Parental practice of child car safety in Enugu, Southeast Nigeria.

Child safety restraints and seat belts are regarded as the most successful safety and cost-effective protective devices available to vehicle occupants, which have saved millions of lives. This cross-sectional descriptive study evaluated the practice and use of child car restraints (CCRs) among 458 purposively selected respondents resident in two local government areas in Enugu State, Nigeria. Self-administered questionnaires were sent to parents of children attending private schools who owned a car. Chi-square and multivariate analyses were used to assess the determinants of the use of car restraints in children among respondents. In all, 56% and 45% of adults and children, respectively, used car restraints regularly. The awareness of child safety laws and actual use of age-appropriate CCRs among respondents was negatively and weakly correlated (r=-0.121, P=0.310). Only respondent's use of seat belt during driving (P=0.001) and having being cautioned for non-use of CCRs (P=0.005) maintained significance as determinants of the use of CCRs in cars on multivariate analysis. The most frequent reasons given for the non-use of CCRs included the child being uncomfortable, 64 (31%); restraints not being important, 53 (26%), and restraints being too expensive, 32 (15%). Similarly, for irregular users, exceptions for non-use included the child being asleep (29%), inadequate number of CCRs (22%), and the child being sick (18%). There is a need for a strategy change to enforce the use of CCRs in Nigeria.

Solute clearance in continuous venovenous hemodialysis. A comparison of cuprophane, polyacrylonitrile, and polysulfone membranes.

Critically ill patients with ARF and MOSF were treated with continuous venovenous hemodialysis (CVVHD). The BSM 22 delivery system (CGH Medical, Denver, CO) and four different dialyzer membranes were used. Vascular access was achieved with a dual lumen catheter placed percutaneously into a large vein. Heparin was used for anticoagulation, and commercially available peritoneal dialysis fluid was used as dialysate. At a fixed blood flow rate of 100 ml/min, the dialysate inflow and outflow rates were regulated to control azotemia and fluid balance. Blood side and dialysate side clearances for urea nitrogen, creatinine, bicarbonate, and lactate were measured. All dialyzer membranes studied provided high urea nitrogen clearance approximating dialysate outflow rate and resulting in excellent control of azotemia. Some of the dialyzer membranes also had high creatinine and bicarbonate clearances. Bicarbonate loss was balanced by lactate uptake with all dialyzers. It is concluded that CVVHD is an efficient and safe therapy for acute renal failure, capable of maintaining nitrogen balance in patients with protein catabolic rates up to 2 g/kg/day. Urea nitrogen clearance is dependent upon dialysate outflow rate rather than the dialyzer membrane type or dialyzer flow geometry, and may prove to be the modality of choice for therapy of acute renal failure in unstable patients with MOSF.

Cytochemical studies of peripheral blood leucocytes in pregnancy.

Three enzymes (alkaline phosphatase, acid phosphatase and peroxidase) and two metabolites (glycogen and lipids), were studied in the circulating leucocytes of pregnant subjects attending the Antenatal Clinic, Ile-Ife State Hospital, during their second and third trimester of pregnancy. Values obtained were compared with those of a non-pregnant control group in the same locality. Leucocyte alkaline phosphatase, glycogen and lipid levels were found to be significantly elevated, while acid phosphatase could not be demonstrated in the study group. Peroxidase levels decreased in the second trimester, only to rise again in the third trimester. Peroxidase had a highly negative correlation with birth weight (r = -0.96) and was, therefore, suggested as a possible prognostic indicator of birth weight. Glycogen and lipids correlated significantly and positively with the Apgar score, and therefore could possibly be useful in antenatal assessment of foetal health status. The necessity for further investigations and confirmation of the possible clinical uses of these parameters in pregnancy has been highlighted.