Renal replacement therapy plays a key role in the management of patients with kidney failure. In most economically disadvantaged nations including Nigeria, haemodialysis is the most available renal replacement therapy. Haemodialysis center was started at Enugu state university teaching hospital on 1st March 2016. The objective of the study is to analyze the activity of the center during the first year of its establishment. This is a retrospective cross sectional study. All the patients that were treated at the center from 1st March 2016 to 28th February 2017 were recruited for the study. Their clinical and laboratory data pre, intra and post-dialysis were entered into a spread sheet and analyzed using SPSS statistical package. A total of 108 patients were dialyzed with a male: female ratio of 1.5:1. The mean age was 46.2±18.1 years, most of the patients were Ibos and of low/middle socioeconomic status. The mean PCV was 22±0.037%, mean serum sodium was 129.8±8.6mmol/l, mean serum potassium was 4.9±0.10mmol/l, mean serum urea was 24.8±12.9mmol/l, and mean serum creatinine was 913.8±424.7umol/l. The month of March had the least(32) sessions of haemodialysis and September had the highest (66)number of sessions. 84.3% had haemodialysis for less than a month and only 4.8% had haemodialysis for at least 6 months. Majority of the patients (67%) had less than 5 sessions of haemodialysis. One (0.9%) patient and 5 (4.8%) patients used ateriovenous fistula and internal jugular catheter as vascular access respectively; others used femoral vein vascular access. Infection, hypertension, hypotension and bleeding were the common complications. One year operation of the haemodialysis at Enugu state university teaching hospital was remarkable; however patients were unable to sustain haemodialysis.
Antibiotics are among the most widely used drugs to treat patients with various diseases in public and private health institutions. It`s use has been found to be associated with various degrees of antibiotic resistance leading to difficulty in managing these various morbidities. The resistance pattern has been found to co-relate strongly with the pattern of antibiotic use. The study is a retrospective study which aimed at studying the resistance pattern to various antibiotics in two Nigerian teaching hospitals located at different geographical areas of the country. The study aimed at determining the factors associated with increased resistance to antibiotics. The pattern of resistance was found to be higher in the rejoin with more frequent use of antibiotics and some recommendations were proposed as a measure of reducing antibiotic resistance to the barest minimum.
Crying describes a category of behavioral states and serves many purposes in infants, especially to shut out disturbing stimuli and it is of etiologic significance for eliciting appropriate care for infants. Children are usually unhappy about going to bed and sometimes react to sleepiness by crying. Therefore, they need sleep training in order to transition successfully to sleeping on their own. Sleep is important for both parents and their babies and serious consequences can arise from parental chronic sleep deprivation as a result of the infant’s inability to fall asleep his own. More efforts are required to create awareness about appropriate care of the crying infant and correct any harmful practices in our environment. This was a hospital based study carried out in the infant immunization clinics of Enugu State University Teaching Hospital Enugu over a six month period from October 2016 to March 2017. A total of five hundred and eleven respondents participated in the study. Among the respondents, 92.6% had experienced pre-sleep cry in their children. Seventy four percent would respond to the crying infant adjusting to sleeping alone by soothing and cuddling, 1.5% would give sedatives, while 0.6% would ignore the infant completely. We recommend that more efforts should be channeled towards counseling parents and caregivers about effective sleep training techniques so they can make informed choices and reduce the risk of future complications related to poor sleep training techniques.
A number of factors are thought to influence the academic performance of children with asthma and absence from school is one. Reports on the impact of school absences on the academic performance of children with asthma are limited and the findings are inconsistent. The impact of school absences on the academic performance of children with asthma in Enugu, Nigeria is determined in this study. Children with Asthma (Subjects) aged 5–11 years were recruited consecutively at the weekly asthma clinic of the University of Nigeria Teaching Hospital (UNTH) Enugu, Nigeria. Their age- , sex- and socio-economic class - matched non- asthmatic classmates (Controls) were recruited from the school. The total number of days of school absence for 2012/2013 academic session was obtained for each pair of pupils from the class attendance register. Academic performance was assessed using the average of the overall scores in the three term examinations of same session. The median number (range) of days of absence from school for the entire study population was 6 (1 - 41) days. The median number (range) of days absent from school was 9 (1 - 29) days for the subjects and 3 (1 - 41) days for the controls. The difference was highly statistically significant (U= 5103, p < 0.001). The number of controls who had average and good academic performance was higher than that of subjects. However there was no significant association between academic performance and school absence in both subjects (2 = 3.92, d.f = 2, p = 0.141) and controls (2 = 0.59, d.f = 1, p = 0.444). We concluded that although children with asthma miss more school days than their non –asthmatic classmates, this does not significantly affect their academic performance.
