Kwashiorkor- is it a dying disease?

Objective. To review the occurrence of kwashiorkor before and after the establishment of the Diarrhoea Training Unit at a Nigerian tertiary hospital in 1992.Design. A retrospective hospital-based analytical study was undertaken. Groups of subjects were compared using odds ratios (95% confidence intervals) and regression analysis.Setting. The paediatric wards of the Wesley Guild Hospital, Ilesa, Nigeria.Subjects. The number of children admitted with kwashiorkor, measles,  gastroenteritis and marasmus between 1983 and 1991 (group I) was compared with similar data for the period 1993 - 2002 (group 2).Results. There was a 30.4% reduction in the total admissions between  these periods, while incidences of  kwashiorkor, measles, gastroenteritis and marasmus fell by 70%, 55%, 57.4% arid 55.8% respectively. Reduction in number of kwashiorkor cases between groups 1 and 2 was significantly related to the reduced incidence of  measles (p = 0.000002) and gastroenteritis (p = 0.000003). The total number of admissions was correlated with the number of measles (r = 0.623 and 0.573 forgroup 1 and 2) and kwashiorkor cases (r =- 0.412 and 0.233 for groups 1 and 2).Conclusion. The incidence of kwashiorkor has fallen in Ilesa, Nigeria. Given the relatively low HIV prevalence rate in the country during the study period, better management of diarrhoeal diseases, including measles, may have accounted for this drastic fall

Pattern of childhood malignant tumours in two tertiary teaching hospitals in Nigeria: Comparative study

Background: Cancer is a public health problem worldwide affecting all categories of persons. It is the second common cause of death in developed countries and among the three leading causes of death in developing countries.Objective: To compare the patterns of malignant childhood tumours intwo tertiary hospitals in the north- Western and South western Nigeria.Methods: Retrospective studies of childhood malignancies diagnosedat Aminu Kano Teaching Hospital (AKTH), Kano and Obafemi Awolowo University Teaching Hospital Complex (OAUTHC) (Ife Hospital Unit, Ile-Ife and Wesley Guild Hospital Unit, Ilesa, Osun state) were undertaken from January, 2001 to December, 2010. The patterns of childhood cancers inthese hospitals were compared.Results: Four hundred and ten children aged 7 months to 15 years were admitted at AKTH with malignancies of which 236 were males and 174 females with male to female ratio of 1.4:1. At OAUTHC, 568 children aged two months to 15 years were admitted with malignancies over the ten year period. There were 401 males and 167 females, with male to female ratio of 2.4:1. Lymphomas were the commonest type of malignancy in both centers, which accounted for 47.3% and 59.7% at AKTH and OAUTHCrespectively. Retinoblastoma was the second commonest tumour atAKTH constituting 14.9% of all malignancies followed by nephroblastomaand acute leukemias. In contrast, acute leukemias were the second commonest malignancy at OAUTHC accounting for 12.7% of all malignancies followed by retinoblastoma and nephroblastoma. Tumoursof central nervous system were observed to be commoner at AKTH, while bone tumours were commoner at OAUTHC.Conclusion: The pattern of childhood cancer varies rather little betweendifferent regions in Nigeria, with malignant lymphomas being the most common as is the case in most developing countries. However, the findings in this study suggest that there is variation in prevalence of leukemia, CNS and bone tumours in northern and southern Nigeria.Key words: Childhood, malignant tumours, pattern, teaching hospitals,Nigeri

