Facility-Based Treatment of Under Five Diarrhoea in Cross River State: A Clinical Audit

Introduction: Diarrhoea is the second leading cause of under-five mortality globally and ranks second among the top 10 priority child health problems in Nigeria. The World Health Organization (WHO) has recommended some cost-effective; evidence- based interventions for diarrhoea case management. It is needful to evaluate the current practice in the treatment of diarrhoea in under-fives in health facilities in the country.Objective: To determine the extent to which current treatment practice for diarrhoea in underfives conforms to the WHO recommendation.Method: A clinical audit was conducted between May and June 2013 in 32 health facilities in the Southern Senatorial district of Cross River State; Nigeria. Trained field workers extracted information from patients' case records using a validated audit tool. Treatment was checked as appropriate; inappropriate; wrong or none; based on prescription on patients' case records.Result: Of the 370 case records audited; prescription for diarrhoea was appropriate in 40 (10.8%); inappropriate in 231 (62.4%); wrong in 82 (22.2%) and no prescription was made in 17 (4.6%).Conclusion: Treatment of diarrhoea in under-fives in health facilities in the State is suboptimum. Retraining of health workers on the current WHO and UNICEF treatment guidelines is highly recommended

Association between Anthropometric Indices, Plasma Insulin, Lipids and Lipoproteins in Overweight and Obese Nigerians.

AIM: The aim of this study was to determine the relationship between excess body weight gain and plasma insulin, lipid profile and anthropometric indices in overweight/obese civil servants urban city dwellers in Nigeria where fast food outlets are fast growing. Study Design: This study was designed to access anthropometric indices, plasma lipid profile and insulin in non diagnosed disease overweight/obese individuals. Place and Duration of Study: The study was carried out in the Department of Chemical Pathology University College Hospital Ibadan Nigeria, between February 2010 and June 2011. Methodology: Ninety (90) male and female subjects consisting of sixty overweight/obese with mean age of 36.38±1.04 years and thirty normal weight with mean age of 35.93±1.73 years served as controls. Anthropometric indices were measured usingstandard procedures. Plasma total cholesterol (TC), high density lipoprotein cholesterol (HDLC) and triglyceride (TG) were estimated using biochemical procedures. Insulin was measured with the Ultrasensitive Insulin assay on the Access® immunoassay system. The low density lipoprotein cholesterol (LDLC) was calculated. Results: The results showed increased plasma insulin (P=.031), TC (P=.004), TG (P=.008) and LDLC (P=.001), BMI (P=.005), weight, waist and hip circumferences (P=.000) were significantly increased compared to the corresponding control values. Insulin was significantly correlated with BMI (r=.403, P=.003) body weight (r=.464, P=.001) and height (r=.380, P=.02) in overweight/obese subjects. Conclusion: Our results suggest that risk factors for cardio metabolic syndrome exist in overweight /obese civil servants urban city dwellers that have no known diagnosed diseases.

Trace elements in patients with thyrotoxicosis.

Studies have indicated a role for oxidative processes in the genesis of various degenerative diseases including hyperthyroidism-induced damage. In this study we investigated the effects of hyperthyroidism on five trace elements: selenium, manganese, copper, zinc and lead. Fourty hyperthyroid patients (mean age: 40.18+5.17 years) and thirty euthyroid, apparently healthy controls (mean age: 40.33+5.31 years) were used for this study. Plasma levels of thyroid hormones were measured using enzyme immunoassay method. The trace elements were measured using atomic absorption spectrophotometry (AAS). The results showed that patients with hyperthyroidism had higher levels of T3 (6.24+2.94 nmol/L) and T4 (245.43+77.87 nmol/L) but lower levels of TSH (0.16+0.08 MIU/L) when compared with those of controls (T3: 1.49+0.26 nmol/L; T4: 89.47+15.64 nmol/L; and TSH: 1.5+0.48 MIU/L; P<0.05) respectively. We also showed from our data, that hyperthyroid patients had a lower and significant plasma selenium, copper and zinc than the controls (P<0.05).Higher and significant levels of plasma lead was seen in the hyperthyroid patients when compared with the controls (P<0.05). Correlation between trace elements and the thyroid hormones showed no significant difference (P>0.05). From this study, it could be inferred that hyperthyroid patients had low plasma level of selenium, manganese, copper, zinc but high plasma lead. Measurement of these trace elements during the treatment of patients with thyrotoxicosis could be useful for adequate prognosis.

Trace elements in patients with thyrotoxicosis.

Studies have indicated a role for oxidative processes in the genesis of various degenerative diseases including hyperthyroidism-induced damage. In this study we investigated the effects of hyperthyroidism on five trace elements: selenium, manganese, copper, zinc and lead. Fourty hyperthyroid patients (mean age: 40.18+5.17 years) and thirty euthyroid, apparently healthy controls (mean age: 40.33+5.31 years) were used for this study. Plasma levels of thyroid hormones were measured using enzyme immunoassay method. The trace elements were measured using atomic absorption spectrophotometry (AAS). The results showed that patients with hyperthyroidism had higher levels of T3 (6.24+2.94 nmol/L) and T4 (245.43+77.87 nmol/L) but lower levels of TSH (0.16+0.08 MIU/L) when compared with those of controls (T3: 1.49+0.26 nmol/L; T4: 89.47+15.64 nmol/L; and TSH: 1.5+0.48 MIU/L; P<0.05) respectively. We also showed from our data, that hyperthyroid patients had a lower and significant plasma selenium, copper and zinc than the controls (P<0.05).Higher and significant levels of plasma lead was seen in the hyperthyroid patients when compared with the controls (P<0.05). Correlation between trace elements and the thyroid hormones showed no significant difference (P>0.05). From this study, it could be inferred that hyperthyroid patients had low plasma level of selenium, manganese, copper, zinc but high plasma lead. Measurement of these trace elements during the treatment of patients with thyrotoxicosis could be useful for adequate prognosis.