Paediatric Endocrine Disorders at the University College Hospital; Ibadan: 2002 - 2009

Background: Until recently; most published research focus more on infectious diseases and malnutrition giving the impression that endocrine disorders are uncommon. Reports on endocrine disorders in children in developing countries are few compared to developed countries reflecting the different level of prevalence in the different geographical locations and or level of awareness and availability of facilities for proper diagnosis. Objective: This study aims at defining the burden of paediatric endocrine disorders in Ibadan. Subjects/Methods: A review of records of children who presented at University College Hospital; Ibadan with paediatric endocrine disorders from 2002 to 2009 was carried out. Results: During the eight-year period; a total of 110 children presented with various endocrine disorders but only 94 had complete data for this study. There were 47(50) males and 37(39.4) females; and in 10(10.6) of them; had genital ambiguity at presentation. Patients' ages ranged from 2 weeks to 15 years with a median of 3 years. Many (35) patients were malnourished with weight less than 80 of the expected weight for age and only 9 were overweight. Yearly distribution of cases showed a steady increase in number of cases from 2005. Rickets and metabolic disorders constituted 56.4 of patients; Diabetes mellitus was diagnosed in 12.8; adrenal disoders in 10.6; pubertal disorders in 5.3 and growth disorders in 4.3 of the patients. Thyroid disorders were present in 6.4; obesity in 3.2 while the least common disorder was Diabetes insipidus (1). About 58 of the children had parents in the low socioeconomic status and the management of the cases were severely hampered by lack of funds. About 60.6 of these patients were lost to follow up; during the period. Conclusions: Paediatric endocrine disorders are associated with a high incidence of malnutrition. Most patients presented with rickets which is a preventable condition

Knowledge and Views of Paediatricians about Pulse Oximetry: a Nationwide Online Survey in Nigeria

Pulse oximetry is a non-invasive method of measuring oxygen saturation in clinical settings. This study was carried out to determine the level of knowledge and competencies relating to pulse oximetry and the ability to interpret the information.We conducted a nationwide, multi-centre, and questionnaire-based online survey between January and June 2010. A 32-item questionnaire relating to the use of pulse oximetry in children was answered by 224 in-training and 157 qualified paediatricians (median duration of practice 6 years) working in 24 states in Nigeria. Knowledge of pulse oximetry was evaluated on a scale of 0­100%. Data were analysed using Chisquare and t-test statistics at 5% level of significance.The overall mean test score was 36.6±20.8% (range0­76.5%). The mean knowledge score among intraining and qualified paediatricians was 35.4±19.1%and38.3±23.1%,respectively(p>0.05). Only 16.3% of the respondents answered all three questions correctly relating to the relationship between oxygen saturationand partial pressure of oxygen. Pertaining to the accuracy of pulse oximeters, 3.9% of the respondents answered all 14 questions correctly. On indications for use of pulse oximetry, 29% correctly answered all nine questions. Only 18% of respondents correctly answered the seven questions on interpretation of pulse oximeter reading. Some 73% of respondents believed that training in the use of pulse oximetry was inadequate.A significant proportion of the paediatricians were untrained in pulse oximetry, lacked knowledge of basic principles, and made serious errors in interpretation of readings from pulse oximeters. We suggest that medical schools and residency training programmes place more emphasis on teaching the principles and uses of pulse oximetry