Journal of Medicine in Africa

Haematological Profile of Patients With Type 2 Diabetes Mellitus In Calabar, Nigeria.

Enang O.E., Okpa H.O., Nimmon S.E., Okoroiwu H., Okpokam D. — Tue, 08 Oct 2024 00:00:00 +0000

Objectives

The objective of this study is to identify the haematological profile of patients with diabetes.

Setting

The study was conducted at the Diabetes Clinic of the University of Calabar Teaching Hospital, Calabar.

Methods/Subject

The study subjects selected for this study consist of 50 type 2 diabetic patients and 25 healthy non-diabetic subjects acted as controls. They were matched for age and sex. The ages in both categories were comparable, the test being 45.2 ±12.3 years and the control 40.2±13.3 years. The hematocrit value (HCT), haemoglobin content, red blood cell count (RBCs) and mean corpuscular volume (MCV) concentration with increased white blood cell counts (WBCs), mean erythrocyte haemoglobin concentration (MCHC), mean corpuscular haemoglobin (MCH), lymphocytes and neutrophils levels were performed.

Results

Hematological studies in the diabetic patients showed significantly lower HCT values, haemoglobin content, RBC count and MCV concentration than in the controls. Greater total WBC counts, MCHC concentrations, MCH, lymphocytes and neutrophils counts were observed in the patients than in the controls. The basophil count had a significantly higher value (p=0.033) in the test (0.03±0.02) than the control (0.01±0.01). Haemoglobin levels (11.9±2.2, p=0.001) and mean corpuscularhaemoglobin concentration (MCHC) (30.7±1.3,p=0.004) were significantly lower in the test group compared to controls (13.3±0.9, 32.6±1.1). No differences were found between platelet counts in the diabetic patients and the control.

Conclusion

There were significant changes in somehaematological parameters associated with Diabetes especially Haemoglobin, MCHC and basophil count identified in this study.

Pattern Of Renal Analytes Following Renal Function Assessment Of Infants In A Tertiary Health Facility In Southern Nigeria

Kelechi U., Vincent M.U., Babatope O.A., Ogarekpe Y.M., Ekpe E.L. — Tue, 08 Oct 2024 00:00:00 +0000

Background/Objectives

Electrolyte imbalance is a common finding in infants, and the story is so in the tropical countries, where most patients are usually victims of fluid losses from various etiologies. This study is aimed at assessing the profile and pattern of electrolytes imbalance and other parameters of renal function assessmentamong infants (0-12 months) in our environment.

Methods/Subjects

This cross-sectional study was carried out over a 6-month period on infants who wereadmitted into University of Calabar Teaching Hospital (UCTH) and investigated forelectrolyte, urea and creatine, after a hospitalstay of ≥24 hours. Blood samples were taken from such patients, analyzed and values obtained were compared with the reference intervals to ascertain the level of deviation from the expected normal for age.

Results

The total number of children that participated on the study was 200, made up of 106(53.0%)males and 94(47.0%) females. The children were classified based on their different ages from 0 to 12 months. Children aged 0-1month made up the bulk of the study population (57.0%). Low level of bicarbonate occurred in 65.5% of all the children. Hyponatremia (37.7%) and Hyperkalemia (28.9%), occurred in 0 -1month age group. These derangements have been known to contribute negatively to the outcome of the admitted infant if not corrected. Most of the infants had normal values of the individual electrolytes.

Conclusion

In view of the fact that infants are more vulnerable to electrolyte imbalance, prevention of electrolyte imbalances is preferable to treatment.

Prevalence and Home Management Practice Of Febrile Convulsion Among Children Admitted In a Tertiary Institute Of A Developing Country

Uzomba C.I, Torty C., Nsa E.I, Nlemedim A.C. — Tue, 08 Oct 2024 00:00:00 +0000

Introduction/Objectives

Febrile convulsion (FC) is a convulsion triggered by fever of extra-cranial origin in young children between the ages of 3 months and 5 years. The objectives of this study were to determine the prevalence and home management practices of children admitted in the children emergency room (CHER), UCTH, Calabar, Nigeria.

