Nigerian medical journal : journal of the Nigeria Medical Association最新文献

{"title":"Prevalence of Gestational Diabetes and Pregnancy Outcome of antenatal patients in Ilorin.","authors":"Akinyosoye Deji Ajiboye, Kikelomo Temilola Adesina, Ishaq Funso Abdul, Grace Gwabachi Ezeoke, Abayomi Sikiru Biliaminu, Akintunde Olusegun Fehintola, Ekundayo Oluwole Ayegbusi","doi":"10.60787/nmj-64-6-320","DOIUrl":"10.60787/nmj-64-6-320","url":null,"abstract":"<p><strong>Background: </strong>Gestational Diabetes mellitus (GDM) is fast becoming an important cause of maternal and perinatal morbidity and mortality. The objective of this study is to assess the prevalence and the perinatal outcome of gestational diabetes in an antenatal population.</p><p><strong>Methodology: </strong>This was a cross-sectional study. The patients were pregnant women between 24-28 weeks of gestation without a prior diagnosis of diabetes mellitus. The consenting women were evaluated using fasting plasma glucose and oral glucose tolerance testing using 75 grams of glucose in 300ml of water orally.</p><p><strong>Results: </strong>Two hundred and fifteen women participated in the study and the prevalence of GDM was 9%. The mean fasting plasma glucose was 4.04mmol/l at the time of the Oral glucose tolerance test (OGTT) and 5.78mmol/l after the oral glucose load. When compared with pregnant normoglycaemic patients, GDM patients had significantly fewer vaginal deliveries (p=0.05), higher birth weight (3.71kg), and more neonatal admissions (50%).</p><p><strong>Conclusions: </strong>Gestational diabetes mellitus is an important disease entity, and it is a cause of maternal and perinatal morbidities.</p>","PeriodicalId":94346,"journal":{"name":"Nigerian medical journal : journal of the Nigeria Medical Association","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11227641/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141560719","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hemolytic Uremic Syndrome: A COVID-19 Vaccine Reaction Case Report.","authors":"Thelma Alalbila Aku, Eugene Kobla Dordoye, Theodore Ofori Apraku, Adwoa Ansomaa Gyamera, Peter Yamoah, Patrick Adjei","doi":"10.60787/nmj-64-6-343","DOIUrl":"10.60787/nmj-64-6-343","url":null,"abstract":"<p><p>The World Health Organization declared the Coronavirus disease of 2019 (COVID-19) a public health emergency of international concern on 30 January 2020, and a pandemic on 11 March 2020. Vaccines have proven to be vital in the effort to control and possibly eventually eradicate this viral infection. There have been reports of thromboembolic events associated with the use of vaccine but from available information, no reported case of atypical Hemolytic Uremic syndrome (HUS) in a black male has been described. We report a case of a 43-year-old black male Sub-Saharan African c5dwho presented with chills, fever, and generalized body aches of 3 days duration after receiving the second booster dose of the COVID-19 vaccine. He developed thrombocytopenia, hemolytic anaemia, and acute kidney injury on admission, and an initial diagnosis of malaria was made. He was managed with parenteral artesunate and then oral artemether/lumefantrine. His hemolytic anaemia was thought to be from malaria-associated hemolysis. This diagnosis was however later re-evaluated to hemolytic uremic syndrome and managed with 50mg daily oral prednisolone which resolved, and he resumed work a week later. Although mass vaccination is a key strategy to control the spread of COVID-19, critical observations should be made to confirm the risk of trigger for abnormal complement activation. Further observations should be made especially if it is a chimpanzee adenovirus-vectored vaccine.</p>","PeriodicalId":94346,"journal":{"name":"Nigerian medical journal : journal of the Nigeria Medical Association","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11227635/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141560714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Laparoscopic Management of Gall Bladder Diseases in Nigeria: A Systematic Review.","authors":"Obinna Joseph Ugwu, Ferdinand Ibu Ogbaji, Tobechukwu Ojiugo Tony-Okeke, Bashir Omeiza Ismaila, Onome Chidinma Nnorom, Joy Hyelni Zoakah, Sarah Kwaghdoo Aule, Suleiman Mshelia","doi":"10.60787/nmj-64-6-378","DOIUrl":"10.60787/nmj-64-6-378","url":null,"abstract":"<p><strong>Background: </strong>Globally, the incidence and mortality from gallbladder diseases is on the rise. The gold standard for the management of symptomatic gallbladder disease is laparoscopic cholecystectomy. The practice of laparoscopic cholecystectomy is at a nascent stage in Low and middle-income countries like Nigeria despite its obvious advantages over traditional open cholecystectomy. This systematic review aims to assess the extent to which laparoscopic cholecystectomy is performed for the management of gallbladder diseases in Nigeria.