Bacterial Isolates of Surfaces in the Neonatal Intensive Care Unit of Enugu State University Teaching Hospital, Parklane, Enugu, and Their Antibiotic Susceptibility Patterns

Introduction: The duration of admission in the hospital, mortality rates, and care costs is increased in Neonatal Intensive Care Unit (NICUs) by nosocomial infections(NIs). There is a need for routine and regular environmental sampling in NICUs. Methodology: This was a cross-sectional study conducted in the NICU of Enugu State University Teaching Hospital. The researchers collected samples for culture from equipment and hospital surfaces in the unit. Susceptibility testing was done for isolates by the agar diffusion method using standard nutrient agar 1 discs. Results: We observed bacterial growth in 58 (54.7%) samples from the 106 samples collected. Staphylococcus aureus 35 (55.6%) was the most common isolate cultured, followed by Escherichia coli 14 (22.2%) and then coagulase-negative Staphylococcus13 (20.6%).  Among S. aureus isolates, 48.6% were methicillin-resistant S. aureus. Among the Gram-negative isolates, resistance was highest for ampicillin followed by meropenem. Conclusion: The most common isolates were S. aureus, coagulase-negative Staphylococcus, and E. coli. Health-care providers need improved hygiene standards to reduce the burden of NI. Keywords: Bacterial contamination, Neonatal Intensive Care Unit, Nigeria, susceptibility pattern

Ophthalmological Findings in Paediatric Non-Traumatic Coma in Enugu State University Teaching Hospital, Parklane, Enugu, Nigeria

The ophthalmological examination is a vital aspect of the central nervous system examination in comatose children. Several authors have documented different findings with disparities in their recommendations about making ophthalmological examination a routine in the management of the unconscious child. This study sought to evaluate the relevance of routine ophthalmological examination in the management of unconscious children admitted into the paediatric emergency room of Enugu State University Teaching Hospital, Parklane, Enugu, Nigeria. This was a prospective longitudinal study conducted from April 2018 to March 2019. Unconscious patients whose caregivers gave consent were recruited into the study. Traumatic causes of coma were excluded. Demographic features of the patients were obtained. The ophthalmologic examination and diagnoses were made by an ophthalmologist, while the emergency room pediatrician made clinical assessment and diagnoses. Sixteen unconscious children had ophthalmologic examinations done. The Glasgow coma scale scores ranged from 3 to 11, with a mean of 6.6±2.2. Thirteen (81.3%) of the children were classified as severe unconsciousness while the rest were moderate. The degree of unconsciousness was significantly associated with the outcome (?2 =16.0, P = 0.03). A total of six (37.5%) ophthalmologic diagnoses were made, which included cerebral malaria, degenerative myopia, orbital cellulitis, and exposure keratopathy. The presence of an abnormal ophthalmologic finding was not significantly associated with outcome (?2 =0.36, P = 0.55). Routine ophthalmologic examination may not be justified as a management protocol in unconscious children but may be considered in selected cases

Acinetobacter baumannii: A Rare Organism Causing Blood Stream Infection in a Five-Year Old Girl in South-East Nigeria

Aim: Acinetobacter baumannii is an aerobic Gram-negative coccobacilli found in the environment, which causes predominantly nosocomial infections in humans. However, the incidence of community acquired infections is on the increase. It is characterized high resistance to the environment and the ability to develop resistance to commonly prescribed antimicrobials.  Its clinical features are non-specific and range from a benign transient bacteremia to fulminant septic shock. Carbapenems are recommended for first line treatment. This series presentation aims to increase awareness of this condition. Presentation of Cases: A case of a five-year old girl who presented with features suggestive of an upper respiratory tract infection in Enugu State, South-East Nigeria is reported. She also had a history of recent travel to Europe. Serial haematologic investigations showed evidence of worsening bacteremia and blood culture revealed Acinetobacter baumannii. She was managed with intravenous Meroponem and was discharged sixteen days after presentation. Discussion: In this case, the finding of Acinetobacter baumannii from blood culture followed an initial non response to conventional antibiotics and the history of recent travel to Europe. This organism has hitherto not been isolated in our environment, and is a significant cause of nosocomial infections with high morbidity and mortality. Isolation of this organism requires BACTEC culture methods. Its high resilience and multidrug resistance makes it difficult to treat. Conclusion: The incidence of community acquired Acinetobacter baumannii is on the increase. Management involves a high index of suspicion, prompt and accurate isolation of infecting strains and the proper choice of antibiotic regimens