The word "dada" is used to describe dreadlocks. Several cultural beliefs and practices are associated with concept of the “dada” child and this influence the health care seeking behaviour of caregivers. To determine the perception of caregivers about childhood dreadlocks (Dada hair) and its effect on the health care seeking behavior of care givers in Enugu South-East Nigeria. A cross sectional study involving care-givers seen at the two tertiary health institutions in Enugu State, South Eastern Nigeria. Interviewer administered questionnaires were used to obtain data from the study participants. There were 273 respondents, 90.1% of whom were females and 40% were of low socioeconomic status (SES). One hundred and twenty three (45%) participants believed in the concept of childhood dreadlock but only 27 (9.9%) reported previously or currently having a child with dreadlocks. Thirteen percent were of the view that under no circumstances should dreadlocked hair be washed or combed while 20% opined that a special ritual should be performed by a religious representative before cutting or shaving the dreadlocked hair. Fourteen percent of the caregivers believed that illness in a child with dreadlocks was of supernatural origin and would not respond to treatment with conventional medicine. For respondents that accept the use of conventional healthcare medicine during ill health of a dada child, twenty nine (11%) would refuse any medical interventions that would involve shaving the hair for venous access or neurosurgical procedures until the necessary ceremony had been performed. Only mother’s level of education was significantly associated with belief in the concept of the “dada” child. There is need for appropriate enlightenment of parents and care givers especially in the lower educational group about the importance of seeking healthcare and other necessary preventive strategies for the dada child while still respecting their cultural belief in the concept of childhood dreadlocks.
Human Immunodeficiency Virus is an infective organism that attacks the immune system of victims, frequently leading to disease known as Acquired Immune Deficiency Syndrome. This virus is present in some body fluids of infected persons. Prevention can be done through; correct and consistent use of male and female condom, safe blood transfusion practices, elimination of mother-to-child-transmission, not using already used injection needles and sharps, testing and counseling for HIV and sexually transmitted infections, voluntary medical male circumcision, and antiretroviral drug use for prevention. This research was conducted in Egede, Udi Local Government Area, Enugu state, Nigeria. Interviewer administered questionnaire was used to collect information from respondents who presented for a medical outreach activity in January 2015. Socio-demographic data revealed that 76.9% were over fifty years, 69.9% females, 82.8% married, 52.7% had no formal education, and 69.9% farmers. On awareness of HIV prevention methods; abstinence from sexual intercourse scored 36.1%, being faithful to one uninfected partner 30.1%, correct and consistent use of condom 28.4%, organizing HIV/AIDS awareness campaign 26.4%, transfusing only screened blood 26.7%, preventing infection from mother to child 26.4%, HIV counseling and testing (HCT) 27.4%, male circumcision 16.9%, treatment of sexually transmitted infections 23.6%, giving antiretroviral drug to an exposed person 24.0%, giving antiretroviral drug to the partner of an infected person 21.3%, and by avoiding skin scarification and tattooing 18.9%. Total awareness on HIV prevention methods was 25.5%. It is important that HIV/AIDS awareness activities be stepped up in rural areas of Enugu state and Nigeria generally.
The academic performance of children with asthma may differ from that of their non-asthmatic colleagues. Reports on the academic performance of children with asthma are limited and the findings are inconsistent. The academic performance of children with asthma in Enugu, Nigeria is determined in this study. Children with asthma aged 5–11 years were recruited consecutively at the weekly asthma clinic of the University of Nigeria Teaching Hospital (UNTH) Enugu, Nigeria. Their age-, sex- and socio-economic- matched non- asthmatic classmates were recruited as controls. Academic performance was assessed overall using the average of the overall scores in the three term examinations of same session as well as specifically using the performance in four key subjects (English, mathematics, Social Studies and Sciences). Socio-economic status was determined using the occupational status and educational attainment of each parent. The median (range) overall academic scores for the children with asthma 79.04% (36.08% - 99.57%) was not significantly different from those of controls 80.01% (50.65% - 97.47%) (U = 6804, p = 0.461). We concluded that the academic performance of children with asthma compares favorably with that of children without asthma.
