraction.

Anemia, Sickle Cell↗