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 56,091 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The social and clinical characteristics of one hundred and thirty-one women who attended the psychiatric outpatient clinic for the first time at the Department of Psychiatry, University of Ghana Medical School, within five years (1988-1992) were studied. The data suggested that the peak age of depressed women at consultation was between twenty and forty; and that a significant proportion of them were in the married group. Moreover the majority have no or very little education and thus little opportunity for gainful employment hence the majority were self employed. This finding is markedly different from the findings in the Western Countries, where the depressed women were much older, between thirty-five and fifty-four years; single and were gainfully employed. The average number of children per woman were between five and eight and the women had no adequate financial support from their husbands. These social characteristics reflected in the life-style and the kind of social stresses imposed upon these women in coping with life. These stresses showed in the clinical symptoms they represented, which were mainly somatisation disorder and somatic symptoms, with headaches and insomnia being the most prominent. However, psychological symptoms such as morbid thoughts were found to be few at this first consultation. It was highlighted that the social stresses might possibly be the causes of the clinical presentation of the depressed Ghanaian women. It was suggested that the specificity of headaches as a symptom of other psychiatric disorders other than depressive illness, for example schizophrenia and other endogenous psychiatric disorder among Ghanaian women require further research.
West Afr J Med
PMID:A study of the social and clinical characteristics of depressive illness among Ghanaian women--(1988-1992). 885 70

Do persons who utilize the services of the alternative therapist demonstrate a greater self-care response to illness? This cross-sectional study was done to compare the health perceptions and self-care response to minor illness among users of conventional medical care and alternative therapy. Data were collected with a pre-tested, self-administered questionnaire to 99 patients of medical practitioners and 74 of alternative therapists. Results indicated statistically significant differences in some health perceptions such as ways to improve general health and responsibility for personal health. For both groups there were similarities in socio-demographic characteristics and self-care responses to minor illness, such as headaches, constipation, diarrhoea, sinus congestion and colds or flu. Also, results reflected a common practice of self-management of minor illness and an overlap in attendance by patients to both groups of practitioners. Recommendations are made for the public to be guided in its practice of self-management of minor illness and that a regulatory body be set up to govern the practice of alternative therapy in Jamaica.
West Indian Med J 1996 Sep
PMID:Health perceptions and self-care response to illness among users of medical and alternative health services in St Andrew, Jamaica. 895 26

We retrospectively compared the clinical manifestations, laboratory features, and outcome of cryptococcal meningitis in 44 human immunodeficiency virus (HIV)-positive and 21 HIV-negative patients in Durban, South Africa, and contrasted our findings with those in the developed world. Cryptococcal meningitis was the initial AIDS-defining illness in 84% of patients. Headache, fever, convulsions, neck stiffness, and neurological signs were more common in HIV-positive patients. We detected neurological abnormalities in 50% of the HIV-positive group. Seventeen percent of HIV-positive patients had completely normal CSF indices. HIV-positive patients with cryptococcal meningitis frequently had oral candidiasis and tuberculosis as coexistent illnesses. Prognostic factors identified in the West do not appear to be applicable in Africa. Death during hospitalization was significantly higher in the HIV-positive group. HIV-associated cryptococcal meningitis in Africa is apparently associated with higher rates of neurological complications and death than is such disease in developed countries of the world.
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PMID:Cryptococcal meningitis in Durban, South Africa: a comparison of clinical features, laboratory findings, and outcome for human immunodeficiency virus (HIV)-positive and HIV-negative patients. 911 35

