Plummer’s nails (onycholysis) in an adolescent nigerian girl with hyperthyroidism due to Graves’ disease

This paper reported a case of a 16 years old Nigerian girl with Plummer’s nails associated with hyperthyroid­ism (Graves’ disease). The issue of excessive weight gain after therapy for the Graves’ disease was also discussed. Following therapy, the patient gained 7 Kg over a period of 5 months. The diagnosis of hyperthyroidism due to Graves’ disease was based on increased heart rate at rest, diffuse smooth goiter, mild ophthalmopathy, low TSH (thyroid stimulating hormone) level, elevated T3 (triiodothyronine)and T4 (tetraiodothyronine) levels. The paper emphasized the need for clinicians to be alert to the possibility of nail changes in adolescents with thyroid diseases and watch out for weight gain following successful therapy

Prediabetes in three siblings of a Nigerian boy with type 1 diabetes mellitus: Is this a case of familial clustering?

We report a case of a 9-year-old Nigerian boy with confirmed type1diabetes (T1D) and whose three elder siblings (sisters) had pre-diabetes, defined by impaired fasting blood glucose, using the ISPAD most recent criteria. The fasting blood glucose levels of the siblings of the index patient were 6.1mmol/L, 5.9mmol/L and 5.6mmol/L, respectively. On insulin therapy, the boy‘s diabetes was well controlled with no hypoglycaemic episodes. The father of the index patient has type 2 diabetes mellitus and his diabetes was initially controlled with oral glucose-lowering agent for 10 years before switching to insulin therapy in the last seven years, following poor glycaemic control with the initial therapy. The three siblings of the index patient are currently being followed up with periodic retesting, using fasting and/or 2-hour postprandial blood glucose determinations as suggested in ISPAD recent guideline. Conclusion: A high index of clinical suspicion of diabetes mellitus is required in the siblings of any child with type 1 diabetes

Hypertension Despite Dehydration in an Adolescent with Diabetic Ketoacidosis

In general, information on blood pressure changes in diabetic ketoacidosis in paediatric population is very scarce. Our aim was to report a case of severe DKA in an adolescent girl who unexpectedly had hypertension rather than hypotension.A 17-year-old girl presented in our Children’s Emergency Unit with complaints of excessive eating for 6 weeks, excessive urination for 2 weeks, fever for 1 week, vomiting for 4 days, difficulty with breathing for one day and unresponsiveness to calls for 3 hours. She had moderated to severe dehydration but no hypotension. Laboratory findings included hyperglycaemia (random blood glucose 20.8 mmo/L; 347 mg/dl), acidosis (serum bicarbonate 5 mmol/L),  ketonuria 2+; glycosuria 2+, and urine  specific gravity of 1.015. At admission, the blood pressure was 100/60 mmHg but progressively rose to 140-180/80-100 mmHg by the third day from admission. A significant hypertension can occur in children and adolescents admitted for severe DKA despite the presence of dehydration. Therefore, the attending physician should be aware of this possibility

Small-for-gestational Age, Ponderal Index and Neonatal Polycythaemia: A Study of Their Association with Maternal Hypertension Among Nigerian Women

