Top PDF Prevalence and determinants of excessive daytime sleepiness in hypertensive patients: a cross-sectional study in Douala, Cameroon

Prevalence and determinants of excessive daytime sleepiness in hypertensive patients: a cross-sectional study in Douala, Cameroon

Prevalence and determinants of excessive daytime sleepiness in hypertensive patients: a cross-sectional study in Douala, Cameroon

One strength of this study was the fact that all partici- pants were interviewed by an investigator who ensured that data were accurately collected. We also used multi- variate logistic regression analysis to investigate factors associated with EDS. This enabled us to avoid the effects of confounders and to obtain factors independently associated with EDS. However, this study has some limita- tions: the absence of sleep diagnostic tools in our context prevented us from investigating sleep apnoea itself. Nevertheless, EDS has been reported to be posi- tively associated with obstructive sleep apnoea, 26 thus serving as a surrogate in this study. The male sex might have been underappreciated in the study as 31 of the 38 subjects who did not give their consent were males. Likewise, ambulatory monitoring of BP over 24 h, which is the best method for the evaluation of controlled BP, was not used. Another limitation of this study is that our results cannot be generalised to all hypertensive Table 2 Univariate and multivariate analysis of factors associated with EDS
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Prevalence and determinants of cigarette smoking among college students: a cross-sectional study in Douala, Cameroon

Prevalence and determinants of cigarette smoking among college students: a cross-sectional study in Douala, Cameroon

Having smoking friends in this study was the most im- portant independent factor associated with cigarette smoking. Reports from different regions of the world found similar results [17, 19–22]. Evidence from two longitudinal studies conducted in the United States showed that non-smoking adolescents who have friends who smoke are more likely to start smoking in the fu- ture than those without any smoking friends [23, 24]. We also found that parental smoking was associated with smoking among college students. The critical influ- ence of parental smoking on adolescent’s smoking be- havior was demonstrated by Bricker et al. in a cohort study involving five thousand families [25]. This finding is consistent with the results of other studies carried out in developing countries as well as in industrialized coun- tries [26]. In fact, children are more likely to reproduce the behaviors and attitudes of their parents who are con- sidered by them as models. Secondly, as demonstrated
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Prevalence and Determinants of Antibiotic Self Medication among Adult Patients with Respiratory Tract Infections in the Mboppi Baptist Hospital, Douala, Cameroon: A Cross Sectional Study

Prevalence and Determinants of Antibiotic Self Medication among Adult Patients with Respiratory Tract Infections in the Mboppi Baptist Hospital, Douala, Cameroon: A Cross Sectional Study

Risks associated with self-medication include lack of clinical evaluation of the condition by a health care provider which could result in misdiagnosis and incorrect choice of drugs, delays in seeking appropriate treatment, use of excessive or substandard drugs and prolonged durationof use, drug interactions, and polypharmacy [13,14]. All these play a pervasive role in the development of antibiotic-resistant microbes. The determinants of self-medication with antibiotics in low- and middle-income countries include unregulated importation and sale of over-the-counter antibiotics, the cost of medical consultation, low satisfaction with medical practitioners, and misconceptions regarding the efficacy of antibiotics [15–17]. Another risk factor for actual self-medication is the availability of drugs at home, which encourages use [4], while cultural beliefs and a lack of health insurance are other possible determinants of self-medication [12].
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Excessive Daytime Sleepiness and Hypertension in Cameroonian Adult Population

Excessive Daytime Sleepiness and Hypertension in Cameroonian Adult Population

In this large population-based study in a sub-Saharan African country, we found no independent association between excessive daytime sleepiness and hypertension. In hypertensive subjects, Sudanese ethnicity, residence in Bandjoun or Douala and obesity are factors independently associated with EDS. Thus, EDS should be systematically evaluated for in hypertensive and obese subjects in order to identify the cause as this will permit optimal management of these patients. In addition, other studies should examine the reasons for a higher prevalence of EDS in Sudanese hypertensive patients and also in those living in West and Littoral region of Cameroon. The reduction of body mass index should also allow a reduction of burden of EDS in hypertensive subjects.
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Excessive daytime sleepiness and falls among older men and women: cross-sectional examination of a population-based sample

Excessive daytime sleepiness and falls among older men and women: cross-sectional examination of a population-based sample

