Mortality Rate and Prognostic Factors in Neonatal Tetanus: A 3-Year Analysis of Cases Presented to Turkey-Somalia Mogadishu Training and Research Hospital

Objective The aim of this study was to evaluate mortality rate and prognostic factors in neonatal tetanuscasespresented toTurkey-Somalia Mogadishu Training and Research Hospital Methods A total of 35 neonatal tetanus cases presented to Turkey-Somalia Mogadishu Training and Research Hospital between 2014 and 2017 were included in this prospective observational study. Data on demographic, clinical and maternal obstetric characteristics, and laboratory findings including complete blood count and blood biochemistry were recorded in each patient. Study parameters were evaluated with respect to survivorship status, while multiple logistic regression analysis was performed to determine independent predictors of increased mortality risk. Results Overall, mortality occurred in 22 (62.9%) of 35 neonates diagnosed with neonatal tetanus. Tetanus prophylaxis was absent in the majority of neonates, regardless of survivorship status (100.0% in nonsurvivors vs. 84.6% in survivors, p = 0.131). In nonsurvivor versus survivor groups, significantly higher likelihood of constipation (50.0 vs. 7.7%, p = 0.002), contracture (81.8 vs. 46.2%, p = 0.035), and ventilator support (95.4 vs. 53.8%, p = 0.006) as well as significantly lower hemoglobin (14.45 +/- 2.06 vs. 17.15 +/- 1.77, p = 0.003) and potassium (3.50 +/- 0.86 vs. 4.14 +/- 0.93, p = 0.003) levels and neutrophil (3.34 +/- 1.75 vs. 4.47 +/- 1.08, p = 0.047, white blood cell (WBC) (5.54 +/- 2.30 vs. 7.78 +/- 1.70, p = 0.003) and platelet (median [min-max] 133.5 [68-332] versus 196 [123-550], p = 0.006) counts were noted. Presence of contracture (odds ratio [OR]: 14.525, 95% confidence interval [CI]: 1.398-150.870, p = 0.025) and ventilator support (OR: 22.282, 95% CI: 1.269-391.131, p = 0.034) was the independent determinants of increased risk of mortality. Conclusion Our findings emphasize high mortality in neonatal tetanus cases in Somalia along with lack of maternal tetanus prophylaxis in majority of cases. Presence of contractures and ventilator support were significant determinants of poor survival, while factors such as constipation, lower hemoglobin, and potassium levels and lower neutrophil, WBC and platelet counts were also more common among nonsurvivors, albeit not found to be associated with mortality risk in the multivariate analysis.WOS:0005714627000012-s2.0-8509179767

Mortality Rate and Prognostic Factors in Neonatal Tetanus: A 3-Year Analysis of Cases Presented to Turkey-Somalia Mogadishu Training and Research Hospital

Objective The aim of this study was to evaluate mortality rate and prognostic factors in neonatal tetanuscasespresented toTurkey-Somalia Mogadishu Training and Research Hospital Methods A total of 35 neonatal tetanus cases presented to Turkey-Somalia Mogadishu Training and Research Hospital between 2014 and 2017 were included in this prospective observational study. Data on demographic, clinical and maternal obstetric characteristics, and laboratory findings including complete blood count and blood biochemistry were recorded in each patient. Study parameters were evaluated with respect to survivorship status, while multiple logistic regression analysis was performed to determine independent predictors of increased mortality risk. Results Overall, mortality occurred in 22 (62.9%) of 35 neonates diagnosed with neonatal tetanus. Tetanus prophylaxis was absent in the majority of neonates, regardless of survivorship status (100.0% in nonsurvivors vs. 84.6% in survivors, p = 0.131). In nonsurvivor versus survivor groups, significantly higher likelihood of constipation (50.0 vs. 7.7%, p = 0.002), contracture (81.8 vs. 46.2%, p = 0.035), and ventilator support (95.4 vs. 53.8%, p = 0.006) as well as significantly lower hemoglobin (14.45 +/- 2.06 vs. 17.15 +/- 1.77, p = 0.003) and potassium (3.50 +/- 0.86 vs. 4.14 +/- 0.93, p = 0.003) levels and neutrophil (3.34 +/- 1.75 vs. 4.47 +/- 1.08, p = 0.047, white blood cell (WBC) (5.54 +/- 2.30 vs. 7.78 +/- 1.70, p = 0.003) and platelet (median [min-max] 133.5 [68-332] versus 196 [123-550], p = 0.006) counts were noted. Presence of contracture (odds ratio [OR]: 14.525, 95% confidence interval [CI]: 1.398-150.870, p = 0.025) and ventilator support (OR: 22.282, 95% CI: 1.269-391.131, p = 0.034) was the independent determinants of increased risk of mortality. Conclusion Our findings emphasize high mortality in neonatal tetanus cases in Somalia along with lack of maternal tetanus prophylaxis in majority of cases. Presence of contractures and ventilator support were significant determinants of poor survival, while factors such as constipation, lower hemoglobin, and potassium levels and lower neutrophil, WBC and platelet counts were also more common among nonsurvivors, albeit not found to be associated with mortality risk in the multivariate analysis.WOS:0005714627000012-s2.0-8509179767

The association between seizure self-efficacy of children with epilepsy and the perceived stigma

This study used a descriptive, correlational, and cross-sectional research design to evaluate the effect of seizure self-efficacy of children with epilepsy on their perceived stigma of seizure. The study was conducted with 303 children with epilepsy. The data of the study were collected using "the Seizure Self-Efficacy Scale for Children" and "the Scale for Perceived Stigma in Children with Epilepsy". The mean age of the children included in the study was 12.65 +/- 2.37. The correlation between seizure self-efficacy of the children and their perceived seizure stigma was examined; a strong, significant, and negative correlation was found. It is recommended that the awareness of all health professionals should be increased in approaching children with epilepsy and that self-efficacy and stigma should be addressed. (C) 2020 Published by Elsevier Inc

Transcobalamin II deficiency in twins with a novel variant in the TCN2 gene: case report and review of literature

Objectives: Transcobalamin II (TC) is an essential plasma protein for the absorption, transportation, and cellular uptake of cobalamin. TC deficiency presents in the first year of life with failure to thrive, hypotonia, lethargy, diarrhea, pallor, mucosal ulceration, anemia, pancytopenia, and agammaglobulinemia. Herein, we present TC deficiency diagnosed in two cases (twin siblings) with a novel variant in the TCN2 gene