Open Access Original Research Article

Behavioral and Psychological Symptoms of Dementia in Nigerian Hospital Patients: Prevalence, Correlates and Caregiver Burden

Abidemi O. Bello, Olusegun Baiyewu, Francis O. Aina, Increase I. Adeosun

International Neuropsychiatric Disease Journal, Page 1-11
DOI: 10.9734/INDJ/2017/38030

Aims: This study was aimed at measuring the prevalence and impact of Behavioral and Psychological Symptoms of Dementia (BPSD) of elderly hospital attendees in Lagos Nigeria; and determining socio-cultural factors associated with the health of these elderly people with dementia.

Study Design: This was a cross-sectional descriptive study. Fifty patients with dementia attending out-patient facilities of three tertiary hospitals in Lagos were interviewed along with their caregivers.

Place and Duration of Study: The study was conducted over a 6 month period at the out-patient clinics of the Federal Neuro-Psychiatric Hospital, Yaba and the Neurology and Psychiatric Clinics of Lagos University Teaching Hospital, Idi-Araba Lagos.

Methodology: Consecutively presenting patients who met the inclusion criteria for the study were recruited after obtaining consent from the participant and caregivers. The Mini Mental State Examination, Stick design and Indiana University Token test were administered to the patient, while Blessed Dementia Scale and Neuropsychiatry Inventory were administered to the caregivers.

Results: Mean age was 72.5(±6.4) years, 52% were females and 54% had primary school education or less. Ninety-two percent lived with family and 96% had at least one BPSD, the commonest being hallucinations (68%), agitation (68%) and night-time behaviour (62%). The most severe BPSD using the mean NPI score (Frequency X Severity) were night-time behaviour 3.84, (SD3.71), aberrant motor behaviour 3.74, (SD4.06) and agitation 3.53, (SD3.52). The more distressing symptoms experienced by caregivers were agitation 1.78, (SD1.56), night-time behaviour 1.78, (SD1.43), and aberrant motor behaviour 1.66, (SD1.59), On regression analysis, BPSD independently predicted caregiver distress.

Conclusion: These findings are similar to previous studies with high prevalence of BPSD in patients with dementia and distress in caregivers. Improving access to treatment of BPSD is vital in alleviating caregiver distress especially in low income countries where family care is about the only option for dementia care.

Open Access Original Research Article

Associated Factors of Stress among Faculty Members of Kathmandu Valley

Ramanand Pandit, Arjun Bhat, Ram Chandra Prasad Yadav, Kailash Timilsina, Ashok Pandey

International Neuropsychiatric Disease Journal, Page 1-6
DOI: 10.9734/INDJ/2017/38000

Background: With mushrooming of health Science College in Kathmandu valley, the occupational related stresses were increasing among faculty members. The stress makes the great deals for the daily life. The objective of this study is to identify the occupational related physiological, psychological and behavioral stresses.

Methods: A cross-sectional study was done on January 2017 to August 2017 among the health science faculty members of Kathmandu valley. The test tool developed by NIMHANS was used for the present study is to measure the level of stress-effects in teaching faculty members. The score was calculated to identify the stress level.

Results: 56.6% of the faculty members rarely felt the impatience in the working environment. Less than half (47.6%) of the faculty members were gossiping due to the stressful working environment. 5.5% of the faculty members always felt fatigue due to working condition. There is the significant difference between physiological factors, psychological factors and behavioral factors among faculty members.

Conclusions: The study reveals that the stress factor is high among faculty among members. Physiological, Psychological and Behavioral factors of stress related associated factors were persists among them. Some faculty members always felt fatigue, feeling powerful and being worried about their working condition.

Open Access Original Research Article

Diagnostic Utility of MRI versus Nerve Conduction Studies in Carpal Tunnel Syndrome

Abdulkadir Koçer, Rukiye Kılıçarslan, Aslı Yaman, Hümeyra Dürüyen

International Neuropsychiatric Disease Journal, Page 1-6
DOI: 10.9734/INDJ/2017/38629

Objective: To prospectively and quantifiably compare Magnetic Resonance Imaging (MRI) findings and nerve conduction study (NCS) findings in clinically diagnosed carpal tunnel syndrome (CTS).

Methods: A total of 27 wrist of 15 with CTS and 24 wrists of 13 healthy controls selected from the same cohort were studied in the present study. The protocol included NCS of the median and ulnar nerves (distal motor latency, sensory conduction velocity from the third fingers to the wrist for the median nerve); electrophysiological severity scale; and T2 intensity measurement of the nerve at place just 2 cm distal to it at the level of hamate bone. Relationships between NCS findings, severity of median nerve damage and T2 intensities were calculated.