</p><p><strong>Methodology: </strong>The review was guided by the PRISMA model. We searched MEDLINE, Embase, CINAHL, Scopus, and Global health databases. All searches were conducted in August 2023. All study designs reporting laparoscopic cholecystectomy in Nigeria, in the past 10 years were included. Three authors conducted the data extraction using data extraction tables and two authors independently assessed the data for accuracy and completeness. The Joanna Briggs Institute critical appraisal tool was used to assess the data quality. Twenty-two articles with 1569 patients were included in this review.</p><p><strong>Results: </strong>Females accounted for 69.5% of the patients and 30.5% were males. Twelve (54.5%) of the studies were from the Southwest of the country, 3 (13.6%) each from the South East and North Central regions, 2 (9.1%) South-South, and 1 (4.5%) each from the North East and North West. Study designs were mostly cross-sectional with sample sizes from 1 to 400. The highest and lowest number of laparoscopic cholecystectomies reported were 300 and 1 respectively. The majority (95.2%) of laparoscopic cholecystectomies were on account of calculous cholecystitis and the methods reported were the 4-port and 3-port techniques. The follow-up period ranged from 3 weeks to 2 years with 54 (3.4%) complications reported.</p><p><strong>Conclusions: </strong>Laparoscopic cholecystectomy in Nigeria is relatively safe with minimal complications. Its demand and uptake are on the rise, though slowly owing to its relatively high cost.</p>","PeriodicalId":94346,"journal":{"name":"Nigerian medical journal : journal of the Nigeria Medical Association","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11227640/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141560716","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medical Biomonitoring of Maternal and Fetal Exposure to Carbon Monoxide and its Modification by Demographic and Obstetric Characteristics.","authors":"Abbey Mkpe, Amadi Simeon Chijioke, Olufemi Adebari Oloyede, Rose Sitonma Iwo-Amah, Paul Ledee Kua, Eghuan Kenneth Okagua, Basil Omieibi Altraide, Faithwin Horsfall, Esther Ijeoma Nonye-Enyidah, Ngozi Joseph Kwosah, Alpheaus Gogo Mba, Uduak Solomon Ocheche, Leesi Sapira-Ordu, Dickson H John, Nestor Mininyo Inimgba","doi":"10.60787/nmj-64-6-192","DOIUrl":"10.60787/nmj-64-6-192","url":null,"abstract":"<p><strong>Background: </strong>There is a paucity of organized human biomonitoring, including that of carbon monoxide (CO) in the Niger Delta, Nigeria. The study aims to quantify the impact of maternal exposure to CO in the first trimester of pregnancy and its modification by maternal demographic and obstetric factors.</p><p><strong>Methodology: </strong>It was of cross-sectional design conducted at the Rivers State University Teaching Hospital (RSUTH) in Nigeria. Four hundred and ninety consecutive pregnant women in the first trimester were recruited from the antenatal clinic from January 2021 to January 2022. Demographic, social, and obstetric characteristics were recorded. Maternal exhaled CO concentration (ECOC) and maternal and fetal carboxyhaemoglobin concentrations (MCOHC and FCOHC) were measured with the aid of a smokelyzer. Data were analyzed, using SPSS version 25.0 software. Ethical approval was obtained from the RSUTH Ethics Committee.</p><p><strong>Results: </strong>The mean values of ECOC, MCOHC, and FCOHC were 3.25±2.51 ppm, 1.15±0.40%, and 0.93±0.72% respectively and the severity (mild, moderate, and severe) of the impact was inversely proportional to the number of women affected. There were statistically significant differences in the mean values of ECOC, MCOHC, and FCOHC in the following maternal characteristics: age, educational levels, BMI, gravidity, and parity. In the case of FCOHC, the measures of the differences were as follows: p:<0.019, <0.020, <0.0001, <0.0001, and <0.038 for age categories, educational levels, BMI, gravidity, and parity respectively. There were statistically significant positive correlations between the BMI and the mean values of ECOC, MCOHC, and FCOHC.</p><p><strong>Conclusion: </strong>The higher the severity of exposure to CO (mild, moderate, and severe), the lower the number of impacted pregnant women. There were statistically significant differences in the mean values of ECOC, MCOHC, and FCOHC in women of different ages, educational levels, BMI, gravidity, and parity categories.