Relationship between Vitamin D Levels and Outcome of Pneumonia in Children

BACKGROUND: Pneumonia; a common childhood infection in Nigerian children with a number of debilitating complications such as empyema thoracis; has been linked to vitamin D deficiency due to its ability to modulate the T lymphocyte of the immune system . OBJECTIVE: To determine the relationship between vitamin D and outcome of pneumonia in children. METHODS: This was a case-control study involving 24 children; admitted for pneumonia as subjects and 10 children without pneumonia as controls. Pre-formatted questionnaire was utilized to obtain background information; anthropometric measurements were made to determine nutritional status and estimation of 25- hydroxy cholecalciferol (25OHD) done for all those studied. RESULTS: The mean (SD) serum 25OHD concentration was 104 (59) nmol/L and 130 (107) nmol/L for subjects and controls respectively. Amongst the subjects 15 (54) had serum 25OHD less than 70nmol/L and 11 (46) serum 25OHD greater than70nmol/L. Hypocalcaemia was present in 15 (54) of the subjects. Further analysis of hypocalcaemia with regards to the concentration of serum 25OHD showed that 2 (13) had levels below 40nmol/L; 10 (67) had levels below 70nmol/L and 3 (20) above 70nmol/L. Hypocalcaemia was more frequent among subjects with 25OHD below 70nmol/L compared with those above70nmol/L; (p = 0.01). Empyema thoracis and death occurred amongst the two subjects with 25OHD between 27.5 and 40nmol/ L. Anaemia was more frequent among subjects with 25OHD below 70nmol/L compared with those above70nmol/L (p = 0.03). CONCLUSION: The study showed that Vitamin D insufficiency; and not solely its deficiency; may have an important role to play in the immune and haemopoetic system. It may therefore affect the response of a child to infections especially pneumonia

Ultrasonographic measurements of the hepatobiliary axis of children with sickle cell anaemia in steady state

Sickle cell anaemia is associated with structural manifestations in the hepatobiliary axis but these manifestations have not been sufficiently examined in Nigerian or African children. This study wasconducted to evaluate the results of ultrasono-graphic measurements of the hepatobiliary axis of children with sickle cell anaemia in a Nigerian teaching hospital. One hundred and twenty children with Hb SS in steady state aged between 12 months and 15 years and sixty children with Hb AA matched by age and sex (as controls) were consecutively recruited from April through November 2002. Past and present medical histories were obtained and physical examination and abdominal ultrasonography were performed. The mean liver span; the common hepatic duct and common bile duct diameters; the longitudinal and transverse dimensions (but not the wall thickness) of the gallbladder were significantly higher in test subjects than controls (p 0.05). Multiple regression showed that age correlated significantly with all the studied ultrasound scan (USS) measurements (p 0.05). Recurrent episodes of abdominal pain correlated with gallbladder wall thickness (p

Infantile achalasia in Down's Syndrome

A 3-year old girl with clinical features of Down's syndrome presented with persistent vomiting of undigested food and recurrent cough. Although her karyotype was not carried out; radiographs of the pelvis and hands revealed characteristic features of Down's syndrome. An investigative barium swallow to diagnose the cause of the vomiting showed achalasia which is a rare association with Down's syndrome