Methods/Materials

A cross-sectional descriptive study, carried out using quantitative and qualitative methods (admission register and key informant interview). Any child with febrile convulsion admitted into CHER from June 2017 to May 2018 was recruited for the study and his/her caregiver was interviewed on the home practices in the management of FC. Quantitative data was analyzed with SPSS version 22.0 while thematic coding was used for the qualitative data.

Results

Out of 1,093 total admissions for the periodunder review, 37 had FC giving a prevalence of 3.4% with a M:F ratio of 1.1:1. Malaria was the most common cause in 59.5%. Caregivers treated FC at home by giving the children palm oil, palm kernel oil and crude oil to drink, rubbing olive oil, heating child’s feet on fire and using spoon to keep the mouth open, while some rushed the child to the hospital immediately.

Conclusion

The prevalence of FC was low and most of the home remedies applied by caregivers were harmful. It is recommended that there is need to intensify health education and create more awareness on the proper management of FC among caregivers in Calabar.

Knowledge Attitude and Practice of Contraceptive Use Among Final Year Medical Undergraduates In The University Of Calabar, Cross River State

Joy N.I., Ikechukwu H.U, Lincoln F., Dickson O.K., Nkese M. — Tue, 08 Oct 2024 00:00:00 +0000

Background

Globally, the rate of risky sexual behaviors among young undergraduates remains a publi hhealth concern. A wide body of evidence underscores the negative consequences of poor sexual and reproductive health. Despite the proven benefits of contraception, the knowledge, attitude and use of contraceptives among healthcare workers who ought to be advocates have been inadequate. We set out to determine these variables among soon-to-be medical doctors in a Nigerian tertiary institution.

Methods/Subjects

We conducted a cross-sectional descriptive study among 83 final-year medical undergraduates of the University of Calabar, Cross River State using an intervieweradministered questionnaire. Study participants were selected by simple random sampling by balloting and data was analyzed using SPSS version 23. Results were presented using descriptive statistics.

Results

Mean age of participants was 25.4±2.0. The results showed a predominance of good knowledge about contraception among the participants (73, 88%) irrespective of age, gender, marital status and religion. However, most of the participants (53, 63.9%) had poor attitude towards contraception. Concerning practice of contraception, there was a high prevalence (62.7%) of contraceptive use among our respondents as condoms were the predominant contraceptive method used with pharmacy stores being the common source of obtaining these contraceptives.

Conclusion

This research investigated the knowledge, attitude, and practice of final-year medical students on contraception. An important finding emerging from this study is that the majority of the participants had a poor attitude toward contraception despite having a good level of knowledge of contraception.

Childhood Hypertension And Obesity In a Developing Country Setting: A Survey Among School Age Children In Calabar, Nigeria

Ineju E.O, Nsa E.I, Amajor A.C., Amah M.U., Etuk I.S., Nlemadim A.C. — Tue, 08 Oct 2024 00:00:00 +0000

Background

Childhood hypertension is silently rising and gradually becoming a serious public health burden and concern due to its attendant significant morbidity and mortality. It is oftenneglected and rarely reported.Also, childhood obesity is increasingly assuming epidemic proportion with a consequent predisposition to cardio-metabolic diseases.

Aim

To determine the prevalence of childhood hypertension in association with obesity among apparently healthy school age children in Calabar

Study Design/Setting

A cross-sectional descriptive study conducted among randomly selected school-age children, in Calabar, Nigeria.

Methods/Subjects

This cross-sectional study was conducted among children, aged 6 – 12 years old who were selected from public and private primary schools through multi-stage sampling. Blood pressure and body mass index (BMI) were categorized based on the updated 2004 fourth Report on the Diagnosis, Evaluation and Treatment of High Blood Pressure in Children and Adolescents and International Obesity Trust Fund (IOTF) respectively.