Clinical effects of Garcinia kola in knee osteoarthritis

<p>Abstract</p> <p>Objectives</p> <p>Over the past years, there has been a growing number of knee osteoarthritis (KOA) patients who are not willing to comply with long-term non-steroidal anti-inflammatory drugs (NSAID) treatment and wish to use herbal anti- rheumatic medicine. This study assessed the clinical effects of <it>Garcinia kola </it>(GK) in KOA patients.</p> <p>Patients and methods</p> <p>Prospective randomized, placebo controlled, double blind, clinical trial approved by the institutional medical ethics review board and written informed consent obtained from each patient. All KOA patients presenting at the Obafemi Awolowo University Teaching Hospital complex were recruited into the study. The patients were grouped into four (A = Placebo, B = Naproxen, C = <it>Garcinia kola</it>, D = Celebrex). The drugs and placebo were given twice a day per oral route. Each dose consisted of 200 mg of <it>G. kola</it>, Naproxen (500 mg), Celebrex (200 mg) and Ascorbic acid (100 mg). The primary outcome measure over six weeks study period was the change in mean WOMAC pain visual analogue scales (VAS). Secondary outcome measures included the mean change in joint stiffness and physical function (mobility/walking).</p> <p>Results</p> <p>143 patients were recruited, 84 (58.7%, males – 24, females – 60) satisfied the selection criteria and completed the study. The effect of knee osteoarthritis bilateralism among the subjects was not significant on their outcome (p > 0.05). The change in the mean WOMAC pain VAS after six weeks of <it>G. kola </it>was significantly reduced compared to the placebo (p < 0.001). Multiple comparisons of the mean VAS pain change of <it>G. kola </it>group was not lowered significantly against the naproxen and celebrex groups (p > 0.05). The onset of <it>G. kola </it>symptomatic pain relief was faster than the placebo (p < 0.001). However, it was slower than the active comparators (p > 0.05). The duration of therapeutic effect of <it>Garcinia kola </it>was longer than the placebo (p > 0.001). <it>G. kola </it>period of effect was less than naproxen and celebrex (p < 0.001). <it>G. kola </it>subjects had improved mean change mobility/walking after six weeks better than the control group(p < 0.001). The mean change in mobility of the <it>G. kola </it>group when compared to the active comparators was not significantly better (p < 0.05). The mean change of knee joint stiffness (p < 0.001) and the change of mean WOMAC score (p < 0.001) were improved on <it>Garcinia kola </it>as compared to the placebo. The mid term outcome of eleven <it>Garcinia kola </it>subjects after cessation of use had a mean pain relief period of 17.27 +/- 5.15 days (range: 9–26 days). There was no significant cardiovascular, renal or drug induced adverse reaction to <it>Garcinia kola</it>.</p> <p>Conclusion</p> <p><it>Garcinia kola </it>appeared to have clinically significant analgesic/anti-inflammatory effects in knee osteoarthritis patients. <it>Garcinia kola </it>is a potential osteoarthritis disease activity modifier with good mid term outcome. Further studies are required for standardization of dosages and to determine long-term effects.</p

Case Report of A Set of Newborn Twins with Neonatal Tetanus and Kernicterus

This is a case report of the tragedy of a 20 year old primipara who lost a set of twins to neonatal tetanus and kernicterus on consecutive days. The twins, who were delivered at a private Hospital, presented at the Wesley Guild Hospital, Ilesha on the seventh day of life because the second twin had been unable tp suck for 24 hours and had been having abnormal body movements for 6 hours. The physiacl signs were compatible with a diagnosis of neonatal tetanus and moderate neonatal jaundice secondary to septicaemia. The first twin had no complaint, but examination findings were in keeping with 'severe neonatal jaundice with features suggestive of kernicterus'. Phototherapy was commenced for the twins, and appropriate antispamodics were also instituted fo rthe second twin being managed for tetanus. They had been on admission for thirteen days when second twin died, and the first twin also died a day after.Keywords: Tetanus, Kernicterus, Twins, Preterm

Acute Renal Failure following Accidental Potassium Bromate Poisoning: A Case Report

Accidental poisoning is common in children. Potassium bromate is a commonly used additive and raising agent in many edibles particularly bread, a staple food worldwide, yet its accidental poisoning has hitherto, not been documented in Nigeria. We report an unusual case of acute renal failure following accidental ingestion of potassium bromate tablets. Key Words: Acute renal failure, Poisoning, Potassium bromate Nigerian Journal of Paediatrics Vol.30(4) 2003: 150-15

