Upper Airway Obstruction among the Paediatric Population in the University of Port Harcourt Teaching Hospital: The Place of Tracheostomy in the Management

Background: The paediatric age group has very peculiar anatomic and physiologic airways therefore, obstructionwhich commonly occurs in this population, can pose serious challenges in this age group.Aim: To study the pattern and aetiologyof acute upper airway obstruction in the paediatric age groupin University of Port Harcourt teaching hospital and to determine the place of tracheostomy in the management.Patients and Methods: It is a descriptive hospital based study of all paediatric patients; aged 0-15years with upper airway obstruction that presented to the ear, nose and throat department and the children emergency ward of university of Port Harcourt teaching hospital within the period of Original Research Article January 2014 to December 2019. Data on demographics, clinical presentations, causes and management were obtained using a Proforma. The diagnosis of upper airway obstruction is made in a child with any degree of respiratory difficulty with or without associated stridor or stertor arising from lesions above the thoracic inlet. Children with respiratory difficulty other than that from an upper airway obstruction were excluded from the study.Data obtained were analyzed with the IBM statistical package for social sciencesSPSS version 20. Results were presented in simple descriptive forms with tables.Results: One hundred and sixty paediatric patients with upper air way obstruction with age ranging from 0-15 years were studied. The prevalence of upper airway obstruction was 1.87%. There were more males than females; male to female ratio was 1.2:1. Age group 4-7 years were the most affected, 43.75%. Foreign body aspiration was the commonest cause. Majority of the patients had tracheostomy done, 48.75%. Mortality was n=1(0.625%).Conclusion: Upper air way obstruction among the paediatric age group is still common with foreign body aspiration as a very important cause in our setting. The very young are the most affected and tracheostomy appears to still be the main option of securing airway in these cases in our environment.

Childhood Urinary Tract Infection in Abakaliki: Etiological Organisms and Antibiotic Sensitivity Pattern

Urinary tract infection (UTI) is a common childhood infection in the Tropics which causes significant illness and is frequently missed; probably because of its non-specific presentation and similarity with other common illnesses. Objectives: To determine the prevalence; common etiological agents; and the susceptibility of these pathogens to the commonly available antimicrobial agents in this center. Materials and Methods: This was a retrospective study carried out at the Children's Outpatient Clinic and Children's Emergency Ward of Ebonyi State University Teaching Hospital Abakaliki (EBSUTH). The study was carried out between January 1; 2007 and December 31; 2009. Results: One hundred ten subjects of the 3625 children seen in the center during the period of study had UTI giving a case prevalence rate of 3.0. Majority of the patients (59; 53.6) were less than 2 years of age with a male:female ratio of 1:1.3. Fever was the commonest presenting symptom and the commonest organisms isolated in urine were Klebsiella (27; 24.5); and Staphylococcus aureus (24; 21.8). The drugs that were most sensitive to these organisms were Gentamicin (50; 45.5); Ceftriaxone (49; 44.5); and Ciprofloxacin (36; 32.7). Conclusion: The study revealed a high prevalence of UTI among children. Klebsiella was the commonest causative organism isolated in the urine. Gentamicin; Ceftriaxone; and Ciprofloxacin were the antimicrobials with the highest sensitivity to all the isolated microorganisms

Non-Traumatic Childhood Coma in Ebonyi State University Teaching Hospital; Abakaliki; South Eastern Nigeria

Background: Coma is a medical emergency; and optimal management; especially in a resource-poor setting; would depend on the knowledge of its etiology and predictors of outcome. This communication reviews the etiology and outcome of non-traumatic childhood coma in Ebonyi State University Teaching Hospital (EBSUTH); Abakaliki. Objective: To determine the incidence; etiology and outcome of non-traumatic coma in children seen at the EBSUTH; Abakaliki. Materials and Methods: This is a retrospective analysis of records of all children admitted to the children emergency ward of EBSUTH in coma of a non-traumatic origin between 1 st of January and 31 st of December; 2007. Results: Forty children presented with coma out of 673 children admitted during the study period; giving an incidence rate of 5.9. The majority of the children (62.5) were aged between 1 and 5 years of age; and 79.5of them were deeply comatose on admission. Most of the cases (85) of non-traumatic coma were due to infective causes; mainly cerebral malaria (47.5); pyogenic meningitis (17.5) and septicemia (10). Twenty-four (60) children recovered while 13 (32.5) died. Conclusion : Infections were the predominant causes of non-traumatic coma in EBSUTH. In view of the high mortality among this group of patients; efforts at the control of malaria and other infections would significantly reduce the incidence of non-traumatic coma in this study site