Early Cessation of Breastfeeding: A Neglected Nutritional Challenge among Infants

Abstract Background: Breastfeeding (nursing) strike and early-weaning occur when infants often older than 3 months refuse to nurse for no apparent reason. This condition can be distressing to both the infant and mother. It is most times difficult for mothers to detect the cause of this phenomenon. This often puzzling state of infants feeding strike could lead to poor infant feeding practices thereby predisposing the infant to malnutrition and infections. Methods: This cross-sectional descriptive and analytical study enrolled 421 mothers who had nursed at least one child for 12 months or more. Appropriate statistical tools were used to determine prevalence of breastfeeding strike and maternal socio-demographics that are associated with refusal of breastfeeding in infants before 6 months of age. Results: Prevalence of breastfeeding strike in our study was 2.8%. Though statistical significance was not attained probably due to small sample size (n= 88), older mothers, those with more children, higher occupational grades and higher educational attainment were more likely to experience infant refusal of breastfeeding before 6 months of age. Conclusion: Despite the low prevalence reported in our study, breastfeeding strike is of great public health and family importance. There is need for more study to determine factors responsible for nursing strike in various cultural contexts in order to better educate mothers on how to prevent this present but covert phenomenon

Distracted driving and cell phone use by Nigerian Road Users: A cross-sectional study

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Negative Marking and the Student Physician–-A Descriptive Study of Nigerian Medical Schools

Background There is considerable debate about the two most commonly used scoring methods, namely, the formula scoring (popularly referred to as negative marking method in our environment) and number right scoring methods. Although the negative marking scoring system attempts to discourage students from guessing in order to increase test reliability and validity, there is the view that it is an excessive and unfair penalty that also increases anxiety. Feedback from students is part of the education process; thus, this study assessed the perception of medical students about negative marking method for multiple choice question (MCQ) examination formats and also the effect of gender and risk-taking behavior on scores obtained with this assessment method. Methods This was a prospective multicenter survey carried out among fifth year medical students in Enugu State University and the University of Nigeria. A structured questionnaire was administered to 175 medical students from the two schools, while a class test was administered to medical students from Enugu State University. Qualitative statistical methods including frequencies, percentages, and chi square were used to analyze categorical variables. Quantitative statistics using analysis of variance was used to analyze continuous variables. Results Inquiry into assessment format revealed that most of the respondents preferred MCQs (65.9%). One hundred and thirty students (74.3%) had an unfavorable perception of negative marking. Thirty-nine students (22.3%) agreed that negative marking reduces the tendency to guess and increases the validity of MCQs examination format in testing knowledge content of a subject compared to 108 (61.3%) who disagreed with this assertion (χ 2 = 23.0, df = 1, P = 0.000). The median score of the students who were not graded with negative marking was significantly higher than the score of the students graded with negative marking ( P = 0.001). There was no statistically significant difference in the risk-taking behavior between male and female students in their MCQ answering patterns with negative marking method ( P = 0.618). Conclusions In the assessment of students, it is more desirable to adopt fair penalties for discouraging guessing rather than excessive penalties for incorrect answers, which could intimidate students in negative marking schemes. There is no consensus on the penalty for an incorrect answer. Thus, there is a need for continued research into an effective and objective assessment tool that will ensure that the students’ final score in a test truly represents their level of knowledge