Prelacteal feeding practices among lactating mothers in Benin City, Nigeria

Background: Exclusive breastfeeding is the cornerstone of adequate early infant nutrition. Despite the acknowledged gains of Baby Friendly Hospital Initiative (BFHI) and other interventional measures in ensuring optimal infant nutrition, it is still a common practice for newborn babies to be givensubstances other than breast milk within the first day of life.Methods: To re-examine why this is so, a prospective, cross-sectionalstudy involving mothers with recent history of lactation was carried. Itinvolved 403 mothers attending the well Baby Clinic of the Universityof Benin Teaching Hospital in 2009. A semi structured questionnairewas used in obtaining relevant information on pre-lacteal feeding.Results: The prevalence of prelacteal feeding was 11.7%. Wateronly constituted the most common (44.3%) pre-lacteal feed. Otherfeeds administered included glucose drink, (37.2%), and honey (4.6%).The reasons for pre-lacteal feeding included perceived delayed lactationand the need to keep the body warm and mouth moist. The younger the respondents, the more likely she would practice pre-lacteal feeding (X2 = 11.4; p = 0.022). Also significantly associated with pre-lacteal feeding is the route of delivery. Pre-lacteal feeding was commoner with surgical deliveries (X2 = 7.0; p = 0.05). Pre-lacteal feeding was however un-associated with respondents’ tribe, educational status, religion and place of delivery. Pre-lacteal feeding remains a challenge to adequate infant nutrition.Conclusion/Recommendations: There is need for further enlightenmenton the dangers inherent in the practice. Education of the populacewould need to be improved upon if the initial gains accruing fromBFHI are not to be reversed.Key words: Pre-lacteal feeding Infant, Nutrition, Benin City

Some economic and socio-cultural factors associated with cerebral malaria among under-fives in Benin City, Nigeria.

Introduction: Risk factors associated with the occurrence of cerebral malaria in under fives are well documented. Outside these acknowledged factors of age, location, and nutrition, other socioeconomic/cultural factors could contribute to the maze of factors determining the occurrence of the morbidity. Methods: To unravel such factors a key informant interview was conducted among resident doctors in paediatrics at the University of Benin Teaching Hospital. Factors identified formed the basis of this cross-sectional, case control study involving 64 cases each of subjects and controls with uncomplicated malaria carried out at the Hospital. Such factors as delay in accessing competent intervention, prolonged use of anti-pyretics, material educational status, use of substandard medication and abdominal scarification as identified were evaluated in the two sets of patients. Others evaluated included mothers’ occupation and health seeking behaviours. Results: Factors found to be significantly associated with occurrence of cerebral malaria were initial treatment in clinics (X2 = 6.43, p = 0.011) presence of fresh abdominal scarification (X2 = 4.30, p=0.038) late presentation (X2 = 32.64; p=0.000) and non- use of mosquito nets (X2 = 9.14; p=0.002). Conclusion/Recommendations: Initial treatment either in clinics or non orthodox facilities contributed significantly to the occurrence of cerebral malaria. The implication of these is that pre- teaching hospital treatments were inadequate in managing the child meant to develop cerebral malaria. Attention should therefore be directed at these areas alongside use of mosquito nets if the objective is to minimise the occurrence of cerebral malaria.Key words: Cerebral malaria, Risk factors, Under fives, Economic factors & Socio-cultural factors

Evaluation of coronary blood flow velocity during cardiac arrest with circulation maintained through mechanical chest compressions in a porcine model

<p>Abstract</p> <p>Background</p> <p>Mechanical chest compressions (CCs) have been shown capable of maintaining circulation in humans suffering cardiac arrest for extensive periods of time. Reports have documented a visually normalized coronary blood flow during angiography in such cases (TIMI III flow), but it has never been actually measured. Only indirect measurements of the coronary circulation during cardiac arrest with on-going mechanical CCs have been performed previously through measurement of the coronary perfusion pressure (CPP). In this study our aim was to correlate average peak coronary flow velocity (APV) to CPP during mechanical CCs.</p> <p>Methods</p> <p>In a closed chest porcine model, cardiac arrest was established through electrically induced ventricular fibrillation (VF) in eleven pigs. After one minute, mechanical chest compressions were initiated and then maintained for 10 minutes upon which the pigs were defibrillated. Measurements of coronary blood flow in the left anterior descending artery were made at baseline and during VF with a catheter based Doppler flow fire measuring APV. Furthermore measurements of central (thoracic) venous and arterial pressures were also made in order to calculate the theoretical CPP.</p> <p>Results</p> <p>Average peak coronary flow velocity was significantly higher compared to baseline during mechanical chests compressions and this was observed during the entire period of mechanical chest compressions (12 - 39% above baseline). The APV slowly declined during the 10 min period of mechanical chest compressions, but was still higher than baseline at the end of mechanical chest compressions. CPP was simultaneously maintained at > 20 mmHg during the 10 minute episode of cardiac arrest.</p> <p>Conclusion</p> <p>Our study showed good correlation between CPP and APV which was highly significant, during cardiac arrest with on-going mechanical CCs in a closed chest porcine model. In addition APV was even higher during mechanical CCs compared to baseline. Mechanical CCs can, at minimum, re-establish coronary blood flow in non-diseased coronary arteries during cardiac arrest.</p