</p>","PeriodicalId":94346,"journal":{"name":"Nigerian medical journal : journal of the Nigeria Medical Association","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11227630/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141560717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Knowledge and Perception of Telemedicine among Medical Students of the University of Jos, Plateau State, Nigeria.","authors":"Nathaniel Birdling Noel, Maryam Birdling Noel, Eric Yila, Chibuzo Anne-Lise Nkala, Mathilda Edmund Banwat","doi":"10.60787/nmj-64-6-373","DOIUrl":"10.60787/nmj-64-6-373","url":null,"abstract":"<p><strong>Background: </strong>Telemedicine has promising potential to address the challenges faced by healthcare systems in developing countries, in providing equitable access to quality care. However, the practice of telemedicine is generally poor in these countries. The success of telemedicine like any technology depends on numerous factors including users' knowledge and perceptions. Hence, this study aimed to examine the knowledge and perceptions of telemedicine among medical students at the University of Jos.</p><p><strong>Methodology: </strong>This was a cross-sectional study among 305 clinical medical students selected through a stratified sampling technique. A self-administered questionnaire consisting of a 28-item 5-point Likert response scale was used to collect data, comprising 13 items for knowledge, 8 for the perception of benefits, and 7 for the perception of ease of use of telemedicine. Data was analyzed using IBM-SPSS.</p><p><strong>Results: </strong>One hundred and eleven (36.4%) participants had good knowledge of telemedicine, while 113 (37.1%) had a good perception of the benefits and 103 (33.8%) had a good perception of the ease of use. Respondents with a good knowledge of telemedicine were about five times more likely (OR = 5.24, 95% CI = 3.15 - 8.69) to have a good perception of the benefits and about eight times more likely (OR = 8.33, 95% CI = 4.57 - 14.26) to have a good perception of ease of use.</p><p><strong>Conclusions: </strong>Few medical students possess desirable levels of knowledge and perceptions of telemedicine which portrays a gap in the medical education curriculum. Therefore, training, and educational opportunities are recommended to improve their knowledge and perception of telemedicine.</p>","PeriodicalId":94346,"journal":{"name":"Nigerian medical journal : journal of the Nigeria Medical Association","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11227638/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141560715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic Accuracy of Plasma Cystatin C and Renal Resistive Index for Acute Kidney Injury in Critically Ill Patients: A Prospective Observational Study.","authors":"Munna Lal Patel, Himanshu Mishra, Rekha Sachan, Vipin Kumar Singh, Radheyshyam Gangwar, Wahid Ali","doi":"10.60787/NMJ-64-5-292","DOIUrl":"10.60787/NMJ-64-5-292","url":null,"abstract":"<p><strong>Background: </strong>Acute kidney injury (AKI) is a quite common problem in critically ill patients. Serum cystatin C has emerged as a marker of AKI. This study was aimed to evaluate the diagnostic ability of serum Cystatin-C and Renal Resistive Index in prediction of AKI among critically ill patients.</p><p><strong>Methodology: </strong>This prospective observational study was carried out in the department of Medicine, over a period of one year. After informed consent and ethical clearance total 120 critically ill patients suffering from sepsis were enrolled, out of which 70 patients developed AKI while 50 did not develop AKI during treatment in Intensive care unit (ICU). Serum cystatin C was measured on day 1 by particle-enhanced immune nephelometric assay, Renal resistive index (RRI) calculated by ratio of the velocities of arterial perfusion throughout the cardiac phase and glomerular filtration rate was measured on days 1, 3, and 7 respectively.</p><p><strong>Results: </strong>S. cystatin C value was significantly higher(>3times) in AKI patients (14.07±4.8 mcg/ml) as compared to those who did not develop AKI (4.28±3.27 mcg/ml) (p<0.001). After ROC analysis it was found that day1, S. cystatin C, at cut off value of ≥9.29 mcg/ml had diagnostic accuracy 90% with sensitivity 91%, specificity89% and PPV 95.5%. While RRI value on day 7, at cut-off value of ≥0.72, had diagnostic accuracy 98%, sensitivity (98.6%) and specificity (96.7%) for AKI with 98.6% PPV, 96.7% NPV.</p><p><strong>Conclusion: </strong>Serum cystatin C appears to be a promising bio- markers for early diagnosis of AKI in critically ill patients. Whereas, RRI although non-invasive had good diagnostic accuracy but it diagnosed AKI after few days thus diagnosis of kidney injury delayed.</p>","PeriodicalId":94346,"journal":{"name":"Nigerian medical journal : journal of the Nigeria Medical Association","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11218858/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141500121","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative Study Between Hysterosalpingo-Contrast Sonography and Hysterosalpingography in Evaluating Tubal Patency at Aminu Kano Teaching Hospital, Kano.","authors":"Ibrahim Danladi Muhammad, Umar Suleiman Sabo, Sa'idu Adamu Ibrahim, Aliyu Dayyabu Labaran, Idris Usman Takai","doi":"10.60787/NMJ-64-5-189","DOIUrl":"10.60787/NMJ-64-5-189","url":null,"abstract":"<p><strong>Background: </strong>Tubal diseases contribute significantly to secondary infertility, affecting 25-35% of couples seeking infertility treatment. Traditional methods for assessing tubal patency, such as laparoscopy and dye tests, are invasive, costly, and require specialized expertise. Hysterosalpingography (HSG) is an alternative, but it involves pain and radiation exposure. This study aimed to compare the effectiveness of Hysterosalpingo-contrast Sonography (HyCoSy) using a saline and air mixture to HSG in assessing tubal patency in infertility patients at Aminu Kano Teaching Hospital.