Correlation between serum zinc level and height of adolescent school girls in a Nigerian community

Background: This study aims to asses the nutritional status among adolescent school girls using their serum zinc levels and to correlate it with their height.Method: This is a cross-sectional study of adolescent girls attending public secondary schools in Oshimili local govt. area of Delta state in Midwestern Nigeria.Results: The mean serum zinc level of the total population was 13.30mmol/l±5.82. Majority (58.3%) of the girls failed to attain the threshold value of 10.71mmol/l of serum zinc. The mean height of the population was 155.4cm with Standard Deviation Scores (SDS) score of  -0.64±0.48, while the mean Body Mass Index (BMI) was 19.1kg/m2 ±2.91 with an SDS score of -0.54±0.47. The mean serum zinc level of urban girls (11.05±4.66ìmol/l) was significantly lower than that of rural girls (15.54±6.31ìmol/l) (p = .009). There was no correlation between the mean serum zinc levels with height SDS (p=0.28) and the BMI SDS (p=0.69).Conclusion: Majority of the adolescent girls in Oshimili local GovernmentArea of Delta State Mid western Nigeria have low serum zinc level when compared to threshold value, and there was no correlation of serum zinc with their height SDS or BMI SDS.  Key Words: Adolescent girls, Zinc level, Height, BMI , Correlation

Unusual presentation of necrotizing fasciitis in an HIV exposed infant: A Case Report.

Necrotizing fasciitis(NF) is a  potentially life threatening  soft tissue infection characterized by rapidly spreading inflammation with necrosis of fascia, subcutaneous tissues and  overlying skin and is associated with  signs of systemic toxicity. We present a case report of an uncommon presentation of NF in an HIV exposed infant. This report is highlighting the unique combination of absence of known pre existing cause, unusual site of presentation of NF, in this instance, it presented on the scalp, in an HIV exposed neonate. It also stressed the importance prompt diagnosis of all skin lesions in HIV exposed neonates, and the role of early diagnosis and aggressive multi disciplinary team management in salvaging NF which is a potentially fatal condition

Digit-Sucking Among Ibo Infants In Eastern Nigeria

Background: Digit-sucking is a common habit among infants and toddlers, it is a normal adaptive process and attempts at stopping are discouraged before 2-4 years of age. Prevalence varies along racial lines. This study is intended to document the prevalence and pattern of this habit among Ibo infants and also to determine maternal attitude and response to it Method: This is a crosssectional study on infant digit-sucking habit. Subjects were the mother/ infant pairs that attended the well baby clinics at the Institute of Child Health of the University of Nigeria Teaching Hospi tal , Enugu (ICHUNTH), Mother of Christ Specialist Hospital (MCSH), Enugu and the Ebonyi State University Teaching Hospital (EBSUTH), Abakaliki, between March and May 2006. Results: One hundred and forty eight (30.8%) infants digit-suck. The right fingers (66.5%) and the thumbs (42.25%) were the digits most frequently sucked. The prevalence of digit-sucking do not vary with sex (Χ² = 1.17, p = 0.28) and infants' age (Χ² = 49.79, p = 0.08). Hunger (71.7%) was the most common condition in which the infants suck their digits, followed by anger (6.7%) and sleep (6.1%). Most mothers (67.70%) had a negative perception to digitsucking and 69.59% of the mothers had attempted to stop the habit in their infants. Methods employed by the mothers include restraint (78.21%), and topical application of bitter substances (23.04%) and pepper (11.37%). Conclusion: digit-sucking is a common habit among Ibo infants and most mothers have negative attitude towards it, majority of which had attempted to stop this habit in their infants using mostly deterrent methods

Mortality among paediatric inpatients in Mile 4 Mission hospital Abakaliki, south-eastern Nigeria: A retrospective study

Background: In the sub-Saharan Africa, one in every five children dies before their 5th birthday, mostly from preventable causes. Recent data from Nigeria, show infant and under-5 mortality rates of 88 and 143 deaths per 1000 live births respectively. Although significant efforts havebeen made in the last two decades towards the reduction of childhoodmortality, the rate still remains unacceptably high.Objective: The aim of the current study was to evaluate the patternand causes of paediatric (childhood) mortality at Mile 4 Mission Hospital, Abakaliki. This will help us to know exactly what happens in a small mission hospital with few facilities and limited skilled medical personnel. In addition, this is the very first time this study was undertaken in thishospitalMaterials and Methods: The records of admissions and deaths ofchildren managed at the Mile 4 Mission Hospital from the 1st January 2009 to 31st December 2009 were retrieved from the Medical Records Department for analysis.Results: Of the 1110 patients admitted within this period, 72 diedgiving an overall mortality of 6.5%. There were 43 males and 29females, giving a male: female ratio of 1.5:1. Most of the deaths58 (80.6%) occurred among children aged younger than 2 years.Malaria was the most common presumed cause of death, followedby gastroenteritis and bronchopneumonia. Twelve and half percent (12.5%) of the children died within 24 hours of admission. The commonest causes of death within 24 hours were severe anaemia, pneumonia and gastroenteritis. The modal months for childhood mortality in this hospitalwere May and August.Conclusion: Mortality was commonest among children younger than 2 years of age. Malaria, gastroenteritis and pneumonia were the commonest causes of death. A proactive planning taking into account the seasonal variation of these diseases could reduce the childhood mortality in this centre

