Avoidable birth injury complicated with limb gangrene: a reflection of an in-efficient health system

Gangrene of the lower extremities in neonates is a rare event except in traumatic cases. When risk factors for trauma to the limb of the newborn exist, it is important to prevent such injuries and when they are inevitable, appropriate management of injuries should further prevent complications such as limb gangrene. This report describes a newborn whose birth was poorly managed and thereafter sustained traumatic unilateral lower limb gangrene from the management of femoral fracture at a traditional bone setting. This report aims to highlightthe deficiencies in the Nigerian health system which permitted this unfortunate scenario.Keywords: Birth injury, Lower limb gangrene, neonatal femoral fracture, unorthodox bone setting practice

National neonatal resuscitation training program in Nigeria (2008-2012): A preliminary report

Background: Routine institutional training of doctors and nurses on newborn resuscitation have commenced, to improve the quality of resuscitation available to high-risk babies, in Nigeria, as a means of reducing newborn deaths in the country. Perinatal asphyxia contributes to 26% of newborn deaths in Nigeria. Perinatal asphyxia results when babies have difficulty establishing spontaneous respiration after birth.Materials and Methods: Between 2008 and 2012, doctors and nurses drawn from all the geo.political zones were trained using the Neonatal  Resuscitation Training (NRT) manual of the American Heart Association and the American Academy of Pediatrics. Questionnaire.based, cross.sectional surveys of doctor and nurse trainees from the six geo.political zones in Nigeria were conducted eight months after the primary training, to evaluate the post.training  neonatal resuscitation activities.Results: Over the period of study, 357 doctors and 370 nurse/midwives were primarily trained in NRT. The overall ratio of step down training was 1:22 with 1:18 for doctors and 1:26 for nurses. In 2008, the delivery attendance rates were 11 per doctor and 9 per nurse/midwife. These rates increased to 30 per doctor and 47 per nurse in 2012. Between 88 and 94% of the doctors and between 72 and 93% of the nurses successfully used bag and mask to help babies breathe in the post.training period. The nurses used bag and mask for infant resuscitation more frequently,   compared to doctors, with the rate fluctuating between two.to.one and four.to.one. Over the years, 87 to 94% of the doctors and 92 to 97% of the nurses/midwives trained other birth attendants.Conclusion: The NRT in Nigeria is well.subscribed and the frequency of secondary training is good.Key words: Birth asphyxia, birth attendants, delivery room care, neonatal resuscitation training, perinatal mortalit

Prevalence and clinical correlates of Microalbuminuria among children with Sickle cell Anaemia attending Lagos State University Teaching Hospital, Ikeja

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Establishing core outcome domains in pediatric kidney disease: report of the Standardized Outcomes in Nephrology—Children and Adolescents (SONG-KIDS) consensus workshops

Trials in children with chronic kidney disease do not consistently report outcomes that are critically important to patients and caregivers. This can diminish the relevance and reliability of evidence for decision making, limiting the implementation of results into practice and policy. As part of the Standardized Outcomes in Nephrology—Children and Adolescents (SONG-Kids) initiative, we convened 2 consensus workshops in San Diego, California (7 patients, 24 caregivers, 43 health professionals) and Melbourne, Australia (7 patients, 23 caregivers, 49 health professionals). This report summarizes the discussions on the identification and implementation of the SONG-Kids core outcomes set. Four themes were identified; survival and life participation are common high priority goals, capturing the whole child and family, ensuring broad relevance across the patient journey, and requiring feasible and valid measures. Stakeholders supported the inclusion of mortality, infection, life participation, and kidney function as the core outcomes domains for children with chronic kidney disease