Childhood acquired heart disease in Nigeria: an echocardiographic study from three centres

Introduction: Acquired heart diseases (AHD) are not uncommon in children. The current multi-center study aims to provide a more representative data of AHD in Nigeria.Methods: Over 42 months, children referred for echocardiographic evaluation who had confirmed AHD in three centers in Nigeria were recruited. The data was collected on biodata and types of AHD.Results: There were 116 children with 132 cases of AHD, with a mean age of 6.7 ± 5.7 years. The males were 63(54.3%). Myocarditis/ dilated cardiomyopathy (DCM) 38(28.8%) was the commonest AHD followed by pericarditis 34 (25.8%), rheumatic heart disease (RHD) 23 (17.4%) and hypertrophic cardiomyopathy 18(13.6%). Endomyocardial fibrosis (EMF) 3(2.3%) was uncommon.Conclusion: Nigerian children face a quadruped of AHD namely, myocarditis, DCM, pericardial disease and RHD. As other types of AHD other than RHD are becoming prevalent, there is need to improve the scope of intervention facilities in the country to meet with the demands of the growing afflictions.Keywords: Acquired heart disease; multicentre; Nigeri

Correlation of cardiac troponin T level, clinical parameters and myocardial ischaemia in perinatal asphyxia

Introduction: Resource limitation in developing countries may preclude access to cardiac troponin-T assay thereby necessitating reliance on clinical judgment for identification of hypoxic myocardial cellular injury.Objectives: To relate selected clinical signs with elevated serum cardiactroponin-T in asphyxiated term neonates.Methods: Asphyxia was identified by low umbilical arterial blood pH . 7.20 and low five minute Apgar score . 6 while controls were term, non.asphyxiated neonates. All babies were examined for heart rate,heart rhythm irregularities, peripheral pulse volume, respiratory rate,pallor, cyanosis, heart murmur and sensorium.Results: Thirty term, asphyxiated neonates and their matched controlswere studied. Central cyanosis, reduced pulse volume, pallor, depressedsensorium; tachycardia and tachypnea were all associated with increased odds ratios for abnormal cardiac troponin.T levels.Conclusion: Clinicians working in resource.limited health facilitiesshould have a high index of suspicion for myocardial cellular injurywhen these signs are elicited.Keywords: neonates, asphyxia, troponin-T, myocardial injur

Burnout Syndrome among Orthopaedic Surgeons in Lagos, Nigeria

Background: The burnout syndrome has been associated with decreased job performance and low career satisfaction. There are many studies on surgeon burnout and globally but none has been carried out in Nigeria to address the issue of burnout among orthopaedic surgeons. This study aimed at assessing the rate of burnout syndrome among orthopaedic surgeons working in an orthopaedic hospital in Lagos State,Nigeria. Methods: The study was a questionnaire-based cross-sectional survey. It took place at the National Orthopaedic Hospital, Igbobi, Lagos, Nigeria. All the doctors working at the specialist hospital were invited to complete a questionnaire on their demographic details and the Maslach Burnout Inventory which was used to measure burnout among the participants. Results: Twenty-nine doctors took part in the study, 28 (96.5%) were males and 1 (3.5%) female, their mean age was 35. 52 years (SD 5.55) with a range of 28- 57 years. Of the total participants, 7 (24.1%) consultant surgeons and 21 (27.5%) were resident doctors. As regards burnout, 4 (13.8%) scored high on the emotional exhaustion subscale, 11 (37.9%) scored high on the depersonalisation subscale while 21 (72%) scored high on the personal achievement subscale. On the overall burnout rate, 15(51.7%) experienced burnout. Conclusions: The findings of this study showed that orthopaedic surgeons working in Lagos State, Nigeria also experience certain degrees of burnout. There is a need for orthopaedic surgeons to acquire the skills of stress management to prevent burnout and also enhance quality service delivery in their various hospitals