Sleep practices among medical students in Pediatrics Department of University of Nigeria Teaching Hospital, Ituku/Ozalla, Enugu, Nigeria

Background: Medical students are a population who are at great risk of having bad sleep practice and hygiene due to demanding clinical and academic activities. Poor sleep practices are a disturbing and destabilizing phenomenon. It affects many people and can affect the quality of work, performance and education of medical students. Determining the sleep practices and behaviors could be useful to establish a systematic mental health curriculum in medical schools.Objectives: The objectives of this study is to describe sleep practices among undergraduate medical students in a Nigerian University.Materials and Methods: Sleep practices were investigated using a convenience sample of medical students from the University of Nigeria Teaching Hospital Ituku Ozalla, Enugu from October 2012 to February 2013.Results: A total number of participants enrolled were 241 consisting of 150 male and 90 female medical students. However, 222 (response rate: 92.1%) completed and returned the questionnaire. The median number of hours of night sleep on a weekday and weekend were 6 and 7 h respectively. There was a significant correlation between the number of hours of sleep and use of caffeine (Spearman r = −0.148, P < 0.0321). Ninety two (45.3%) had a sleep latency of 10-30 min while 157 (70.7%) woke up 1-2 times/night. Twenty five (11.3%) experience unusual sleep practices such as sleep walking, talking or night terrors.Conclusion: Medical students in our institution have varying degrees of sleeping practice and behavior and this may affect academic performance.Key words: Medical students, pediatrics, sleep practic

Pattern and outcome of paediatric medical admissions at the University of Nigeria Teaching Hospital (UNTH), Ituku-Ozalla, Enugu: a five year retrospective review (2007 – 2011)

Background: Most health information from Nigeria and other developing countries are based on hospital records which although may not be a true representative of the whole population, they serve as pointers. Such information has shown that infections and malnutrition remain the leadingcauses of morbidity and mortality , although non-communicable diseases also pose substantial threat to child health.Objective: To review the pattern, trend and outcome of paediatricadmissions at the University of Nigeria Teaching Hospital over afive year period.Methods: Patients admitted into the main pediatric wards of the hospital over a five year period were reviewed, through information obtained from their case notes. Neonates, surgical and trauma patients as well as patients admitted into the children’s emergency room were excluded.Results: Infections (44.5%) were the leading causes of hospital admissions while non-communicable diseases were the leading causes ofdeath in this study with an overall mortality rate of 9%.Conclusion: Despite all efforts over the years, infections continue to pose serious challenges to child health in developing countries. At the same time, non-communicable diseases are taking over as leading causes of mortality. Therefore, as we make stronger efforts to tackle infections and malnutrition, we should make provisions for improved diagnosis and management of non-communicable diseases.Key words: Outcome, Paediatric, medical admissions, Enugu

A prospective study of childhood malignancy in Enugu, Eastern Nigeria (2011-2013)

Background: The review of childhood cancers has most times been done in retrospect by most authors and this has its inherent limitations. Most reviews in Africa show that lymphomas are the commonest malignancies of childhood while acute leukemia ranks much lower.Objective: To do a prospective audit of the pattern of childhood malignancies in Enugu, southeast, Nigeria.Methods: Demographic and medical information on patients aged 1 -17 years admitted over a 36 month period for malignancies was obtained and recorded in pretested interviewed administered questionnaire. Data was analyzed using spss, 15 (Chicago II, USA) software.Results: A total of 103 patients were admitted with diagnosis of cancer with a male: female ratio of 1.3: 1 and median age of 7 years. Majority (63.1%) of patients were from the rural area with low socioeconomic background. There was a decline in the incidence of childhood lymphoma from 40% about 25 years ago to 34% in the present study. Although lymphoma remains the leading childhood malignancy, sarcomas and acute leukemia rather than renal and eye tumors ranked second and third respectively among childhood cancers in the center.Conclusion: There is a reversing trend in the pattern of malignancies of childhood in Enugu as acute leukemia becomes one of the leading malignancies of children.Key words: childhood, malignancy, lymphomas, leukaemi

Prevalence of hypoxemia among children with sickle cell anemia during steady state and crises: A cross.sectional study

