Massive hepatomegaly in a 6-week-old infant: is it neuroblastoma?

Neuroblastoma is described in a 6-week-old baby presenting with a rapidly enlarging liver. Initial ultrasound examination of the abdomen could not characterize the tumour but a second examination showed a cyst in the superior pole of the kidney which at autopsy was found to be due to adrenal haemorrhage. The role of prenatal and postnatal ultrasonography in the diagnosis of neuroblastoma is emphasized. This tumour is more common in white children in the more industrialized countries, but even in developing countries clinicians should remain alert to its myriad manifestations.

Childhood convulsions: a hospital survey on traditional remedies.

A study of one hundred and thirty five children with convulsions admitted in the University of Port Harcourt Teaching Hospital, Nigeria over a 15-month period, October 1986 to December 1987 showed that 65 (48%) of the children received some traditional remedy at home prior to presentation in hospital. Crude oil and palm kernel oil either singly or in combination were the most commonly administered remedies. The central nervous system was more affected by remedies containing crude oil than others (P < 0.05). Administration of cow's urine to convulsing children, reported from other parts of Nigeria, was not observed in the present study and would appear to be uncommon in this part of the country.

Survival in very low birthweight infants at the University of Port-Harcourt Teaching Hospital, Nigeria.

Between January 1984 and December 1987, 1509 singleton neonates were admitted into Special Care Baby Unit at the University of Port Harcourt Teaching Hospital; 29(1.9%) of these were Extreme Low Birthweight (ELBW), 86(5.7%) were Very Low Birthweight (VLBW), 406(26.9%) were Low Birthweight (LBW) and 988 (65.5%) were Normal Birthweight (NBW) infants. Survival rates in the four categories were 10.3%, 46.5%, 89.2% and 94.7% respectively. Factors which significantly influenced survival in the VLBW infants included higher mean birthweight (p less than 0.01) longer mean gestation (p less than 0.001) and lower incidence of birth asphyxia (p less than 0.02 with Yates's correction). Furthermore the survivors were significantly more mature for their gestation than those who died (p = 0.008, Fisher's Exact test). Care of the VLBW infant is not beyond the capabilities of Special Care Baby units in developing countries. In the light of our report, survival of Low Birthweight infants is a strong reflection of that of VLBW infants and survival of this category of babies could be improved by instituting general measures such as those aimed at reducing the incidence of LBW in the environment and by specific measures like carrying out prompt and effective resuscitation of the asphyxiated neonate and preventing sepsis.

PIP: A total of 1509 singleton neonates (849 males and 660 females) were admitted into the Special Care Baby Unit at the University of Port Harcourt Teaching Hospital in Nigeria between January 1984 and December 1987. Of these, 29 (1.9%) were extreme low birth weight (ELBW); 86 (5.7%) were very low birth weight (VLBW), 40 of whom survived; 406 (26.9%) were low birth weight (LBW); and 988 (65.5%) were normal birth weight (NBW) babies. Survival rates in the 4 groups were 10.3%, 46.5%, 89.2%, and 94.7%, respectively. Higher mean birth weight (p .01), longer mean gestation (p .001), and lower incidence of birth asphyxia (p .02 with Yates's correction) significantly more mature for their gestational age (p = .008, Fisher's exact probability test) than those who died. Among infants who survived, one each had idiopathic respiratory distress syndrome (RDS) and septicemia. Among the infants who died there were 2 cases of RDS and 1 each of aspiration pneumonia and septicemia. Survival of babies with birth weights under 1000 gm improved very little over the 4-year period, while the survival rates stayed constant at 90% in babies with birth weights of 1500 gm and above. The overall survival rate in the Unit improved from 86.1% in 1984 to 91.4% in 1987. There were relatively fewer cases of birth asphyxia in the VLBW category than in the rest of the babies resulting in better survival. The survival of LBW infants was distinctly reflected by that of VLBW infants whose survival could be improved by instituting measures such as prompt resuscitation of the asphyxiated neonate and prevention of sepsis.

Survival in very low birthweight infants at the University of Port-Harcourt Teaching Hospital; Nigeria

Between January 1984 and December 1987; 1509 singleton neonates were admitted into special care baby unit at the University of Port-Harcourt Teaching Hospital. Among them there were extreme low birthweight; very low birthweight and low birthweight and normal birthweight infants. Survival rates in the four categories were 10.3 per cent; 46.5 per cent; 89.2 per cent and 94.7 percent. Furthermore the survivors were significantly more mature for their gestation and lower incidence of birth asphyxia. Therefore each low birthweight has special care

Appendicitis presenting with dysuria in a 2-year-old: ultrasound-aided diagnosis--a case report.

A 2-year-old Fijian boy presented with a week's history of fever and dysuria. On ultrasound scan of the abdomen, he was found to have an appendicular mass. The role of ultrasound in the diagnosis is emphasized as well as the need for consideration of appendicitis in any young child with abdominal pain.