Fatalities from perinatal asphyxia remain high in developing countries, and continually assessing its risk factors will help improve outcomes in these settings. We explored how some identified risk factors predict mortality in asphyxiated newborns, to assist clinicians in prioritizing interventions. This was a 4-year prospective study conducted at the Enugu State University Teaching Hospital, Enugu, Nigeria. All newborns who met the study criteria that were admitted to this facility in this period were enrolled and monitored. Data collected were analysed with SPSS Version 18. A total of 161 newborns with perinatal asphyxia were enrolled into the study with an in-hospital incidence rate of 12.81 per 1000 birth and a case fatality rate of 18%. Overall, the APGAR scores were severe in 10%, moderate in 22%, mild to normal in 68%, whereas the SARNAT stages were III in 24%, II in 52%, and I in 25%. In terms of mortality, 66.7%, 22.2%, and 11.1% mortalities were, respectively, observed with SARNAT scores III, II, and I (P = .003), whereas the findings with APGAR were 31.2% (severe), 25.0% (moderate), 25.0% (mild), and 18.8% (normal) (P = .030). Fatality outcome was more correlated with SARNAT (R = .280; P = .000) than APGAR (R = −.247; P = .0125). The SARNAT score significantly differentiated between the degrees of asphyxia in newborns based on gestational age at delivery (P = .010), place of delivery (P = .032), and mode of delivery (P = .042). Finally, it was noted that newborns that were female (P = .007), or born outside the hospital (P = .010), or with oxygen saturations <60% (P = .001), or with heart rate <120 (P = .000), and those with respiratory rate <30 (P = .003), all have significantly higher likelihood of deaths from asphyxia. Therefore, predictors of neonatal mortality from perinatal asphyxia in our centre include being female and being born outside the hospital, as well as low oxygen saturations, heart rates, and respiratory rates at presentation.
Background: Birth injury is defined as structural damage of a newborn secondary to mechanical forces that occur during labor and/or delivery. This study determined the incidence, risk factors and outcome of birth injury. Methodology: This was an observational study of birth injuries in neonates, over a period of one year, carried out at a tertiary hospital in Enugu, south east, Nigeria. Results: Out of the 1,735 births recorded during the period of the study, there were 19 cases of birth injuries. This gave an incidence of 11 per 1000 live births. No neonate had more than one injury. They were thirteen males and six females that sustained birth injury. Cephalohematoma was the most common birth injury. Others are caput succedaneum, clavicular fracture, Erb's palsy, femoral fracture, humeral fracture, shoulder dislocation and facial laceration. Mode of delivery, neonatal birth weight, gestational age and maternal parity were significant predictive risk factors for birth injury. Conclusion: In the current study, cephalohematoma was the most common birth injury, followed by caput succedaneum. There is need to reduce the morbidity and mortality associated with birth injuries.
Objective: uvula. It is usually performed by non-medical personnel using mostly unsterile instruments. Notwithstanding the increasing number of health facilities, it is surprising that this aged-long crude practice with significant complications is still rampant in the 21st century. Material and Methods: This is a case series of four males with the age range of 5-months to four years who had traditional uvulectomy following febrile illnesses but with no improvement of symptoms. Thereafter, all presented late to our facility with diverse complications, including haemorrhage, infections, and convulsions. Three recovered fully following prompt treatment, however, one mortality was recorded. Conclusion: These cases highlight the life-threatening complications associated with traditional uvulectomy and the need for drastic measures to curtail the practice.
Objective: As more care is provided for children in outpatient facilities, it is increasingly important to understand the potential for disease transmission and this is particularly so for nosocomial infections which are infections originating in hospitals. Knowledge of the profile of bacterial isolates of surfaces in outpatient facilities and their sensitivity patterns serves as a guide for prevention of nosocomial infection transmission. Material and Methods: This hospital-based cross-sectional study was conducted in the Children's Outpatient Clinic (CHOP) of Enugu State University Teaching Hospital, Parklane, Enugu, Nigeria (ESUT-TH). Samples for culture were collected from equipment and hospital surfaces. Antimicrobial susceptibility testing was determined for each isolate by the Agar diffusion method using Standard Nutrient Agar 1 discs. Results: Out of 122 samples collected from various sites, bacterial growth was observed in 55 (45.0%) specimens. Staphylococcus aureus and Coagulase-negative Staphylococcus were the most common isolates cultured from 23 different locations. Among the Staphylococcus aureus isolates, 17.4% (4/23) were MRSA. Levofloxacin and Imipenem showed the best sensitivity pattern for Staphylococcus aureus Conclusion: Staphylococcus aureus, Coagulase-negative Staphylococcus were the commonest isolates. There is need to develop specific protocols that will ensure hand hygiene, judicious use of antimicrobials, active surveillance, and enhanced cleaning/disinfection of surfaces in outpatient clinics as essential components of prevention and control of nosocomial infections.
Objectives: This study aimed to evaluate the knowledge and use of hypertonic saline among doctors in the Southeast region of Nigeria. Methods: It was a cross-sectional study conducted amongst 182 doctors in the paediatric departments of the six tertiary institutions in South Eastern Nigeria. Data to assess knowledge and use of hypertonic saline were collected using self-administered, structured questionnaires. Results: After aggregating the knowledge questions (definition of hypertonic saline, knowledge of available concentrations and modes of administration) and categorizing knowledge into good or poor, 148 (81.3%) had good knowledge, while 34 (18.7%) had poor knowledge. Respondents who had ever seen an infusion of hypertonic saline were 93 (51.1%), while only 62 (34.1%) had ever used it during their practice. Among those who had used it, only 33 (18.1%) obtained it from their hospital pharmacy. Most respondents (91.2%) would support advocacy for its increased availability and use in Nigeria. Conclusions: Our study demonstrated good knowledge of hypertonic saline, however, there is low usage due to unavailability. There is a need for collaboration between paediatricians, pharmaceutical companies and other stakeholders to create demand and initiate the production of hypertonic saline.
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