The prevalence rate and other aspects of migraine were investigated among school children (aged 6-13 years) in Enugu. The diagnosis of migraine was made by means of a questionnaire completed by parents which was based on the criteria proposed by Prensky and Sommer, and was further confirmed by personal interview of the parents in their homes. A prevalence rate of 6.8% was found among the 4,398 schoolchildren studied. More girls were affected than boys (158 and 140 respectively). Most (88.4%) of the children had their first attack by 10 years of age. Attacks occurred mostly in the afternoon, with sunlight and exercise as the most important trigger factors. Headache of a throbbing nature, sensory aura and relief after sleep were the commonest symptoms. Clinical examination was abnormal in only one child who had paralytic poliomyelitis, but EEG abnormalities were found in 51.1% of the children who had the test. The study revealed a hitterto unrecognised high level of morbidity from migraine among school children in Enugu, resulting in a disturbingly high incidence of school absenteeism.
West Afr J Med
PMID:Childhood migraine in Nigeria--I: A community-based study. 947 55

This study was carried out in 60 AIDS patients who presented toxoplasma encephalitis in Martinique (French West Indies). Diagnosis was based on a combination of fever, neurologic signs, and characteristic CT-scan images in patients with positive HIV serology. There were 46 males and 14 females with a mean age of 40 years. The mode of transmission was heterosexual in most cases (68.3%). The incidence of drug-related transmission was low (6.7%). Neurotoxoplasmosis was the most frequent presenting symptom of AIDS (53.3%) followed by esophageal candidosis (20%) and pneumocystosis (10%). Clinical symptoms were headache (56.5%), fever (48.3%), hemiparesia (36.6%), and confusion (36.6%). CT-scan showed most lesions to be multiple (70%), hypodense (89%), and subject to contrast uptake (93%). Mean lymphocyte level was 1128/mm3 with 88 CD4/mm3 and a CD4-to-CD8 ratio of 0.14. Conventional treatment using a combination of pyrimethamine and sulfadiazine led to skin rash and neutropenia and had to be discontinued in 30% of cases. Clinical symptoms and mean survival (327 days) were the same as comparable findings from Europe and North America.
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PMID:[Cerebral toxoplasmosis and AIDS in Martinique]. 951 53

Headache is a ubiquitous complaint, yet it is one that often elicits anxiety in both patients and physicians. When a patient presents with headache, the clinician must answer the following questions: (1) Is the headache "worrisome" (secondary to underlying disease)? (2) If the headache is benign, what type is it? (3) How is the acute headache best treated? and (4) How may future headaches be prevented? The following review is intended to aid primary care physicians in answering these questions.
West J Med 1998 Mar
PMID:The clinician's approach to the management of headache. 954 29

All consecutive cases of chronic renal failure (CRF) seen over a twelve-month period (January-December 1992) were evaluated. Those that fulfilled strict diagnostic criteria for hypertension induced CRF (HICRF) were further studied to determine peculiarities of its clinico-pathological features that may render this possibly preventable condition readily identifiable. Twenty one (23.1%) of the 91 cases of CRF satisfied these criteria. There was a male preponderance (M.F.4.3:1). Nocturia was a prominent symptom predating other symptoms of CRF in all. Throbbing frontal headache necessitating significant consumption of analgesic was found in 13(61.9%). Hypertension had been diagnosed in the patients for periods ranging from 2-15 years and compliance to therapy was adjudged poor. Ten smoked cigarette in significant quantities. Hypertension occurred in 8 of the families of the patients. Hypertension was severe in all, with evidence of accelerated phase in 19(90.5%). A majority (71.4%) presented with severe uraemia (serum creatinine > or = 100 umol/l). Target organ damage, evident in cardiomegaly with heart failure occurred in 15, while ultrasonographic features of bilateral shrunken kidneys was seen in all. Blood pressure control was largely inadequate with a combination of 3 drugs. Mortality rate was 51% in the first year. Renal histopathological findings of glomerular sclerosis, malignant arteriolar changes with absence of glomerular cellular proliferation were observed in renal biopsies and 6 autopsy tissues. It is concluded that HICRF is a major cause of mortality; renal failure is often advanced at presentation, and blood pressure is usually in the accelerated phase. Significant cigarette smoking, severe headache necessitating consumption of significant quantity of analgesics, and a family history of hypertension are striking features.
West Afr J Med
PMID:Hypertension induced chronic renal failure: clinical features, management and prognosis. 971 16