</p><p><strong>Methodology: </strong>A cross-sectional study involved 50 consenting patients seeking fertility evaluation. The researchers used a semi-structured questionnaire to gather demographic information. HyCoSy with the saline and air mixture was performed between the 5th and 10th day of the menstrual cycle, followed by HSG within the next five days. The patency of each fallopian tube was assessed, and pain levels experienced during both procedures were recorded using a numerical rating scale.</p><p><strong>Results: </strong>The results indicated that 68.8% of patients had bilateral patent tubes according to HyCoSy, while 60.4% were found to have patent tubes with HSG. A comparison of findings for individual tubes showed an 89.6% concordance rate between the two tests, with a Kappa index of 0.73, indicating substantial agreement. Importantly, patients reported significantly less pain during the HyCoSy procedure (mean NRS score of 4.1) compared to HSG (mean NRS score of 7.1).</p><p><strong>Conclusion: </strong>This study demonstrated that HyCoSy using a saline and air mixture is highly comparable to HSG in assessing tubal patency. Notably, HyCoSy was preferred by patients due to its reduced pain and better tolerance, with minimal adverse effects. This suggests that HyCoSy may be a more patient-friendly and cost-effective alternative for tubal assessment in cases of infertility.</p>","PeriodicalId":94346,"journal":{"name":"Nigerian medical journal : journal of the Nigeria Medical Association","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11218854/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141500119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative Study of Extrapyramidal Side Effects, Sexual Dysfunctions and Hyperprolactinaemia Using Typical and Atypical Antipsychotic Medications Among Patients with Schizophrenia in Maiduguri.","authors":"Falmata Baba Shettima, Musa Abba Wakil, Taiwo Lateef Sheikh, Isa Bukar Rabbebe, Mohammed Abdulaziz, Said Jidda, Asma'u Mohammed Chibado Dahiru","doi":"10.60787/NMJ-64-5-311","DOIUrl":"10.60787/NMJ-64-5-311","url":null,"abstract":"<p><strong>Background: </strong>Extra-pyramidal side effects, sexual dysfunctions and hyperprolactinaemia are major side effects with the use of antipsychotic medications that impede treatment adherence leading to relapse, increased cost of care and rehospitalization among patients with schizophrenia on antipsychotic medications. The study aims to compare the prevalence of extra-pyramidal side effects (EPSE), sexual dysfunctions (SD) and hyperprolactinaemia (HPRL) among patients with schizophrenia spectrum disorders on typical and atypical antipsychotic medications. The secondary aim is to determine if any associations exist between extra-pyramidal side effects, sexual dysfunctions and hyperprolactinaemia.</p><p><strong>Methodology: </strong>A cross-sectional hospital-based survey involving 209 patients with schizophrenia were interviewed with structured instruments for the assessment of sexual dysfunction, EPSE and the estimation of serum prolactin was done using Enzyme-linked Immunosorbent Assay. Frequencies and Chi-square analysis were used to compare differences in EPSE, SD & HPRL.</p><p><strong>Results: </strong>The study revealed non-statistically significant differences as a group between typical and atypical antipsychotic medication in terms of extra-pyramidal side effects, sexual dysfunction and hyperprolactinaemia. However, a significant association was observed when individual drugs were compared with haloperidol causing the highest frequency of hyperprolactinaemia (<i>χ</i> ² = 14.9, <i>P</i> = 0.011). A significant relationship between sexual dysfunction and hyperprolactinaemia, sexual dysfunction and extra-pyramidal side effects as well as extra-pyramidal and hyperprolactinaemia was found when individual items for sexual functionin were used.</p><p><strong>Conclusion: </strong>The significant relationships between sexual dysfunction only in the domains of sexual desire and arousal with hyperprolactinaemia and extrapyramidal side effects as well as hyperprolactinaemia with extrapyramidal side effects point to a common anti-dopaminergic activity of antipsychotics via different pathways. Prospective studies among a larger sample of patients with schizophrenia are needed to unfold these relationships.