Epileptic spasms - 175 years on: Trying to teach an old dog new tricks

PURPOSE: This text provides an overview of how the condition "infantile spasms" has evolved in the last 175 years. METHOD: Key references are summarised to assimilate this review. Results: Infantile spasms, first described by Dr West in 1841, has undergone extensive investigation to understand the pathogenesis, aetiologies, optimal intervention and most likely prognosis for the affected child. The terminology has recently evolved such that the preferred term for the condition is now “epileptic spasms” in recognition of the fact that cases can present outside infancy. The aetiologies are diverse and can be structural, genetic, metabolic or acquired. Increasing numbers of presumed causative genetic mutations are now being identified. The condition is an epileptic encephalopathy such that without adequate control of the clinical seizures and correction of the abnormal EEG, ongoing neurological damage occurs. In some cases neuroregression is inevitable despite intervention. First-line treatments are either hormonal therapies, adrenocortcotrophic hormone or prednisolone, or vigabatrin. In the sub-group of patients with tuberous sclerosis complex, vigabatrin is the preferred treatment. High dose prednisolone may be a more viable option in resource limited settings. Recent research has suggested that combining hormonal therapies with vigabatrin will result in more patients achieving spasm cessation. CONCLUSIONS: Despite extensive study, the pathogenic mechanisms remain an area of debate and in need of further exploration. The enigma, however, may be explained as the role of resting state and dysfunctional brain networks are elucidated further

Prevalence and pattern of sexual abuse among children attending Ebonyi State University Teaching Hospital, Abakiliki, Ebonyi State

Background: Child sexual abuse is broadly defined as both direct genital contact and indirect interactions such as ‘exposure’ or internet-based activity (for example, the sending of electronic sexual pictures to minors). Though sexual abuse is common, yet many adults are not prepared or unwilling to deal with the problem when faced with it, this could lead tounderreporting of the crime and stigmatizing of the victim.Objectives: To determine the prevalence and pattern of sexual abuse among children attending Ebonyi state university teaching hospital, Abakiliki.Methods: A retrospective study of cases of sexual abuse that presentedin the children outpatient clinics of EBSUTH between the 1st of January and 31st of December 2010.Results: A total of 3750 children attended clinic of which 33 were diagnosed as being sexually abused, giving a prevalence rate of 0.9%.They were 31 (93.9%) females and 2 (6.1) males, most of the reportswere made by the victims 23 (69.7%) and or their parents 9 (27.3%). Most of the reports made happened within one week 15 (45.5%). It is noted that HIV test was done which was negative among 15 (42.4%) children andpositive in one (3%) after twelve weeks.Conclusions: The prevalence or sexual abuse in EBSUTH is 0.9%. This low prevalence could be due to the fact that child sexual abuse is scantly reported because of the stigma attached to it.Key words: child sexual abuse; prevalence; pattern; EBSUT

Knowledge of conversion disorder in children by pediatricians in a developing country

Introduction: Conversion disorder (CD) in children presents the clinician with a diagnostic and treatment dilemma. Mistaking a physical condition for CD carries serious consequences for the child while continued investigation in line with physical disease in a child with CD also may expose the child to serious harm.Materials and Methods: One hundred and seventy‑four consenting doctors who attended a national conference of pediatricians were administered a 10 item questionnaire developed by the researchers.Results: Only 5 (2.9%) of participants had good knowledge (scored above the mean plus one standard deviation of the score obtained by the psychiatry residents. Gender, rank, years of experience, availability of psychiatric service in center and duration of the psychiatry posting as the medical student could not differentiate those with good/fair knowledge from those without. However, those who have referred children for psychiatric assessment (P = 0.015), those who believe that children can have CD (P = 0.000) and those who are fairly confident that they could diagnose CD in children (P = 0.000) had better knowledge of CD.Conclusion: Pediatricians have poor knowledge of CDs in children. Those that know that children could have the condition have confidence that they can identify children with the condition and have referred with mental health problems to psychiatrists have better knowledge than those who did not.Keywords: Conversion disorder, knowledge, pediatrician

