What is the cost benefit ratio of sending adeno-tonsillar tissues for histology: does adenoid/tonsillar tissue in children undergo malignant transformation?

Due to the enormous amount spent on histology of adenoid and tonsillar samples from children with adeno-tonsillectomy with no confirmed result of malignancy, it has become expedient to reconsider sending such tissues for histology. Objectives: this study is aimed at determining the necessity of sending tissues of adenoid and tonsils for histology by means of ascertaining the prevalence of malignancy among children with adeno-tonsillectomy. This was a retrospective study done in three private hospitals that provide care for children in Enugu. Data was obtained from the medical records of 72 patients who had undergone tonsillectomy and/or adenoidectomy from September 2011 to May 2018. All the surgical cases done had their samples sent immediately for histology. A total of 72 adeno-tonsillar tissues were taken for histology of which all showed lymphoid hyperplasia with none showing any form of malignancy. Age group ranged from 6 months-18 years with 57 males and 15 females. Histology of the adeno-tonsillar tissue specimen was done among all the children with each costing 9000 Naira (26 US dollars). There were 3 tonsillectomies, one adenectomy and 68 adeno-tonsillectomies done. Indications for surgery were mainly upper air way obstruction for 69 cases and recurrent tonsillectomy for 3 cases. Histology revealed lymphoid hyperplasia for all cases. None of the patients in our study had histologic evidence of malignancy. Routine histopathologic examination in adeno-tonsillectomy specimens among children may be dispensable as it showed a negative cost-benefit ratio

Observed Causes of Severe Respiratory Distress among Children with Congenital Heart Disease

Background: Severe respiratory distress is a clinical feature commonly observed among children with congenital heart disease (CHD), butthe underlying cause is often misdiagnosed. Objectives: This study is aimed at determining the common causes of severe respiratory distress observed among children with CHD. Methods: This study was a retrospective study on children who had severe respiratory distress with underlying CHD seen between June 2017 and June 2018, and were consecutively recruited from two teaching hospitals. Results: Forty‑seven children aged 2 months to 15 years were admitted for severe respiratory distress secondary to CHD at our center between June 2017 and June 2018. The most common CHD was isolated ventricular septal defect (VSD), which made up 36.2%, followed by tetralogy of Fallot with 23.4%. Identifiable causes of respiratory distress in these children were restrictive airway disease (36.2%) as the most common cause, followed by pulmonary edema from congestive cardiac failure (27.7%). Among children with heart failure, 57.1%, 47.4%, 0%, and 50% of infants, children aged 1–5, 6–10, and above 10 years, respectively, were affected. Conclusion: Restrictive airway disease was noted as the most common cause of severe respiratory distress among children with CHD. Keywords: Children, congenital heart disease, restrictive airway disease, severe respiratory distres

Mothers’ Perception of COVID‑19 Infection in Their Under‑Five Children Presenting in a Tertiary Health Institution in South‑East Nigeria and Associated Factors

Background: Maternal attitude to health‑seeking behavior of their under‑five children in the COVID‑19 pandemic is not  well‑known. Objectives: This study is aimed at determining mothers’ perception of COVID‑19 pandemic among their under‑five children and associated factors. Methodology: This is a prospective and observational study carried out in two health institutions in South‑East Nigeria. Results: Most subjects, 243 (65.3%) noted that someone without showing symptoms of COVID‑19 could transmit the virus. Of the mothers of children under‑five, 271 (72.8%) highlighted the possibility of COVID‑19 infection in the under‑five. A small number of participants 53 (14.2%) showed awareness that people should cough into their elbows as a way of preventing the transmission of COVID‑19. A small  number of participants, 160 (43.0%) had a good perception of COVID‑19. Majority of mothers who were married, 148 (44.7%) showed a good perception of COVID‑19 when compared with those who were single, 12 (29.3%); however, this is not significant, (χ2 = 3.550, P = 0.060). A large number of participants who have attained tertiary education, 92 (48.9%) had a good perception of COVID‑19 which is higher than that seen in mothers with secondary education 68 (37.0%) (χ2=5.444, P = 0.020). Participants who were 30–34 years had 1.8 times higher odds of good perception of COVID 19 compared with mothers who were more than 35 years (adjusted odds ratio = 1.803, 95% confidence interval = 1.026–3.170). Conclusion: Although most mothers affirm that a child could be infected by COVID‑19, a small number of them actually had a good perception of COVID‑19 infection. Good perception of COVID‑19 among the under‑five is enhanced by the high level of education and age of 32–34 years

Sleep pattern and practice among adolescent school children in Nigerian secondary schools

Introduction: some adolescent may have sleep disorder at some point during adolescence. Determining the pattern and practice of sleep among adolescent could be useful to establish a lasting sleep hygiene program among adolescent. The objectives of this study are to describe sleep pattern and practice among adolescent in Nigerian secondary schools. Methods: sleep habits were investigated using a random sampling of adolescent from secondary schools from February to April 2013. A self-administered questionnaire was developed based on the Diagnostic and Statistical Manual of Mental Disorders (DSM) IV criteria. Epworth Daytime Sleepiness Scale and Pittsburgh Sleep Quality Index (PSQI) were used. Results: a total of 443 subjects, comprising 263 (59.4%) females and 180 (40.6%) males completed the questionnaire. The mean duration of night sleep of the subjects during weekday was 7.84 (1.9) hours and 8.65 (2.07) hours during the weekend. 22.8% (101/443) had abnormal sleep onset latency (< 5 minutes and > 30 minutes). The gender of the subjects did not influence the sleep onset latency (χ2 = 32.89, p= 0.57). Twenty six (5.9%)of the subjects reported difficulty falling asleep . Conclusion: adolescent have varying degrees of sleeping practice and hygiene