</p>","PeriodicalId":94346,"journal":{"name":"Nigerian medical journal : journal of the Nigeria Medical Association","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11218855/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141500120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Active Euthanasia for Perinatal Osteogenesis Imperfecta; An Ethical Dilemma in a Tertiary Facility in Southwestern Nigeria: A Case Report.","authors":"Michael Abel Alao, Oluseye James Sobande, Ayodeji Matthew Borokinni, Abimbola Ellen Akindolire, Adejumoke Idowu Ayede, Olukemi Oluwatoyin Tongo","doi":"10.60787/NMJ-64-5-347","DOIUrl":"10.60787/NMJ-64-5-347","url":null,"abstract":"<p><p>Managing a newborn with lethal congenital anomalies is challenging but handling a parent's request for doctors under oath to terminate the baby's life is another major ethical dilemma requiring cautious evaluation. We present a term male neonate who presented on the 7^th day of life, with a dark-blue sclera, multiple limb deformities, long bone fractures, beaded ribs, a flattened forehead, a narrow chest, and respiratory distress. A Diagnosis of Type II Osteogenesis imperfecta was made and he was managed by a multidisciplinary team including neonatologists, geneticists/endocrinologists, orthopaedic surgeons, nurses, and medical social workers. Supplemental oxygen, intravenous fluids and antibiotics, analgesia, and bisphosphonates were offered as supportive care. The main concern was the challenges of managing a newborn with lethal OI and balancing the demand for euthanasia by the parents to end the baby's misery. In providing care, the rights of the child to life, the morals of the physician, the best interests of the baby, and the family's role in decision-making in a setting of out-of-pocket expenditures must be weighed. Following extensive multidisciplinary team meetings, it was ultimately decided to allow nature to take her course. Baby subsequently had progressive respiratory distress from pulmonary hypoplasia and died of respiratory failure on the twelfth day of life. In Conclusion, Osteogenesis imperfecta of the perinatal type is usually a lethal disease, with death often occurring within the perinatal period. The physician must, therefore, balance the parental rights, the oath of office, and the existing legal framework to avoid charges of murder or manslaughter.</p>","PeriodicalId":94346,"journal":{"name":"Nigerian medical journal : journal of the Nigeria Medical Association","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11218853/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141500106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Review of Post Neonatal Paediatric Admission Pattern and Outcome in a Public Tertiary Health Facility in Nigeria.","authors":"Ebenezer Olatunji Adeyemi, Ayomide Oladele, Samuel Olu Ajigbotosho, Adeline O Adaje, Olufunke B Bolaji, Olubunmi A Lawal","doi":"10.60787/NMJ-64-5-211","DOIUrl":"10.60787/NMJ-64-5-211","url":null,"abstract":"<p><strong>Background: </strong>Admissions over the years have been largely due to preventable aetiologies and the possible outcomes are discharge, death, referral or discharge against medical advice. This study aimed to understand the patterns of postneonatal paediatric admissions and outcomes from a public tertiary health facility in South-West Nigeria.</p><p><strong>Methodology: </strong>A descriptive retrospective study of paediatric admissions over a 2-year period. Information concerning age, sex, diagnosis and outcome were extracted from patients' medical records. Data was presented in numbers and percentages, Chi-square was used to compare groups and a p-value of <0.05 was accepted as significant.</p><p><strong>Results: </strong>There were a total of 875 admissions, over the 24 months period, with a male-female ratio of 1.3:1. Malaria, sepsis, sickle cell crises, pneumonia, pharyngotonsilitis and acute watery diarrhoea constituted the six leading causes of all admissions. The mortality rate for all admissions was 5.0% while the under-five mortality rate was 3.9%. Seven hundred and ninety nine (91.3%) of the admitted patients were discharged, 44 (5.0%) died, 30 (3.4%) DAMA and two (0.3%) patients were referred.</p><p><strong>Conclusion: </strong>A large percentage of children still die from preventable and treatable diseases. Prompt health seeking behaviour, enrollment of more citizens on insurance scheme, and adoption of the newly developed malaria vaccine will help reduce child mortality. Also, early referral of patients by private hospitals should be encouraged and paediatricians to have a high index of suspicion for the diagnosis of septicaemia.</p>","PeriodicalId":94346,"journal":{"name":"Nigerian medical journal : journal of the Nigeria Medical Association","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11218861/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141500105","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}