Anthropometric measurements of term babies delivered in a mission hospital in Southwest Nigeria.

Background: Babies birth anthropometric measurements are useful for retrospective assessment of foetal in utero health status, anticipatory care and growth monitoring. At community level, measurements other than birth weight (BW) may help predict low BW (LBW). Aim: The aim of the study was to determine the mean anthropometric measurements of term babies, its comparability with standard values, acceptable cutoff and surrogate for LBW. Methods: A cross-sectional study involving 257 term babies delivered by booked mothers at the Sacred Heart Hospital Abeokuta and selected by systematic random sampling. BW, occipitofrontal circumference (OFC), chest circumference (CC), mid-upper arm circumference (MUAC) and crown-heel length (CHL) were measured, and data were analysed using SPSS version 21 with significant P < 0.05 and confident interval of 95%. Results: Mean BW, CC, OFC, CHL and MUAC were 3.25 ± 0.47 kg, 33.32 ± 1.98 cm, 34.7 ± 1.93 cm, 48.16 ± 2.87 cm and 11.57 ± 1.41 cm, respectively, with no significant mean difference between male and female babies. The mean OFC was higher than the national standard, World Health Organization Multicentre Growth Reference Study (WHO-MGRS) and INTERGROWTH-21. The mean cutoff for LBW was OFC - 31.89 cm, CC - 29.56 cm, CHL- 43.33 cm and MUAC - 9.35 cm (P = 0.000) with OFC being the best surrogate of LBW at Sensitivity, Specificity and Degree of Accuracy/area under the curve of 66.7%, 97.6% and 82.1% respectively. Conclusions: LBW babies had lower mean anthropometric cutoff values at variance from the WHO-MGRS and INTERGROWTH-21. Mean OFC was higher than both standards reflecting the need for cautious interpretation to prevent misdiagnosis of macrocephaly. We recommend OFC as an alternative for predicting LBW when access to weighing scale is a challenge.

Routine chest radiograph in pre-employment medical examination for healthcare workers: Time for a review of the protocol.

BACKGROUND: Pre-employment medical examination (PEME) sought to evaluate the ability of workers to work without risk to their own or others' health and safety. This is important especially in a hospital environment where the patients may be at risk in case of employees harbouring infectious lung conditions or as a result of occupational exposure. Although not all healthcare workers are at risk or pose risk, they are expected to undergo chest X-ray (CXR) as part of PEME. AIMS: The aim of this study is to determine the number of prospective employees with abnormal findings on routine CXR, describe their characteristics and reassess the value of CXR in PEME. SETTINGS AND DESIGN: This was a retrospective study of all the staffs employed into the Olabisi Onabanjo University Teaching Hospital, Sagamu, Nigeria, from January 2004 to December 2013. SUBJECTS AND METHODS: Of the 633 personnel employed during this period, medical records of 416 staffs were available for analysis. Data extracted included age, gender, and CXR report. Descriptive statistics was used for analysis and presentation. RESULTS: The mean age of the prospective employees was 26.6 years ± 5 with a range of 20-49 years. Three hundred and ninety-six (95.2%) employees had normal CXR report while 20 (4.8%) had abnormal CXR. The only abnormality reported was cardiomegaly which was found in 66% of those aged ≥41 years. Cardiomegaly was significantly associated with increasing age (P = 0.003). CONCLUSIONS: Routine CXR as part of PEME for prospective employees into this healthcare institution is no longer necessary. It is suggested that its routine use should be limited to older job seekers.

Vestibular disorders in elderly patients: characteristics, causes and consequences.

INTRODUCTION: This study assessed vestibular disorders in elderly patients, describing the causes, clinical characteristics, therapies and treatment outcomes. METHODS: Five-year hospital-based prospective study, conducted at the ENT clinic of a tertiary referral center. Subjects were consecutive elderly patients with dizziness, treated and followed-up for a minimum of six months. Data was generated using structured questionnaire and case record files. Analyzed results were presented in simple descriptive forms as graphs and tables. RESULTS: Among the elderly patients, prevalence of vestibular disorders was 18.6%, 49.1% were retired, 71.9% were married, M:F was 1:1.1. Mean age±SD were 69.4±1.1 and 69.0±0.8 years for males and females respectively. 56.9% of the patients presented early on experiencing the vestibular symptoms. The symptoms were associated with nausea or vomiting in 26.3%, with an aura in 12.3%. While 50.9% of the patients experienced intermittent symptoms, laterality of the symptoms was not clear in 45.6%. Positional vertigo was diagnosed in 33.3% while in 17.5%, the symptoms could be attributable to previous trauma or assaults. 31.6% of the elderly were referred to ENT surgeons by other specialties, 45.6% were managed with multidisciplinary approach, while 82.5% had the vestibular symptoms initially controlled with labyrinthine sedatives. At follow-up, 43.9% had intermittent periods of recurrence of symptoms. CONCLUSION: Prevalence of vestibular disorders in elderly patients is high, most patients present early with intermittent, relatively innocuous symptoms which may be difficult to lateralize. Positional vertigo was the most common cause, it is frequently relieved with labyrinthine sedatives but tends to recur intermittently.