Some haematological alterations due to active cases of tuberculosis caused by Mycobacterium tuberculosis were investigated in Enugu Urban of South East, Nigeria. The results revealed thrombocythaemia, leucocytosis and elevated Erythrocyte sedimentation rates (p<0.05). There was oligocythaemia, as well as reduced haematocrit and haemoglobin concentrations (p<0.05). The significant oligocythaemia, anaemia, reduced packed cell volume found in active TB positive persons are all attributed to invasion of haematopoietic organs by any of the Mycobacteria tuberculosis complex (MTBC) namely: M tuberculosis, M. bovis, M africanum, M. canetti, M. microti, and M. leprae, which reduced substantially the rate of erythropoiesis. The invasion of lymphoid organs such as lymph nodes, thymus and tonsils by MTBC stimulated the synthesis of leucocytes leading to leucocytosis (p<0.05). This could be an inflammatory response which prepared the victim to defend itself against any of the MTBC that invaded the lungs and might even invade other extrapulmonary organs. Thrombocythaemia in active TB is attributed to haemoptysis, since the latter occurs whenever there is a wound or a threat to tissue injury or damage. When these changes in haematological parameters are used in combination with other tests, microscopic and clinical methods, TB diagnosis and treatment could be well improved.
Low birth weight (LBW) babies account for a large number of neonatal deaths globally, with over 90% of these occurring in developing countries with low resources. Identifying factors that determine survival in these sub-groups of babies in such a low-resource setting will help clinicians prioritize care and improve outcomes. This study aims to bridge some knowledge gaps in this regard. This was a 45-month prospective study carried out at the Enugu State University Teaching Hospital (ESUTH), Enugu, Nigeria. All eligible newborns weighing between 500g and <2500g that were seen in this period were enrolled and monitored. Data collected were analysed with SPSS Version 24, and significant associations identified using logistic regression models. A total of 166 LBW neonates were enrolled, and 68.2% of them survived. Asphyxia and episodes recurrent apnoea were recorded at least once in 78.8% and 68.4% of the babies respectively, with about two-thirds requiring respiratory support at one time or the other. Survival in these LBW newborns was negatively associated with gestational age at birth of less than 32 weeks (OR 0.17; CI 0.03-0.50; P<0.01) as well as with episodes of recurrent apnoea (OR 0.07; CI 0.02-0.34; P<0.01). However, intra-uterine exposure to malaria was associated with a 15 times higher likelihood of survival (OR 15.41; CI 2.22-106.91; P=0.01). No significant associations was found between survival and attendances to antenatal care, mode of delivery, birth weight and a number of neonatal morbidities like necrotizing enterocolitis, hypothermia, hypoglycaemia, septicaemia, anaemia and neonatal jaundice. Survival rate among low birth weight neonates in a low resource setting is decreased with delivery at less than 32 weeks completed gestation as well as recurrent episodes of apnoea, but is increased with in-utero exposure to malaria.
Malaria and typhoid are known major causes of febrile conditions in the South-Eastern Nigeria, hence healthcare providers usually co-administer antibiotics and anti-malaria on febrile patients without or before proper laboratory diagnosis. Despite this, fever and other symptoms of malaria sometimes persist after repeated treatment regimens. We investigated possible co-existence and prevalence of another fever-causing condition – brucellosis, with malaria and typhoid. The systematic study done between January 2015 and June 2016 involved 682 febrile patients referred to a private medical laboratory in Enugu metropolis in South-Eastern Nigeria for investigation for malaria and typhoid only. The number was made up of 295(43.3%) males and 387(56.7%) females, aged between 10 and 50 years. Identification of malaria parasites was done using thick films stained with Giemsa stain while typhoid and brucellosis were investigated serologically using Chromatest® febrile antigen kits. Our results showed prevalence of 39.1%, 66.0% and 28.6% for malaria, typhoid and brucellosis respectively in the studied population. Prevalence among male and female patients was 46.1% and 33.9% for malaria, 80.3% and 55.0% for typhoid, and 34.2% and 24.3% for brucellosis respectively. The results also showed that prevalence of malaria decreased with age while typhoid and brucellosis increased with age. We opine that 28.6% prevalence of brucellosis in a city with rare pastoral activities is high, and may be the cause of persistent fever after repeated combined treatment for malaria and typhoid. We advocate that these disease conditions should be simultaneously investigated for in all cases of febrile conditions to ensure wider investigation and treatment options, improvement on patients\' recovery time and reduction in man-hour loss.
The Editor in Chief, Journal of Experimental Research Department of Anatomy, Enugu State University of Science and Technology, College Of Medicine (ESUCOM), GRA Enugu, Nigeria.
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Enugu State University of Science and Technology