Cerebrovascular Accident Complicating Diabetic Ketoacidosis in a Nigerian Adolescent: A Case Report and Review of the Literature

Cerebrovascular accident (CVA) is a rare neurological complication of diabetic ketoacidosis (DKA) in the paediatric population. The risk of developing CVA in DKA patients is often increased due to abnormalities in coagulation factors, platelet activation, blood volume and flow, and vascular reactivity. Cerebral oedema, the most common neurological complication of DKA, may also predispose to CVA. We report the case of a -12-year-old adolescent with DKA complicated by CVA. She developed features of right hemispheric CVA while on admission and had radiological confirmation of an ischaemic CVA. This report highlights that cerebrovascular accidents in DKA can easily be missed or confused with cerebral oedema

Neonatal Diabetic Ketoacidosis In A Nigerian Infant: A Case Report

Neonatal diabetic ketoacidosis is a rare condition that may occur in the first few weeks of life as a complication of neonatal diabetes mellitus. The prominent clinical features are hyperglycaemia and dehydration. It could also mimick an infection. The danger of inappropriate diagnosis is increased morbidity and mortality. To prevent this, we advocate routine testing of blood glucose levels in neonates and infants who present at the emergency rooms. We report a case of neonatal diabetic ketoacidosis in a female who presented at our facility.Keywords: Neonate Diabetes mellitus Ketoacidosis Dehydratio

The effects of genotype and week of lactation on milk yield, udder dimensions and linear body measurements of non-dairy ewes

One hundred and ninety two records were taken weekly for twenty four (24) weeks from West African Dwarf (WD), the Yankasa (YN) and the West African Dwarf X Yankasa crossbred (XB) sheep . The traits evaluated were milk yield (MK), linear body measurements (LB) such as height at withers, (HT), body length (BL), heart girth (HG), shoulder width (SW), Tail length (TA), Neck length (NL), Neck circumference (NC), Face length (FA), Hind leg length (HL), Foreleg length (FL), Face length (FA), Ear length (EA), Head width (HW) and Rump height (RH) together with the following Udder dimensions (UD): Udder circumference (UC), Teat length (TL) and Teat circumference (TC). There was significant (P<0.05) influence of genotype on MK, WHT, HT, BL, TA, FL, HL, FA, EA and RH. The WD ewes produced more milk than either the YN or XB ewes. Average daily milk yield (ml) was 122.25, 90.88 and 108.8. The YN genotype was superior in all LBs except SW and NC than the WD and XB in the three genotypes. Height at withers was 59.08, 69.21 and 61.81 cm; BL 48.54, 55.08 and 54.49 cm and RH 62.88, 75.11 and 68.46 cm for WD, YN and XB ewes respectively. Since milk offtake is related to body weight and some linear body measurements, selection for WT, HG, SW, NL, NC, UC and TL in WD ewes could lead to higher milk and mutton production. Keywords: West African Dwarf, Yankasa, Yankasa x West African Dwarf, milk yield, weight, linear body measuremen

Severe hyperglycaemia due to neonatal sepsis - A case report

Neonatal sepsis is a clinical syndrome characterized by signs and symptoms of infection with or without  accompanying bacteremia in the first month of life. The clinical signs of neonatal sepsis are neither specific nor uniform. Neonatal sepsis may present with fever, hypotonia, respiratory distress, apnea and hyperglycaemia. Untreated hyperglycemia unequivocally leads to undesirable clinical outcomes. Hyperglycemia is associated with increased mortality, which is significantly related to the duration of the elevated blood glucose. The  constant risk that hyperglycaemia presents must be borne in mind when evaluating neonates presenting with sepsis. Adequate measurement and control of elevated blood sugar must be done bearing in mind that the administration of insulin can cause a precipitous fall in glucose and increase the risk of hypoglycemia. This report documents a case of severe hyperglycaemia due to neonatal sepsis.KeyWords : Neonatalsepsis; Hyperglycaemia; Diabetes mellitus

A Case Report of Congenital Neuroblastoma

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COVID-19 Complicating Cushing Syndrome in a Nigerian Infant: A Case Report

Cushing syndrome (CS) is an uncommon morbidity in children. As a result of this rarity, there may be a delay in making the diagnosis or it may be missed completely resulting in progression to life-threatening complications. COVID-19 is an infectious disease that is currently the cause of a global pandemic although it affects children less commonly than adults. Our patient developed CS in early infancy which was diagnosed by elevated serum cortisol and left adrenal adenoma on abdominal magnetic resonance imaging (MRI). Unfortunately, the diagnosis of CS was missed earlier thereby delaying treatment and she also contracted the COVID-19 infection. The presence of these two medical conditions in a very young child may have resulted in a more advanced diseased state and increased chances of a poor outcome. A high index of suspicion for CS is necessary to forestall delay in commencement of appropriate treatment. Parental consent was obtained to publish this report

The global burden of cancer attributable to risk factors, 2010-19: a systematic analysis for the Global Burden of Disease Study 2019

Background Understanding the magnitude of cancer burden attributable to potentially modifiable risk factors is crucial for development of effective prevention and mitigation strategies. We analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 to inform cancer control planning efforts globally. Methods The GBD 2019 comparative risk assessment framework was used to estimate cancer burden attributable to behavioural, environmental and occupational, and metabolic risk factors. A total of 82 risk–outcome pairs were included on the basis of the World Cancer Research Fund criteria. Estimated cancer deaths and disability-adjusted life-years (DALYs) in 2019 and change in these measures between 2010 and 2019 are presented. Findings Globally, in 2019, the risk factors included in this analysis accounted for 4·45 million (95% uncertainty interval 4·01–4·94) deaths and 105 million (95·0–116) DALYs for both sexes combined, representing 44·4% (41·3–48·4) of all cancer deaths and 42·0% (39·1–45·6) of all DALYs. There were 2·88 million (2·60–3·18) risk-attributable cancer deaths in males (50·6% [47·8–54·1] of all male cancer deaths) and 1·58 million (1·36–1·84) risk-attributable cancer deaths in females (36·3% [32·5–41·3] of all female cancer deaths). The leading risk factors at the most detailed level globally for risk-attributable cancer deaths and DALYs in 2019 for both sexes combined were smoking, followed by alcohol use and high BMI. Risk-attributable cancer burden varied by world region and Socio-demographic Index (SDI), with smoking, unsafe sex, and alcohol use being the three leading risk factors for risk-attributable cancer DALYs in low SDI locations in 2019, whereas DALYs in high SDI locations mirrored the top three global risk factor rankings. From 2010 to 2019, global risk-attributable cancer deaths increased by 20·4% (12·6–28·4) and DALYs by 16·8% (8·8–25·0), with the greatest percentage increase in metabolic risks (34·7% [27·9–42·8] and 33·3% [25·8–42·0]). Interpretation The leading risk factors contributing to global cancer burden in 2019 were behavioural, whereas metabolic risk factors saw the largest increases between 2010 and 2019. Reducing exposure to these modifiable risk factors would decrease cancer mortality and DALY rates worldwide, and policies should be tailored appropriately to local cancer risk factor burden. Funding Bill & Melinda Gates Foundation