Psychosis following caffeine consumption in a young adolescent: Review of case and literature.

Caffeine, a popular over-the-counter methylxanthine, is widely consumed for its potent psychoactive properties. Toxicity generally occurs with intentional overdose and is often multisystemic and life-threatening. Consumption by children is rarely planned, and safe doses are potentially toxic in them. A 12-year-old boy whose parents had denied him coffee on several occasions eventually had access to it. The caffeine dose ingested was sub-toxic although he developed severe and life-threatening multisystemic caffeinism. Following ingestion, he became aggressive and was talking irrationally, with visual and auditory hallucinations. In addition, he had severe abdominal pain, multiple vomiting episodes, circulatory collapse, hypertension, angioedema, dysfunctional tear syndrome, hyperglycemia, ketonuria, hypokalemia, and metabolic acidosis. The clinical presentation, laboratory findings, and interventions are reviewed and discussed. Besides routine immunization, routine anticipatory guidance should be at the center of preventive pediatrics. Packaging of caffeinated beverages should also target the prevention of caffeine toxicity in children.

Résumé La caféine, une méthylxanthine en vente libre populaire, est largement consommée pour ses puissantes propriétés psychoactives. La toxicité se produit généralement avec surdosage intentionnel et est souvent multisystémique et potentiellement mortelle. La consommation par les enfants est rarement planifiée et les doses sûres sont potentiellement toxique chez eux. Un garçon de 12 ans dont les parents lui avaient refusé du café à plusieurs reprises a fini par y avoir accès. La caféine la dose ingérée était sub toxique bien qu'il ait développé un caféinisme multisystémique grave et menaçant le pronostic vital. Suite à l'ingestion, il est devenu agressif et parlait de manière irrationnelle, avec des hallucinations visuelles et auditives. De plus, il avait de fortes douleurs abdominales, des vomissements multiples épisodiques, collapsus circulatoire, hypertension, œdème de Quincke, syndrome lacrymal dysfonctionnel, hyperglycémie, cétonurie, hypokaliémie et troubles métaboliques acidose. La présentation clinique, les résultats de laboratoire et les interventions sont passés en revue et discutés. Outre la vaccination de routine, la routine le guidage préventif doit être au centre de la pédiatrie préventive. L'emballage des boissons contenant de la caféine devrait également cibler la prévention de la toxicité de la caféine chez les enfants. Mots-clés: Conseils anticipatifs, caféine, toxicité potentiellement mortelle, toxicité paradoxale, organisme de réglementation, jeune ado.

Identifying challenges in implementing child rights instruments in Nigeria: A nationwide survey of knowledge, perception, and practice of child rights among doctors and nurses.

Context: After thirty years of ratifying the child rights convention and nineteen years of the Child Rights Act, implementing child rights instruments remains challenging in Nigeria. Healthcare providers are well positioned to change the current paradigm. Aim: To examine the knowledge, perception, and practice of child rights and the influence of demographics among Nigerian doctors and nurses. Materials and Methods: A descriptive, cross-sectional online survey was done using nonprobability sampling. Pretested multiple-choice questionnaire was disseminated across Nigeria's six geopolitical zones. Performance was measured on the frequency and ratio scales. Mean scores were compared with 50% and 75% thresholds. Results: A total of 821 practitioners were analyzed (doctors, 49.8%; nurses, 50.2%). Female-to-male ratio was 2:1 (doctors, 1.2:1; nurses, 3.6:1). Overall, knowledge score was 45.1%; both groups of health workers had similar scores. Most knowledgeable were holders of fellowship qualification (53.2%, P = 0.000) and pediatric practitioners (50.6%, P = 0.000). Perception score was 58.4% overall, and performances were also similar in both groups; females and southerners performed better (59.2%, P = 0.014 and 59.6%, P = 0.000, respectively). Practice score was 67.0% overall; nurses performed better (68.3% vs. 65.6%, P = 0.005) and postbasic nurses had the best score (70.9%, P = 0.000). Conclusions: Overall, our respondents' knowledge of child rights was poor. Their performances in perception and practice were good but not sufficient. Even though our findings may not apply to all health workers in Nigeria, we believe teaching child rights at various levels of medical and nursing education will be beneficial. Stakeholder engagements involving medical practitioners are crucial.

