Relationship between Ponderal Index, Mid-Arm Circumference/ Head Circumference Ratio and Clinical Assessment of Nutritional Status Score (CANSCORE) in the Determination of Nutritional Status of Newborn at Birth in Nigeria

Background: Early and accurate assessment of the nutritional status of newborns is important to many clinicians because of the potential immediate and late sequelae of malnutrition.Objective: To assess the relationship between different methods of assessing the nutritional status of neonates.Methods: Subjects were consecutive, live, singleton, full term neonates delivered in the hospital. The birth weights, Ponderal index, Mid arm circumference/head circumference ratio, birth weight for gestational age using intrauterine growth charts and Clinical Assessment of Fetal Nutritional Status Score (CANSCORE) were used to determine the nutritional status in the first 24 hours of life.Results: Of 386 subjects, 172 (44.6%) were males and 214 (55.4%) females. Nutritional status assessment using various indices showed the following prevalence of malnutrition: using birth weights, 54 (14.0%) were LBW; MAC/HC ratio showed 56 (14.5%), with PI, 64(16.6%), weight for gestational age, 112(29.0%) were SGA and CANSCORE showed 90(23.3%) as malnourished among the babies.MAC/HC showed a better specificity and had a more positive correlation than PI when compared to CANSCORE whilst PI showed a better sensitivity than MAC/HC when evaluated against CANSCORE.Conclusions: Prevalence of FM is high in this study. Intrauterine growth charts and CANSCORE appeared to identify more babies with FM than other methods. CANSCORE in this study has revealed the rising trend in the prevalence of FM when compared with other studies with similar methodology. Early routine assessment of the nutritional status of newborns should be carried out so as to reduce the risk of increased morbidity and mortality associated with fetal malnutrition

Posterior urethral valves in fraternal twins: case report and review of the literature

We report a pair of dizygotic twins with type 1 posterior urethral valves. Concomitant and discordant presentation of posterior urethral valves in twins is rare, with a handful of cases in the literature. The occurrence of identical pathology in dizygotic twins probably suggests the possibility of an inherited trait as it does exist in monozygotic twins.Keywords: fraternal twins, identical pathology, inherited trait, posterior urethral valve

Use of serum levels of selected enzymes as a supportive tool in assessing severity of birth asphyxia in low resource setting

Introduction: Severe birth asphyxia is one of the reasons why babies are admitted into the newborn unit and contributing significantly to neonatal morbidity and mortality. Hypoxic injury, when severe, leads to leakage of intracellular enzymes into the circulation. The level of these enzymes reflects the severity of the damage; this can identify babies with a severe injury, especially the out borns whose deliveries were not supervised. This study aimed to relate the serum levels of three enzymes at the age of twelve hours to the severity of birth asphyxia using the Apgar score and neurological state of the babies.Methods: A prospective comparative cross-sectional study. Term babies with Apgar score ˂ 7 at 1-minute of life were recruited, scores of 0-3 were taken as severe birth asphyxia. Serum levels of lactate dehydrogenase, aspartate aminotransferase, and alanine aminotransferase, were determined at the age of 12 hours using an ultraviolet spectrophotometer. Levels of the enzymes were related to the severity of birth asphyxia. SPSS for Windows, version 18 was used to analyse the dataResults: Seventy babies with birth asphyxia and 70 controls were studied. Fifteen (41.7%) of the 36 babies with severe birth asphyxia had hypoxic-ischemic encephalopathy, four (5.7%) of which died. The mean values of each of the enzymes were higher in babies with hypoxic-ischaemic encephalopathy than in those without (p = 0.001), and in babies that died than babies that survived (p = 0.001).Conclusion: Estimation of these enzymes clearly defines the severity of hypoxic injury in babies with birth asphyxia. The estimation of these enzymes will be a useful tool in identifying babies with birth asphyxia especially in outborns whose deliveries were not supervised