A comparative analysis on risk of pulmonary hypertension in children with Atrio-ventricular (AV) canal defect: a multi-centre study.

Objectives: This study is aimed at determining the risk of pulmonary hypertension in children with AV canal defect when compared with children with other congenital heart disease. Methods: A descriptive study carried out in three institutions over a six-year period among children who presented with AV canal defect and their controls who presented with other congenital heart defects. Results: A large proportion of the children with AV canal (77.5%) had pulmonary hypertension. Among the patients with pulmonary hypertension, 45.2% were males compared 54.8% females (χ2 = 3.2, p = 0.2). There was a positive correlation between pulmonary hypertension and size of VSD and ASD, although the correlation was not significant (Pearson correlation coefficient = 0.01 and 0.4, p = 0.9 and 0.1 respectively). Children with AV canal defect had higher odds of developing most clinical symptoms and pulmonary hypertension than children with other congenital heart disease and this is statistically significant. Conclusion: Majority of children with AV canal defect presented with pulmonary hypertension. These children present with higher odds of having pulmonary hypertension and clinical symptoms than children with other types of congenital heart disease.

What is the cost benefit ratio of sending adeno-tonsillar tissues for histology: does adenoid/tonsillar tissue in children undergo malignant transformation?

Due to the enormous amount spent on histology of adenoid and tonsillar samples from children with adeno-tonsillectomy with no confirmed result of malignancy, it has become expedient to reconsider sending such tissues for histologyThe objective of this study was to determine the necessity of sending tissues of adenoid and tonsils for histology by means of ascertaining the prevalence of malignancy among children with adeno-tonsillectomy. This was a retrospective study done in three private hospitals that provide care for children in Enugu. Data was obtained from the medical records of 72 patients who had undergone tonsillectomy and/or adenoidectomy from September 2011 to May 2018. All the surgical cases done had their samples sent immediately for histology. A total of 72 adeno-tonsillar tissues were taken for histology of which all showed lymphoid hyperplasia with none showing any form of malignancy. Age group ranged from 6 months-18 years with 57 males and 15 females. Histology of the adeno-tonsillar tissue specimen was done among all the children with each costing 9000 Naira (26 US dollars). There were 3 tonsillectomies, 1 adenectomy and 68 adeno-tonsillectomies done. Indications for surgery were mainly upper airway obstruction for 69 cases and recurrent tonsillectomy for 3 cases. Histology revealed lymphoid hyperplasia for all cases. None of the patients in our study had histologic evidence of malignancy. Routine histopathologic examination in adeno-tonsillectomy specimens among children may be dispensable as it showed a negative cost-benefit ratio.

Impact of parity and gestational age of mothers with hypertension on birth weight, red blood cells and mode of delivery of their babies.

BACKGROUND: Maternal factors are determinants of birth outcome which includes birth weight, haematological indices and mode of delivery of their babies. OBJECTIVES: To determine the impact of parity and gestational age of hypertensive mothers on some neonatal variables. METHODS: A hospital based cross-sectional study of measurement of neonatal variables (birth weight, red blood cells and mode of delivery) among hypertensive mothers and their controls was conducted over a period of six months. Data were analyzed using the Statistical Package for Social Sciences program (SPSS), version 20. RESULTS: There were statistically significant differences in means between the neonates of the hypertensive group and non-hypertensive group for maternal age (t =1.61, p = 0.002), baby weight (t =2.87, p < 0.001), haemoglobin (Hb) (t =4.65, p = 0.010) and packed cell volume (PCV) (t =4.75, p = 0.009), but none for gravidity (t =1.95, p = 0.927)For all subjects, there was poor correlation between gestational age and variables; birth weight, haemoglobin (Hb), packed cell volume (PCV), nucleated red blood cell (nRBC) and parity. Likewise, parity poorly correlated with variables; age, birth weight, Hb, PCV, and nRBC. There was a statistically significant association between mode of delivery and hypertension (χ2 =53.082, p <0.001) but none with having a family history of hypertension (χ2 =1.13, p = 0.287). CONCLUSION: Parity and gestational age of mothers with hypertension have no impact on birth weight and red cells when compared with their non-hypertensive counterparts. However, mothers of babies delivered by elective and emergency caesarean section were about 2-3 times more likely to be hypertensive than those that delivered through spontaneous vertex delivery.

Psychosomatic problems among medical students: a myth or reality?

BACKGROUND: Medical students are exposed to stress and this can predispose them to psychological and behavioral consequences. METHODS: Psychosomatic disorders were investigated among 385 medical students from two teaching hospitals using a stratified random sampling. The Enugu somatization Scale (ESS) was used to evaluate for presence of somatization in the participants. Statistical analysis was done with the Statistical Package for Social Sciences (SPPS) version 19 (Chicago IL). RESULTS: A total of 385 medical students with a calculated mean age of 23.55 ± 3.33 years were recruited in this study. The prevalence of psychosomatic disorder was 55 (14.3%) with prevalence among males 33 (14.2%) and among females 22 (14.4%). Based on features, 44 (11.4%) had head features while 30 (7.8%) had body features of psychosomatic disorder respectively. Similar proportion of both males and females (about 14% each) had psychosomatic disorder. There was no statistically significant difference ([Formula: see text] = 0.002, p = 0.966). Students aged 24 years and below had similar proportion of psychosomatic disorder 38 (14.3%) with those aged over 24 years 17 (14.2%). The difference was not statistically significant ([Formula: see text] = 0.002, p = 0.964). Students from lower social class had lower proportion of psychosomatic disorder (10.6%) when compared to middle (17.2%) and upper (15.2%). The difference was equally not statistically significant ([Formula: see text] = 1.759, p = 0.415). Male students had similar likelihood of psychosomatic disorder with females (OR 1.01, 95% CI 0.56-1.82). Those had belong to middle socio-economic class were about 1.2 times (AOR 1.15, 95% CI 0.54-2.45) and lower socio-economic class about 0.6 times (AOR 0.66, 95% CI 0.31-1.37) likely to have psychosomatic disorder than those from upper socio-economic class. CONCLUSIONS: Psychosomatic disorders constitute an emerging mental health problem among medical students in Nigerian Universities. This can pose a major mental health problem if neglected.

Sleep pattern and practice among adolescents school children in Nigerian secondary schools.

INTRODUCTION: Some adolescents may have sleep disorder at some point during adolescence. Determining the pattern and practice of sleep among adolescents could be useful to establish a lasting sleep hygiene program among adolescents. The objectives of this study are to describe sleep pattern and practice among adolescent in Nigerian secondary schools. METHODS: Sleep habits were investigated using a random sampling of adolescents from secondary schools from February to April 2013. A self-administered questionnaire was developed based on the Diagnostic and Statistical Manual of Mental Disorders (DSM) IV criteria. Epworth Daytime Sleepiness Scale and Pittsburgh Sleep Quality Index (PSQI) were used. RESULTS: A total of 443 subjects, comprising 263 (59.4%) females and 180 (40.6%) males completed the questionnaire. The mean duration of night sleep of the subjects during weekday was 7.84 (1.9) hours and 8.65 (2.07) hours during the weekend. 22.8% (101/443) had abnormal sleep onset latency (< 5 minutes and > 30 minutes). The gender of the subjects did not influence the sleep onset latency (χ(2) = 32.89, p= 0.57). Twenty six (5.9%)of the subjects reported difficulty falling asleep. CONCLUSION: Adolescents have varying degrees of sleeping practice and hygiene.