Abnormal blood glucose and the relationship with clinical outcome in acutely ill children admitted to the emergency unit of a Nigerian Tertiary Hospital.

BACKGROUND: Dysglycemia (hyper- or hypoglycemia) is frequently seen in acutely ill children and may be associated with poor outcome. OBJECTIVE: To determine and compare clinical characteristics and outcomes of children admitted for acute illnesses presenting with euglycemia and dysglycemia. A prospective cohort study was conducted in Emergency Pediatric Unit (EPU), of Usmanu Danfodiyo University Teaching Hospital (UDUTH), Sokoto. SUBJECTS AND METHODS: Children aged ≤15 years, admitted for acute illnesses were enrolled consecutively for a 6-month period. An Accu-Chek Active glucometer was used to check blood glucose of subjects at admission, and based on the result; subjects were categorized as either euglycemic or dysglycemic. The clinical characteristics and outcomes (discharged or died) were compared in the two groups. Statistical analysis involved Chi square test and logistic regression. RESULTS: The median age of 376 subjects was 24 months (range: 1-156 months). Forty-four subjects (11.7%) had dysglycemia, consisting of 36 (9.6%) with hyperglycemia, and 8 (2.1%) with hypoglycemia, whereas 332 (88.3%) had euglycemia. The clinical characteristics associated with hyperglycemia were presence of fever (p = 0.001), and convulsion (p = 0.04), whereas hypoglycemia; coma and hepatomegaly (p = 0.01). Forty subjects (40/376, 10.6%) died. The proportion of those that died in the dysglycemic group (10/44, 22.7%) was significantly higher than that in the euglycemic group (30/332, 9%) (p = 0.006). Subjects who had hyperglycemia were 2.6 times less likely to survive (OR = 2.64, 95% CI: 1.02--6.79, P = 0.05) compared to their euglycemic counterparts. Hypoglycemia was not significantly associated with death outcome (p = 0.13). CONCLUSION: Dysglycemia, particularly hyperglycemia, was significantly associated with increased mortality in acutely ill children. We recommend routine bedside glucose estimation for all acutely ill children at admission to the emergency unit, to detect dysglycemia, treat hypoglycemia promptly, monitor closely, and treat aggressively the underlying conditions in children with hyperglycemia to prevent attendant high mortality.

Knowledge, risk perception and practices related to antibiotic resistance among patent medicine vendors in Sokoto metropolis, Nigeria.

BACKGROUND: Resistance to antibiotics is now a serious threat to global health, and inappropriate use of drugs has been identified as a major contributing factor in the developing countries. OBJECTIVES: The aim of this study is to assess the knowledge, risk perception, and practices related to antibiotic resistance among patent medicine vendors (PMVs) in Sokoto metropolis, Nigeria. MATERIALS AND METHODS: A cross-sectional study was conducted among 200 PMVs selected by multi-stage sampling technique. Data were collected with a set of pretested, self administered, semi structured questionnaire. RESULTS: A larger proportion (83, 42.1%) of the 197 respondents who completed the questionnaire were aged 20 29 years. Most of them were males (80.2%) and had tertiary education (80.7%). Most of the respondents had adequate knowledge of the causes of antibiotic resistance (94.9%), and its prevention (98.0%). Most of the respondents also perceived antibiotic resistance as a serious threat to their own health (95.4%), and the health of their clients (89.4%). Practices favorable to the development of antibiotic resistance were very prevalent among the respondents. Majority of respondents (59.9%) consistently sell antibiotics to clients without doctor's prescription, and close to half of them (49.2%) consistently practice self-medication. CONCLUSION: Despite high levels of knowledge of the causes, prevention, and perception of the risks associated with antibiotics resistance, practices favorable to its development were very prevalent among PMVs in Sokoto, Nigeria. Government should regulate and closely monitor PMVs' practices in order to avert the looming crisis in medical practice that will become inevitable if there are no potent antibiotics.

Pubertal breast development in primary school girls in Sokoto, North-western Nigeria

Background. There is wide variation in normal pubertal timing among various populations. Objectives. To determine the mean age of pubertal stages of breast development and menarche, and the influence of nutrition and ethnicity on pubertal onset in primary school girls in Sokoto, North-Western Nigeria.Methods. A cross-sectional study using a multistage random sampling design was conducted on 994 primary school girls in grades 3 - 6. Weight and height measurements and Tanner breast staging were done. Body mass index (BMI) was calculated, and a BMI-for-age percentile was used to categorise nutritional status. There were four major ethnic groups. P≤0.05 was taken as showing statistical significance. Results. The participants' mean age was 10.23 years (standard deviation (SD) 1.70, range 6 - 15 years). Of the 994 girls, 628 (63.2%) were pre-pubertal, and 366 (36.8%) were pubertal. Of the latter, 158 (15.9%) were in breast stage 2, while 112 (11.3%), 70 (7.0%) and 26 (2.6%) were in breast stages 3, 4 and 5, respectively. The mean ages (SD; range) of pubertal onset and menarche were 10.50 (1.33; 8 - 13), and 12.67 (1.65; 11 - 15), years, respectively. The overnourished (overweight/obese) and Igbo ethnic group girls had early-normal pubertal onset (p=0.006 and p=0.001, respectively). Conclusion. The mean ages of Tanner breast stages 1 - 5 and menarcheal age of girls in Sokoto, North-Western Nigeria, were within the age ranges reported worldwide. Pubertal onset was influenced by nutrition