Infant Sleeping Environment in South-Eastern Nigeria (Sleeping Place and Sleeping Position): A Preliminary Survey

Objective. To determine infant sleeping position/place and the factors associated with them in South-eastern Nigeria. Methods. this is a cross-sectional study on infant sleeping environment. Subjects were the mother/ infant pairs that attended the well baby clinics at the Institute of Child Health of the University of Nigeria Teaching Hospital, Enugu (ICH-UNTH), Mother of Christ Specialist Hospital (MCSH), Enugu and the Ebonyi State University Teaching Hospital (EBSUTH), Abakaliki. Results. Lying on the side was the most common (51.1%) and the least stable sleeping position. Only 36.6% of infants who slept in that position were likely to be found in the same position the following morning; lying supine was the most stable (74.1%). The difference in stability of sleeping positions was statistically significant (P < .01). Twenty six point seven percent of the mothers routinely lay their infants in prone position. On logistic regression, maternal parity was the only factor that was predictive of nonprone sleeping position (P = .01). Bed sharing, though common (66.9%), was more among the experienced (P = .03) and less educated mothers (P < .01). Conclusion. There is a high level of prone sleeping position and bed sharing among infants in this study site. The potential consequences of these are unclear. There is therefore a need to conduct local studies to clarify its implication

Indications and socio-demographic determinants of blood transfusion among children attending secondary health facilities in South-East Nigeria

Background: The complications associated with blood transfusion can be reduced by carefully preventing the conditions necessitating transfusion especially the common ones. Studies are therefore needed to identify these indications but the available ones in Nigeria are from tertiary hospitals. This study therefore aimed to determine the common indications for blood transfusion among children attending secondary health facilities in South-East Nigeria. It also assessed the socio-demographic factors which influenced blood transfusion. Methods: Children aged >1month to 18years admitted into the paediatric wards of three secondary care hospitals with indications for blood transfusion were recruited. Questionnaires for documentation of admitting and final diagnoses as well as socio-demographic profiles were administered. Socio- economic status of each child was calculated using occupational and educational attainment of each parent. Pre- and post- transfusion haemoglobin were determined via the use of an autoanalyser. Results: Majority (61.9%) of the children transfused were in 1 -< 5 year age group. The commonest indications for blood transfusion were Severe Malaria (60%), Sepsis (15.2%) and Bronchopneumonia (5.7%). Age of the children had a significant negative linear relationship (r = -0.783. p = 0.000) while socio-economic status had a significant association (X 2 = 49.77, p = 0.000) with number of children transfused. However, no relationship existed between gender and number transfused (X 2 = 0.086, p = 0.770). Conclusion: Severe Malaria is the commonest indication for transfusion in children attending secondary health facilities in South East, Nigeria. Most of the children transfused are the under-5s from the low socio-economic class

Bacteriology of asymptomatic bacteriuria in pre-school children in Enugu

Objective: This study was undertaken to ascertain the predominant bacterial isolates in the urine of pre-school children with asymptomatic bacteriuria and determine their sensitivity pattern. Methods: This was a cross-sectional study in which analysis of urine cultures obtained from 800 nursery school children aged 2-5 years in Enugu, South East Nigeria, between January and November 1989 was done. Results: Three hundred and ninety-one (48.8%) of the children were females while 409 were males, with a male female ratio of 1.05:1.The mean age was 3.79 ±1.3yrs and seventeen out of 800 (2.1%) cultures were positive, 2 (12%) from male children and 15 (88%) from female children. Nine out of the 17 (53%) positive cultures yielded Escherichia Coli. (E. Coli), 5 specimens (29%) yielded streptococcus faecalis (strept. Faecalis) while the remaining 3 specimens yielded Proteus species (6%), staphylococcus pyogenes (6%) and Micrococcus (6%) respectively. There was 100% resistance of the E. Coli, staphylococcus pyogenes (staph. Pyogenes) and proteus species to Ampicillin, while there was 100% sensitivity of all the organisms to nitrofurantoin. Seventy-eight percent of the E. Coli were sensitive to gentamycin while 100% sensitivity to this drug was obtained for staphylococcus, pyogenes, micrococcus and proteus spp. However only 40% of the Strept. Faecalis was sensitive to gentamycin. Most of the organisms (88%) were resistant to co-trimoxazole. Conclusion: It is concluded that nitrofurantoin or gentamycin should be used as first line drugs in urinary infections rather than co-trimoxazole which is the practice at present. Orient Journal of Medicine Vol. 17(3&4) 2005: 37-4

