Postural hypotension in type 1 diabetes: The influence of glycemic control and duration of illness

Background: Postural hypotension (PH) indicates the presence of cardiac autonomic neuropathy and in diabetes mellitus (DM) is associated with adverse outcome. Nonetheless, PH has been rarely characterized in young persons in Sub‑saharan Africa where suboptimal care of DM is prevalent.Aims: The aim of the study was to determine the prevalence of PH in young patients with type 1DM and its relationship with the duration of DM and glycemic control.Settings and Design: It was a cross‑sectional, case control study carried out in the pediatric out‑patient clinic.Materials and Methods: Each study participant had blood pressure (BP) measured in the supine and standing positions. Glycated hemoglobin (HbA1c) levels were determined and disease duration was documented. Statistical Analysis: The mean BP in the different positions was determined. The occurrence of PH, duration of disease and HbA1c levels was determined with logistic regression analysis.Results: A total of 26 diabetic subjects and 26 age and sex matched controls were studied. 12 (46.2%) diabetic subjects had evidence of PH while none of the controls had PH. Diabetic subjects with PH had significantly longer duration of DM than those diabetics without PH (6.79 ± 4.81 vs. 2.83 ± 2.36, P = 0.023). The mean HbA1c level was similar in both groups of diabetic subjects (9.79 ± 2.07 vs. 9.17 ± 2.35). On logistic regression, age, duration of disease, HbA1c level and body mass index were not significant predictors of PH.Conclusion: PH is common in young persons with type 1 DM, with higher frequency in those with long standing disease.Key words: Diabetes mellitus, duration, glycemic control, postural hypotensio

Booster Dose of Bacille Calmette-Guérin Vaccine for Tuberculosis in Low and Middle-Income Countries: A Systematic Review

Background: The Bacille Calmette-Guérin (BCG) vaccine, given as a single dose, offers variable protection against Tuberculosis (TB). It is plausible that repeat doses could improve the effectiveness of the BCG vaccine in settings where the population remain at risk of the disease. Objective: To assess the effectiveness of BCG revaccination as a booster dose in preventing TB in Low- and Middle- Income Countries (LMICs). Methods: We searched the electronic databases without language or publication restrictions and followed the procedures for preparing systematic reviews, including assessing the risk of bias as outlined in the Cochrane handbook. We included randomised controlled trials (RCTs) conducted in LMICs involving children and adults receiving one or more BCG vaccine doses after the primary BCG vaccination. The incidence of severe forms of TB, active TB and adverse events were the primary outcomes. Results: Five RCTs were included in this systematic review. Revaccination with BCG probably makes little or no difference to the risk of active TB measured after five years (Relative risk (RR) 1.16, 95% CI 0.88 to 1.51; 348,083 participants; one study, moderate certainty evidence) or nine years post-revaccination (RR 0.96, 95% CI 0.82 to 1.12; 348,083 participants; one study, moderate certainty evidence). In populations with HIV co-infection, revaccination probably increases the risk of pulmonary tuberculosis compared to placebo (RR 1.74, 95% CI 1.00 to 3.01; 46,764 participants; one study, moderate certainty evidence). Conclusion: The available evidence suggests that BCG revaccination probably makes little or no difference in preventing tuberculosis disease in LMICs

The Impact of Housing in Paediatrics Burns Cases: A Review of Health Implication of Habitat in Centre Families in Lagos.

Objective: To determine the impact of housing on paediatric Burns Cases in Lagos Design: Prospective Study Subject: 40 children aged 10 days to 10 years admitted for Management after sustaining burns Main Outcome Measurements: Housing plays a significant role in paediatric Burns Cases. Results: 70% of a total of 40 Paediatric burns patients had moderate severe burns. These were from one apartment room while only two of them lived in a two-room apartment. 85% of the patients were from low social-economic cadre. All the burns occurred intramural. Conclusion: Housing plays a significant role in burn cases in Urban Lagos. This is related to the poor housing situation which has a direct bearing on the Social Status of the parents of victims. Nig. Qt. J. Hosp. Med. Vol.12(1-4) 2002: 52-5

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

Congenital Cystic Adenomatoid Malformation of the Lung: A case report and diagnostic challenges in a typical African Setting.

Congenital cystic adenomatoid malformation (CCAM) of the lung an entity which results from a harmatomatous proliferation of the bronchioles constitutes 25% of the all congenital lung anomalies. Majority of cases of CCAM usually present with respiratory distress from birth, while others may present with recurrent chest infections in childhood or in adulthood. Most reports on CCAM have been on caucasian children and the diagnosis of the condition appears to be challenging unless there is a high index of suspicion. This report describes the case of a child who presented in late infancy and was initially managed as a case of hydropneumothorax, however a Computed Tomography (CT) of the chest confirmed CCAM. The diagnostic challenges is also addressed

Effect of chloroquine on strips of non-pregnant and pregnant mice uteri in-vitro

No Abstract. Nigerian Quarterly Journal of Hospital Medicine Vol. 17 (1) 2007: pp. 13-1