An unfortunate outcome in a child with an encephalocoele from a rural area

A case of a three-and-a-half month old infant from a rural area, who presented with an encephalocoele, is reported. The case was complicated by acute rupture of the encephalocoele. Due to financial difficulties, there was late presentation at an appropriate health facility, and this delayed adequate management. The problem was further compounded by an industrial unrest in the public health sector at the time. There is a need to site investigational and surgical services for minor neurosurgical problems in the rural areas of the country. Nigerian Journal of Paediatrics Vol. 31(3) 2004: 93-9

Fresh plasma transfusion in the care of critically ILL neonates

No Abstracts.Nigerian Medical Practitioner Vol.50(5)2006: pp.96-9

Management of Burn Injuries by Daily soaking in Normal Saline prior to Dressing

A review of 121 children with burn injuries admitted over a five-year period (January 1992 – December 1996) at the Wesley Guild Hospital, Ilesa was undertaken. The patients were soaked in normal saline for at least one hour daily, prior to dressing with topical application of silver sulphadiazine. Scalds were responsible for 67 per cent of the cases while naked flame, including kerosene explosion and therapeutic burns were responsible for the rest. The burns were categorised as major in 58 per cent of cases. The trunk was affected in 66 per cent of cases, the upper and lower limbs were each affected in 51 per cent, the head and neck in 30 per cent, and the hands and feet in 25 per cent. Wound infection was the commonest complication occurring in 16.5 per cent, while mortality was 6.6 per cent; these were lower than the 24.4 per cent and 7.7 per cent respectively, obtained in previous studies in the Unit when saline solution was not used. Similarly, the rates of contractures and severe anaemia were lower among those whose burns were soaked in saline (5 per cent vs 10.9 per cent, and 2.5 per cent vs 10.3 per cent, respectively). Although the rates were lower in the present study except for septicaemia, the differences did not reach statistical significance except for severe anaemia. However, the study thus indicates that soaking of burn injuries in saline prior to dressing may improve prognosis. Nigerian Journal of Paediatrics 2001; 28:115.pp. 115-11

Relationship between breastfeeding practices and nutritional status of children aged 6-24 months in South-west Nigeria

Background:&nbsp;Breastfeeding is the ideal form of nutrition for the healthy growth of infants, and it reduces the risk of malnutrition and several childhood morbidities. Objectives:&nbsp;To assess the breastfeeding practices of mothers and the relationship between these practices and the nutritional status of their children. Methods:&nbsp;It was a descriptive, hospital-based, cross-sectional study that involved children aged six to 24 months in Ilesa, Osun State, Nigeria. Socio-demographic characteristics and breastfeeding practices were documented, anthropometric measurements were obtained, and nutritional status was determined for the children. Underweight, stunting and wasting were defined as z-score &lt; -2 for the weight-for-age, length-for-age and weight-for-length, respectively. A child was taken to be undernourished if any of underweight, stunting or wasting was present. Results:&nbsp;Fifteen (3.6%) of the 420 children studied had mixed feeding from birth, while 273 (65.0%) were exclusively breastfed for six months. Two hundred and sixty-eight (63.8%) of them were still breastfeeding at the time of the study, while 152 (36.2%) had stopped breastfeeding. Nearly one-quarter (103/420; 24.5%) of the children were undernourished. A significantly lower proportion of children who had exclusive breastfeeding were undernourished, compared to those who were not exclusively breastfed (p = 0.033). Exclusive breastfeeding was independently associated with reduced odds of undernutrition (OR = 1.62, 95% CI = 1.02-2.57, p = 0.039). Conclusion:&nbsp;Exclusive breastfeeding for six months significantly reduces the risk of undernutrition among young children