Background/Objective: To examine the influence of maternal hypertension on rate of delivery of small-for-gestation age (SGA) infants, incidence of neonatal polycythaemia and mean ponderal indices of the resultant newborn infants. Methods: From the birth weights and lengths, the ponderal indices of SGA infants born to mothers with chronic hypertension were compared with those of their counterparts born to mothers with pregnancy-induced hypertension. In addition, the spun venous haematocrit values of 265 infants born to mothers whose pregnancies were complicated by hypertension were compared with those of 804 infants born to control mothers. Results: The rates of delivery of SGA infants were 82.0 and 54.7 per 1000 live births among hypertensive and normotensive mothers respectively (p>0.05). The prevalence of neonatal polycythaemia was 8.2% and 2.2% for infants of hypertensive and control mothers respectively (p<0.001). The rate of delivery of SGA infants was 18.6 times higher in mothers with chronic hypertension than in mothers with pregnancy-induced hypertension (p<0.001). SGA infants born to mothers with chronic hypertension had normal mean ponderal index ( 65 2.3) while their counterparts born to mothers with pregnancy-induced hypertension had low mean ponderal index (<2.3). The prevalence of neonatal polycythaemia was 52.9% and 5.0% in infants born to mothers with chronic hypertension and infant of mothers with pregnancy-induced hypertension respectively (p<0.001). Conclusion: Maternal hypertension is associated with an increased incidence of neonatal polycythaemia and delivery of SGA infants. This risk is dramatically higher in women with chronic hypertension. Chronic maternal hypertension causes proportionate foetal growth retardation while pregnancy-induced hypertension causes disproportionate foetal growth retardation.Contexte/Objectifs: Examinerl'influence de l'hypertension maternelle sur le taux d'accouchement de nouveaux-n\ue9s petits par rapport \ue0 l'\ue2ge gestationnel, l'incidence de la polycyt\ue9mie n\ue9onatale et l'indice de poids moyen des nouveaux-n\ue9s r\ue9sultant. M\ue9thodes: A partir de la longueur et du poids de naissance, l'indice pond\ue9ral d'enfants petits par rapport \ue0 l'\ue2ge gestationnel n\ue9s de m\ue8res souffrant d'hypertension chronique a \ue9t\ue9 compar\ue9 \ue0 celui d'enfants n\ue9s de m\ue8res ayant une hypertension gravidique. De m\ueame la valeur de l'h\ue9matocrite de sang centrifug\ue9 de 265 enfants n\ue9s de m\ue8res dont la grossesse s'\ue9tait compliqu\ue9e d'hypertension a \ue9t\ue9 compar\ue9e \ue0 celle de 804 enfants n\ue9s de m\ue8res t\ue9moins. R\ue9sultats : Le taux d'accouchement d'enfants petits par rapport au poids de naissance \ue9tait de 82 et de 54,7 pour1000 naissances vivantes, respectivement pour les m\ue8res hypertendues et les m\ue8res normotendues (p>0.05). La pr\ue9valence de la polycyth\ue9mie n\ue9onatale \ue9tait respectivement de 8,2% et 2,2% pour les enfants de m\ue8res hypertendues et les t\ue9moins (p<0.001). Le taux d'accouchement d'enfants petits par rapport \ue0 l'\ue2ge gestationnel \ue9tait 18,6 fois plus \ue9lev\ue9 chez les femmes souffrant d'hypertension chronique par rapport aux m\ue8res ayant une hypertension gravidique (p<0.001). Les enfants petits par rapport \ue0 l'\ue2ge gestationnel n\ue9s de m\ue8res souffrant d'hypertension chronique avaient un index pond\ue9ral moyen normal ( 652.3), tandis que leurs homologues n\ue9s de m\ue8res souffrant d'hypertension gravidique avaient un faible index pond\ue9ral moyen (<2.3). La pr\ue9valence de polycyth\ue8mie n\ue9onatale \ue9tait de 52,9% et 5,0% pour les enfants n\ue9s respectivement de m\ue8res souffrant d'hypertension chronique et de m\ue8res souffrant d'hypertension gravidique (p<0.001). Conclusion : Une hypertension maternelle est associ\ue9e \ue0 une incidence \ue9lev\ue9e de polycyth\ue9mie n\ue9onatale et \ue0 un accouchement de nouveaux n\ue9s petits par rapport \ue0 l'\ue2ge gestationnel. Ce risque est dramatiquement plus \ue9lev\ue9 chez les femmes souffrant d'hypertension chronique. L'hypertension chronique maternelle entra\ueene un retard proportionn\ue9 de croissance fetal, tandis que l'hypertension gravidique entra\ueene un retard dysproportionn\ue9 de croissance foetal