Over one-tenth of older men and women sampled in this study report EDS (16 % and 13.6 %, respectively), which is comparable to population-based prevalence we have cited previously [1], but higher than that cited by others [9]. Healthy, independent community-dwelling older adults often report lower rates of EDS than those who reside within aged-care facilities [30]. This may in part be attributed to typically higher levels of physical functioning and greater levels of independence among these individuals [31], as well as lower overall rates of peripheral factors often associated with EDS, such as dis- ease comorbidity [32] and increased rates of polypharmacy [33]. We further report an overall fall prevalence for both men and women that is comparable to [34], but lower than some [35] of the previous research assessing falls among healthy, community-dwelling adults. Higher rates of falls are often observed among older adults living within aged care or assisted living facilities compared to those living within the community [36, 37]. Indeed, individuals living in long-term institutionalised care have as much as a three- fold increased risk of reporting a fall, and a 10-25 % increased risk of sustaining injuries such as a fracture or laceration as a direct result of a fall [38]. Falls are often considered independent determinants of functional decline and worse disability outcomes among older community- dwelling adults [39]; and are often cited as the primary contributing factor for later admission to institutionalised care [38]. Community-based prevention strategies are therefore pivotal in the reduction of nursing home admissions among at-risk individuals.
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Prevalence of obstructive sleep apnoea in sleep consultations in Burkina Faso: Implications for monitoring

Prevalence of obstructive sleep apnoea in sleep consultations in Burkina Faso: Implications for monitoring

An anonymous survey record collected sociodemographic characteristics, past medical histories, clinical data, polygraphic and therapeutic data. The Epworth scale was used to evaluate daytime sleepiness and the Pichôt scale for fatigue. A CIDELEC CID 102L respiratory polygraph (level III (Cidelec, France)) was used for the recordings. The polygraph included a continuous oximetry sensor, tracheal sound sensor, suprasternal pressure sensor, nasal flow sensor (nasal canula), and sensors for thoracic and abdominal movements. The questionnaire was administered during the consultation as an interview and explained in the local language for patients who did not speak French. Details of the history of the disease, the past medical history, and a physical examination with measurement of the anthropometric parameters (weight, height, neck and abdominal circumference) were recorded. The patients were then referred for an ear, nose and throat (ENT) consultation for a possible local cause. On the night of the polygraphic recording, an intern (7th year of medicine) measured the pulse and the blood pressure. The reading of the results was carried out by a pulmonologist trained on sleep-related breathing pathologies.
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Prevalence and correlates of depressive symptoms in HIV positive patients: a cross sectional study among newly diagnosed patients in Yaoundé, Cameroon

Prevalence and correlates of depressive symptoms in HIV positive patients: a cross sectional study among newly diagnosed patients in Yaoundé, Cameroon

living with HIV than the general population (approximately 10% versus 5%), as determined by a meta-analysis of pub- lished studies [9]. Depression is associated with increased health care utilization [10], decreased quality of life [11], and increased suicide rate among patients in primary care [12]. Among people living with HIV/AIDS, depression increases the likelihood of HIV transmission [13], is associated with poor adherence to antiretroviral therapy (ART) [14] leading to virologic failure [15], and may independently increase HIV progression [16]. It is therefore crucial to identify patients with depression for an appropriate management. Unfortunately in Cameroon, the management of HIV/AIDS emphasizes on somatic aspects of the disease and neglects psychiatric mani- festations, and depression is therefore underdiagnosed. This is essentially due to the fact that mental health is not effectively integrated into HIV/AIDS clinical care.
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Prevalence and Distribution of Gingival Recession in Adult Population, Loni, Maharashtra: A Cross Sectional Prevalence Study – Part I

Prevalence and Distribution of Gingival Recession in Adult Population, Loni, Maharashtra: A Cross Sectional Prevalence Study – Part I

To evaluate the distribution, prevalence and etiology of gingival recession in adult population visiting the Out Patient Department of Rural Dental College, Loni during the period of 2017-2018. (For convenience two parts have been created this particular part of research paper focuses on association of age, gender, socio-economic status (SES) with prevalence of gingival recession).