The Civilian Vascular Trauma in a Low‑Income Country: The Determinant Factors of Morbidity and Mortality

Background: Civilian vascular injury is relatively common in the West African subregion, but it is highly underreported. Aim/Objective: The aim of the study was to evaluate the patients managed for civilian vascular surgeries and to determine the factors causing morbidity and mortality in low‑income countries. Materials and Methods: This is a retrospective study spanning a period of 13 years (2007–2019) of civilian vascular injuries managed in a tertiary hospital in a low‑income country. We obtained data from our hospital record department. Data obtained and analyzed were demography, etiology, vessels affected, pattern of presentation, stratification, and treatment. Results: Within the envisaged period, 58 patients were affected in civilian vascular trauma with a mean of 4.5 cases per year. The male‑to‑female&nbsp; ratio was 0.9:0.1. The age range of patients affected was from 0–10 to 71–80, with the age group of 21–30 years being the most affected. Male was more affected (87.9%). Motor vehicle crashes were the most common etiology agent (42.0%). The femoral artery was the most commonly injured vessel (31.3%). In the pattern of presentation, bleeding with shock was dominant (49.8%). Lateral tarsorrhaphy accounted for the major vascular&nbsp; treatment interventions (30.2%). Conclusion: The outcome was very variable and depended on warm ischemic time, type and/or mechanism of injury, collateral blood supply at the site of injury, and comorbidity. Keywords: Amputation, civilian, injury, vascular, warm ischemic tim

Disseminated Histoplasmosis in a 13-year-old girl: A case report

BACKGROUND: Disseminated histoplasmosis is a rare fungal infection and most documented cases are in immune-compromised individuals such as those with acquired immuno-deficiency syndrome. OBJECTIVE: To describe a case of disseminated histoplasmosis in an adolescent girl. METHOD: We report a case of disseminated histoplasmosis in a 13-year-old adolescent girl. She was admitted for 16 days because of neck masses of 3 years duration, generalized body swelling of 3 months and reduction in urinary output of 2 months. She tested negative for human immunodeficiency virus antibodies. RESULT: An autopsy was performed because a definitive diagnosis could not be made while the patient was still alive. The autopsy revealed central caseating areas in the lymph nodes and membranoproliferative glomerulonephritis. The periodic acid-Schiff staining technique for tissues showed viable yeast cells suggestive of histoplasmosis. Zeihl-Neelsen's staining for mycobacteria tuberculosis was negative. CONCLUSION: Undiagnosed case of disseminated histoplasmosis while the patient was alive is being reported in a 13-year-old girl. Disseminated histoplasmosis should be considered as a differential diagnosis of childhood chronic infections and malignancies as in Nigeria

Disseminated Histoplasmosis in a 13-year-old girl: a case report

Background: Disseminated histoplasmosis is a rare fungal infection and most documented cases are in immunecompromised individuals such as those with acquired immuno-deficiency syndrome. Objective: To describe a case of disseminated histoplasmosis in an adolescent girl. Method: We report a case of disseminated histoplasmosis in a 13-year-old adolescent girl. She was admitted for 16 days because of neck masses of 3 years duration, generalized body swelling of 3 months and reduction in urinary output of 2 months. She tested negative for human immunodeficiency virus antibodies. Result: An autopsy was performed because a definitive diagnosis could not be made while the patient was still alive. The autopsy revealed central caseating areas in the lymph nodes and membranoproliferative glomerulonephritis. The periodic acid-Schiff staining technique for tissues showed viable yeast cells suggestive of histoplasmosis. Zeihl-Neelsen’s staining for mycobacteria tuberculosis was negative. Conclusion: Undiagnosed case of disseminated histoplasmosis while the patient was alive is being reported in a 13-yearold girl. Disseminated histoplasmosis should be considered as a differential diagnosis of childhood chronic infections and malignancies as in Nigeria