A two-part study was conducted in several centres in Nigeria to develop and evaluate a simple method for maturity determination in newborn infants. The first part involved the development of a six-feature model which included head circumference, mid-arm circumference, skin texture, ear form, breast size and genitalia. These were features which had highly significant correlation with gestational age in the studied population. The model consisted of a chart showing the regression line of gestational age on total maturity score based on the six selected features. It had comparable accuracy with the Dubowitz method. Different subgroups of term and low-birth weight infants were also reliably identified by the model. In the evaluation of sick newborn infants, the model was more accurate than a previously reported abbreviated method from the same population. The model is suggested as an appropriate clinical tool for rapid and reliable maturity determination in healthy and sick newborn infants.

Background: Childhood pneumonia is the foremost killer of under-fives. Indoor air pollution by smoke from cooking fuel is a major risk factor for childhood pneumonia. The knowledge of caregivers about risk factors can facilitate the practice of appropriate preventive measures. This study set out to evaluate the perception of traders about cooking smoke as a risk factor for childhood pneumonia. Methodology: A researcher administered, questionnaire based, cross-sectional study was carried out at a major market in Benin City prior to a market rally to celebrate World Pneumonia Day 2014. The respondents were traders. Information on biodata, place of cooking, fuel for cooking and presence of under-fives in the cooking area of homes of respondents was sought. Results: There were 1374 respondents of which 1192(88.5%) were females. Only 67(4.9%) respondents considered smoke from cooking fuel a risk factor for pneumonia while 99(7.2%) considered avoidance of smoke as a method for preventing pneumonia. Firewood (biomass fuel) was utilized by 272(19.8%) respondents. Respondents with no education were significantly more likely to use firewood (p<0.000). All respondents with under-fives reported having them in the cooking area. Having a child who had suffered pneumonia in the past was not significantly associated with knowing that smoke was a risk factor for childhood pneumonia p>0.05. Conclusion: There is poor awareness of smoke as a risk factor for childhood pneumonia while the use of unclean fuel is significant. As part of health education on childhood pneumonia, smoke as a risk factor should be emphasized. Government should make cleaner fuels more available, accessible and affordable.

Data from a previous study were analysed to develop a new model for neonatal nutritional evaluation which is independent of precise maturity determination. Birth weights and arm/head ratios were recorded for each infant recruited for the study. Both indices were correlated by simple regression analysis with gestational age as the independent variable. Birth weight showed highly significant correlation with gestational age (r = 0.77; P < 0.001). Arm/head ratio was also correlated with birth weight with highly significant correlation coefficient (r = 0.81; P < 0.001). The regression line of arm/head ratio on birth weight, with the demarcated 95 per cent confidence spread, formed the new model for neonatal nutritional assessment. The model had a sensitivity of 80.54 per cent and specificity of 90.22 per cent using nutritional status determined by clinical features as reference. Since the model is independent of precise maturity determination, which limits the potential usefulness of several methods of neonatal nutritional assessment, it is recommended as a rapid, simple, and reliable appropriate health technology for developing communities.

Abstract:The term conjoined twins refers to babies who are physically joined at some point. It is a rare condition with an estimated incidence of 1 per 200,000 live births. We report our experience with conjoined twins over a twelve year period in tertiary hospital in Nigeria and a case of the first set of conjoined twin survivors in Benin City, Nigeria. Over the last twelve years (1999)(2000)(2001)(2002)(2003)(2004)(2005)(2006)(2007)(2008)(2009)(2010)(2011), three cases of conjoined twin have been recorded in our teaching hospital. A set of thoracoomphalopagus twins (females) were delivered in 1999 and they survived for only 36hrs. Another set of female omphalopagus twins were delivered in 2009 and survived a separation surgery. A third set of female thoracoomphalopagus was delivered in another institution same year and referred to our unit but they only survived for 48 hours. The first surviving twins were omphalopagus, sharing a single liver, and common bile duct emptying into a common duodenum. The stomach, as well as the jejunum was normal and unshared. Surgical separation of the liver was done and biliary reconstruction procedure performed for twin II. A three -year follow up showed good outcome.