Factors associated with substance use among secondary school adolescents in Gwagwalada Area Council, Abuja, Nigeria

Background: Adolescents use substances for various reasons such as for pleasure, stress and anger management. Many factors have been reported to influence adolescent substance use. However, there is paucity of reports from this part of Nigeria.Aim/Objectives: To identify the socio-demographic factors associated with substance use among secondary school adolescents in Gwagwalada Area Council.Materials and methods: A cross-sectional, descriptive, questionnaire-based, study was carried out in secondary schools among adolescents aged 10 years to 18 years who met the inclusion criteria and after appropriate ethical approval had been obtained.Results: One thousand, one hundred and ninety-six student-filled questionnaires were analysed. The mean age of the students was 14.54 years ± SD 2.28. The students' religion, family structure, residence and type of school were associated with licit substance use while their religion, family structure and residence were associated with illicit substance use (P =<0.05). There was also statistically significant relationships between frequency in participation in religious activities and tobacco use (P = <0.01) and birth order and cocaine and hallucinogen use at P = 0.014 and P = 0.018, respectively.Conclusion and recommendation: Several factors were associated with adolescent substance use in this study. It is recommended that more in-depth studies be done to determine causality.Kewords: Factors, substance use, adolescent, Abuj

Acute kidney injury in children

Acute kidney injury (AKI) (previously called acute renal failure) is characterized by a reversible increase in the blood concentration of creatinine and nitrogenous waste products and by the inability of the kidney to regulate fluid and electrolyte homeostasis appropriately. The incidence of AKI in children appears to be increasing, and the etiology of AKI over the past decades has shifted from primary renal disease to multifactorial causes, particularly in hospitalized children. Genetic factors may predispose some children to AKI. Renal injury can be divided into pre-renal failure, intrinsic renal disease including vascular insults, and obstructive uropathies. The pathophysiology of hypoxia/ischemia-induced AKI is not well understood, but significant progress in elucidating the cellular, biochemical and molecular events has been made over the past several years. The history, physical examination, and laboratory studies, including urinalysis and radiographic studies, can establish the likely cause(s) of AKI. Many interventions such as ‘renal-dose dopamine’ and diuretic therapy have been shown not to alter the course of AKI. The prognosis of AKI is highly dependent on the underlying etiology of the AKI. Children who have suffered AKI from any cause are at risk for late development of kidney disease several years after the initial insult. Therapeutic interventions in AKI have been largely disappointing, likely due to the complex nature of the pathophysiology of AKI, the fact that the serum creatinine concentration is an insensitive measure of kidney function, and because of co-morbid factors in treated patients. Improved understanding of the pathophysiology of AKI, early biomarkers of AKI, and better classification of AKI are needed for the development of successful therapeutic strategies for the treatment of AKI

Epidemiology of chronic kidney disease in children

In the past 30 years there have been major improvements in the care of children with chronic kidney disease (CKD). However, most of the available epidemiological data stem from end-stage renal disease (ESRD) registries and information on the earlier stages of pediatric CKD is still limited. The median reported incidence of renal replacement therapy (RRT) in children aged 0–19 years across the world in 2008 was 9 per million of the age-related population (4–18 years). The prevalence of RRT in 2008 ranged from 18 to 100 per million of the age-related population. Congenital disorders, including congenital anomalies of the kidney and urinary tract (CAKUT) and hereditary nephropathies, are responsible for about two thirds of all cases of CKD in developed countries, while acquired causes predominate in developing countries. Children with congenital disorders experience a slower progression of CKD than those with glomerulonephritis, resulting in a lower proportion of CAKUT in the ESRD population compared with less advanced stages of CKD. Most children with ESRD start on dialysis and then receive a transplant. While the survival rate of children with ERSD has improved, it remains about 30 times lower than that of healthy peers. Children now mainly die of cardiovascular causes and infection rather than from renal failure

Double diabetes: an emerging disease in children and young adults

Background: Studies in most countries have shown an increasing incidence of diabetes mellitus in children and young adults. Double diabetes is a newly recognized problem in children with different diagnostic and therapeutic measures. Methods: A review of over 30 literature obtained from Google, PUBMED search and journal publications on “double diabetes” was done to determine the incidence, pathophysiology, pathogenesis, diagnostic criteria, treatment and prevention of double diabetes in children and young adults. Results: Most of the reports on double diabetes were from western countries and Asia. Type 1 diabetes resulting from antibodies to the insulin-producing pancreatic beta cell was more prevalent in children. However, with increasing obesity the incidence of type 2 diabetes resulting from insulin resistance was high in children and young adults. Most patients with double diabetes were established type 1 diabetics, who while on insulin and on hypercaloric diet developed obesity especially during puberty and hence associated type 2 diabetes. The incidence was more in black than in white children. They presented with some clinical and laboratory features of both types 1 and 2 diabetes. Some authors advocated treatment with both insulin and oral hypoglycaemic drugs mainly metformin to improve insulin sensitivity. Prevention of childhood obesity by encouraging physical activities and dietary control would prevent double diabetes. Conclusion: Double diabetes is increasing in children and young adults. A high index of suspicion is required in obese children with diabetes. Keywords: Double diabetes, Emerging problem, Children, Young adults Port Harcourt Medical Journal Vol. 1 (2) 2007: pp. 76-8

Childhood diabetes mellitus in Port Harcourt: any change in prevalence and outcome?

Background: Diabetes mellitus (DM) is the commonest endocrine disorder seen in children. A previous study, done in Port Harcourt, showed a prevalence of 1.2/1000, with all the cases being type 1, and a high mortality rate of 28.4%. This study was carried out, to determine if there had been any changes in the type of DM and the outcome. Method: A retrospective search of diabetic patients admitted into our Children\'s medical wards, over a 6-year period (January 2000- December 2005) was done. Their case files were analyzed for patients\' characteristics, type and duration of DM, frequency of hospitalization, complications and outcome. All the patients were managed by the Paediatric endocrinology unit which was set up in 2000. Results: Out of 6,715 admissions, 11 patients had DM, giving a hospital prevalence of 1.6/1000. The male: female ratio was 1: 1.2. The patients were aged 10months- 16years, with a mean age of 11.8 ± 1.53 years. All the patients were newly diagnosed type 1 DM. Nine (81.8%) were from low socioeconomic background and two (18.2%) had a positive family history of diabetes. The mean body mass index of the patients was 18.5 ±0.88 kg/m2. All the patients were managed with parenteral insulin and diabetic ketoacidosis (DKA) was seen in 10 (90.1%). There was no hospital mortality, showing a marked improvement compared to the previous study. Conclusion: Type 1 DM is still the commonest type of diabetes seen in children in Port Harcourt, and has improved outcome. Keywords: Diabetes, Prevalence, Outcome, Children, Port HarcourtPHMJ Vol. 2 (2) 2008: pp. 126-12