The Effect of Severe Intraventricular Hemorrhage on the Biorhythms of Feeding in Premature Infants.

Background: Suck-swallow rhythmicity and the integration of breathing into infant feeding are developmentally regulated. Neurological injury and breathing abnormalities can both impact feeding in preterm infants. Objective: To determine the effects of neurologic injury independent of effects of disordered breathing on feeding biorhythms in premature infants. Methods: Low-risk preterm infants (LRP), infants with Grade 3-4 Intraventricular Hemorrhage (IVH), those with bronchopulmonary dysplasia (BPD), and those with both BPD and IVH (BPD+IVH) were identified. Forty-seven infants, 32-42 weeks Postmenstrual Age (PMA) were evaluated on one or more occasions (131 studies). Of these, 39 infants (81 studies) were performed at >35 weeks PMA. Coefficient of variation (COV) (=standard deviation of the inter-event (e.g., suck-suck, swallow-breath, etc.) interval divided by the mean of the interval) was used to quantify rhythmic stability. Results: To adjust for PMA, only those infants >35-42 weeks were compared. Suck-suck COV was significantly lower (more rhythmically stable) in the LRP group [COV = 0.274 ± 0.051 (S.D.)] compared to all other groups (BPD = 0.325 ± 0.066; IVH = 0.342 ± 0.072; BPD + IVH = 0.314 ± 0.069; all p < 0.05). Similarly, suck-swallow COV was significantly lower in LRP babies (0.360 ± 0.066) compared to the BPD group (0.475 ± 0.113) and the IVH cohort (0.428 ± 0.075) (p < 0.05). The BPD+IVH group (0.424 ± 0.109), while higher, was not quite statistically significant. Conclusions: Severe IVH negatively impacts suck-suck and suck-swallow rhythms. The independent effect of neurological injury in the form of IVH on feeding rhythms suggests that quantitative analysis of feeding may reflect and predict neurological sequelae.

Pattern of childhood cancer in University College Hospital, Ibadan during 1991-2010 and comparison with the previous three decades.

BACKGROUND: Cancer is an important cause of morbidity and mortality worldwide in children under 15 years of age, with the incidence and mortality rate varying from 40 to 155 per million children. AIM: To describe the pattern of childhood cancer in Ibadan, Nigeria. OBJECTIVE: To compare the findings of this study with those of previous studies in Ibadan and internationally. METHODS: A retrospective review of histologically and cytologically confirmed cases of cancer in children aged <15 years diagnosed at University College Hospital (UCH), Ibadan between January 1991 and December 2010 was undertaken. The cases were categorised using the International Classification of Childhood Cancer, third edition (ICCC-3). RESULTS: There were 625 cases comprising 360 (57·6%) males with a modal age of 3 years. The most common neoplasms were lymphomas (140, 22·4%), of which 90% were non-Hodgkin lymphomas, with Burkitt lymphoma constituting the majority of cases (73). Other common neoplasms were retinoblastomas (21%), soft tissue sarcomas (14·9%), leukaemias (10·2%) and CNS tumours (6·9%). Lymphomas, bone tumours, malignant hepatic tumours and other malignant epithelial neoplasms had the highest mean and modal ages, while retinoblastomas, neuroblastomas, germ cell tumours and renal tumours had the lowest mean and modal ages. During 1960-72 there were 1326 cases and during 1973-90 there were 1881 cases and the proportion of lymphomas was 58·9% and 45·4%, respectively. The present study demonstrated a marked decline in the number of cases and proportion of lymphomas (22·4%), particularly Burkitt lymphomas. CONCLUSION: During the last 20 years, there has been a decline in the number of cases of childhood cancer seen at UCH, Ibadan. This may be due to the establishment of additional specialist centres in the sub-region. Owing to a persistent decline in the frequency of Burkitt lymphoma, retinoblastoma is now the most common individual childhood cancer seen at Ibadan.

Pattern of biliary tract carcinoma at the University College Hospital, Ibadan.

