B. Fetuga, T. Ogunlesi, Folashade A Adekanmbi, D. Olanrewaju, Runsewe-Abiodun T Iyabo, Ogunfowora B Olusoga
Background: It is essential to continually study the pattern of occurrence of neonatal tetanus (NNT) for better control measures. Objective: To compare the prevalence rates and outcome of NNT in a Nigerian tertiary hospital over two periods characterized by different national immunization programmes the Expanded Programme on Immunization (EPI) and the National Programme on Immunization (NPI). Methods: The records of babies hospitalized with NNT between 1991 and 1996 (EPI period) and between 1997 and 2005 (NPI period) were studied. Results: The prevalence rates for the EPI and NPI periods were 6.4 percent and 2.9 percent respectively. Most of the mothers did not receive ante-natal care (81.4 percent for EPI and 75.6 percent for NPI), did not take anti-tetanus vaccines in pregnancy (87.7 percent for EPI and 88.4 percent for NPI) and delivered their babies outside the health facilities (86.6 percent for EPI and 83.3 percent for NPI). The Case Fatality Rate was 49.5 percent and 61.5 percent for the EPI and NPI periods respectively. Conclusion: The prevalence and mortality of NNT remains high in Nigeria despite a change in immunization programme.
{"title":"Neonatal tetanus in Sagamu, Nigeria during the Expanded Programme on Immunization and the National Programme on Immunization eras: A comparative analysis.","authors":"B. Fetuga, T. Ogunlesi, Folashade A Adekanmbi, D. Olanrewaju, Runsewe-Abiodun T Iyabo, Ogunfowora B Olusoga","doi":"10.5580/7dd","DOIUrl":"https://doi.org/10.5580/7dd","url":null,"abstract":"Background: It is essential to continually study the pattern of occurrence of neonatal tetanus (NNT) for better control measures. Objective: To compare the prevalence rates and outcome of NNT in a Nigerian tertiary hospital over two periods characterized by different national immunization programmes the Expanded Programme on Immunization (EPI) and the National Programme on Immunization (NPI). Methods: The records of babies hospitalized with NNT between 1991 and 1996 (EPI period) and between 1997 and 2005 (NPI period) were studied. Results: The prevalence rates for the EPI and NPI periods were 6.4 percent and 2.9 percent respectively. Most of the mothers did not receive ante-natal care (81.4 percent for EPI and 75.6 percent for NPI), did not take anti-tetanus vaccines in pregnancy (87.7 percent for EPI and 88.4 percent for NPI) and delivered their babies outside the health facilities (86.6 percent for EPI and 83.3 percent for NPI). The Case Fatality Rate was 49.5 percent and 61.5 percent for the EPI and NPI periods respectively. Conclusion: The prevalence and mortality of NNT remains high in Nigeria despite a change in immunization programme.","PeriodicalId":75037,"journal":{"name":"The Internet journal of pediatrics and neonatology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2009-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70824975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: To evaluate the role of C-Reactive Protein (CRP) in the diagnosis of early onset sepsis (EOS) in neonates Design: Prospective study Settings: intensive care unit of a tertiary level teaching hospital in India subjects: 225 neonates at risk of / or with clinical features of EOS Methods: CRP levels were measured semi-quantitatively (at value of 8 mg /L) at the time of admission and 8-24 hours later on the next morning. Results: of 225 neonates 30 had positive blood cultures. The sensitivity, specifity, PPV and NPV of CRP at 0 hours were 40%, 87.7%, 33.3%and 90.4% respectively, the corresponding values at 24 hours were 70%, 72.3%,28% and 94% respectively Conclusions: a single CRP value done at the time of admission lacks sensitivity. The sensitivity is increased by serial testing. A negative CRP value is more important than a positive CRP value in that it excludes infection with a high certainty
{"title":"Role Of C-Reactive Protein In Early Onset Neonatal sepsis","authors":"Mohmmad Himayun, S. Ahmad, A. Rasool","doi":"10.5580/a1b","DOIUrl":"https://doi.org/10.5580/a1b","url":null,"abstract":"Objective: To evaluate the role of C-Reactive Protein (CRP) in the diagnosis of early onset sepsis (EOS) in neonates Design: Prospective study Settings: intensive care unit of a tertiary level teaching hospital in India subjects: 225 neonates at risk of / or with clinical features of EOS Methods: CRP levels were measured semi-quantitatively (at value of 8 mg /L) at the time of admission and 8-24 hours later on the next morning. Results: of 225 neonates 30 had positive blood cultures. The sensitivity, specifity, PPV and NPV of CRP at 0 hours were 40%, 87.7%, 33.3%and 90.4% respectively, the corresponding values at 24 hours were 70%, 72.3%,28% and 94% respectively Conclusions: a single CRP value done at the time of admission lacks sensitivity. The sensitivity is increased by serial testing. A negative CRP value is more important than a positive CRP value in that it excludes infection with a high certainty","PeriodicalId":75037,"journal":{"name":"The Internet journal of pediatrics and neonatology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2009-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70825906","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The frontline treatment for relief of acute attacks of bronchial asthma is administration of a sympathomimetic drug by inhalation. Difficulties in administration of nebulization treatment, made us search for an alternative, the use of adrenaline by infusion. When the “pre-adrenaline period” was compared with the “post-adrenaline period”, the patient profile was comparable, indices of effectiveness improved and cost of care declined significantly in the “post-adrenaline period”. Our study suggests that adrenaline infusion is a good option where nebulization is not feasible as an emergency treatment of bronchial asthma in children.