Isolation and characterization of pyropheophorbide-a from moringa oleifera lam

Moringa oleifera is a plant rich in pharmacologically active compounds. This study investigated the phytochemical constituents of Moringa oleifera leaf extracts. Dried M. oleifera leaves were ground and extracted successively with hexane, ethyl acetate and methanol using a Soxhlet apparatus. Different chromatographic techniques were used to fractionate the ethyl acetate extract. Thin layer chromatography was used to pool similar fractions together. Fractions obtained were purified using sephadex glass column. The structures of isolated compounds were identified using nuclear magnetic resonance (NMR), electrospray ionization mass spectrometry (ESI-MS) and comparison with published data. Phytochemical screening revealed the presence of flavonoids, terpenoids, carbohydrates and phenols. Ethyl acetate extract which was subjected to column chromatography resulted to the isolation of two compounds: mono acetyl glycerol and pyropheophorbide-a, from the leaves of M. oleifera. This is the first report on the isolation of pyropheophorbide-a from the leaves of M. oleifera

Role of antenatal care and iron supplementation during pregnancy in preventing low birth weight in Nepal: Comparison of national surveys 2006 and 2011

Background: Low birth weight (LBW) is a major cause of neonatal deaths in developing countries including Nepal. Its social determinants in Nepal have rarely been identified. This study aimed to identify the factors associated with low birth weight among under-five children comparing data from the Nepal Demographic and Health Surveys (NDHS) of 2006 and 2011. Methods: Pooled data from the Nepal Demographic and Health Surveys (NDHS) of 2006 and 2011 were analysed initially and the two survey data were then compared separately. The association between LBW and socio-demographic and health related factors were analysed using multiple logistic regression analysis with a stepwise backward elimination procedure. Complex Sample Analysis method was used to account for study design and sampling.Results: A total of 2845 children, 923 children in 2006 and 1922 children in 2011, had their birth weight recorded. The mean birth weight was 3024 (SD = 654.5) grams. A total of 12.1% (95% Confidence interval (CI); 10.6%-13.7%) children had low birth weight (<2500 grams) at the time of birth. Attending antenatal care was found to be consistently associated with low birth weight for the pooled survey data, and both 2006 and 2011 survey data, respectively. Not attending antenatal care increased the odds of having a LBW infant by more than two times [OR 2.301; 95% CI (1.526-3.471)]. Iron supplementation, which is an integral part of antenatal care in Nepal, was also significantly associated with birth weight for combined and individual surveys. Mothers not consuming iron supplementation during their pregnancy were more likely to have LBW infants [OR 1.839; 95% CI (1.282-2.363)]. Residing in the Far-western and Eastern region were also significant risk factors for LBW in the pooled dataset and in 2011 survey. Conclusions: The current study indicated there was no significant decrease in the LBW prevalence and there is a need of targeted interventions aimed at decreasing the high rate of LBW through increasing antenatal care and consumption of iron supplementation during pregnancy

Twin delivery: comparison of incidence and foetal outcome in two health institutions in benin city, Nigeria

Background: The incidence of twin delivery in Nigeria may have changed, in view of the worldwide increase in the rates of twinning attributed to increasing maternal age and use of fertility therapies. Objective: To determine the current incidence of twin delivery in Benin City and document the foetal outcome in twins. Methods: A four-year descriptive (cross-sectional) study of twin deliveries in a Nigerian mission hospital was conducted. The foetal outcome in 115 sets of twin was compared with that of 230 singleton controls. Results: The current incidence of twin delivery was 25.3 per 1000 deliveries or one in 40 births, representing a reduction by 24.2%. Sex ratio was 0.98 : 1 in favour of females. Seasonal variation was observed in the incidence of twin delivery with a significantly higher incidence in wet than in dry season 

Twin Delivery: Comparison of Incidence and Foetal Outcome in two Health Institutions in Benin City, Nigeria

Background: The incidence of twin delivery in Nigeria may have changed, in view of the worldwide increase in the rates of twinning attributed to increasing maternal age and use of fertility therapies. Objective: To determine the current incidence of twin delivery in Benin City and document the foetal outcome in twins. Methods: A four-year descriptive (cross-sectional) study of twin deliveries in a Nigerian mission hospital was conducted. The foetal outcome in 115 sets of twin was compared with that of 230 singleton controls. Results: The current incidence of twin delivery was 25.3 per 1000 deliveries or one in 40 births, representing a reduction by 24.2%. Sex ratio was 0.98 : 1 in favour of females. Seasonal variation was observed in the incidence of twin delivery with a significantly higher incidence in wet than in dry season (