Headache is a very common problem in the community, but only a small proportion of people who have it presents to the health services. In the Caribbean little is known of its prevalence, the resulting morbidity or the nature of self care used. This paper reports on a survey of 679 adults who attended three polyclinics as patients, or accompanying young, elderly or acutely ill relatives. 68.9% reported having experienced a headache in the previous month. Headaches were more prevalent among respondents aged 25-44 years (78.6%) than among those in other age groups; in women (73%) than in men; in those living in households of four or more people (72%) than in those living in smaller households; in those whose family members were reported as using alcohol, tobacco or marijuana singly or in combination (70-72.5%) compared to those whose families did not use any of these substances (55%); and in those whose family members were reported as having allergy, asthma and migraine (72.5 to 77.1%). No significant association was shown in relation to employment. 18.4% of the respondents visited the doctor for their headache. In the clinical evaluation of these patient, the number of costly investigations may be reduced by attention to the epidemiological variables such as age and gender, domestic factors such as stress, and family diseases such as migraine, asthma and allergy.
West Indian Med J 1998 Jun
PMID:Headaches in persons attending polyclinics in Barbados. 976 53

During the summer of 1996 an unusual clustering of meningoencephalitis cases was recorded in the Capital City, Bucharest, and in some areas from South-East Romania. After an initial suspicion of an enteroviral etiology was discarded, the West Nile etiology was confirmed by specific antibodies demonstration through hemagglutination-inhibition and ELISA tests. This study included 251 patients with the diagnoses of West Nile acute encephalitis (166 cases), acute meningitis (57 cases) and acute febrile disease (33 cases). The patients' age ranged from 1 to 89 years (mean 51.1 years). The most frequent clinical manifestations were: fever (95.7% of cases), cephalalgia (92.6%), stiffness of the neck (89.1%), vomiting (62.5%), marked asthenia (46.5%), myalgia (28.9%). In addition, patients with encephalitis exhibited: alteration of consciousness (89.2% of cases), tremor of extremities (40.4%), ataxia (44%), paralysis (15.1%). The fatality rate was 15.1% in acute encephalitis, 1.8% in acute meningitis and 0% in the acute febrile disease.
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PMID:Clinical manifestations in the West Nile virus outbreak. 983 23

Dengue infection is nowadays considered a re-emergent disease. It has a worldwide tropical and subtropical distribution. The dengue virus in a member of the flavivirus family composed by 4 different serotypes. The virus is transmitted by mosquitos of the Aedes genus. With the increment of travels to the endemic areas, dengue is now observed frequently in our country. We analyzed 57 patients, 30 with imported dengue (ID) and 27 with dengue fever suffered during the trip (DDT). This series is compared with other published ones and a review of the subject is presented. Patients with ID followed a protocol as a febril syndrome returning from the tropics. Dengue was diagnosed through a compatible clinico-epidemiological history, the absence of other ferbil illness and positivity of specific serology. All patients had travelled to endemic areas (Central America 28 cases, Indian subcontinent 15, South-East Asia 10, South America 2, West Africa one, and Pacific one). The following were the most important clinical characteristics: fever and asthenia (100%), headache (98%), mialgia (84%), arthralgia (72%), morbilliform rash (61%) and retroocular pain (65%). For ID cases, the most helpful analitical results were: leucopenia (70%), reactive lymphocytes in peripheral blood smear (70%), thrombocytopenia (70%), and increased hepatic enzymes ALAT (53%), ASAT (63%) and LDH (100% in the 7 patients tested for this enzyme). Dengue must be included in differential diagnosis of fever in patients coming back to travels to tropical areas.
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PMID:[Dengue: a re-emerging disease. A clinical and epidemiological study in 57 Spanish travelers]. 985 93


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