{"title":"Adrenaline infusion in bronchial asthma: A before- and- after study","authors":"S. Daga, Shalaka Patil, B. Verma, Chetan Mokashe","doi":"10.5580/209c","DOIUrl":"https://doi.org/10.5580/209c","url":null,"abstract":"The frontline treatment for relief of acute attacks of bronchial asthma is administration of a sympathomimetic drug by inhalation. Difficulties in administration of nebulization treatment, made us search for an alternative, the use of adrenaline by infusion. When the “pre-adrenaline period” was compared with the “post-adrenaline period”, the patient profile was comparable, indices of effectiveness improved and cost of care declined significantly in the “post-adrenaline period”. Our study suggests that adrenaline infusion is a good option where nebulization is not feasible as an emergency treatment of bronchial asthma in children.","PeriodicalId":75037,"journal":{"name":"The Internet journal of pediatrics and neonatology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2009-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70816937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
An 8-day-old infant was admitted to a paediatric intensive care unit with severe hypernatraemic dehydration. An MRI brain was performed which revealed extensive venous sinus thromboses. This is a recognised but rare complication of hypernatraemic dehydration and the importance of early detection and intervention of this condition is again highlighted.This is the first case report of venous sinus thrombosis secondary to hypernatraemic dehydration in a patient with no clinical neurological signs. We postulate that there may be a cohort of infants with subclinical cerebral venous thrombosis secondary to hypernatraemic dehydration.
{"title":"Subclinical Venous Sinus Thrombosis Secondary to Hypernatraemic Dehydration","authors":"C. Locke, S. Depani, A. Gour, M. Gray","doi":"10.5580/1f6f","DOIUrl":"https://doi.org/10.5580/1f6f","url":null,"abstract":"An 8-day-old infant was admitted to a paediatric intensive care unit with severe hypernatraemic dehydration. An MRI brain was performed which revealed extensive venous sinus thromboses. This is a recognised but rare complication of hypernatraemic dehydration and the importance of early detection and intervention of this condition is again highlighted.This is the first case report of venous sinus thrombosis secondary to hypernatraemic dehydration in a patient with no clinical neurological signs. We postulate that there may be a cohort of infants with subclinical cerebral venous thrombosis secondary to hypernatraemic dehydration.","PeriodicalId":75037,"journal":{"name":"The Internet journal of pediatrics and neonatology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2009-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70817349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: The greatest risk of childhood death occurs during the neonatal period. The World Health Organization estimates that approximately 4 million newborns die each year with most deaths occurring in developing countries. Any discharge against medical advice (DAMA) amongst this vulnerable group can adversely affect morbidity and mortality.Aim: To identify the causes of DAMA and try to find ways to reduce its incidence in neonates in Port Harcourt, Nigeria. Method: This was a retrospective study done amongst neonates admitted into the Special Care Baby Unit of the University of Port Harcourt Teaching Hospital. Case files of all affected neonates over a 2 year period were reviewed and relevant information obtained and analysed.Results: There were 63 cases of DAMA out of 1481 admissions during the period, giving a prevalence rate of 4.3%. 58 case files were retrieved and analysed. There were 37 males and 21 females with a male: female ratio of 1.7: 1. Preterm babies constituted 25.9% of the cases. The commonest diagnoses were neonatal sepsis and birth asphyxia. Most discharges occurred within the first week of admission (mean =5.9± 4.5days). Common reasons for DAMA were lack of funds and falsely perceived improvement. The discharge document was signed by the father in 77.6% of cases.Conclusion: Poverty, mis-conceived ideas, and other social issues contributed to DAMA in this study. Some babies had life threatening conditions and discharges occurred more within the first few days of life. DAMA in neonates will retard progress in achieving millennium development goal 4.
