Paediatric heart failure in Uyo A retrospective analysis

heart failure is a condition that continues to present challenges in management in our environment especially in its treatment and outcomes hence the aim of this study. Materials and Methods: A retrospective analysis of the case notes of all children who were diagnosed and managed for heart failure from January 2019 ­ October 2021 was undertaken. Data obtained included age, sex, presenting features, primary diagnosis, treatment modalities, duration of hospital stay and outcomes. Results: A total of 2226 children were admitted over the study period with 67 children diagnosed with heart failure giving a prevalence rate of 3% although only 47 case notes could be retrieved giving a case retrieval rate of 70%. There were 26 (55.3%) males and 21 (44.7%) females (M: F ratio1.2:1). Mean age of patients was 32.6 months (±52.23) with 28(59.6%) of them being infants. Bronchopneumonia was the commonest cause of heart failure 31 (65.9%) either singly or in combination with a cyanotic congenital heart disease followed by severe anemia in 14 (29.8%). Average duration of hospital stay was 6.9days (±5.08) and average cost of admission was N13,266. Twenty-three patients were discharged (48.9%), while 10 (21.3%) left against medical advice, 2 absconded (4.3%) while 12 (25.3%) died. Conclusion: Heart failure remains an important cause of morbidity and mortality in children in our environment arising from largely preventable causes. Urgent steps such as patient care giver education, immunization and screening for congenital heart disease are needed to reduce its effect on children in our environment

Conduct Disorder among Primary Schoolchildren in Southern Nigeria.

BACKGROUND: Conduct disorder is a mental disorder characterized by hostile and sometimes physically violent behavior. It is a source of concern not only to the parents but also to the children's teachers and the community. Its prevalence rate in our environment is unknown. AIM: The aim of the study is to determine the prevalence rate of conduct disorder among primary school pupils in Ikot-Ekpene, Southern Nigeria. MATERIALS AND METHODS: Vanderbilt attention-deficit hyperactivity disorder (ADHD) diagnostic teacher rating scale for oppositional defiant disorder/conduct disorder was administered on 1174 pupils aged 6-12 years drawn from 12 primary schools in Ikot-Ekpene, Akwa-Ibom State, Nigeria. Parents of the pupils with conduct disorder completed a pro forma on their sociodemographic characteristics. RESULTS: One hundred and fifteen of the studied 1174 pupils had conduct disorder with a prevalence rate of 9.8%. A greater number of males had conduct disorder with a male-to-female ratio of 4.75:1. Children from upper social class comprised the highest number with conduct disorder. Younger children (6-9 years) were more affected (76.5%) than the older ones. The predominant symptom exhibited by the children was difficult temperament. Comorbidities associated with conduct disorder were ADHD, anxiety disorder, and depression. CONCLUSION: The prevalence rate of conduct disorder is within the global range in our environment and tends to affect the younger children. Policy should be put in place to screen these children at school entrance so as to render appropriate health intervention.

Prevalence of hypertension and prehypertension among children and adolescents in a semi-urban area of Uyo Metropolis, Nigeria.

INTRODUCTION: In the past, Hypertension in childhood was not considered a problem but in the last few decades, it has gradually become a source of concern especially as children are known to maintain their blood pressures into adulthood. Therefore, hypertensive children are at risk of developing cardiovascular complications earlier in adulthood. In our own environment, the prevalence of hypertension in children is undocumented, hence the purpose of this study. METHODS: Two hundred children aged between 3-17 years were recruited into this study from two public schools-one primary, one secondary in a semi urban community in Uyo metropolis. The blood pressure of respondents was measured in accordance with the technique described by the 4th Task Force on Blood Pressure Control in Children. The height and weight of all eligible subjects was measured using a stadiometer and a calibrated scale respectively. Body Mass Index (BMI) was assessed for each subject and World Health Organization (WHO) charts of BMI for age and sex were used as reference standards. Waist circumference was measured according to the technique described in the National Health and Nutrition Examination Survey. RESULTS: The prevalence of hypertension and prehypertension was found to be 3.5% and 2.5% respectively in this study. Only age (OR = 1.74, p = 0.005, 95%CI = 1.186-2.566), BMI (OR = 1.54, p = <0.001, 95% CI = 1.249-1.913) and waist circumference (OR = 1.16, p = 0.002, 95%CI = 1.056-1.271) were found to significantly predict the development of high blood pressure. CONCLUSION: The prevalence of hypertension and prehypertension in this study was found to be low. Hypertension/prehypertension was more likely to develop with increasing age, BMI and waist circumference.

Audit of availability and distribution of paediatric cardiology services and facilities in Nigeria.

BACKGROUND: Paediatric cardiac services in Nigeria have been perceived to be inadequate but no formal documentation of availability and distribution of facilities and services has been done. OBJECTIVE: To evaluate and document the currently available paediatric cardiac services in Nigeria. METHODS: In this questionnaire-based, cross-sectional descriptive study, an audit was undertaken from January 2010 to December 2014, of the personnel and infrastructure, with their distributions according to geopolitical zones of Nigeria. RESULTS: Forty-eight centres participated in the study, with 33 paediatric cardiologists and 31 cardiac surgeons. Echocardiography, electrocardiography and pulse oximetry were available in 45 (93.8%) centres while paediatric intensive care units were in 23 (47.9%). Open-heart surgery was performed in six (12.5%) centres. South-West zone had the majority of centres (20; 41.7%). CONCLUSIONS: Available paediatric cardiac services in Nigeria are grossly inadequate and poorly distributed. Efforts should be intensified to upgrade existing facilities, establish new and functional centres, and train personnel.

Prevalence of hypertension and prehypertension among children and adolescents in a semi-urban area of Uyo Metropolis, Nigeria

Introduction: in the past, Hypertension in childhood was not considered a problem but in the last few decades, it has gradually become a source of concern especially as children are known to maintain their blood pressures into adulthood. Therefore, hypertensive children are at risk of developing cardiovascular complications earlier in adulthood. In our own environment, the prevalence of hypertension in children is undocumented, hence the purpose of this study.Methods: two hundred children aged between 3-17 years were recruited into this study from two public schools-one primary, one secondary in a semi urban community in Uyo metropolis. The blood pressure of respondents was measured in accordance with the technique described by the 4th Task Force on Blood Pressure Control in Children. The height and weight of all eligible subjects was measured using a stadiometer and a calibrated scale respectively. Body Mass Index (BMI) was assessed for each subject and World Health Organization (WHO) charts of BMI for age and sex were used as reference standards. Waist circumference was measured according to the technique described in the National Health and Nutrition Examination Survey.Results: the prevalence of hypertension and prehypertension was found to be 3.5% and 2.5% respectively in this study. Only age (OR = 1.74, p = 0.005, 95%CI = 1.186-2.566), BMI (OR = 1.54, p = <0.001, 95% CI = 1.249-1.913) and waist circumference (OR = 1.16, p = 0.002, 95%CI = 1.056-1.271) were found to significantly predict the development of high blood pressure.Conclusion: the prevalence of hypertension and prehypertension in this study was found to be low. Hypertension/prehypertension was more likely to develop with increasing age, BMI and waist circumference

Congenital Ewing's Sarcoma in a neonate in Uyo--a case report.

Congenital Ewing's sarcoma is a very rare occurrence indeed with only one case involving the humerus and none involving the ulna that has been noted in the literature to our knowledge. It is one of those tumours that not only do they rarely occur in the neonatal period, but is also very uncommon in black people. We present a case report of Congenital Ewing's Sarcoma in a black female infant involving the ulna bone and surrounding soft tissues which was diagnosed by histology and immnohistochemistry.