Sickle cell disease clinical phenotypes in children from South.Western, Nigeria

Background: The clinical phenotypes of children with sickle cell disease (SCD) are poorly described in many sub-Saharan countries including Nigeria.Objectives: The objective was to highlight various clinical phenotypes of SCD in children and investigate the influence of sociodemographic indices on the development of SCD complications.Methods: We carried out a cross.sectional study of 240 pediatric patients attending the sickle cell clinic and the emergency room in a teaching hospital in South.Western Nigeria over a 12.month period. The clinical phenotypes and severity of the disease were documented, and the  influence of sociodemographic variables was investigated.Results: The five leading clinical phenotypes in our patients were  significant pain episodes, that is, vaso.occlusive crisis in 159 (66.3%); anemic crisis in 62 (25.8%); severe bacterial infections, 57 (23.8%); acute chest syndrome (ACS), 27 (11.3%) and stroke, 7 (2.9%). Forty.two  (33.1%) had a previous history of dactylitis (hand.foot syndrome). Other clinical phenotypes such as avascular necrosis of the femur, 4 (1.7%); nephropathy, 2 (0.8%); priapism, gallstone and chronic leg ulcer, one (0.4%) each, were not commonly seen. More children with a history of asthma had ACS. Furthermore, high steady.state white blood cell count was associated with severe disease.Conclusion: The clinical phenotypes of SCD in children from South.Western Nigeria are highly variable with the disease manifesting very early and about 10% having significant complications. Sociodemographic  characteristics appear to have little influence on the development of SCD complications among our patients, but age and low-socioeconomic class are associated with anemic crisis.Key words: Clinical phenotypes, Nigeria, sickle cell disease,  sociodemographic variable

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

Septicaemia complicated by digital gangrene - a case report

No Abstract. Nigerian Journal of Paediatrics Vol. 31(4) 2004: 137-13

The use of anitmalaria drugs and insecticide treated nets in Ile-Ife, Nigeria

No Abstract. Nigerian Journal of Medicine Vol. 15(3) July-September 2006: 277-28

Treatment Challenges and Outcome of Intra-cardiac Lymphoma in a Resource-limited Setting: A Case Report

Malignant lymphoma, presenting as primary intra-cardiac mass, is rare in children. Without timely intervention, morbidity and mortality may be high in this condition, particularly when it is associated with pericardial effusion and cardiac tamponade. A case of a 9-year old Nigerian girl with primary cardiac lymphoma associated with pericardial effusion and cardiac tamponade is reported. For reasons of parental financial incapability, the girl received only two of the six recommended courses of systemic chemotherapy following emergency pericardiostomy. She was alive and well for one year but suddenly died at home following the re-emergence of symptoms similar to the initial presentation of the primary neoplastic disease. The response of primary cardiac lymphoma to combination chemotherapy alone is known to be good, thus, it is advocated as the treatment of choice for primary cardiac lymphoma where the resources for cancer treatment are limited and the cost of care is prohibitive. The lack of access to adequate chemotherapy may be the key factor responsible for the poor prognosis and fatality in this case