Clinical Profile and Electrolyte Abnormalities in Hospitalized Under‑Five Children with Acute Gastroenteritis in a Tertiary Health Facility

Background: Electrolyte abnormalities constitute the leading causes of morbidity and mortality in younger children with acute gastroenteritis.The aim of the study was to determine the clinical profile and pattern of electrolyte abnormalities in under‑five children hospitalized for acutegastroenteritis from November 1, 2014, to January 31, 2015. Methodology: This was a cross‑sectional descriptive study among hospitalized under‑five children with acute diarrhea who were consecutively recruited from November 1, 2014, to January 31, 2015. Relevant clinical data were obtained, while the physical examination was done on all subjects. Serum electrolytes values were determined using the ion‑selective electrode system and compared with standard reference ranges. The data were analyzed using SPSS version 21.0 with the level of statistical significance set at P < 0.05. Results: A total of 108 under‑five children were studied. The majority (101; 93.5%) were <24 months of age, while 41 (38%) of low socioeconomic class background. Metabolic acidosis was the most common electrolyte abnormality followed by hyponatremia and hypokalemia occurring singly or in combination. The case fatality rate was 13 (12.0%). The electrolyte derangements associated with mortality were hypokalemia and acidosis: 11 (84.6%) each, 9 (69.2%) had hyperchloremia, while 6 (46.2%) were reported to have hyponatremia. Conclusion: Electrolyte derangements are common in under 5 years children with acute diarrhea with increased mortality in those with severe acute malnutrition. Proper health education is needed to ensure adequate nutrition and timely use of low‑osmolar oral rehydration solution as well as early referral of cases with persistent gastrointestinal losses in order to save lives. Keywords: Acute gastroenteritis, electrolyte abnormalities, under‑five childre

Editorial: Nephrology, an emergent specialty in Africa

No Abstrac

Relationship between Glycemic Levels and Treatment Outcome among Critically Ill Children admitted into Emergency Room in Enugu

Abstract Background Critically ill children are those in need of immediate attention on arrival to an emergency room. The importance of glycemic level measurement as well as maintaining the patency of the airway, effective breathing and circulation cannot be overemphasied. It has been highlighted that the peak hyperglycemia and hypoglycemia predict poor prognosis, longer lengths of hospital stay and higher mortality. The study aims to assess the relationship between glycemic level and treatment outcomes as well as length of hospital stay. Methods Analytical cross sectional method was used to study critically ill children aged ≥1 month to ≤10 years admitted into the Children Emergency Room of Enugu State University Teaching Hospital, Enugu. Their admission blood glucose was done. Interviewer administered questionnaire was used to collect information including sociodemographics, duration of hospitalization and outcome of treatment. Data was analysed using SPSS version 20. Chi square, logistic regressions and Kruskal Wallis tests were done as appropriate. Results A total of 300 patients were recruited. One hundred and seventeen (39%) had hyperglycemia, 62 (20.7%) patients had hypoglycaemia and 121 (40.3%) had euglycemia. Two hundred and fifty two (84%) were discharged while 48 (16%) died. There was significant association between glycemic levels and treatment outcome (p = < 0.001). Among the 48 who died, 12 (25.0%) had euglycemia, 21 (43.75%) had hypoglycaemia while 15 (31.25%) had hyperglycemia. On multivariate analysis, there was statistically significant association between hypoglycaemia and mortality (p = < 0.001). Unadjusted, those children with hypoglycaemia at presentation were about 4.7 times (UOR = 0.21, 95% Cl: 0.08–0.38) and adjusted, about 5 times (AOR = 0.20, 95% CI: 0.09–0.47) less likely to survive compared with those with euglycemia. Although not statistically significant, those with hyperglycemia were about 1.3 times less likely to survive compared with euglycemic children, adjusted and unadjusted (UOR = 0.75, 95% Cl: 0.33–1.68). Conclusion While both hypo- and hyperglycemia are associated with mortality, hypoglycaemia had a greater effect than hyperglycemia. Glycemic levels significantly affects treatment outcome

Additional file 2: of Relationship between Glycemic Levels and Treatment Outcome among Critically Ill Children admitted into Emergency Room in Enugu

BMCPed data on Hypoglycemia and outcome1. (XLS 160 kb

Additional file 1: of Relationship between Glycemic Levels and Treatment Outcome among Critically Ill Children admitted into Emergency Room in Enugu

BMCPed glycemic levels and treatment outcome data. (XLS 158 kb

Paracetamol use (and/or misuse) in children in Enugu, South-East, Nigeria

<p>Abstract</p> <p>Background</p> <p>Paracetamol (also known as acetaminophen) is the commonest available analgesic and anti-pyretic. It is readily accessed from pharmacy, patent medicine and provision shops as over the counter drug making it a potential drug of abuse, especially in children. We sought to find its use and/or misuse in children seen at the paediatric outpatient clinic of the University of Nigeria Teaching Hospital (UNTH) Ituku-Ozalla, Enugu.</p> <p>Objective</p> <p>To determine the dosage, formulation, and frequency of paracetamol administration to children by caregivers and factors associated with its use and/or misuse.</p> <p>Method</p> <p>An observational prospective study involving 231 children and their caregivers seen at the paediatric outpatient clinic of the University of Nigeria Teaching Hospital, Ituku - Ozalla, Enugu between June and November 2011 was undertaken. Data on paracetamol use before presentation to the clinic, in addition to demographic and other data were obtained from the caregivers using a structured questionnaire. Ethical consent for the study was obtained from the Hospital Ethics and Research Committee and informed consent was further obtained from the caregivers of the children.</p> <p>Results</p> <p>A total of 231 children aged six weeks to 16 years and their caregivers participated in this study. The mean ages of the children and their caregivers were 3.8 and 33.9 years, respectively. One hundred and thirty three of the children studied were males while 98 were females. Most of the children (75.6%) received paracetamol at home before presenting. Paracetamol tablet alone or in combination with the syrup was mostly used (60%) and this observation was made across all age groups. The commonest reason for using paracetamol tablet instead of the syrup was that it was more effective. Most caregivers relied on past experience (71.2%) rather than on enclosed information leaflet to decide the appropriate dosage. Half of the children also received other medications, mainly anti-malarials and antibiotics.</p> <p>Conclusions</p> <p>Paracetamol was commonly given to children on “self prescription” basis and the tablet formulation was most frequently used, with the possibility of misuse and overdose. Caregivers need to be educated on age-appropriate formulations which are less likely to lead to overdose.</p