Childhood suppurative otitis media in Abakaliki: Isolated microbes and in vitro antibiotic sensitivity pattern

Background: Suppurative otitis media (SOM) is the most common pediatric problem seen by otolaryngologists in Nigeria. Devising simple and effective ways of treating pediatric patients with suppurating ears, especially in situations without a specialist care, will help prevent chronicity. Our experience with SOM at the Ebonyi State University Teaching Hospital (EBSUTH), Abakaliki, is reviewed in this study. It may serve as a guide in patient care.Objective: Determine the bacteriology of SOM in children in Abakaliki and ascertain their sensitivity to common antibiotics.Materials and Methods: A 2-year retrospective analysis of ear swabs culture results and case files of children aged 0-18 years with SOM managed in EBSUTH.Results: Sixty-five patients with discharging ears were reviewed. Of these, 73% were ≤5 years, of which 41.5% were infants. About 83% had unilateral ear discharge. Acute suppuration was seen in 67%. Overall swab yield was 87.7%; Pseudomonas was (57.4%), Klebsiella (16.4%), and Proteus species (11.5%). Ciprofloxacin showed 60% sensitivity, Gentamicin (58%), and Ceftazidime (35%). Amoxicillin/Clavulanic acid, ceftriaxone, and cefuroxime showed sensitivity of 4.3%-9.7%.Conclusions: Treatment protocols of SOM in children should emphasize the use of Ciprofloxacin or Gentamicin, especially in situations with limited access to laboratory services or specialist care

Symptoms of Attention Deficit Hyperactivity Disorder (ADHD) Among Rural Primary School Children in Southeastern Nigeria: Comparison of School and Home Settings

Background: Diagnosis of ADHD depends on manifestation of symptoms in at least two different settings. This therefore emphasizes the importance of multiple informants, parents and teachers. However perception could differ because of differences and inconsistencies across different settings. This is particularly important in rural settings in Africa where the educational  attainment and outlook of teachers are very different from those of the parents. The study is aimed at comparing the presentations of children with ADHD in the rural area, across two different settings: home and school.Methods: The teachers of 181 rural primary school children in Ogberuru in Imo state, south eastern, Nigeria completed the school version of ADHD rating scale-IV, and their parents completed a Socio demographic questionnaire and the home versions of the ADHD rating scale-IV.Results: Of the 18 symptoms of the condition, there were significant differences in the rate of identification in eight symptoms. These symptoms include ‘being easily distracted’ (p=0.0427), ‘difficulty following through on instruction’ (p=0.0026), ‘fails to give close attention to details (p=0.0001), ‘avoids tasks necessary for tasks’ (p=0.0013), ‘difficulty playing quietly (p=0.0059 ) , ‘talks excessively’ (p=0.0023), ‘intrudes on others’ (p=0.0004), and ‘seems not to listen when spoken to directly’ (p=0.0002). They were all consistently more manifest in school settings than in their homes.Conclusion: Teachers identified ADHD symptoms more commonly than parents. They could therefore play critical roles in programs aimed at improving early identification and management of children with ADHD especially in rural Africa where healthcare facilities are scarce

Seroprevalence and Correlates of Hepatitis C Virus Infection in Secondary School Children in Enugu, Nigeria

Background: Although children comprise a small fraction of the burden of hepatitis C virus (HCV) infections, which is a major global health challenge, a significant number of them develop chronic HCV infection and are at risk of its complications. Aim: The aim of the current study was to determine the prevalence and associated factors of HCV infection in school children in Enugu urban. Subjects and Methods: This was a cross‑sectional seroepidemiological study involving children aged 10–18 years selected using multistage systematic sampling in Enugu metropolis, Southeast Nigeria. The anti‑HCV was tested using a 3rd generation enzyme‑linked immunosorbent assay. Data were analyzed using SPSS Version 16.0 with the level of significance set at P < 0.05. Results: Four hundred and twenty children were selected and screened comprising 210 (50.0%) males and females. The seroprevalence of anti‑HCV was 4 (1.0%). Three (75%) out of the four positive cases for the anti‑HCV were females while one was a male giving a male to female ratio of 0.3–1. Traditional scarifications/tattoos were the putative riskfactors observed to be significantly associated with anti‑HCV seropositivity. Conclusion: This study has demonstrated an anti‑HCV seroprevalence of 1.0% among children aged 10–18 years in Enugu with traditional scarification as the predominant associated risk factor. Proper health education including school health education and promotion of behavioral change among the public on the practice of safe scarifications/tattoos should be encouraged in our setting.Keywords: Anti‑hepatitis C virus, Children, Prevalence, Risk factor