ABSTRACT
Taking advantage of the lack of consensus in our neonatal unit regarding the early (prior to the onset of signs of hypoxic-ischaemic encephalopathy) administration of phenobarbital to term infants with perinatal asphyxia, we evaluated the possible cerebral sparing effect of phenobarbital by doing a retrospective case-control analysis. Fifty-seven infants who received 10 mg/kg loading dose of phenobarbital within one hour following resuscitation and before the onset of signs of hypoxic-ischaemic encephalopathy were compared with 91 infants who did not to determine the effect of early phenobarbital on the incidence of subsequent seizures, and mortality in the perinatal period. Early phenobarbital was associated with a threefold (P < 0.025) increase in the incidence of subsequent seizures, and consequently a trend towards increased mortality. Seizures per se were associated with almost a 20-fold increase in mortality (P < 0.0001). These findings suggest that early phenobarbital administration may produce adverse rather than beneficial effects following asphyxia. Because this is an observational study; these results need to be confirmed by appropriate randomized trials in similar clinical settings.
Subject(s)
Anticonvulsants/adverse effects , Asphyxia Neonatorum/drug therapy , Phenobarbital/adverse effects , Anticonvulsants/administration & dosage , Asphyxia Neonatorum/complications , Humans , Infant, Newborn , Perinatal Care/methods , Phenobarbital/administration & dosage , Retrospective Studies , Seizures/etiology , Seizures/prevention & control , Time Factors , Treatment OutcomeABSTRACT
PIP: Although oral rehydration therapy (ORT) is an effective and inexpensive means of treating dehydration resulting from acute gastroenteritis, many parents in Nigeria usually first seek treatment from patent-medicine dealers for their children with diarrheal diseases. The authors investigated the treatment of diarrhea by 75 patent and proprietary medicine store vendors in Ilorin, capital of Kwara State. There are 417 registered patent and proprietary medicine stores in the city. Seven investigators visited the stores where they individually presented themselves as parents or guardians of a child with diarrhea. 33.3% of respondents selling the medicines at the stores were owners, while the rest were only employees. 30% of the employees were primary school students. The storekeepers and employees rarely asked questions about the diarrhea and did not ask to see the child with diarrhea to determine whether there were signs of dehydration. Unaware of the efficacy of ORT, respondents at all stores recommended drugs to treat diarrhea. Storekeepers also poorly understood the seriousness of the condition and the need to refer some cases to a medical center. The government needs to review the existing laws which regulate the establishment and functions of such proprietary medicine stores. Furthermore, courses for store vendors need to be updated, with vendor training supervised by a monitoring system.^ieng
Subject(s)
Diarrhea, Infantile , Fluid Therapy , Knowledge , Pharmaceutical Preparations , Pharmacies , Pharmacists , Therapeutics , Africa , Africa South of the Sahara , Africa, Western , Delivery of Health Care , Developing Countries , Diarrhea , Disease , Health , Health Personnel , Health Planning , Nigeria , Organization and AdministrationABSTRACT
Treatment of diarrhoea by 75 patent and proprietary medicine-store vendors in Ilorin; was investigated; using a questionnaire. The study revealed that 66.7 percent of those selling the medicines at the stores; were employees and of these; 30 percent were primary school children. Questions were seldom asked by the storekeepers; or the employees about the diarrhoea; nor was the child with diarrhoea asked to be seen for evidence of dehydration. Knowledge about the efficacy of oral rehydration therapy was totally lacking among the respondents in the stores
