Management of chylous ascites with surgery and frusemide in a new born.

Chylous ascites is the accumulation of milky fat-rich chyle in the peritoneal cavity. It is a rare condition in children. Congenital malformations of the lymphatic vascular channel are the predominant cause in children. Diagnosis is often confirmed by paracentesis of the chylous ascitic fluid. Treatment is generally conservative except in rare refractory cases that surgery is required for closure of the leak site or excision of the lymphatic cyst. Here is a report on the management of chylous ascites in a 6-h-old girl presenting in acute respiratory distress with acute abdominal distention due rapid increase in chylous ascitic fluid volume that was managed with surgery and frusemide.

Newborn resuscitation practices and paucity of resuscitative devices in Nigeria; a call to action.

BACKGROUND: Neonatal resuscitation is a method of preventing morbidities & mortality from asphyxia. Up to 85% of facilities in sub-Saharan Africa lack supplies or skilled personnel for neonatal resuscitation. Relative to the place of birth and the skill of the birth attendant, a variety of resuscitative practice are employed to make babies cry instead of helping the baby breathe. Many painful procedures are applied when the baby is unable to cry after birth in the absence of a health care worker trained in bag-mask ventilation. OBJECTIVES: To ascertain the resuscitation practices in communities lacking bag-mask-valve devices. METHODS: Surveys on the resuscitation practices during NISONM annual community outreach and mENCC trainings for four consecutive years in different geopolitical zones of the country. RESULTS: Spanking of the baby usually in the upside down position (>90%), body massage with hot compress or salicylate containing balms, herbal concoctions, injection hydrocortisone or crystalline penicillin were used. CONCLUSION: There is an urgent need to address the issue of training on bag-mask ventilation and provision for frontline healthcare workers in Nigeria as a neonatal mortality reduction strategy.

The effects of weathering demonstrated by maternal age on low birth weight outcome in babies.

BACKGROUND: Increasing age has been hypothesized with wear and tear (weathering) in mothers, which may result to low birthweight of their babies. The prevalence of low birthweight could be heightened if maternal weathering is associated with poor maternal socioeconomic variables. In this current study, we analyzed the effects of maternal weathering on babies' birthweights. METHODS: One hundred and twenty four mother-baby pairs were selected using systematic random sampling method. Maternal age formed part of the demographic data that was obtained from the mothers' case notes and from interviews held with them. Maternal socioeconomic variables were assessed using Oyedeji's parameters and birthweights of babies were determined using bassinet weighing scale. Associations between maternal socioeconomic variables and birthweight of babies were assessed using univariate analysis. Differences in mean birthweight of babies according to their maternal age were evaluated using one-way analysis of variance ANOVA. RESULTS: Among the 124 babies, 66(53.2%) were males and 58(46.8%) females of whom the majority 104(83.9%, had normal birthweight. The mean birthweight of babies was 3.05±0.57 (95% CI, 2.95-3.15) kg, while the mean maternal age was 23.60 (5.2) 95% CI, (22.68-24.52) years. The difference between mean birthweight of babies and mean maternal age was not significant (F=1.35, p=0.255). Similarly, the association between birthweight, maternal education and occupation computed using univariate analysis was not significant (F=2.163, p=0.120) for education and (F=1.825, p=0.166) for occupation. CONCLUSION: In this study, maternal weathering was not found to be associated with LBW outcome. This implies that an increase in maternal age may not be significantly associated with LBW. However, there is need for further research on this subject from different centers using larger sample size in order to enhance the precision of the study.