RESUMO
Background and Objectives: This study was aimed at determining our experience with occluder devices over last 5 years. The objective of this study is to compare the complication rates and efficacy of different devices used for the closure of PDA. Methods: A cross-sectional retrospective study in which a review of the records of all children who had PDA surgery in a paediatric cardiac center, Innova Childrens’ Heart Hospital, Hyderabad, India over a five year period (June 2007 and July 2011) was undertaken. The hospital records showed that from June 2007 to July 2011, a total of 456 children aged 9 months to 18 years had trans-catheter closure over the study period, of these, 159 underwent trans-catheter device closure of PDA. A team of experienced paediatric cardiologist performed all the procedures. Results: Out of the 159 cases, 134 (84.2%) were successful while 25 (15.7%) were complicated. Five (5) {20.0%} cases had temporary residual leak, 3 (12.0%) had failure of the procedure that required surgical intervention, 9 (36.0%) had protrusion of the device into the aorta without significant Doppler pressure gradient. There exist a relation between success, complication and device used for the procedure.The type of occluder device used for the procedure significantly affect the outcome (χ2 = 16.37; p = 0.02) Chinese occlude devise had the highest success rate. Twenty five (25.0) {15.7%} patients had complications in all. The commonest complication (protrusion of the device into the aorta) was seen in 3 (1.8%) cases with Chinese duct occluder, 3(1.8%) with Sear Heart R and 3 (1.8%) cases with ADOs. Non died from the procedure. Conclusion: The commonest complication is (protrusion of the device into the aorta) with Chinese occludes devise showing the highest success rate. The learning curve and accumulating experience play an indispensable role in choosing the proper device and its size.
RESUMO
Background: Acute respiratory tract infections (ARIs) constitute the major causes of mortality and morbidity among under-five children of the developing world. The prevalence of ARIs is determined individually or collectively by a number of factors which may be prevalent in our environment. Aim: The present study is aimed to determine the risk factors that affect the prevalence of ARIs in under-five children in Enugu. Subjects and Methods: A cross-sectional study of 436 under-five children diagnosed with ARI was carried out in three hospitals in Enugu. Participants were consecutively enrolled after being diagnosed as a case of ARI. Structured pro foma was used to collect sociodemographic characteristics; anthropometric data and risk profile. Data were analyzed using Epi info version 6.0 and significant probability value was 5 . Results: A total of 436 patients were enrolled for the study 224 males and 212 females M: F 1.06:1. The mean age of the population was 18.75(13.38) months and there were 31.6 (138/436) cases of pneumonia 6.9 (30/436) cases of bronchiolitis and 61.5 (268/436) cases of acute upper respiratory tract infections. Children less than 20 months accounted for 60.9 (84/138 cases) of pneumonia; 86.7 (26/30 cases) of bronchiolitis; and 64.5 (173/268 cases) of acute upper respiratory tract infections. Pneumonia was noted in about 75.7 (56/74) of inadequately nourished children compared to 22.6 (82/362) in adequately nourished children. Other risk factors identified in the study include inadequate breast feeding; poor immunization statues; attendance to daycare centers; large family size; poor parental educational statues; parental smoking; living in the urban area and use of biofuels. Conclusion: ARIs are affected by socio-demographic and socio-cultural risk factors; which can be modified with simple strategies. It is recommended that control program for ARIs should be multifaceted with a strong political will