Neonatal Diabetic Ketoacidosis In A Nigerian Infant: A Case Report

Neonatal diabetic ketoacidosis is a rare condition that may occur in the first few weeks of life as a complication of neonatal diabetes mellitus. The prominent clinical features are hyperglycaemia and dehydration. It could also mimick an infection. The danger of inappropriate diagnosis is increased morbidity and mortality. To prevent this, we advocate routine testing of blood glucose levels in neonates and infants who present at the emergency rooms. We report a case of neonatal diabetic ketoacidosis in a female who presented at our facility.Keywords: Neonate Diabetes mellitus Ketoacidosis Dehydratio

A Case Report of Congenital Neuroblastoma

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Necrotizing Fasciitis In A Preterm, HIV Infected Baby

Necrotizing fasciitis (NF) is a rapidly progressive life threatening bacterial infection of the soft tissues. It is commoner in the adult population where it is associated with systemic and local disease conditions such as diabetes mellitus, intravenous drug abuse, dental lesions, trauma and immunosuppression. It is rare in children, especially neonates.The hallmark of the management of NF is prompt diagnosis. Effective modalities of management include resuscitation, early surgical wound debridement to control infection and use of intravenous antimicrobial agents.We report a case of NF in a preterm HIV infected neonate.Key words: Necrotizing fasciitis, Intravenous access site, Intravenous antibiotic

Severe hyperglycaemia due to neonatal sepsis - A case report

Neonatal sepsis is a clinical syndrome characterized by signs and symptoms of infection with or without  accompanying bacteremia in the first month of life. The clinical signs of neonatal sepsis are neither specific nor uniform. Neonatal sepsis may present with fever, hypotonia, respiratory distress, apnea and hyperglycaemia. Untreated hyperglycemia unequivocally leads to undesirable clinical outcomes. Hyperglycemia is associated with increased mortality, which is significantly related to the duration of the elevated blood glucose. The  constant risk that hyperglycaemia presents must be borne in mind when evaluating neonates presenting with sepsis. Adequate measurement and control of elevated blood sugar must be done bearing in mind that the administration of insulin can cause a precipitous fall in glucose and increase the risk of hypoglycemia. This report documents a case of severe hyperglycaemia due to neonatal sepsis.KeyWords : Neonatalsepsis; Hyperglycaemia; Diabetes mellitus

Accuracy of the Siriraj Stroke Score in Differentiating Cerebral Haemorrhage and Infarction in African Nigerians (English)

Background Scoring systems based on discriminant analysis technique and multivariate logistic regression have been developed to distinguish cerebral haemorrhage (CH) from cerebral infarction (CI). This distinction is necessary in the acute management of stroke patients. Objectif The Siriraj stroke score (SSS) was evaluated in Siriraj hospital, Bangkok, and the Western Infirmary, Glasgow, and needs to be validated in an African setting. Methodology The computerised tomography (CT) brain scans of all patients referred with clinical diagnosis of stroke at the University College Hospital (UCH), Ibadan, and RADMED diagnostic centre, Lagos were retrieved and reviewed as well as the case notes of the patients at the referral hospitals. The SSS was computed and the stroke subtype classified. This was compared with the CTscan diagnosis using the latter as the gold standard. Data analysis was performed with Epi-info software and by standard statistical methods. Results Ninety-six patients had complete clinical records and CT scan features consistent with stroke. Of these, 52 had cerebral infarction (CI) and 44 had cerebral haemorrhage (CH). SSS had sensitivity of 50% for CH and 58% for CI with an accuracy of 54.2%. Conclusion In this study, the SSS was not sufficiently sensitive to differentiate between CH and CI in Africans. A prospective study with larger sample size and modification of the discriminant variables is suggested. For now, while efforts must continue to find a simple clinical scoring system to differentiate between CH and CI, we contend that CTscan should remain the investigative technique of choice and should be made affordable and available. Keywords: Africa, cerebral haemorrhage, cerebral infarction, Nigeria, stroke, CT-scan, Accident vasculaire cérébral hemorragique, Accident vasculaire cérébral ischémique, A frique, Nigeria, tomodensitométrie Résumé  Introduction Dans le but d\'agir avec efficacité dans la prise en charge thérapeutique des accidents vasculaires cérébraux un score discriminant à l\'aide de variables multiples a été élaboré afin de distinguer les accidents vasculaires hémorragiques (AVCH) des accidents vasculaires ischémiques (AVCI). Objective Le Siriraj stroke score (SSS) a été évalué au Siriraj hospital, Bangkok et au Western infirmary, Glasgow. Il importait de le valider dans le cadre africain. Méthodologie Les dossiers des malades hospitalisés au Centre Hospitalier Universitaire d\'Ibadan et au centre diagnostic RADMED à Lagos ont été étudiés rétrospectvement de même que les CT-scan. Les données scannographiques ont été comparées au SSS. Les informations ont été analysées grâce au logiciel Epi-info et à l\'aide de différentes méthodes stastistiques. Résultats 96 patitents ont été retenus. 52 malades avaient un infarcissement cérébral et 44 une hémorragie cérébrale. Le SSS avait une sensiblité de 50% pour les AVC hémorragiques et 58% pour les AVCI avec une spécificité de 54,2%. Conclusion Cette étude permet de conclure en l\'absence de spécificité du SSS dans la distinction des AVCH et AVCI chez les Africains. Une étude prospective est préconisée en modifiant certaines variables. Actuellement le CT-scan reste la technique de choix pour différencier les AVCI des AVCH. Af J Neuro Sci: 2002 20(1