BackgroundThe formulation and implementation of national ethical regulations to protect research participants is fundamental to ethical conduct of research. Ethics education and capacity are inadequate in developing African countries. This study was designed to develop a module for online training in research ethics based on the Nigerian National Code of Health Research Ethics and assess its ease of use and reliability among biomedical researchers in Nigeria.MethodologyThis was a three-phased evaluation study. Phase one involved development of an online training module based on the Nigerian Code of Health Research Ethics (NCHRE) and uploading it to the Collaborative Institutional Training Initiative (CITI) website while the second phase entailed the evaluation of the module for comprehensibility, readability and ease of use by 45 Nigerian biomedical researchers. The third phase involved modification and re-evaluation of the module by 30 Nigerian biomedical researchers and determination of test-retest reliability of the module using Cronbach’s alpha.ResultsThe online module was easily accessible and comprehensible to 95% of study participants. There were significant differences in the pretest and posttest scores of study participants during the evaluation of the online module (p = 0.001) with correlation coefficients of 0.9 and 0.8 for the pretest and posttest scores respectively. The module also demonstrated excellent test-retest reliability and internal consistency as shown by Cronbach’s alpha coefficients of 0.92 and 0.84 for the pretest and posttest respectively.ConclusionThe module based on the Nigerian Code was developed, tested and made available online as a valuable tool for training in cultural and societal relevant ethical principles to orient national and international biomedical researchers working in Nigeria. It would complement other general research ethics and Good Clinical Practice modules. Participants suggested that awareness of the online module should be increased through seminars, advertisement on government websites and portals used by Nigerian biomedical researchers, and incorporation of the Code into the undergraduate medical training curriculum.

Depressive symptoms are common in epilepsy. Early detection and prompt management are recommended. Good seizure control with an appropriate antiepileptic drug, among other interventional measures, may contribute to the prevention of depression in epilepsy.

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CKD is associated with significant CI in Nigerian patients especially with progressive deterioration in renal function. There is a need for regular evaluation of CKD patients for cognitive deficits.

ABSTRACT:Objective:The objective of this study was to evaluate the pattern of cognitive disturbances in Nigerian Africans with newly diagnosed epilepsy, prior to onset of drug therapy.Methods:A total of 60 consecutive patients (mean age 31.6 ± 17.4, range 14 - 55 years) presenting with a clinical diagnosis of epilepsy were recruited for the study. Sixty healthy volunteers without a history of epilepsy and who were age-, sex- and level of education matched with the epileptic patients, were recruited as controls. The administration of cognitive tests was done with the FePsy computerized neuropsychological test battery. The tests administered were the visual and auditory reaction times, the continuous performance test and the recognition memory tests to assess mental speed, attention and memory respectively. The means of the cognitive performances of the epileptic patients and controls were statistically compared.Results:Epileptic patients performed worse than the controls across the spectrum of cognitive tasks assessed (P = 0.00001; P < 0.025), with the exception of the β parameter (response bias) of the vigilance test (P = 0.488; P> 0.025).Conclusions:The cognitive impairments of short-term memory, psychomotor speed and sustained attention observed in this study are similar to those reported in the literature for patients with epilepsy. The results of this study will be useful in the counseling of patients on their educational, social and vocational needs.

154Neuropsychological impairments in HIV/AIDS have been extensively researched and reported in developed countries, usually reflecting the prominence of initial sub-cortical involvement and characterized by memory loss (usually impaired retrieval), general slowing of psychomotor speed and thought processes and impaired manipulation of acquired knowledge. 1,2 Memory impairment, both verbal and non-verbal, is characteristic of HIV-associated dementia. 3 During the early years of the HIV epidemic, cognitive symptoms were thought to be common even during the initial ABSTRACT: Background: Memory impairment, usually impaired retrieval of information, has been described in HIV/AIDS, especially among those with severe illness. Neuro-cognitive disturbances in HIV/AIDS have been linked to poor quality of life and medication adherence. This prospective, case-control study was designed to assess the verbal and non-verbal memory as well as the attention abilities of Nigerian Africans with HIV/AIDS and correlate their performances with their CD4+ T lymphocytes (CD4+) counts. Methods: A total of 288 randomly selected subjects, comprising 96 HIV-positive symptomatic patients, 96 HIV-positive asymptomatic patients and 96 HIV-negative controls, participated in the study. The subjects were age-, sex-, and level of education matched. The Recognition Memory Test and Choice Reaction Time tasks, components of the computer-assisted neuropsychological tests battery-the Iron Psychology 'FePsy' were used for cognitive assessments. Results: The mean memory scores of the HIV-positive asymptomatic subjects did not differ significantly from the controls (p>0.05) but the HIV-positive symptomatic subjects' scores were significantly lower than the controls (p<0.05). Both HIV-positive groups had psychomotor slowing and impaired attention (p<0.05). The HIVpositive subjects with CD4+ counts <200/µl and between 200 and 499/µl had significant memory impairment (p<0.001 and p<0.001 respectively) but there was no significant impairment among those with count ≥500/µl. Impaired ability for sustained attention was however present irrespective of the CD4+ level relative to controls (p<0.001). Conclusions: We concluded that there was no significant memory disturbance among HIV-positive asymptomatic subjects despite the presence of impaired attention and psychomotor slowing, and that the severity of immune suppression (as indicated by the CD4+ T lymphocytes count) is a strong determinant of cognitive decline in HIV/AIDS. RÉSUMÉ: Étude prospective cas-témoin du fonctionnement mnésique chez les patients atteints du VIH/SIDA. Contexte : Une atteinte de la mémoire, habituellement de la récupération de l'information, a été décrite chez les patients atteints du VIH/SIDA, spécialement chez ceux dont la maladie est sévère. Les perturbations neuro-cognitives dans le VIH/SIDA ont été associées à une faible qualité de vie et de fidélité à la médication. . Il n'existait pas d'atteinte significative chez ceux dont le décompte était ? 500/Ìl. Cependant, ils avaient un déf...