BACKGROUND: Biliary tract carcinomas are uncommon but highly fatal malignancies. Most patients in our environment are diagnosed late and are not candidates for curative resection. OBJECTIVE: To determine the pattern and risk factors of biliary tract carcinoma in Ibadan. METHODOLOGY: This was a retrospective study of histologically confirmed cases of biliary tract carcinoma diagnosed at the University College Hospital, Ibadan between January 1971 and December 20 10. Data was obtained from the records of the Ibadan Cancer Registry, surgical day books and post-mortem records of the Department of Pathology. Histological classification based on the 2010 'WHO classification for tumours of the intrahepatic bile duct, gallbladder and extrahepatic bile duct' was done. RESULTS: There were 37 cases of biliary tract carcinoma accounting for 0.18% of cancers seen during the period of study. These comprised of 26 (70.3%) females and 11 (29.7%) males. 20 females and 4 males had gallbladder carcinoma, while 6 females and 7 males had cholangiocarcinoma (P = 0.02). The age range was from 37 years to 75 years (mean = 52.5 ± 9.7 years). The peak occurrences of gallbladder carcinoma and cholangiocarcinoma were in the fifth and sixth decades of life respectively. The identified risk factors included female gender (83%), gallstones (33%), and dysplasia (42%). CONCLUSION: The findings in this study agree with what has been described in the English literature in respect of gender distribution, histological types and some associated risk factors as well as in the fact of its being rare.

Pattern of childhood leukaemia in University College Hospital, Ibadan.

BACKGROUND: Leukaemias are haematological malignancies characterized by unregulated clonal proliferation of haematopoietic cells. OBJECTIVE: To determine the pattern of childhood leukaemia in Ibadan. METHODOLOGY: This was a retrospective study of leukaemia cases diagnosed at the University College Hospital (UCH), Ibadan between January 1991 and December 2010 in children less than 15 years of age. Data obtained was subjected to statistical analysis using the Statistical Package for Social Sciences version 20. RESULTS: There were 64 cases of childhood leukaemia, accounting for 10.2% of childhood cancers seen during this study period. The male to female ratio was 2:1 and modal age group was between 10 and 14 years. Thirty (46.9%) cases were acute lymphoblastic leukaemia (ALL), 22 (34.4%) were acute myelogenous leukaemia (AML) and 12 (18.8%) were unspecified acute leukaemias. There was no case of chronic myeloid or lymphocytic leukaemia. CONCLUSION: There has been a relative increase in the frequency of leukaemia cases at UCH, Ibadan, which may be largely explained by increased awareness and referrals. There is a need for further collaborative multicentre studies of childhood leukaemias in Nigeria and other developing countries and focused research on childhood leukaemias in order to unravel the aetiology.

The prevalence of cobalamin deficiency among vegetarians assessed by serum vitamin B12: a review of literature.

Individuals following vegetarian diets are at risk for developing vitamin B12 deficiency owing to suboptimal intake. As vitamin B12 is essential for the synthesis of nucleic acids, erythrocytes and in the maintenance of myelin, deficiency may result in a variety of symptoms. Some of these symptoms may be severe while others may be irreversible. The objective of this review was to assess vitamin B12 deficiency, based on reported serum vitamin B12, among individuals adhering to different types of vegetarian diets. A systematic literature search was carried out using multiple search engines including PubMed, Medline, CINAHL plus, ERIC, Nursing and Allied Health Collection and Nursing/Academic Edition. The inclusion criteria consisted of original studies that assessed serum vitamin B12, studies written in English, non-case studies and studies that reported actual percentages of vitamin B12 deficiency. Forty research studies were included. The deficiency prevalence among infants reached 45%. The deficiency among the children and adolescents ranged from 0 to 33.3%. Deficiency among pregnant women ranged from 17 to 39%, dependent on the trimester. Adults and elderly individuals had a deficiency range of 0-86.5%. Higher deficiency prevalence was reported in vegans than in other vegetarians. Thus, with few exceptions, the reviewed studies documented relatively high deficiency prevalence among vegetarians. Vegans who do not ingest vitamin B12 supplements were found to be at especially high risk. Vegetarians, especially vegans, should give strong consideration to the use of vitamin B12 supplements to ensure adequate vitamin B12 intake. Vegetarians, regardless of the type of vegetarian diet they adhere to, should be screened for vitamin B12 deficiency.

Effects of pyrethroid insecticide exposure on haematological and haemostatic profiles in rats.

High malaria burden has led to the increase use of insecticides in the tropics and subtropics. This study thus aimed at assessing the haematological effects and associated haemostatic alteration of pyrethroid insecticide exposure using experimental animal model. Rats of comparable ages and weights were randomized into four groups (A-D). Rats in groups B, C and D were exposed to pyrethroid insecticide by inhalation for 1, 2 and 3 min daily respectively for three weeks. Rats in group A (control) were not exposed. Haematological and haemostatic variables were comparable in all groups (< 0.05). Results from the study show that minimal exposure to pyrethroids is safe.