Congenital Hydrocephalus in Mono and Dizygotic Twins

Background: Information regarding the occurrence of hydrocephalus (HC) in twins is important in establishing the significance of environmental factors as well as a genetic basis in congenital HC aetiology. This was the basis for this study. Methods: A single institution retrospective study was conducted between August 1, 2006 and July 31, 2008. Only those cases of hydrocephalus (based on clinical and radiological testscranial Computeried tomographic or Magnetic resonance imaging scan) that required placement of a ventricular shunt or endoscopic third ventriculostomy were included in the study. Data regarding the patient’s demographics, clinical history, examination and the maternal demographics were retrieved and analysed. DNA analysis was done to confirm the fraternity of the twins when applicable. Results: Fifty-eight patients with congenital hydrocephalus presented to the unit over the study period. We identified three sets of twins in the study. Only one set were identical (both male) and both had hydrocephalus. In the remaining two sets only one out of each pair had hydrocephalus (one male and one female). Two of the patients (1male, 1female) were twins with discordant HC. All the children had normal thumbs. DNA analysis confirmed identical twins in both the like sex twins. The mothers were not known diabetics, hypertensive or sickle cell patients neither did they smoke or take alcohol. There was no family history of hydrocephalus in all patients. Conclusion: Concordance for HC is likely if the twins are like sex and identical. Congenital hydrocephalus seems to be a multifactorial disorder, triggered by environmental factors in genetically predisposed individuals

Teaching Nurses Neonatal Resuscitation: Knowledge gained from a Neonatal Resuscitation Training Program

Neonatal care provided within the first few minutes of life plays a major role in the reduction of neonatal morbidity and mortality. At least one health care worker knowledgeable about neonatal resuscitation should be at the delivery. To evaluate the knowledge gained following Neonatal Resuscitation Program training courses for nurses. Nurse-midwives attending the annual Neonatal Resuscitation Program of the Pediatric Association of Nigeria was trained according to the American Academy of Pediatrics Neonatal Resuscitation Program module which included didactic and practical teaching participated in the study. Assessment was by direct observation within the seminar room and written pre- and post-test evaluations with practical evaluation after the training session. 281 nurse-midwives were trained at the Neonatal Resuscitation Program workshops between 2010 and 2013. Overall average score was 10.58 (±2.73) and 14.02 (±2.19) for pre-test and post-test respectively and observed difference was significant (p = <.001). The results suggest that participation in Neonatal Resuscitation Program course significantly increased knowledge of neonatal resuscitation by nurses. Keywords: Neonatal Resuscitation Program; Birth asphyxia; pre-test; post-test; Nigeri