Postpartum depression among mothers as seen in hospitals in Enugu, South-East Nigeria: an undocumented issue

Introduction: Postpartum depression is an uncommon and frequently undocumented issue that impacts negatively on maternal and child health. Methods: The study was carried out among mothers who attended postpartum clinics from two teaching hospitals and three private hospitals all in Enugu metropolis. The instrument employed for data collection was a structured self-administered questionnaire developed from the Edinburgh Postnatal depression Scale. The families were assigned socio-economic classes (SEC) using the recommended method (modified) by Oyedeji. The objectives of this study was therefore aimed to highlight the pattern and prevalence of post-natal depression among mothers in Enugu, south east Nigeria. Results: A total of 214 mothers attending postpartum clinics were recruited in this study. The prevalence of postpartum depression from this study is 22.9%. There are no significant association between socio-demographics of mother and depression, age (p= 0.556), educational level (p= 0.667), occupation (p=0.494), parity (p= 0.823) and mode of delivery (p= 0.760). Conclusion: This study has shown that the prevalence of postpartum depression in Enugu, south east Nigeria is 22.9% which is comparable to that obtained in African continents. We noted no significant associations between socio-demographics of mother, age, educational level, occupation, parity and mode of delivery and depression.Pan African Medical Journal 2016; 2

Impact of parity and gestational age of mothers with hypertension on birth weight, red blood cells and mode of delivery of their babies

Background: Maternal factors are determinants of birth outcome which includes birth weight, haematological indices and mode of delivery of their babies. Objectives: To determine the impact of parity and gestational age of hypertensive mothers on some neonatal variables. Methods: A hospital based cross-sectional study of measurement of neonatal variables (birth weight, red blood cells and mode of delivery) among hypertensive mothers and their controls was conducted over a period of six months. Data were analyzed using the Statistical Package for Social Sciences program (SPSS), version 20. Results: There were statistically significant differences in means between the neonates of the hypertensive group and non-hypertensive group for maternal age (t =1.61, p = 0.002), baby weight (t =2.87, p < 0.001), haemoglobin (Hb) (t =4.65, p = 0.010) and packed cell volume (PCV) (t =4.75, p = 0.009), but none for gravidity (t =1.95, p = 0.927) For all subjects, there was poor correlation between gestational age and variables; birth weight , haemoglobin (Hb), packed cell volume (PCV), nucleated red blood cell (nRBC) and parity. Likewise, parity poorly correlated with variables; age, birth weight, Hb, PCV, and nRBC. There was a statistically significant association between mode of delivery and hypertension (\u3c72 =53.082, p <0.001) but none with having a family history of hypertension (\u3c72 =1.13, p = 0.287). Conclusion: Parity and gestational age of mothers with hypertension have no impact on birth weight and red cells when compared with their non-hypertensive counterparts. However, mothers of babies delivered by elective and emergency caesarean section were about 2-3 times more likely to be hypertensive than those that delivered through spontaneous vertex delivery

Establishing Sustainable Pediatric Cardiac Surgery Program in Nigeria: Challenges and Prospects

Unlike in the Western world, the delivery of cardiovascular services to children and adults born with congenital heart defects (CHDs) in Nigeria is grossly inadequate. There are problems all through the ages of these unfortunate patients. Accurate statistical data of CHD in Nigeria is lacking, but it is comparable to 8 per 1000 live births as seen in other countries. The burden is presently being ameliorated by medical tourisms and foreign cardiac surgery missions, but such services are still inadequate. There is a need for the government to share resources between this noncommunicable (CHD) and communicable diseases. When this is done with assistance of international partners and humanitarian organizations, a sustainable pediatric cardiac surgery program will be established that will definitely enhance the care of these patients at childhood, adolescent, and adult stages of their lives

Negative Marking and the Student Physician–-A Descriptive Study of Nigerian Medical Schools

Background There is considerable debate about the two most commonly used scoring methods, namely, the formula scoring (popularly referred to as negative marking method in our environment) and number right scoring methods. Although the negative marking scoring system attempts to discourage students from guessing in order to increase test reliability and validity, there is the view that it is an excessive and unfair penalty that also increases anxiety. Feedback from students is part of the education process; thus, this study assessed the perception of medical students about negative marking method for multiple choice question (MCQ) examination formats and also the effect of gender and risk-taking behavior on scores obtained with this assessment method. Methods This was a prospective multicenter survey carried out among fifth year medical students in Enugu State University and the University of Nigeria. A structured questionnaire was administered to 175 medical students from the two schools, while a class test was administered to medical students from Enugu State University. Qualitative statistical methods including frequencies, percentages, and chi square were used to analyze categorical variables. Quantitative statistics using analysis of variance was used to analyze continuous variables. Results Inquiry into assessment format revealed that most of the respondents preferred MCQs (65.9%). One hundred and thirty students (74.3%) had an unfavorable perception of negative marking. Thirty-nine students (22.3%) agreed that negative marking reduces the tendency to guess and increases the validity of MCQs examination format in testing knowledge content of a subject compared to 108 (61.3%) who disagreed with this assertion (χ 2 = 23.0, df = 1, P = 0.000). The median score of the students who were not graded with negative marking was significantly higher than the score of the students graded with negative marking ( P = 0.001). There was no statistically significant difference in the risk-taking behavior between male and female students in their MCQ answering patterns with negative marking method ( P = 0.618). Conclusions In the assessment of students, it is more desirable to adopt fair penalties for discouraging guessing rather than excessive penalties for incorrect answers, which could intimidate students in negative marking schemes. There is no consensus on the penalty for an incorrect answer. Thus, there is a need for continued research into an effective and objective assessment tool that will ensure that the students’ final score in a test truly represents their level of knowledge