SummaryBackgroundA pre-anaesthestic echocardiogram (echo) is requested for most non-cardiac surgeries to identify possible cardiac structural anomaliesObjectiveTo describe the prevalence and spectrum of structural cardiac abnormalities seen in various non-cardiac conditionsMethodsWe carried out a retrospective review of pre-anaesthetic echos performed over five years on children scheduled for non-cardiac surgery. The requests were categorised according to referring specialities, and the biodata and echo findings were notedResultsA total of 181 children and 181 echocardiograms were studied, and 100 (55.2%) of the patients were male. Most of the children (87, 48.1%) with oro-facial clefts were referred from dentistry. Of the 181 children, 39 (21.5%) had cardiac abnormalities, most (34, 87.2%) of whom had congenital heart disease (CHD). Ophthalmic requests with suspected congenital rubella syndrome (CRS) had the highest prevalence of 8/12 (66.7%) while the lowest was oro-facial clefts at 15/87 (17.2%). Atrial septal defect was the commonest abnormality, found in 14 patients (35.9%)ConclusionPre-anaesthetic echo should be performed, especially for children with suspected CRS and other congenital anomalies, requiring non-cardiac surgery.
IntroductionThe WHO estimates a shortage of 18 million health workers (HWs) by 2030, primarily in low-income and middle-income countries (LMICs). The perennial out-migration of HWs from LMICs, often to higher-income countries, further exacerbates the shortage. We propose a systematic review to understand the determinants of HWs out-migration, intention to migrate and non-migration from LMICs.Methods and analysisThis protocol was designed in accordance with the Preferred Reporting Items for Systematic Review and Meta-analysis Protocols guideline for the development and reporting of systematic review protocols. We will include English and French language primary studies (quantitative or qualitative) focused on any category of HWs; from any LMICs; assessed migration or intention to migrate; and reported any determinant of migration. A three-step search strategy that involves a search of one electronic database to refine the preliminary strategy, a full search of all included databases and reference list search of included full-text papers for additional articles will be employed. We will search Ovid MEDLINE, EMBASE, CINAHL, Global Health and Web of Science from inception to August 2022. The retrieved titles will be imported to EndNote and deduplicated. Two reviewers will independently screen all titles and abstract for eligibility using Rayyan. Risk of bias of the individual studies will be determined using the National Institute of Health study quality assessment tools for quantitative studies and the 10-item Critical Appraisal Skills Programme checklists for qualitative studies. The results will be presented in the form of narrative synthesis using a descriptive approachEthics and disseminationWe will not seek ethical approval from an institutional review board, as this is a systematic review. At completion, we will submit the report of this review to a peer-reviewed journal for publication. Key findings will be presented at local and international conferences.PROSPERO registration numberCRD42022334283.
Objective
The aim of this study was to evaluate the predictors of mortality in childhood heart failure (HF) in 2 tertiary hospitals.
Methods
A 51-month retrospective review of case notes of children with HF admitted into children's emergency rooms of 2 tertiary centers in Southern Nigeria was done. Bio-data and certain sociodemographic variables including mortality were abstracted. Bivariate and multivariate analyses were done to evaluate the predictors of mortality in HF.
Results
The case notes of 289 children were analyzed, consisting of 153 males (52.9%) and 142 infants (49.1%). Lower respiratory tract infections, 121 (41.9%), were the commonest causes of HF. Twenty-eight children (9.7%) died. In multivariate analyses, only late presentation (P < 0.0001) was an independent predictor of mortality in HF.
Conclusion
Education of the populace about early presentation to hospital is imperative to prevent unnecessary deaths associated with HF.
Background: Birth weight is among the most common measures for assessment of intrauterine growth, particularly in developing countries. Aberrations in intrauterine growth can result in profound sequelae in the immediate neonatal period and later in life.In Nigeria, there is generally a poor national summary of abnormal birth weight pattern.
Aim of work:To describe the patterns of birth weight and associated factors among term babies delivered in an urban private hospital setting. Patients and methods: This was a single-center cross-sectional study. Records of all babies delivered from January 1 st , 2020, to December 31 st , 2020, were retrospectively reviewed. Preterm deliveries were excluded from the data. Results: There were 411 term deliveries during the study period, 255 vaginal deliveries and 156 caesarean deliveries. 407 babies were from singleton pregnancies and 8 by twin pregnancies. Thirty-one (7.5%) of the term babies had macrosomia and 14 (3.4%) had low birth weights. Bivariate analysis shows statistically significant association between birth weights of term babies and type of gestation (χ 2 -11.288, p -0.002) and mode of delivery (χ 2 -9.718, p -0.035). There was however no association between birth weights and mother's age or parity and baby's sex. Conclusions:Our findings show that newborn under-nutrition (LBW) and over-nutrition (HBW) are significant public health problems even among high income mothers in Benin City.
Background
Psychomotor slowing is more commonly reported in children with epilepsy (CWE) compared to healthy controls. The effect of anti-epileptic drug (AED) treatment on psychomotor abilities of CWE remains controversial. In Nigeria, psychomotor abilities of CWE are scarcely investigated and the impact of AEDs is not known. The present study sought to assess psychomotor performance of CWE compared to healthy controls and to determine any association with seizure characteristics and treatment.
Method
A comparative cross-sectional study involving 160 children with idiopathic epilepsy and 80 controls aged 6–16 years. Psychomotor function was assessed using reaction times and tapping task of the Iron psychology computerised test battery. The criterion for impairment was fixed at two standard deviations (SD) worse than the mean of age-matched controls. The relationship between seizure variables and psychomotor function was assess with the one-way analysis of variance (ANOVA).
Result
Fifty-nine (36.9%) CWE had impaired auditory reaction, 50 (31.3%) with impaired visual reaction and 11 (6.9%) had fine motor control impairment. There was no significant difference in psychomotor performance between CWE on AED and the newly diagnosed counterparts yet to start AED treatment (auditory reaction time—p = 0.226; visual reaction time—p = 0.349; tapping task—p = 0.818). AED treatment duration over 5 years was associated with better auditory reaction time (F = 4.631, p = 0.034) in CWE. Also, seizure onset before 5 years of age was associated with slower auditory reaction (F = 4.912, p = 0.028) and verbal reaction (F = 14.560, p < 0.001).
Conclusion
Nigerian CWE perform less favourably on tests of psychomotor function than healthy controls. The performance of children on AED is not significantly different from those not on AED. Longer duration of AED treatment may result in psychomotor improvement in CWE. CWE should be closely monitored for psychomotor slowness so that deficits can be identified and appropriate interventions instituted.
Progressive Familial Intra-hepatic Cholestasis (PFIC) is a group of heterogeneous, autosomal recessive disorders characterized by cholestasis, jaundice and mutilating pruritus, mostly in infancy. The incidence of PFIC ranges from 1:50,000 to 1:100,000. There are three subtypes; Types 1 and 2 typically present in the neonatal period and early infancy while Type 3 can present in early infancy, childhood or adolescence.
This report is about a 6-year old Nigerian girl who presented with jaundice and severe pruritus of one-month duration and abdominal pain of a week duration. The symptoms were preceded by ingestion of Atropine meant for ocular examination two days earlier. She was well-nourished, deeply icteric, had generalized healing scratch marks and hepatomegaly. The laboratory findings included conjugated hyperbilirubinaemia, moderately elevated liver transaminases and Gamma-Glutamyltransferase enzymes. She was managed for PFIC3 using oral ursodeoxycholic acid with complete resolution of the disease.
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