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Risk of obstructive sleep apnea and excessive daytime sleepiness in hospitalized psychiatric patients

Risk of obstructive sleep apnea and excessive daytime sleepiness in hospitalized psychiatric patients

The investigators recruited 152 participants from the patients hospitalized at the AUB-MC psychiatric unit. Our psychi- atric unit admits ~ 250 patients per year. The sample used in this study was collected over 2 years. Some of the patients admitted to the unit did not agree to participate, and some did not meet criteria for inclusion. We estimate a response rate of ~ 30%. The participants were 56.6% female and the average age range was 26 to 45. The demographic and descriptive characteristics of the group are shown in Table 1. As expected, a lower risk of sleep apnea, per the Berlin ques- tionnaire scores, was detected in females when compared to males (Table 1). Most of the participants were overweight, and this group had the highest risk of sleep apnea. The primary psychiatric diagnoses of the participants upon admission to the psychiatric unit are listed in Table 1. Depression was the most common admitting diagnosis at 44.0% (Table 1). When the participants were asked if they ever received a diagnosis of sleep apnea, or ever used continuous positive airway pressure or bi-level positive airway pressure devices for treatment of OSA, only 5% responded affirmatively. Per the Berlin questionnaire, 39.5% of the participants were
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Hematological Profile and Risk Factors of Anemia in Pregnant Women: A Cross Sectional Descriptive and Analytical Study in Douala Cameroon

Hematological Profile and Risk Factors of Anemia in Pregnant Women: A Cross Sectional Descriptive and Analytical Study in Douala Cameroon

multivariate analysis, the following categories of women had more odds of developing anemia; women between the age range of 30 - 35 (OR = 2.81, 95%CI: 1.16 - 6.81, p = 0.023), women in the second trimester of pregnancy (OR = 2.20, 95%CI: 0.88 - 5.48, p = 0.024), women with blood group O (OR = 3.57, 95%CI: 1.41 - 16.66, p = 0.012). Conclusion: This study confirms sig- nificant variations in hematological parameters. The findings reinforce the need for supplementation and provide additional information on hematolog- ical reference values in pregnancy in Cameroon. It also helps us understand that, third trimester, age range 30 - 35, and blood group may be potential risk factors associated with anemia in pregnancy though a cohort study would be necessary to ascertain this hypothesis.
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Excessive daytime sleepiness, metabolic syndrome, and obstructive sleep apnea: two independent large cross-sectional studies and one interventional study

Excessive daytime sleepiness, metabolic syndrome, and obstructive sleep apnea: two independent large cross-sectional studies and one interventional study

In both our EDS and non-EDS OSA subjects, obesity and insulin resistance were the main factors associated with MetS in CFA. In further analysis, EDS was independ- ently associated with obesity. An independent relationship between EDS and obesity was also been found in previous studies [29, 30]. One study found that EDS was associated with greater risk of central obesity, independent of diet and physical activity [29]. Another study showed that weight gain had a detrimental effect on daytime sleepiness, mostly through pathways other than OSA [30]. Weight loss interventions improve daytime sleepiness, supporting the hypothesized causal effect of obesity on daytime Table 1 Effects of upper-airway surgery on components of MetS in patients with OSA with and without EDS
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Clinical Assessment Of Non Motor Symptoms In Parkinson’s Disease

Clinical Assessment Of Non Motor Symptoms In Parkinson’s Disease

Sleep disorders are among the most frequent non-motor problems of PD (Tandberg et al., 1998). They include difficulties falling asleep, frequent awakenings, nocturnal cramping, painful dystonia, or nocturnal motor symptoms with difficulties turning in bed, restless legs syndrome (RLS), night- time incontinence, nocturnal hallucinations, and daytime sleepiness (Poewe et al., 2007). Kumar et al., 2002 in a study found out the prevalence of sleep related problems like insomnia (32%), nightmares (32%) and excessive day time sleepiness (15%) in PD and concluded that sleep problems are common in PD than in control (p<0.001) (Kumar et al., 2002). Olfactory dysfunction (OD) may affect up to 90% of PD patients and has been described as a preclinical marker (Doty). Studies have reported olfactory deficits in asymptomatic relatives of patients with PD, some of whom subsequently became symptomatic. Visual problems during the course of the disease like alterations in visual acuity, contrast sensitivity, colour discrimination, pupil reactivity, eye movements, motion perception, visual field sensitivity, and visual processing speeds have been reported in PD patients (Matsui et al., 2006). In addition, there may be disturbances of visuo-spatial orientation, facial recognition problems, and chronic visual hallucinations (Matsui et al., 2006 Diederich et al., 2002).
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Factors Associated with Smoking Behaviors among Military Cadets of King Khalid Military Academy (KKMA), Riyadh, Saudi Arabia (2015-2016)

Factors Associated with Smoking Behaviors among Military Cadets of King Khalid Military Academy (KKMA), Riyadh, Saudi Arabia (2015-2016)

