Rare Occurrence of Mix Stromal Tumours: A Case Report Of Gastrointestinal and Extra-Intestinal Stromal Tumour on the Jejunum And Omentum of a Nine Year Old Girl From Adamawa State, Nigeria

Background: Stromal tumors of the jejunum (GIST) and omentum (EGIST) are uncommon and dearth of information still exists on their occurrence concurrently.Case details: Here, we report a nine year old girl that presented with tender abdominal mass measuring 14 x 8 cm associated with features of gastric outlet obstruction and hyponatremia of 115mmol/L. A diagnosis of hyponatremia in a child with gastric outlet obstruction secondary to intraabdominal mass was made for which exploratory laparotomy was carried out. Histology of the tumour revealed stromal spindle epithelioid as well as myxoid cells. Complete resection of the tumour and correction for hyponatremia was done in addition to antibiotics therapy with remarkable improvement.Conclusion: Index case is that of mixed stromal tumours that presented with features of gastric outlet obstruction, and the patient did well after surgery.Keywords: Gastrointestinal/extraintestinal stromal tumors, Jejunum,  Omentum, Paediatrics, Adamawa state, Nigeria

The effects of weathering demonstrated by maternal age on low birth weight outcome in babies

BACKGROUND: Increasing age has been hypothesized with wear and tear (weathering) in mothers, which may result to low birthweight of their babies. The prevalence of low birthweight could be heightened if maternal weathering is associated with poor maternal socioeconomic variables. In this current study, we analyzed the effects of maternal weathering on babies’ birthweights.METHODS: One hundred and twenty four mother-baby pairs were selected using systematic random sampling method. Maternal age formed part of the demographic data that was obtained from the mothers’ case notes and from interviews held with them. Maternal socioeconomic variables were assessed using Oyedeji’s parameters and birthweights of babies were determined using bassinet weighing scale. Associations between maternal socioeconomic variables and birthweight of babies were assessed using univariate analysis. Differences in mean birthweight of babies according to their maternal age were evaluated using one-way analysis of variance ANOVA.RESULTS: Among the 124 babies, 66(53.2%) were males and 58(46.8%) females of whom the majority 104(83.9%, had normal birthweight. The mean birthweight of babies was 3.05±0.57 (95% CI, 2.95–3.15) kg, while the mean maternal age was 23.60 (5.2) 95% CI, (22.68–24.52) years. The difference between mean birthweight of babies and mean maternal age was not significant (F=1.35, p=0.255). Similarly, the association between birthweight, maternal education and occupation computed using univariate analysis was not significant (F=2.163, p=0.120) for education and (F=1.825, p=0.166) for occupation.CONCLUSION: In this study, maternal weathering was not found to be associated with LBW outcome. This implies that an increase in maternal age may not be significantly associated with LBW. However, there is need for further research on this subject from different centers using larger sample size in order to enhance the precision of the study.KEYWORDS: Mother-baby pairs, Maternal Weathering, Low birthweight, Maiduguri, Nigeri

Microeconomics of managing Diabetic Ketoacidosis in a rural Nigerian child of low socioeconomic class: a case report

Health care delivery is a concurrent responsibility of the various levels of government in Nigeria where most of the populace earn less than one dollar a day. The total expenditure on Nigerian health care as a percentage of gross domestic product, and the percentage of federal government expenditure on health care is far below the World Health Organization recommended standard. Thus, caregivers pay out of their pockets to settle health care expenses of their children thereby creating a negative microeconomic impact on parents, households and health workers. Herein, we report the case management of newly diagnosed Diabetic Ketoacidosis (DKA) in an eight-year-old boy from a low socioeconomic class (SEC), and the costs implication of the child’s hospital care. After forgoing indirect costs like opportunity cost which is difficult to determine, the direct total cost involved in patient’s hospital care for DKA was forty eight thousand eight hundred naira only (N48, 800.00) equivalent to three hundred and ten United States Dollars and eighty three cents (310.83 USD). Based on the high cost of managing DKA observed in the study case, there is a need to convince health system administrators and policy makers to strengthen health insurance so as to enable patients, especially those from low SEC, to pay their hospital bills promptly.Keywords: Diabetic ketoacidosis; Microeconomics; Costs; Low socioeconomic class; Child; Yola; Nigeri

Profile and management of central nervous system malformations in a tertiary hospital

Central Nervous System (CNS) malformations rank among the commonest malformations. These may be identified in utero or noticed immediately after birth. Most studies showed Myelomeningocoele, a Neural Tube Defect (NTD) to be the commonest. Severe defects have a significant impact on long term disability. While some are preventable, most are surgically managed. Objective: To study the profile and management of CNS malformation in a tertiary hospital. Method: we undertook a 3-year retrospective study of the profile and surgical management, including the postoperative complications among Neonates admitted into the Special Care Baby Unit (SCBU). Data on place of delivery, Gender, Gestational age, Mode of delivery, Prenatal Diagnosis (Ultrasound Scan), types of malformations, types of surgeries, and postoperative complications were retrieved. Result: We found 71 patients with CNS anomalies (31.8% of all congenital anomalies), in delivery 10 (14.1%), out delivery 46(64.8%). Male=43, females=28. Term gestation 66 (93%), preterm 3(4.2%), post-term 2(2.8%). Delivered by Vagina (SVD) in 65(91.6%), Caesarean section 4(5.6%), and undocumented in 4(5.6%). Prenatal diagnosis in only 3(4.2%). Myelomeningocoele was 35(49.3%), meningocoele was 9(12.7%), Hydrocephalus was 18(25.3%), anencephaly was 1(1.4%), occipital Encephalocoele was 6(8.5%), Sincipital Encephalocoele was 2(2.8%). Operated on 53(75%), LAMA/lost to follow was 13(18%), preoperative death was 5(7%). Excision and closure of Neural Tube Defect were 34(64.2%), VP Shunt was 13(24.5%), Excision and closure of occipital Encephalocoele were 5(9.4%) craniofacial excision and repair of Sincipital Encephalocoele was 1(1.9%). CSF leak in 4(28.6%), wound infection in 3(21.4%), shunt infection and obstruction in 2(14.3%) each. meningitis, hypertrophied scar, and pseudo meningocoele in 1(7.1%) each. Conclusion: The commonest CNS anomaly is a Myelomeningocoele a preventable condition, Sincipital Encephalocoele is not common in our environment. Concomitant treatment of hydrocephalus averts post excision CSF Leak

Psoralen And Bergapten From The Leaves Of Ficus iteophylla

The leaves of Ficus iteophylla gave 2 furanocoumarins; Psoralen and Bergapten. Their structure was elucidated using spectroscopic technique. Key words: Ficus iteophylla, Moraceae, Psoralen and Bergapten Nig. J. Nat. Prod. and Med. Vol.8 2004: 6

Flavonoid Glycosides From The Leaves Of Daniellia oliveri

Four flavonoid glycoside: Rutin, Quercitin-3/-O-methyl-3-O-α-rhamnopyranosyl-(→)-β-D-glucopyranoside (Narcissin), Quercitrin and Quercimeritrin were isolated from the n-butanol soluble portion of the aqueous part of the ethanolic extract of the leaves of the plant Daniellia oliveri. The structures of these compounds were determined by spectroscopic techniques. Key words: Daniellia oliveri, Fabaceae, Flavonoid glycoside: Narcissin, Quercitrin, Quercimeritrin, rutin Nig. J. Nat. Prod. and Med. Vol.8 2004: 67-6