Background: Patients with sickle cell anemia (SCA) are prone to recurrent pain crises related to red blood cell sickling and vaso.occlusion with subsequent tissue hypoxia. Alveolar hypoxia has been shown to be associated with entrapment of sickle cells in the pulmonary microcirculation which may propagate a cycle of further hypoxemia and sickling. Pulmonarycomplications are common in sickle cell disease (SCD) and may  exacerbate microvascular occlusive phenomena. Thus, detecting hypoxemia is of particular importance in SCD.Objectives: This study was designed to determine the prevalence of hypoxemia among children with SCA and compare the oxygen saturation of those in crises with those in steady state.Materials and Methods: This is a prospective observational study involving 46 children with SCA in steady state, 42 with crises, and 42 with HbAA genotype carried out between August and December 2010. The study compared the oxygen saturation of sickle cell anaemic children in steady state and in crises with normal hemoglobin genotype using Nellcon pulse oximeter while the hemoglobin concentration was analyzed using automated Sysmex KX.21N model.Results: A total of 130 participants aged 6 months to 18 years were recruited. The overall prevalence of hypoxemia in this study was 13.8%. Hypoxemia was highest among SCA patients in the crisis state (23.8%) compared to 13% and 0% for those in the steady state and in those with normal hemoglobin genotype, respectively (ƒÔ2 = 6.425, P = 0.04).Hypoxemia was higher among those with hemoglobin less than 5 g/dl (30%) and least among those whose hemoglobin levels were 10 g/dl and above.Conclusions: Hypoxemia was significantly higher among children with SCA during Vaso-occlusion crises. We recommend that one should have a high index of suspicion and take prompt action in managing these individualsespecially those with acute chest syndrome. Key words: Enugu, hypoxemia, oxygen saturation, sickle cell anemi

Sonographic evaluation of the spleen among sickle cell disease patients in a teaching hospital in Nigeria

Background: Regional variations in size and parenchyma echo-texture of the spleen among sickle cell disease (SCD) patients have been documented in various publications. The objectives of this study were to assess the size and parenchyma echo-texture of the spleen of SCD patients and ascertain the relationship of age, height and weight with the spleen sizes.Methods: This was a cross sectional study involving 103 each of SCD and age matched control subjects. Aloka ST- 550 -3500 ultrasound machine with 3.5 and 5 MHz convex transducers was used to scan the subjects over a 15 months period (September, 2012 to November, 2013). The age, height and weight of each subject were recorded.Results: The spleen sizes of SCD patients were generally larger than those of the controls (p < 0.05). Abnormal spleen parenchyma of varied appearances was found among the SCD subjects. There were negative correlations between mean spleen sizes and height, weight and age in SCD patients but positive correlations were found between them in the controls.Conclusion: Routine sonographic assessment of spleen size and echo-texture is useful in the management of SCD patients.Key words: sickle cell disease, sonography, spleen morphology, patient management, Nigerian population

Performance of medical students in paediatric examinations and associated factors

Abstract A student who just enrolled in a medical school has several examinations to write and about six to twelve years of major examinations from the very first year of school to becoming a consultant paediatrician. Paediatrics is a major course which needs to be passed before qualifying as a doctor. Attaining this is a rather formidable task in any Nigerian university. High failure rates in this course have become an allegory or a myth. The aim of this present study is to determine the performance of medical students in paediatric examinations and associated factors. This is an observational prospective study involving 102 medical students seen at the paediatric departments of College of Medicine, University of Nigeria, Enugu Campus and 54 medical students from Enugu State University College of Medicine, Enugu. 126 (80.8%) of the students attended lectures regularly. One hundred and fifteen (73.7%) confirmed that ward rounds are very interesting and important. One hundred and thirty students (83.3%) admitted that performance in paediatrics examinations is poor and 147 (94.2%) students attributed this failure to clinicals .Eighty seven (62.2%) students preferred OSCE as a perfect replacement for clinicals. It is concluded that performance of Medical students in paediatrics is poor and clinical have been pointed out as the major cause of this

Progressive myelopathy, a consequence of intra‑thecal chemotherapy: Case report and review of the literature

Intra‑thecal chemotherapy is a recognized therapy for hematological malignancies such as acute lymphoblastic leukemia (ALL). Despite the advantage of these drugs in treating or preventing central nervous system disease, they are not without complications. The authors describe a 12‑year‑old girl with ALL, who developed progressive myelopathy following intra‑thecal administration of cytosine arabinoside. Initial presentation was urine and fecal retention that progressed to paraplegia, and finally encephalopathy. magnetic resonance imaging of the neuroaxis showed T2‑weighted foci of increased signal intensity within the substance of the cervical cord indicative of myelopathy. Physicians should be wary of this rare complication of intra‑thecal chemotherapy.Key words: Cytosine arabinoside, intra‑thecal, myelopath

Timing of cardiac surgery and other intervention among children with congenital heart disease: A review article

Background: Early diagnosis and improved facilities are necessary for determining the optimal timing of surgery and other interventions in children with congenital heart diseases in Nigeria. This is because late presentation, late diagnosis and delayed surgery can lead to mortality and affect the quality of life among these children. Objectives: This review article is aimed at enumerating the timing of cardiac surgeries and other interventions and to seek if there is any factor associated with the timing of cardiac surgery. Methods: A search on PubMed database, World Health Organization libraries, Google scholar, TRIP database, and reference lists of selected articles on timing of cardiac surgery in children was done. The Cochrane Database of Systematic Reviews was also searched. We noted few data from African setting. Key words such as timing of cardiac surgery; children, congenital heart defect were used. Conclusion: Appropriate timing for cardiac surgery in children with congenital heart disease is very important as late surgical intervention could result in several morbidities and mortality