Neonatal seizures in Calabar: A revisit

Newborns admitted with convulsion in the University of Calabar Teaching Hospital, Calabar during the period 1st May 2004 to 30 April 2006 were studied prospectively. The aim was to determine the place of birth in relation to the cause of seizures, the current situation in terms of the aetiology, clinical spectrum and outcome. There were 55 neonates with convulsion representing 5% of admissions into the newborn unit during the period. Birth asphyxia, sepsis, and hypoglycaemia were important identifiable aetiological factors which operated either singly (45.5%) of cases) or in concert (54.5% of cases) in causing seizures. Hypocalcaemia and hyponatraemia contributed less. These results are similar to that of a previous study carried out in this centre ten years earlier . There was no statistical significant difference between home and hospital deliveries in relation to causes of seizures. Septicaemia was caused mainly by staphylococcus aureus, enterobactericae and unclassified coliforms. No neonatal meningitis was diagnosed. Surprisingly, there was a high prevalence of generalized seizures (76.4%). The mortality of 34.0% was related to onset of the seizures within 4 days of life but not the place of birth.The causes of neonatal seizures in our environment are mostly preventable. There is need to provide modern facilities for investigating newborn seizures, training and retraining of Traditional Birth Attendants, health education of expectant mothers

Prevalence of Persistent Proteinuria using Urine Protein/Creatinine Ratio in Asymptomatic Primary School Children in Calabar, Nigeria

Background: Quantitative urinary protein estimation is the cornerstone in the diagnosis, treatment and prognostication of renal diseases. This could either be carried out by 24-hour urine protein estimation or spot urine protein: creatinine (UPC) ratio. The latter is simple, convenient, quick and reliable. It can be used in the follow-up of asymptomatic proteinuric children at risk of developing chronic renal disease.Aim: To determine the prevalence of persistent proteinuria in asymptomatic primary school children in Calabar, Nigeria using the UPC ratio.Methodology: This was a descriptive cross-sectional study of 1,600 apparently healthy primary school children aged 5 to 12 years recruited by multi-stage sampling. Urinalysis using dipstick was performed and those with significant proteinuria (proteinuria ≥ 1+) had urinalysis repeated after two weeks. Those with persistent proteinuria were quantitated using the modified Biuret method while urine creatinine was measured with the modified Jaffe Kinetic method (done with the Biolabo creatinine kit). Urine protein:creatinine ratios > 0.20 were confirmed as persistent proteinuria.Results: Out of the 1,600 pupil, 761(47.6%) were males and 839(52.4%) females, giving a male to female ratio of 1:1.1. The mean age was 8.7 ± 1.9 ranging from 5-12 years.The modal age group was 9-10 years. The prevalence of persistent proteinuria using the dipstick urinalysis was 1.8% while with the UPC ratio was 1.6%. There was a high female preponderance 19 (1.2%) of persistent proteinuria, which was statistical significant. Age and social class did not contribute significantly to having persistent proteinuria.Conclusion: The prevalence of persistent proteinuria in these asymptomatic children using UPC ratio was almost similar to the repeat urinalysis done after two weeks. It is hereby recommended that where UPC ratio is not available a positive repeat urinalysis using first void early morning urine after two weeks can be used as persistent proteinuria. This information will enable proper treatment and follow-up which will forestall rapid progression to kidney damage.Keywords: Urinalysis,Protein: Creatinine Ratio,Asymptomatic Children

The Profile Of Congenital Malformation Among Newborn Infants In Calabar, Nigeria

Objective: The study pattern of congenital malformations (CM) among newborn infants in Calabar, South-south Nigeria.Patients and Methods: Medical records of all inborn and out-born neonates who were admitted and treated for CM in University of Calabar teaching Hospital (UCTH) from 1997 to 2006 (10 years) were reviewed. The diagnosis was made clinically in 91.1% of cases; 95.5% was made postnatally and 4.5 % by prenatal ultrasonography.Results: The prevalence of CM in the institution was 10.8 per 1000 live births during the period. There was a male preponderance. The prevalence of CM was highest in mothers aged 30-34 years and in those of parity 1-2. Malformations of the alimentary canal formed the majority (44.6%) followed by musculoskeletal (19.8%), then the central nervous system (17.8%). Imperforate anus was the dominant malformation in the alimentary tract, myelomeningocoele in the central nervous system, and talipes in the musculoskeletal. Seven babies presented with multiple malformations (7.7%). A case fatality rate of 9.8% was recorded and constituted 1.4% of the total mortality within the period.Conclusion: The present study can be utilized as a database for further surveys. An indepth analytic research is necessary to determine the possible factors underlying the various types of CM encountered in Calabar and therefore to consider possible preventive measures. Facilities for prenatal and postnatal diagnosis need to be provided.Keywords: Profile of congenital malformatio