Results: In comparison of age and gender matched two groups, we found that T2 signal intensities were higher in the patient group (p<0.001). There was no relationship between T2 signal intensity and NCS findings, gender, and the clinical findings such as provocative tests, the presence of motor or sensory symptoms except age.

Conclusion: In patients with idiopathic carpal tunnel syndrome, T2 intensity of median nerve measured by wrist MRI may be considered as a valuable indicator but it is not superior to electrophysiological studies in grading the severity of disease.

Open Access Original Research Article

Diffusion-weighted MR Imaging of the Brain: Correlation of Ischemic Lesion Patterns with ASCO Stroke Subtypes

Ashraf Ahmed Zaher, Mohammed EL Sherif, Ayman Abdallah Elazzouny, Ahmed Abdel Khalek Abdel Razek

International Neuropsychiatric Disease Journal, Page 1-8
DOI: 10.9734/INDJ/2017/38789

Background: There are many etiologies for ischemic cerebral stroke. Previous studies have not shown whether specific ischemic lesion patterns on early brain diffusion-weighted imaging (DWI) are associated with specific ischemic stroke causes.

Objective: This study was designed to correlate the pattern and distribution of ischemic lesions on (DWI) with ASCO stroke subtypes [atherosclerosis (A), small vessel disease (S), cardiac source (C), and other cause (O)].

Subjects and Methods: We retrospectively evaluated patients with ischemic lesions within 72 hours of stroke onset who underwent brain DWI. Ischemic lesions were classified as single, scattered and multiple. The stroke subtypes were classified according to ASCO criteria.

Results: A total of 490 patients was studied, (285 Males, 205 females) with a mean age of 69.8± 10.4 years. We found (A) (N=180), (S) (N=70), (C) (N=145) and (O) (N=95). In patients with (A) the scattered anterior circulation lesions were statistically significant (45 patients, P=0.04). With (S) the most common and only pattern was to single subcortical lesion (70 patients, P=0.000). While, with (C), the statistical significance was to single cortical, multiple unilateral anterior circulation, single subcortical, and scattered anterior circulation respectively (65, 45, 15 and 15 patients, P=0.01, 0.02, 0.03, and 0.03). Patients with (O) were highly statistically significantly associated with single subcortical lesions (40 patients, P=0.000).

Conclusion: There is a significant correlation between the ASCO stroke subtypes and DWI patterns which assisted in determining the stroke etiology.

Open Access Original Research Article

Cerebrospinal Fluid Biomarkers of Neuroinflammation and Axonal Degeneration in Patients with Multiple Sclerosis

Mohammed El Sherif, Ahmed Esmael, Ayman Abdallah Elazzouny

International Neuropsychiatric Disease Journal, Page 1-8
DOI: 10.9734/INDJ/2017/38721

Background: Inflammation mediators have important roles in leukocyte recruitment and the central nervous system (CNS) inflammation and damage. Axonal and neuronal damage are associated with the level of CNS inflammation and determine physical handicap on multiple sclerosis (MS) patients.

Objectives: On distinguishing and inspect the associations between a group of inflammatory biomarkers {matrix metalloproteinase 9 (MMP9), neurofilament light chain (NFL), osteopontin (OPN), and chemokine ligand 13 (CXCL13)} on MS patients.

Patients and Methods: We collected the patients the electronic Mansoura Neurology department data sheet, and all patients encountered assessment by Expanded Disability Status Scale (EDSS) at the onset. All patients and control had cerebrospinal fluid (CSF) biomarkers work-up (MMP9, CXCL13, OPN, and NFL) that measured by ELISA. A correlation statistic matrix was done to demonstrate the presence of relationships between CSF biomarkers within the MS cases.

Results: The enclosed fifty patients comprising different MS subtypes {relapsing-remitting (RRMS) (70%), secondary progressive (SPMS) (22%) and primary progressive (PPMS) (8%)} with the mean age of 34.6±8.9 years. Healthy controls (HC) were 25. The most common clinical presentations were sensory manifestations (34%) and optic neuritis (24%). We found that the levels of CXCL13, NF-L, OPN, and MMP-9 were highly significantly increased among MS patients (P<0.0001, P<0.0001, P<0.001, and P<0.0001 respectively). The correlations between CSF biomarker levels showed a highly significant correlation between CXCL13 and MMP-9 followed by OPN and NF-L.

Conclusion: Our results showed that there is a strong association between CSF biomarkers of inflammation and axonal damage and MS, especially in RRMS patients.