Results

A total of 374 children were enrolledwith a male to female ratio of 1.0: 1.3 and mean (SD) age of 9.48 (1.42) years. Mean (SD) systolic blood pressure was 95.9 ±8.8mmHg and the mean (SD) BMI was 16.6 ± (2.6) kg /m2. Hypertension was observed in 9 (2.4%) out of 374 children. Hypertension occurred more in the adolescents 6(3.2%) than in the preadolescents 3(1.6%). Similarly, hypertension was higher in females 8(3.7%) than in males 1(0.6%) With regards to obesity,15 (4%) were obese with a female: male ratio of 1.5: 1. Obesity was higher in adolescents [11 (5.8%)] than in pre-adolescents [4(4%)]

Conclusion

The prevalence of hypertension was 2.4% and it was commoner in females than in males who were more obese. Obesity was strongly associated with increasing BP. Awareness should be created among health care professionals to regularly check for hypertension and overweight among school children for early diagnosis and treatment.

Human Immunodeficiency Virus Associated Neuropathy Perinatally Infected HIV Children In Calabar, Nigeria. Clinical Features, Treatment and Outcome

Nsa E.I., Uzomba C.I., Amah M.U., Etuk I.S. — Tue, 08 Oct 2024 00:00:00 +0000

Background

Renal disease is increasing being recognized as a significant cause of morbidity and mortality in HIV positive patients. Human Immunodeficiency virus associated nephropathy (HIVAN) is the most common type of HIV related renal disease and rapidly progress to end stage renal disease(ESRD). There is paucity of report on true prevalence of HIVAN in African. This study was aimed at determining the prevalence of HIVAN, clinical features, treatment and outcome, in Calabar Nigeria.

Methods/Subject

This was a retrospective review of all renal patients managed by Pediatric nephrology unit of University of Calabar Teaching Hospital from January 2016 to December 2022 enrolled in the Renal register. During the period of study 215 patients had renal diseases out of which 15 had HIVAN. The following information were extracted from the HIVAN patients; Demographics and clinical data as well as mode of transmission, laboratory investigations, renal Ultrasound scan, treatment and Outcome were obtained and analyzed using SPSS version 20.

Results

There were 215 cases of renal diseases seen during the study period of which 15 had HIVAN giving a prevalence of 6.9% There were 5 males and 10 females giving a ratio of 1:2, age range 69-192months. with a mean age of 127±43.7months All received HAART and had acquired HIV infection through vertical transmission. 8 (53%) of patient were asymptomatic with 6 (40%) presenting with both legs and facial swelling. Nephrotic range proteinuria was a common presentation seen in 40% of the patients and 5(33.3%) had hypertension. Only 4 (33%) had eGFR<60 ml/min/1.73m2 and 2(16%) had ESRD. Two were lost to follow-up and 4 (26%) died with two requiring dialysis.

Conclusion

HIVAN is common in patients with renal diseases and there is need to monitor patient at initiation of HAART and at risk patients with low CD4+ count and exposure to nephrotoxic HAART.

Yellow Fever Vaccine-Associated Neurotropic Disease: A Case Report Of A 9-Month Old Infant And Review Of Literature

Torty C., Amajor C., Adewale O. — Tue, 08 Oct 2024 00:00:00 +0000

Introduction

Yellow fever vaccine-associated neurotropic disease (YEL-AND) is a rare and serious complication following vaccination with the 17D live attenuated yellow fever vaccine. Cases of YEL-AND present as acute inflammatory demyelinating polyneuropathy, acute disseminated encephalomyelitis, and meningoencephalitis and encephalitis. To date, only a few cases have been reported in the literature in children.

Methods/Subject

We present the case of a 9-month-old male who developed YEL-AND. He suffered "3 episodes of unprovoked generalized tonicclonic seizure," the first occurring within 2 hours of receiving a dose of the Yellow Fever vaccine, Measles, and Meningococcal vaccines. He was lethargic for 28 hours and had intermittent inconsolable cries for 48 hours, low-grade fever, and loss of motor milestones (sitting and standing). Available laboratory investigations and neuroimaging ruled out other possible causes. He was treated with anticonvulsants and IV Methylprednisolone and made a significant recovery and was discharged on the sixth day and has remained stable on follow-up. His clinical presentation, neuroimaging, and challenges in his management are discussed in this case report.

Conclusion

The licensed Yellow fever vaccines are safe, effective for the prevention of Yellow fever, and highly recommended, however, it is not completely devoid of serious adverse reactions. This case highlights a possibility of a very early onset of YEL-AND in children and should be suspected in individuals with a temporal relationship of symptom onset to vaccination.