Prescribing practices in the management of childhood diarrhoea in primary health care centres in a sub-urban community in Nigeria

Background: Childhood diarrhoea remains the second leading cause of morbidity and mortality among children under the age of five. Oral rehydration therapy and zinc tablets are the cornerstone for its management both at home and in the health facilities. Primary health care is the first level of contact of individuals and communities with the health care system and appropriate prescription is crucial for sustainable health benefits. This study assessed the prescribing pattern for childhood diarrhoea management and determined the appropriateness of treatment for acute watery diarrhoea without comorbidities in Primary Health Care (PHC) facilities in a sub-urban community in Nigeria.Methods: This descriptive study was done in 19 PHC facilities in Ikorodu Local Government Area of Lagos State, Nigeria. A retrospective review of 1271 prescriptions for diarrhoeal cases of children between 6 to 59 months was done using the records from the Outpatient Department register for a period of one year. Descriptive analysis was done. Results: From the cases reviewed, 1239 (97.5%) had acute watery diarrhoea (AWD), either alone 819 (64.4%), or with malaria/fever 347 (27.3%), cough/URTI 59 (4.6%), and other conditions 14 (1.1%). For cases of AWD alone, there were 499 (60.9%) prescriptions for ORS/Zinc, 249 (30.4%) for antibiotics and 203 (28.4%) for antimalarials. Antibiotic and antimalarial injections were also included in the prescriptions.Conclusion: This study found the prescription pattern for childhood diarrhoea to be inadequate with suboptimal prescriptions of ORS/Zinc. The prescriptions of antibiotics and antimalarials for acute watery diarrhoea was high and unnecessary

Asymmetric septal hypertrophy and systolic anterior motion of the mitral valve in a patient with pulmonic stenosis and complete heart block: a rare association [case report]

Apart from hypertrophic cardiomyopathy; asymmetric septal hypertrophy has been reported in many disease entities. Its association with pulmonic stenosis although not unknown is none the less rare (1;2). We present the case of a 21 year old back female student who presented with a 2 day history of chestpain; dyspnoea and syncope. She had intermittent dizziness exertional dyspnea and palpitations in the antecedent nine years. She also later admitted to progressive effort intolerance since childhood. Her referal letter stated that she was diagnosed as having hypertrophic cardiomyopathy. The previous echo had been prompted by a University preadmission electrocardiographic finding of multiple multiforal ventricular ectopics