Management and outcomes of gastrointestinal congenital anomalies in low, middle and high income countries: Protocol for a multicentre, international, prospective cohort study

Introduction Congenital anomalies are the fifth leading cause of death in children <5 years of age globally, contributing an estimated half a million deaths per year. Very limited literature exists from low and middle income countries (LMICs) where most of these deaths occur. The Global PaedSurg Research Collaboration aims to undertake the first multicentre, international, prospective cohort study of a selection of common congenital anomalies comparing management and outcomes between low, middle and high income countries (HICs) globally. Methods and analysis The Global PaedSurg Research Collaboration consists of surgeons, paediatricians, anaesthetists and allied healthcare professionals involved in the surgical care of children globally. Collaborators will prospectively collect observational data on consecutive patients presenting for the first time, with one of seven common congenital anomalies (oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation and Hirschsprung''s disease). Patient recruitment will be for a minimum of 1 month from October 2018 to April 2019 with a 30-day post-primary intervention follow-up period. Anonymous data will be collected on patient demographics, clinical status, interventions and outcomes using REDCap. Collaborators will complete a survey regarding the resources and facilities for neonatal and paediatric surgery at their centre. The primary outcome is all-cause in-hospital mortality. Secondary outcomes include the occurrence of postoperative complications. Chi-squared analysis will be used to compare mortality between LMICs and HICs. Multilevel, multivariate logistic regression analysis will be undertaken to identify patient-level and hospital-level factors affecting outcomes with adjustment for confounding factors. Ethics and dissemination At the host centre, this study is classified as an audit not requiring ethical approval. All participating collaborators have gained local approval in accordance with their institutional ethical regulations. Collaborators will be encouraged to present the results locally, nationally and internationally. The results will be submitted for open access publication in a peer reviewed journal

Radiological dose implications of the natural radioactivity in surface soils in Ekiti State, Nigeria

The radiological dose implications of the natural radioactivity in the surface soil across Ekiti State, Nigeria have been determined in this study by using a very sensitive gamma spectroscopic system of measurement. Effective dose at 1.0m above the ground in the State was found to vary between 0.037 and 0.227mSvy-1 while the fifty years integral dose obtained ranged from 1.85 to 11.5mSv with a mean of 5.4770+ 2.926mSv. The estimated average effective dose equivalent for the State is 0.109+ 0.058 mSvy-1. This value is far below the 0.41 mSvy-1 estimated as the world average by UNSCEAR and the dose limit of 1.0 mSv per year recommended as the individual dose limit for members of the public by the International Commission for Radiological Protection (ICRP). (Global Journal of Pure and Applied Sciences: 2002 8(3): 357-360