{"title":"Discharge against medical advice amongst neonates admitted into a Special Care Baby Unit in Port Harcourt, Nigeria","authors":"P. Opara, G. Eke","doi":"10.5580/262","DOIUrl":"https://doi.org/10.5580/262","url":null,"abstract":"Background: The greatest risk of childhood death occurs during the neonatal period. The World Health Organization estimates that approximately 4 million newborns die each year with most deaths occurring in developing countries. Any discharge against medical advice (DAMA) amongst this vulnerable group can adversely affect morbidity and mortality.Aim: To identify the causes of DAMA and try to find ways to reduce its incidence in neonates in Port Harcourt, Nigeria. Method: This was a retrospective study done amongst neonates admitted into the Special Care Baby Unit of the University of Port Harcourt Teaching Hospital. Case files of all affected neonates over a 2 year period were reviewed and relevant information obtained and analysed.Results: There were 63 cases of DAMA out of 1481 admissions during the period, giving a prevalence rate of 4.3%. 58 case files were retrieved and analysed. There were 37 males and 21 females with a male: female ratio of 1.7: 1. Preterm babies constituted 25.9% of the cases. The commonest diagnoses were neonatal sepsis and birth asphyxia. Most discharges occurred within the first week of admission (mean =5.9± 4.5days). Common reasons for DAMA were lack of funds and falsely perceived improvement. The discharge document was signed by the father in 77.6% of cases.Conclusion: Poverty, mis-conceived ideas, and other social issues contributed to DAMA in this study. Some babies had life threatening conditions and discharges occurred more within the first few days of life. DAMA in neonates will retard progress in achieving millennium development goal 4.","PeriodicalId":75037,"journal":{"name":"The Internet journal of pediatrics and neonatology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2009-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70819427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Eating disorders have been reported worldwide. They typically develop in adolescence, particularly among females. Referrals of male adolescents are uncommon. The characteristics of 2 male adolescents referred to a hospital in Singapore are described.
{"title":"Male Adolescents And Eating Disorders","authors":"B. Rajendra","doi":"10.5580/613","DOIUrl":"https://doi.org/10.5580/613","url":null,"abstract":"Eating disorders have been reported worldwide. They typically develop in adolescence, particularly among females. Referrals of male adolescents are uncommon. The characteristics of 2 male adolescents referred to a hospital in Singapore are described.","PeriodicalId":75037,"journal":{"name":"The Internet journal of pediatrics and neonatology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2009-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70823996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Many cultures around the world believe in the spirit world and the ability of spirits to possess humans and alter behaviours. We present a case where the patient was of one culture but presented to a hospital in another country with altered mental state. Delay in establishing a diagnosis occurred due to language barriers as well as ignorance about the cultural context.
{"title":"A Hungry Ghost, Spirit Possession Or A Clash Of Cultures: A Case Report","authors":"B. Rajendra","doi":"10.5580/2266","DOIUrl":"https://doi.org/10.5580/2266","url":null,"abstract":"Many cultures around the world believe in the spirit world and the ability of spirits to possess humans and alter behaviours. We present a case where the patient was of one culture but presented to a hospital in another country with altered mental state. Delay in establishing a diagnosis occurred due to language barriers as well as ignorance about the cultural context.","PeriodicalId":75037,"journal":{"name":"The Internet journal of pediatrics and neonatology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2009-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70818746","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The intrapartum acid-base status of the fetus is an important parameter to establish the relation between intrapartum events. Respiratory acidosis is the beginning event after intrapartum asphyxia. If the asphyxia continues metabolic acidosis developes and complicates the delivery (1). During the respiratory acidosis phase pCO2 can be an important parameter.Noninvasive monitoring of pCO2 and oxygen saturation (SpO2 ) can give idea about intrapartum and respiratory status of the newborn infant. AIM To evaluate the relation between SpO2, pulse rate (PR) and transcutaneous measerement of pCO2 ( TcPCO2 ) in healthy term infants immediately after birth in delivery room .