Methods: This cross-sectional study conducted among medical students in the Medical College, University of Tabuk, Saudi Arabia during the period from February to May 2017. Two hundred and seventy-seven medical students were invited to sign a written informed consent then responded to a structured questionnaire based on the Epworth Sleepiness Scale, demographic factors, Technology use, Cumulative Academic Grade (GPA), coffee consumption and sleeping pill use. The Chi-square and t-test were used to compare the students with excessive daytime sleepiness and those without the disorder and test the associated factors. The ethical committee of the Medical College approved the research. Results: They were 277 medical students (men 49.5%), mean age (21.78±1.59) years, excessive daytime sleepiness was evident in 52.3% of students, the average technology use/day was 5.25± 2.84 hours, the coffee intake was 1.98±1.36 cups/day, while 14.3% were using sleeping pills. No significant statistical associations were evident between the daytime
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Obesity and Excessive Daytime Sleepiness in Prepubertal Children With Obstructive Sleep Apnea

Obesity and Excessive Daytime Sleepiness in Prepubertal Children With Obstructive Sleep Apnea

Habitually snoring children (6 –9 years of age) with ad- enotonsillar hypertrophy who were evaluated at the University of Louisville Pediatric Sleep Medicine Center because of habitual snoring and suspected OSA were recruited into the study. The study was approved by the University of Louisville Human Research Committee. Parental informed consent and child assent, in the pres- ence of a parent, were obtained. Children were excluded if they had any chronic medical condition, were receiv- ing medications known to affect sleep, were known to have narcolepsy or idiopathic hypersomnia, or had any genetic or craniofacial syndromes.
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Altered irisin/BDNF axis parallels excessive daytime sleepiness in obstructive sleep apnea patients

Altered irisin/BDNF axis parallels excessive daytime sleepiness in obstructive sleep apnea patients

kidney disease, COPD and asthma) and by controlling for parameters known to reflect conditions in which excessive daytime sleepiness may be present (e.g. BMI, neck circum- ference, Beck depression inventory score, included in the initial model). In OSAHS, excessive daytime sleepiness is generally considered to be the consequence of intermittent nocturnal hypoxemia that leads to sleep fragmentation, hence poorer sleep quality. To attest for the possible influ- ence of reversible upper airway obstruction on daytime hy- persomnolence, significant polysomnography derived indices (AHI, oxygen desaturation index and obstructive apnea index) were also included in the model as well as (log) PSQI gauging perceived nocturnal sleep quality. Previ- ous studies have shown a poor association between ESS and PSQI as well as between PSQI, ESS and polysomnogra- phy measures [79] to the extent that it was suggested that these measures reflect distinct aspects of sleep. After con- trolling for causes other than altered circadian rhythm, we feel that ESS may be considered as an indicative parameter reflective of altered circadian rhythm in our explorative study. Nevertheless, characterization of the circadian rhythm by obtaining serial measurements of either salivary or serum melatonin or core body temperature could have added value at the cost of extra inconvenience for the patients and possibly have interfered with other measures e.g. polysomnography. However, alteration of the circadian rhythm in OSAHS has been established previously [37], allowing the speculative notion that altered irisin/BDNF axis may be causative for circadian misalignment in OSAHS, and thus, it may be suggested that excessive day- time sleepiness is a result of the deterioration of circadian pacemaker process. This alternative mechanism could account for the phenomenon of residual EDS as well as the excess risk of cardiovascular and all-cause morbidity and mortality in CPAP treated OSAHS patients. Measure- ments from a single timepoint may be considered as further limitation of the study, as serum BDNF levels are themselves circadian [80]. Nevertheless, the current find- ings suggest a putative relationship between the subjective measure of excessive daytime sleepiness and the alteration of the irisin/BDNF axis as reflected by the single measure- ment. Furthermore, this finding may contribute to teasing apart two parallel mechanisms underlying excessive day- time sleepiness e.g. one stemming from the mechanical obstruction of the airways and the other from the alter- ation of the circadian regulation.
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Differences in self-reported weekend catch up sleep between children and adolescents with and without primary hypertension

Differences in self-reported weekend catch up sleep between children and adolescents with and without primary hypertension

