Attempt at Ultrasound-Guided Aspiration of Intracranial Abscess in Children in our Environment with its Peculiarity

Background: Intracranial abscesses are rare and have grave consequences if not treated early. There are several surgical treatment modalities, including ultrasound-guided aspiration, which has been proven to be a quick, safe and cost-effective means of evacuation. This may be carried out through a burrhole or through a pre-existing cranial defect such as the anterior fontanelle. Aims and Objectives: To demonstrate the benefit of ultrasound-guided aspiration of intracranial abscesses in infants and older children.Materials and Methods: Five children (four infants aged 2 to10months, all of whom were females, and a 14-year old male) with various intracranial abscesses had surgical evacuation after detailed clinical and radiological evaluation. One had multiple burrholes for evacuation of multiple abscesses, but did not survive; two had initial burrhole evacuation followed by ultrasound-guided evacuation for recurrent or residual abscess. The remaining two had ultrasound-guided evacuation for both the initial evacuation and the follow-up procedure for evacuation of recurrent or residual abscesses. Results: One of the infants had multiple burrholes for drainage of 600mls of pus as the first and only procedure. She died after 48hours. The other four had two-staged procedures involving either burrhole or ultrasound-guided evacuation as initial procedure, followed by ultrasound-guided evacuation alone as second procedure for recurrent or residual abscesses. The latter improved and were discharged without further neurological deficits.Conclusion: Ultrasound-guided aspiration of intracranial abscesses under local anesthesia is a quick, safe, and cost-effective means of evacuating multiple abscesses in infants and older children. This is useful in settings with limited resources especially for patients who may be too ill for general anaesthesia. Keywords: Intracranial Abscess; Ultrasound guidance; Cranial defect: Anterior fontanelle; Burrhole

Polymerase Chain Reaction (PCR) Detection of Schistosoma Haematobium Cercariae in Water Samples from Ogun – Osun River Basin Authority, Oyan Dam, Abeokuta

Despite decades of prevention and control efforts, the water-borne parasitic disease schistosomiasis is still endemic in 74 countries of the developing nations of the world. It is known that five species of the Schistosoma trematode are pathogenic to humans; S. haematobium is one of these infective agents of schistosomiasis in Nigeria. This study investigated the levels of prepatent S. haematobium infection in water samples collected from transmission sites in Oyan Dam in Ogun Osun River Basin Authority, Abeokuta, Nigeria, using a polymerase chain reaction (PCR) assay amplifying the DNA I repeated sequence of S. haematobium cercariae from the water samples. Samples of cercariae obtained from a laboratory population of (Bulinus globosus and Bulinus rohlfsi) snail intermediate hosts were assayed following DNA extraction as control. The results demonstrated that Oyan Dam area was still an highly S. haematobium endemic environment and also that PCR assay is sensitive enough and possess capability of detecting the presence of as little as one cercaria in water sample, does not require matured infection for positive signal and is not inhibited by additional organic matter contaminants such as those found in local creek water. On the known strength of focal effects of environmental conditions, implications of these results in the epidemiology and design of control activities are very encouraging.Keywords: PCR, Cercaria, Schistosomiasis, Oyan Dam, BulinusNigerian Journal of Parasitology, Vol. 32 [2] September 2011, pp. 265-26

Breastfeeding knowledge, attitude and practice among school teachers in Abha female educational district, southwestern Saudi Arabia

<p>Abstract</p> <p>Background</p> <p>Inadequate knowledge, or inappropriate practice, of breastfeeding may lead to undesirable consequences. The aim of this study was to assess breastfeeding knowledge, attitude and practice (KAP) among female teachers in the Abha Female Educational District and identify factors that may affect breastfeeding practice in the study population.</p> <p>Methods</p> <p>A cross-sectional study using a self-administered questionnaire was conducted among school teachers in Abha Female Educational District during the months of April to June, 2011. Breastfeeding KAP of participants who had at least one child aged five years or younger at the time of the study were assessed using a self-administered questionnaire, based on their experience with the last child.</p> <p>Results</p> <p>A total of 384 women made up of 246 (61.1%) primary-, 89 (23.2%) intermediate- and 49 (12.8%) high-school teachers participated in the study. One hundred and nineteen participants (31%) started breastfeeding their children within one hour of delivery, while exclusive breastfeeding for 6 months was reported only by 32 (8.3%) participants. Insufficient breast milk and work related problems were the main reasons given by 169 (44%) and 148 (38.5%) of participants, respectively, for stopping breastfeeding before two years. Only 33 participants (8.6%) had attended classes related to breastfeeding. However, 261 participants (68%) indicated the willingness to attend such classes, if available, in future pregnancies.</p> <p>Conclusions</p> <p>This study revealed that breast milk insufficiency and adverse work related issues were the main reasons for a very low rate of exclusive breastfeeding among female school teachers in Abha female educational district, Saudi Arabia. A very low rate of attending classes addressing the breastfeeding issues during pregnancy, and an alarming finding of a high percentage of babies receiving readymade liquid formula while still in hospital, were also brought out by the present study. Such findings, if addressed comprehensively by health care providers and decision-makers, will lead to the improvement of breastfeeding practices in the study community.</p

Trends in infant nutrition in Saudi Arabia: compliance with WHO recommendations

<b>Background and Objective: </b> The WHO recommends exclusive breastfeeding in the first 6 months of life. Our objective was to evaluate trends in infant nutrition in Saudi Arabia and the degree of compliance with WHO recommendations. <b> Subjects and Methods: </b> A nationwide nutritional survey of a sample of Saudi households was selected by the multistage probability sampling procedure. A validated questionnaire was administered to mothers of chil--dren less than 3 years of age. <b> Results: </b> Of 5339 children in the sample, 4889 received breast milk at birth indicating a prevalence of initia--tion of 91.6&#x0025;. Initiation of breastfeeding was delayed beyond 6 hours after birth in 28.1&#x0025; of the infants. Bottle feeding was introduced by 1 month of age to 2174/4260 (51.4&#x0025;) and to 3831/4260 (90&#x0025;) by 6 months of age. The majority of infants 3870/4787 (80.8&#x0025;) were introduced to "solid foods" between 4 to 6 months of age and whole milk feedings were given to 40&#x0025; of children younger than 12 months of age. <b> Conclusions: </b> The current practice of feeding of Saudi infants is very far from compliance with even the most conservative WHO<b> </b> recommendations of exclusive breastfeeding for 4 to 6 months. The high prevalence of breastfeeding initiation at birth indicates the willingness of Saudi mothers to breastfeed. However, early intro--duction of complementary feedings reduced the period of exclusive breastfeeding. Research in infant nutrition should be a public health priority to improve the rate of breastfeeding and to minimize other inappropriate practices