Background/Objective: The morbidity and mortality of neurological patients managed in the intensive care unit reflect the causes of neurological disorders and the effectiveness of management. Method: The morbidity and mortality patterns of neurological patients admitted into the intensive care unit of the University of Benin Teaching Hospital (UBTH), a tertiary health institution in Nigeria, was examined over an 18-year period (January 1985 to December 2003. A complete sampling frame was used with all patients' records scrutinized. Results: A total of 187 patients, (16.6% of the total ICU admissions) with neurological morbidity were admitted during the period. We observed that morbidity was high for preventable etiologies -head injury (119 patients constituting 63.7%), tetanus (26 patients constituting 13.9%), hypertensive encephalopathy (12 patients constituting 6.4%) and meningitis (8 patients constituting 4.8%). The case fatality rates for these causes were 50.4%, 61.5%, 66.7% and 62.5% respectively. The case fatality rate for cerebral malaria was 100%. In addition, males (67.9%) were more likely to have trauma-related morbidity (P<.001) than females (32.1%). Overall mortality rate was high (52.4%) and calls for urgent attention. Conclusion:We concluded that preventable morbidities (head injury, tetanus, meningitis and hypertensive encephalopathy) accounted for fatality among neurological patients in the ICU, Benin City, Nigeria. Mortality was higher among those that required significant intensive interventions. Improved public awareness, traffic legislation, prompt emergency medical care and immunization against tetanus and meningitis should reduce morbidity and mortality. Key words: Morbidity, mortality, neurological patients, intensive care unitRésumé Introduction/Objectif: La morbidité et la mortalité des malades neurologiques traités dans le Service de soins intensifs a montré les causes des troubles neurologiques et l'efficacité de la prise en charge. Méthodes: La tendance de la morbidité et de la mortalité des malades neurologiques admis dans le service des soins intensifs du centre hospitalier universitaire du Benin (CHUB), un centre de la sente tertiaire au Nigeria, a été étudié au cours d'une période de 10 ans (janvier 1985 au décembre 2003). Un plan de sondage complet a été utilisé avec tous les dossiers des patients étudiés. Résultats: Un total de 187 patients, (16,6% du total des admissions ICU) atteints de la morbidité neurologique ont été admis au cours de la période. Nous avons noté que le taux de la morbidité est élevé pour les étiologies évitables -blessures de tête (119 patients recensés en 63,7%) ; le tétanos (26 malades recensés en 13,9%) ; hypertension encéphalopathie (12 malades recensés en 6,4%) et la méningite (8 malades recensés en 4,8%) ; Le taux du cas de la fatalité pour ces causes étaient 50,4%, 61,5%, 66,7% et 62,5% respectivement. Le taux du cas de la fatalité pour la fièvre cérébrale était 100%. En outre, sexe masculin (67,9(%) étaient plus susceptibles d'avoir des tra...

Tetanus is a vaccinepreventable disease that yearly causes a total of 309,000 deaths. Reports showed up to 1 million cases annually, mostly in underdeveloped countries. Clostridium tetani, the causative organism, is widespread in the faeces of domestic animals and humans, while spores of C. tetani are abundant in soil and in the environment surrounding the habitation of humans and animals. In developing countries, mortality rates are as high as 28 per 100,000; in North America the rate is less than 0.1 per 100,000. Immunization programs clearly decreased neonatal tetanus deaths, and some recent evidence suggests progress in prevention throughout the World. Tetanus remains a great public health problem in developing countries such as Nigeria and it is associated with high mortality, but the understanding of the epidemiological aspects of this disease forms the basis of preventive strategies in any community. This paper reviewed the history, epidemiology and clinical diagnosis of tetanus and emphasized the current opinions in the management of tetanus outlining the various suggested treatment plans from experts in developing countries which form the basis for World Health Organization recommendations.