In this study, the control group reported more subject- ive sleepiness even though they had same weekday sleep time and longer weekend sleep time as compared to the HBP group. The weekday sleep duration was inversely correlated to subjective sleepiness in both groups confirming that both groups respond to sleep loss quali- tatively in the same way but children in the hypertensive group seem to have lower magnitude of subjective sleepiness (Figs. 2 and 3). Also, weekday total sleep time was inversely proportional to the weekend catch up sleep in both groups but HBP group had comparatively less weekend catch up sleep. Several explanations are possible for this pattern. It is possible that some individ- uals have learned behaviorally to ignore or become desensitized to the sensation of sleepiness due to com- peting priorities. In our clinical practice, we have observed that some children wake up on weekend in time to watch their favorite television shows. It is also known that the ability to feel sleepiness (subjective sleepiness) is an intrinsic biological trait [28] and indi- viduals have differential vulnerability to sleep loss [29]. Higher level of subjective sleepiness in the control group may either allow or force them to obtain more catch-up
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Association of excessive daytime sleepiness with migraine and headache frequency in the general population

Association of excessive daytime sleepiness with migraine and headache frequency in the general population

Another potential limitation is that the data reported in the present study were self-reported. This study asked about lifetime prevalence of migraine. The single ques- tion about lifetime occurrence of migraine, which was used, has previously been evaluated against a clinical interview by two physicians in another Norwegian sur- vey in eastern Akershus County, reporting a raw agree- ment rate of 0.81 and kappa (κ) of 0.62, which is considered to be a good agreement [23]. Two previous epidemiological surveys used the same screening ques- tion for migraine as in the present study, and the ob- served agreement rates were 0.92 and 0.94, and κ were 0.77 and 0.81, respectively [2, 40]. Due to the high num- ber of participants in our survey, it was not feasible to apply the gold standard, i.e. a clinical interview by a physician/neurologist with expertise in headache diag- nostics. The current study did not investigate the effect of EDS on clinical characteristics of migraine, which would require more detailed clinical information than is possible in a questionnaire-based general population survey.
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Sleep disturbances among patients with epilepsy

Sleep disturbances among patients with epilepsy

Our initial hypothesis was that the sociodemographic and clinical variables impact sleep quality. The impact of sociodemographic (age, gender, and employment status) and clinical variables (duration of epilepsy, seizure type and frequency, and type and kind of treatment) on sleep disorders was analyzed. This study did not demonstrate any correlation between sleep quality and demographic or clinical factors, or selected factors affecting sleep and conditions conducive to sleeping (in all cases, P.0.005). Hypothesis is rejected.

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Erectile dysfunction and associated factors among men with diabetes mellitus from a tertiary diabetic center in Northern Sri Lanka

Erectile dysfunction and associated factors among men with diabetes mellitus from a tertiary diabetic center in Northern Sri Lanka

Results: 326 diabetic male patients between ages 18–60 years were interviewed. Majority (62.9%; 95% CI 57.5– 68.0%) of the diabetic patients suffered from ED and 22.4% (95% CI 17.8–26.8%) were found to have severe ED. Most of the patients (98.8%) were not screened or treated for ED. Bivariate analysis showed age above 40, duration of DM (> 5 years), type of diabetes (type 2), having micro-vascular complications, co-existing hypertension, BMI, consuming unsafe level of alcohol and taking beta-blockers were associated with ED at 5% level (P < 0.05). This study failed to show association with dyslipidemia, macro vascular complications such as coronary artery disease (CAD, P-0.052), gly- cemic control (P-0.082) and smoking. Regression analysis revealed age > 40 (AOR: 2.13; 95% CI 1.05–4.33), duration of diabetes (AOR: 2.90; 95% CI 1.67–5.01), co-existing hypertension (AOR: 1.8; 95% CI 1.06–3.06), and unsafe level alcohol intake (AOR: 3.14; 95% CI 1.76–5.59) were independent risk factors.
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PREVALENCE OF EXCESSIVE DAYTIME SLEEPINESS (EDS) AMONG MEDICAL STUDENTS

PREVALENCE OF EXCESSIVE DAYTIME SLEEPINESS (EDS) AMONG MEDICAL STUDENTS

The current study was aimed to estimate EDS prevalence among medical students in Chennai. Among the participants higher percentage (30.57%) were reported to have EDS which was almost consistent with previous studies [15, 16]. However our results appeared comparatively higher than North Indian medical students which showed a prevalence of EDS to be 17.3% [14]. We presume the higher prevalence estimated in our study could be due to the huge academic load [13], frequent shifts, anxiety that our medical students are facing throughout. Also males seem to have more EDS than females which are similar to North Indian studies [14]. Sleep disorders were found to be more common in males than in females [18, 19, 20]. The reason for this was believed to be increased BMI, waist-hip ratio and neck circumference in males that lead to the development of sleep disturbances [18, 19]. In our previous study, we showed that male sex hormone – testosterone was one of the reasons to influence sleep disorders in males [20].
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