Childhood diabetes mellitus in Kano, North West, Nigeria.

BACKGROUND: There is paucity of literature on childhood diabetes mellitus from developing countries and especially North west Nigeria and this has made it pertinent for documentation of the features of the disease in a major regional referral centre. The study was designed to describe the clinical presentation and outcome of childhood diabetes mellitus. METHODOLOGY: Retrospective review of hospital records of paediatric patients managed for diabetes at Aminu Kano Teaching Hospital, Kano. Nigeria between January 1999 and December 2006. The age, sex, presenting features, complications, laboratory features and outcome of the patients were retrieved from the hospital records: RESULTS: During the years under review eleven out of 3,585 admissions were managed for Type 1 diabetes mellitus giving a prevalence rate of 3.1/1000. Male to female ratio was 1:0.6. The mean age at presentation was 10 +/- 4.5 years most of the patients (72.7%) belonged to the lower socio-economic classes IV and V. The duration of symptoms ranged from 6 58 days with a mean of 24 +/- 22.8 days. The patients presented with urinary tract infections (36.4%), malaria (27.3%) and recurrent boils (18.2%). Three (27.3%) of the patients had polyuria and polydypsia while only one (91%) patient had polyphagia and weight loss. The mean random blood glucose on admission was 28.5 +/- 7.9 mmo/L (16.9 39.2mmo/L). Four patient presented with diabetic Keloacidosis. Two patients (18.2%) were discharged against medical advice while 1 (9.1%) patient died. CONCLUSION: Childhood Diabetes Mellitus, remains relatively uncommon in Nigeria.

Congenital inclusion cyst of the subgaleal space: a case report.

BACKGROUND: Subgaleal cysts are epidermal cysts located under the galea aponeurotica. They are rare lesions but are commoner among the children of African descent. To the authors knowledge, none has been described in Kano, Northwestern, Nigeria. METHODS: We present the management of a 6 month old Nigerian boy with scalp swelling. RESULT: The scalp swelling was noticed soon after birth and was progressively increasing in size. There was no preceding fever or trauma to the scalp and no associated pain. At six months, the child could sit without support and had attained adequate neck control. Examination revealed a swelling over the anterior fontanelle, measuring 3x2cm. The swelling was hemispherical, firm, fluctuant, and non-tender. It was not pulsatile. Its size did not increase on crying. Diagnosis was confirmed by plain x-ray film and transfontanelle sonography. Total excision of the mass was carried out under general anesthesia and histology confirmed the diagnosis of epidermal inclusion cyst. The child was discharged home in good condition. CONCLUSION: Awareness of this lesion will avoid misdiagnosis and inappropriate treatment.

Structural heart diseases in Nigerian children.

BACKGROUND: Cardiovascular diseases both in adults and children constitute a major public health problem and structural heart diseases are an important group of disorders in children worldwide. The pattern of this group of disorders however, varies between regions and countries and even within countries. Recognizing the structural cardiac conditions that prevail in a particular area is important in health planning and for improving health care services. The present survey sets out to describe the pattern of structural heart diseases among children in Aminu Kano Teaching Hospital, Kano from our echocardiography data. METHODS: The echocardiographic reports of all children seen in Aminu Kano Teaching Hospital, Kano between August 2002 and September 2004 (24 months) were reviewed. Information obtained from the records includes age, gender, clinical diagnosis and echocardiographic findings. Data was analyzed using SPSS version 10.0 software. RESULTS: A total of 108 children, aged between two weeks and eighteen years, were referred for echocardiographic examination in the 2-year study period. Of these, 88 had an abnormal echocardiogram. There were 55 boys and 31 girls, giving a male and female ratio of 1.8:1. Congenital heart diseases accounted for 55 (62.5%) of the studied subjects while acquired heart diseases were responsible for 33 (37.5%). Isolated ventricular septal defect (VSD) was the commonest congenital heart disease. Rheumatic valvular heart diseases were the commonest acquired structural heart disease. CONCLUSION: With the establishment of tertiary healthcare institutions in Nigeria, availability of echocardiographic facilities as well as increasing number of paediatric cardiologists, more of these cases are likely to be seen in the future. There is an urgent need for the government to establish a well equipped cardiothoracic surgical centre to cater for these patients either free or at highly subsidized rates.

Urinary tract infection in children with nephrotic syndrome in Kano, Nigeria.

BACKGROUND: Nephrotic syndrome is a common childhood renal disorder; the prevalence of Urinary tract infection (UTI) in these patients is high. The increased prevalence of UTI are due to immunoglobulin loss, defective T cell function, presence of ascites and relative malnutrition. OBJECTIVE: The study is to evaluate the prevalence of UTI , its etiological agents, antibiotics, sensitivity pattern and the outcome in children with nephrotic syndrome. METHODS: A prospective study of all patients with diagnosis of nephrotic syndrome from January 2003 to December 2006. Urine specimen were routinely obtained by clean catch method following careful preparation urethral orifices. The specimens were processed immediately. Five millimeters (5 ml) loopful of the sample were inoculated on a blood agar and CLED agar plates. Identification of the organism to species level was by using stokes disc diffusion technique. RESULTS: Forty two patients were studied. The mean age and SEM for males was 8.2 + 0.5 years and females with 7.9 + 0.8 years. The age range was two to fifteen years UTI was caused predominantly by Staphylococcus aureus in 67.9%, Klebsiella species (17.9%) and Pseudomonas (14.2%). There was high in vitro resistance of these organisms to nalidixic acid and ampicillin but sensitive to cefotaxime, ceftriazone and ciprofloxacin. CONCLUSION: It is recommend that UTI should be sought for in patients with nephrotic syndrome and treatment should be prompt and appropriate.