{"title":"Evaluatıon Of A New Transcutaneous Measurement Of Pco2 Sensor In Newborns In Delıvery Room","authors":"Tutku Özdo an, S. K. Lu, Yasemin enel","doi":"10.5580/1006","DOIUrl":"https://doi.org/10.5580/1006","url":null,"abstract":"The intrapartum acid-base status of the fetus is an important parameter to establish the relation between intrapartum events. Respiratory acidosis is the beginning event after intrapartum asphyxia. If the asphyxia continues metabolic acidosis developes and complicates the delivery (1). During the respiratory acidosis phase pCO2 can be an important parameter.Noninvasive monitoring of pCO2 and oxygen saturation (SpO2 ) can give idea about intrapartum and respiratory status of the newborn infant. AIM To evaluate the relation between SpO2, pulse rate (PR) and transcutaneous measerement of pCO2 ( TcPCO2 ) in healthy term infants immediately after birth in delivery room .","PeriodicalId":75037,"journal":{"name":"The Internet journal of pediatrics and neonatology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2008-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70810968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Wacker, F. Neunhoeffer, J. Fuchs, S. Warmann, C. Schwarze, K. Sotlar, H. Scheel-Walter, R. Handgretinger
Extragonadal yolk sac tumors (YST) are extremely rare tumors. Only a few case reports can be found in the literature. We report about a female term newborn. After delivery a sacrococcygeal tumor was obvious. Alpha Fetoprotein (AFP) levels were in the upper normal range (91 006 ng/ml). The tumor was completely removed. Histological examinations revealed a typical YST. In the follow-up examinations a subcutaneous metastasis in the abdominal wall was found and excised at the age of 6 weeks. Curative polychemotherapy was induced. After 2 cycles AFP levels were decreased. However, the patient had a local relapse after the 4 cycle of chemotherapy and showed increased AFP levels. Therefore, hyperthermia combined with chemotherapy was applied and a second surgical resection was done. Despite of multiple therapy regime, the patient died due to tumor progress. This case demonstrates an uncommon dissemination of a primary YST. Therapeutic options in neonates are extremely difficult.
{"title":"A yolk sac tumor in a female newborn with a subcutaneous metastasis of the abdominal wall","authors":"A. Wacker, F. Neunhoeffer, J. Fuchs, S. Warmann, C. Schwarze, K. Sotlar, H. Scheel-Walter, R. Handgretinger","doi":"10.5580/1636","DOIUrl":"https://doi.org/10.5580/1636","url":null,"abstract":"Extragonadal yolk sac tumors (YST) are extremely rare tumors. Only a few case reports can be found in the literature. We report about a female term newborn. After delivery a sacrococcygeal tumor was obvious. Alpha Fetoprotein (AFP) levels were in the upper normal range (91 006 ng/ml). The tumor was completely removed. Histological examinations revealed a typical YST. In the follow-up examinations a subcutaneous metastasis in the abdominal wall was found and excised at the age of 6 weeks. Curative polychemotherapy was induced. After 2 cycles AFP levels were decreased. However, the patient had a local relapse after the 4 cycle of chemotherapy and showed increased AFP levels. Therefore, hyperthermia combined with chemotherapy was applied and a second surgical resection was done. Despite of multiple therapy regime, the patient died due to tumor progress. This case demonstrates an uncommon dissemination of a primary YST. Therapeutic options in neonates are extremely difficult.","PeriodicalId":75037,"journal":{"name":"The Internet journal of pediatrics and neonatology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2008-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70813494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: We used a rubber bag adapted for ventilation with orotracheal continuous positive airway pressure (CPAP), to provide constant alveolar distention pressure and alveolar stability while compensating for pressure or volume changes from physiological events like coughing or crying. Materials and Methods: We administered orotracheal CPAP with compensation bag to nine newborns with mean weight of 1077 g (range, 779-1311 g) and mean gestational age of 28.5 weeks (range, 26 30 weeks). All infants underwent measurement of blood gases and vital signs, and chest radiographs. Results: Orotracheal CPAP with compensation bag was effective in eight patients; high-frequency oscillatory ventilation for pulmonary arterial hypertension was required in one patient. No adverse events were attributable to the procedure. Mean time to extubation was 86 hours. Conclusions: This simple compensation bag may provide alveolar protection and stability for infants who require mechanical ventilation. This technique opens a new line of research in assisted ventilation.
{"title":"Orotracheal Continuous Positive Airway Pressure With a Compensation Bag: A Preliminary Report About a New Technique for Assisted Ventilation in Premature Infants","authors":"G. A. Orozco, V. Estrada","doi":"10.5580/2560","DOIUrl":"https://doi.org/10.5580/2560","url":null,"abstract":"Objective: We used a rubber bag adapted for ventilation with orotracheal continuous positive airway pressure (CPAP), to provide constant alveolar distention pressure and alveolar stability while compensating for pressure or volume changes from physiological events like coughing or crying. Materials and Methods: We administered orotracheal CPAP with compensation bag to nine newborns with mean weight of 1077 g (range, 779-1311 g) and mean gestational age of 28.5 weeks (range, 26 30 weeks). All infants underwent measurement of blood gases and vital signs, and chest radiographs. Results: Orotracheal CPAP with compensation bag was effective in eight patients; high-frequency oscillatory ventilation for pulmonary arterial hypertension was required in one patient. No adverse events were attributable to the procedure. Mean time to extubation was 86 hours. Conclusions: This simple compensation bag may provide alveolar protection and stability for infants who require mechanical ventilation. This technique opens a new line of research in assisted ventilation.","PeriodicalId":75037,"journal":{"name":"The Internet journal of pediatrics and neonatology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2008-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70819447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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