Evaluation of Perceived Causes of Puerperal Psychosis Among Post Cesarean Section Patients in General Hospital, Wushishi, Niger State,Nigeria (Published)
Background: Puerperal psychosis is a rare psychiatric emergency in which symptoms of high mood and racing thoughts, depression, severe confusion, loss of inhibition, paranoia, hallucinations and delusions set in, beginning suddenly in the first two weeks after childbirth. For the fact that majority of pregnant women perceived Cesarean section as a complicated birth option, various complications attached to the Post Cesarean section have proven that, there is need for special attention on caesarean section option. Methodology : A descriptive survey research design was employed. A total of 38 respondents were selected using judgmental and convenience sampling techniques due to the busy schedule of these health practitioners after determining the sample size using the Okpanachi (2011) restructured Yemane (1967) sampling model. Data were collected using self structured questionnaire that was pilot tested with the Cronbach Alpha of 0.78. Data collected were analyzed with SPSS software using both descriptive and inferential statistics. Results: The study revealed that the incidence of Puerperal psychosis among Post Cesarean section patient was very high, Knowledge of Respondents on Puerperal psychosis was also high, the identified causes of Puerperal psychosis among Post Cesarean section patient include, history of bipolar disorder, schizophrenia, prior episode of postpartum psychosis, or a family history of postpartum psychosis, Mutations in chromosome and in specific genes involved in serotoninergic, hormonal, and inflammatory pathways, giving birth for the first time, Depression or anxiety during pregnancy, stressful recent life events, poor social support and a previous history of depression. the identified Management strategies employed towards control of Puerperal psychosis among Post Cesarean section patient include, Psycho-education and psychotherapy, Pharmacotherapy, Lithium Treatment and Prophylaxis, Antiepileptic drugs (AED). However, Electroconvulsive Therapy and Breastfeeding of baby are alternative methods often used to manage Puerperal psychosis. Conclusion: It was concluded that family care and financial status of family were also very good predictor of Puerperal psychosis, thus Management of Health facilities should intensify the need for self financial assessment before planning on having babies.
Concomitant Use of Dietary Supplements and Orthodox Medicines among Primary Care Patients Due To Non-Communication with Physicians in a Tertiary Hospital in Uyo (Published)
Introduction. The use of dietary supplements has recently increased worldwide. Because of non-communication, however, patients often do not disclose their dietary supplements use to their physicians. Danger exists because physicians give orthodox medications to patients who may be using supplements already in an attempt to promote health, prevent or treat diseases. Objective. The objective of this study was to describe the scope of concomitant use of dietary supplements and orthodox medicines among primary care patients due to non-communication with physicians in a tertiary hospital in Uyo, Nigeria. Method. This was a prospective descriptive cross-sectional study involving 573 respondents conducted between September 2014 and February 2015. Using a systematic sampling technique, respondents aged between 18 and 69 years were recruited, data were collected using a structured interviewer-administered questionnaire. Result. Of the 573 respondents recruited into the study, 62.2% (n=356) used dietary supplements; made up of 43.0 %( n=246) females and 19.2 %( n=110) males. Frequency of dietary supplements use was seen to increase with age 16.1%(n=92), among the more educated 43.3%(n=248), and among high level income earners,26.4%(n=151).Herbs or other botanicals were the most preferred supplements,37.1%(n=132).The patterns of concomitant dietary supplements and orthodox medicine use were as follows: one kind of supplement and one medicine,21.3%(n=76),two kinds of supplements and four medicines,6.7%(n=24), three kinds of supplements and more than four kinds of medicine,5.3%(n=19),more than four kinds of supplements and more than four kinds of medicines,5.6%(n=20).The commonest reason given for not disclosing dietary supplements use to physicians was that physicians never asked(p=0.001). Conclusion. In conclusion, concomitant use of dietary supplements and orthodox medicine is common among primary care patients in uyo.Primary care physicians need to be more pains-taking in their interactions with patients to forestall any adverse event that may arise following the prescription of orthodox medicines to patients that are already taking dietary supplements.