Improvised bubble continuous positive airway pressure (BCPAP) device at the National Hospital Abuja gives immediate improvement in respiratory rate and oxygenation in neonates with respiratory distress

Background: Prematurity accounts for 25% of Neonatal mortality in Nigeria and Respiratory Distress Syndrome is responsible for half of these deaths. Introducing continuous positive airway pressure for the treatment of RDS in Nigeria where health care financing is predominantly out-of-pocket is quite challenging. It was hypothesized that applying the principle of under-water-seal pressure generation could convert a simple oxygen delivery system into an effective Bubble CPAP device.Objectives: To provide evidence in support of the immediate clinical effectiveness of the NHBCPAP device.Design/Methods: At the neonatal unit of the National Hospital Abuja, we assembled a circuit of tubing connecting a gas source (oxygen concentrator or cylinder) through an interface (nasal prongs) to the baby and this was further connected through an expiratory tube to an under-waterseal bottle to generate CPAP. The device is activated by turning on the oxygen source. The device was applied to preterm babies with RDS as well as some term babies with respiratory distress admitted into the neonatal intensive care units. Respiratory rate, SPO2 and other signs of respiratory distress were monitored before and at 1 hour, 6 hours and 12 hours after the application.Results: Forty eight newborn babies with respiratory distress were treated with the device out of whom twenty three (48%) were very low birth weight with respiratory distress syndrome. The mean respiratory rate dropped from 64.5 (19.2)/min before commencement of CPAP to 59.5(11.6)/min, 56.6 (10.5), and 56.6(10.7) at 1, 6 and 12 hours respectively, p<0.05. The corresponding values for SPO2 were 84.5(14) before and 95.9 (5.3), 95.9(6.5) and 96.9(6.4) at 1, 6 and 12 hours respectively, p<0.05. The respiratory changes were however less marked among very low birth weight babies.Conclusion: The simplified customized device produces clinical responses similar to those reported for the conventional CPAP devices

Customized bubble continuous positive airway pressure (BCPAP) device at the National Hospital Abuja for the treatment of respiratory distress syndrome (RDS)

Using the principle of under-water-seal pressure, we assembled a circuit to produce an effective Bubble Continuous Positive Airway Pressure device at theNational Hospital. The device is reasonably inexpensive and is suitable for use at secondary and tertiary health institutions for the care of the preterm infant with RDS

Hypomelanosis of Ito: Case report of a rare neurocutaneous syndrome in a neonate and review of the literature.

Hypomelanosis of Ito (HI) though said to be the third most common neurocutaneus disorder, is rarely reported in paediatric practice in Africa. A high index of suspicion must be maintained in children with cutaneous lesions as a seizure may be the first symptom that may bring the child to attention. A case of HI in a neonate is hereby reported to sensitize clinicians about this relatively uncommon disorde

Unexplained massive subdural haematoma in a newborn delivered by elective caesarian section: a case report

Symptomatic subdural haematoma (SDH) in term infants typically occur following traumatic vaginal delivery. Emergency Caesarean Section (EmC/S) carried out after failed attempts at vaginal delivery may also be complicated by symptomatic SDH but spontaneous symptomatic SDH complicating Elective Caesarean Section (ElC/S) is a rarity. We describe a case of massive SDH in a term baby delivered by Elective C/S in the absence of risk factors for intracranial haemorrhage. The aim of this presentation is to highlight the significance of acute subdural haematoma in the diagnostic work up of neonates presenting with acute neurologic symptoms in the absence of traumatic delivery.Key words: Symptomatic subdural haematoma, Caesarean section, severe birth injuries, neonatal seizur

Prune belly syndrome in a set of twins, a family tragedy: Case report

We report prune belly syndrome, a rare congenital malformation, in a set of twins delivered to a young couple with a history of three previous first  trimester spontaneous abortions, discordant HIV seropositivity and antenatal ultrasound report that indicated renal abnormalities in only one of the twins. The challenges of management are discussed.Keywords: Prune Belly Syndrome, Twins, Nigeria, Management challenge

Conference summary report of the 10th Annual General and Scientific Meeting of the Nigerian Society of Neonatal medicine (NISONM) held in Ibadan, Nigeria on 4th -7th July, 2017

The 10th Annual General and Scientific Meeting (AGSM) of the Nigerian Society of Neonatal Medicine (NISONM) took place in Ibadan, South -West Nigeria. The theme of the conference was: Imperatives in neonatal survival initiatives in Nigeria: The current state. The conference addressed a variety of topics relevant to newborn health from eminent speakers from across the globe. The four-day conference included preconference workshops and community mobilization/ health outreach in Lagelu local government area

Flying to Quality: Cultural Influences on Online Reviews

Customers increasingly consult opinions expressed online before making their final decisions. However, inherent factors such as culture may moderate the criteria and the weights individuals use to form their expectations and evaluations. Therefore, not all opinions expressed online match customers’ personal preferences, neither can firms use this information to deduce general conclusions. Our study explores this issue in the context of airline services using Hofstede’s framework as a theoretical anchor. We gauge the effect of each dimension as well as that of cultural distance between the passenger and the airline on the overall satisfaction with the flight as well as specific service factors. Using topic modeling, we also capture the effect of culture on review text and identify factors that are not captured by conventional rating scales. Our results provide significant insights for airline managers about service factors that affect more passengers from specific cultures leading to higher satisfaction/dissatisfaction

A year of genomic surveillance reveals how the SARS-CoV-2 pandemic unfolded in Africa.

The progression of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic in Africa has so far been heterogeneous, and the full impact is not yet well understood. In this study, we describe the genomic epidemiology using a dataset of 8746 genomes from 33 African countries and two overseas territories. We show that the epidemics in most countries were initiated by importations predominantly from Europe, which diminished after the early introduction of international travel restrictions. As the pandemic progressed, ongoing transmission in many countries and increasing mobility led to the emergence and spread within the continent of many variants of concern and interest, such as B.1.351, B.1.525, A.23.1, and C.1.1. Although distorted by low sampling numbers and blind spots, the findings highlight that Africa must not be left behind in the global pandemic response, otherwise it could become a source for new variants