Delayed presentation of patients with posterior urethral valve with complications like severe urosepsis, uremia, and anemia are seen in our setting. Renal replacement therapy which should have been offered to these patients is not readily available for children in our country. The aim of this study is to determine the pattern of late presentation and outcome of management of posterior urethral valve in a resource-limited setting. A descriptive retrospective study (1997–2009) was conducted. Data including pattern of presentation, duration of symptoms, complications, and outcome of initial management were analyzed. Twenty-one patients were seen. The median age was 3 years (2 days–13 years). The mean duration of symptoms before presentation was 2.6 years. Nineteen patients (91%) presented with urosepsis while 8 patients (36%) presented with significant renal insufficiency. Laboratory findings varied from-mild-to marked elevation in serum creatinine. Radiological findings confirmed the diagnosis of posterior urethral valve. We concluded that late presentation is common in our setting. This is associated with high morbidity and mortality rates. Efforts at improving awareness and early diagnosis among the health team should be made to stem the tide.

Nigeria has a record of high newborn mortality as an estimated 778 babies die daily, accounting for a ratio of 48 deaths per 1000 live births. The aim of this paper was to show how a deteriorating neonatal delivery system in Nigeria may have, in part, been improved by the application of a novel recycled incubator technique (RIT). Retrospective assessment of clinical, technical, and human factors in 15 Nigerian neonatal centres was carried out to investigate how the application of RIT impacted these factors. Pre-RIT and post-RIT neonatal mortalities were compared by studying case files. Effect on neonatal nursing was studied through questionnaires that were completed by 79 nurses from 9 centres across the country. Technical performance was assessed based on 10-indices scores from clinicians and nurses. The results showed an increase in neonatal survival, nursing enthusiasm, and practice confidence. Appropriately recycled incubators are good substitutes to the less affordable modern incubators in boosting neonatal practice outcome in low-income countries.

During the six-year period 1982 to 1987, 49 of 5454 children (0.89%) admitted to the pediatric medical ward of the Armed Forces Hospital in Tabuk were treated for bacterial meningitis. Ninety percent were younger than 24 months. The causative organisms isolated were Hemophilus influenzae type B (55%), H. influenzae (2%), Streptococcus pneumoniae (18%), and Neisseria meningitidis (2%). Cerebrospinal fluid cultured showed no organisms in 22% of the patients. Eighty-nine percent of the children with H. influenzae type B meningitis were younger than 24 months. Forty-five percent of the patients had had prior antibiotic treatment. Eleven percent of the cases of H. influenzae type B meningitis were ampicillin resistant, and 7% were both ampicillin and chloramphenicol resistant. The overall mortality was 14.3%. Survivors were followed from a minimum of 4 months to a maximum of 96 months. Recurrent seizures and psychomotor retardation were found in 12% and sensorineural impairment in 2%.

In a prospective study of multiple births conducted a t three hospitals, a University Teaching Hospital, an urban Maternity Hospital and a Community Hospital, in Eastern Nigeria. the average incidence was found t o be 35 per 1000 births. The twinning rate was found to increase progressively with both birth rank and maternal age, with a n indication that parity plays the more important role

To evaluate the usefulness of simple screening tests such as urinalysis and blood pressure measurement in the early detection of renal disorders in pre-School children, we used a multi-staged random sampling method to select subjects from registered nursery schools within Enugu metropolis in south-east Nigeria. We selected 630 children for this cohort study. There was a prevalence of 2.7%, 0% and 1.9% for asymptomatic proteinuria, hematuria and hypertension, respectively. There was no age, gender or social class preponderance (P = 0.44). Hypertension seemed to be limited to children close to the age group of five years (P <0.001). No correlations could be documented between asymptomatic proteinuria, hematuria or hypertension. The prevalence of persistent proteinuria was found to be 1.6% and the mean urinary protein excretion estimation (spot urine protein/creatinine) was 1.88 g/mg ± 0.53, with a mean glomerular filtration rate of 78.7 ± 12.6 mL/min/1.73 m³ . Renal ultrasonography revealed abnormal findings in 30% of the children with persistent proteinuria. Asymptomatic persistent proteinuria with or without hematuria and hypertension could be a presumptive evidence of an underlying renal parenchymal disease and should be properly investigated and followed-up.

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