Challenges in the management of early versus late presenting congenital diaphragmatic hernia in a poor resource setting

Background: Despite the advances in management; congenital diaphragmatic hernia (CDH) has continued to pose a significant challenge to paediatric surgeons. This is amplified in a setting like ours where there is a dearth of facilities to cope with the problem of CDH. This study was undertaken to highlight the peculiarities of the management of CDH in a poor resource setting. Methods: All confirmed cases of CDH were prospectively documented from 2003 till date. Results: Seven children were treated from 2003 till date. The diaphragmatic defect was on the left side in six (83.8) and on the right side in one (17.7). All the patients had primary closure of the defect without patch via an abdominal approach. The three patients presenting at birth died while the remaining four patients survived. Conclusion: With inadequate neonatal intensive care facilities; the severe early presenting CDH has a dismal prognosis. In contrast; the late presenting CDH poses more diagnostic challenges; but once identified and appropriate treatment instituted; it has an excellent prognosis. We recommend that physicians should include CDH in the differential diagnosis of patients with birth asphyxia and in patients with chronic respiratory symptoms with failure to thrive

Morphometric Study of the Eyeball of Three Breeds of Goats in Nigeria / Estudio Morfométrico del Bulbo Ocular de Tres Razas de Cabras en Nigeria

A comparative study of ocular morphometry was done in goats in Nigeria using the three major breeds. The result showed that the circumferences (mediolateral and anteriorposterior) were fairly constant between the breeds. The mean relative eyeball weight ranged from (0.39 ­ 0.59) x 10-3. Asymmetry was observed between the right and left eyeball weights and circumferences in all breeds and there was disparity in the asymmetry. It was also observed that heavier eyeball weights did not always correspond to a wider circumference. Female WAD and RS goats had significantly heavier (p < 0.05) eyeball weights than the males but that was not the case in the Sahel breed. Animals above one year had consistently higher values in most of the parameters examined on the eye than those below the age group. The results are added information to baseline data on regional anatomy of the head of small ruminant breeds in Nigeria and for comparative ocular studies.

Se efectuó un estudio comparativo de la morfometría del bulbo ocular, en las tres razas más grandes de cabras de Nigeria. Los resultados mostraron que las circunferencias (mediolateral y anteroposterior) fueron equitativamente constantes, entre las cabras. El peso medio relativo del bulbo ocular estaba entre (0.39 - 0.59g) x 10-3. Fueron observadas asimetrías de los pesos y circunferencias entre los bulbos oculares derecho e izquierdo, en todas las cabras y hubo disparidad en la asimetría. También fue observado que los bulbos oculares más pesados no necesariamente corresponden a los que presentan circunferencia más grande. Los pesos de los bulbos oculares de las cabras hembras WAD y RS, son signficativamente más pesadas (p < 0.05) que los bulbos oculares de los machos, pero no es el caso en las cabras Sahel. Animales de alrededor de un año de edad tienen consistentemente valores más altos, en la mayoría de los parámetros examinados a nivel de los ojos que en los ejemplares de mayor edad. Los resultados obtenidos aumentan la información de datos de la anatomía regional de la cabeza de cabras rumiantes en Nigeria y permite estudios oculares comparativos.