Résumé Contexte: Après trente ans de ratification de la convention sur les droits de l'enfant et dix-neuf ans de la loi sur les droits de l'enfant, la mise en œuvre des instruments relatifs aux droits de l'enfant reste difficile au Nigéria. Les fournisseurs de soins de santé sont bien placés pour changer le paradigme actuel. Objectif: Examiner la connaissance, la perception et la pratique des droits de l'enfant et l'influence de la démographie parmi les médecins et les infirmières nigérians. Matériels et méthodes: Une enquête en ligne descriptive et transversale a été réalisée à l'aide d'un échantillonnage non probabiliste. Un questionnaire à choix multiples prétesté a été diffusé dans les six zones géopolitiques du Nigeria. Les performances ont été mesurées sur les échelles de fréquence et de rapport. Les scores moyens ont été comparés aux seuils de 50 % et 75 %. Résultats: Au total, 821 praticiens ont été analysés (médecins, 49,8 % ; infirmiers, 50,2 %). Le ratio femmes/hommes était de 2 : 1 (médecins, 1,2 : 1 ; infirmières, 3,6 : 1). Dans l'ensemble, le score de connaissances était de 45,1 % ; les deux groupes avaient des scores similaires. Les plus informés étaient les titulaires d'une bourse (53,2 %, P = 0,000) et les pédiatres (50,6 %, P = 0,000). Le score de perception était de 58,4 % dans l'ensemble, et les performances étaient également similaires dans les deux groupes ; les femmes et les sudistes ont obtenu de meilleurs résultats (59,2 %, P = 0,014 et 59,6 %, P = 0,000, respectivement). Le score de pratique était de 67,0 % dans l'ensemble ; les infirmières ont obtenu de meilleurs résultats (68,3 % contre 65,6 %, P = 0,005) et les infirmières post-base ont obtenu le meilleur score (70,9 %, P = 0,000). Conclusions: Dans l'ensemble, les connaissances de nos répondants sur les droits de l'enfant étaient médiocres. Leurs performances en perception et en pratique étaient bonnes, mais pas suffisantes. Même si nos conclusions ne s'appliquent peut-être pas à tous les agents de santé au Nigeria, nous pensons que l'enseignement des droits de l'enfant à différents niveaux de la formation médicale et infirmière sera bénéfique. Les engagements des parties prenantes impliquant des médecins praticiens sont cruciaux. Mots-clés: droits de l'enfant, travailleurs de la santé, connaissances, Nigéria, perception, pratique.

Navigating through Nigeria's struggling health system: The staggering experience of a struggling family.

She was born at 28 weeks of gestation and weighed 800g. Following delivery, her mother suffered wound dehiscence and was re-admitted for a prolonged period. For the care of the little baby, the father had preferred a public health facility where the cost is less prohibitive. Incidentally, Nigerian resident doctors were 23 days into a nationwide industrial action at the time; health workers were on strike during the two previous births. With no one available to help out with household chores, the father alone combined the care of two children and the logistics of two hospitals. Having to pay hospital bills out of pocket, the financial burden became unbearable, and the baby's siblings soon dropped out of school. Though the prolonged stay in the hospitals eventually ended on a happy note, it came at a huge social and economic cost that may linger for some time.

Résumé Elle est née à 28 semaines de gestation et pesait 800g. Après l'accouchement, sa mère a subi une déhiscence de la plaie et a été réadmise pour une période prolongée. Pour la garde du petit bébé, le père avait préféré un établissement de santé public où le coût est moins prohibitif. Incidemment, les médecins résidents nigérians étaient à 23 jours dans une action revendicative nationale à l'époque; les agents de santé étaient en grève lors des deux accouchements précédents. Sans personne disponible pour aider aux tâches ménagères, le père combinait à lui seul la garde de deux enfants et la logistique de deux hôpitaux. Devant payer de leur poche les factures d'hôpital, la charge financière est devenue insupportable et les frères et sœurs du bébé ont rapidement abandonné l'école. Bien que le séjour prolongé dans les hôpitaux se soit finalement terminé sur une note heureuse, il a entraîné un coût social et économique énorme qui peut persister pendant un certain temps. Mots-clés: Système de santé, grande prématurité, coût socio-économique, famille en difficulté, Nigeria.

Identifying challenges in implementing child rights instruments in Nigeria: A nationwide survey of knowledge, perception, and practice of child rights among doctors and nurses

Context: After thirty years of ratifying the child rights convention and nineteen years of the Child Rights Act, implementing child rights instruments remains challenging in Nigeria. Healthcare providers are well positioned to change the current paradigm. Aim: To examine the knowledge, perception, and practice of child rights and the influence of demographics among Nigerian doctors and nurses. Materials and methods: A descriptive, cross-sectional online survey was done using nonprobability sampling. Pretested multiple-choice questionnaire was disseminated across Nigeria's six geopolitical zones. Performance was measured on the frequency and ratio scales. Mean scores were compared with 50% and 75% thresholds. Results: A total of 821 practitioners were analyzed (doctors, 49.8%; nurses, 50.2%). Female-to-male ratio was 2:1 (doctors, 1.2:1; nurses, 3.6:1). Overall, knowledge score was 45.1%; both groups of health workers had similar scores. Most knowledgeable were holders of fellowship qualification (53.2%, P = 0.000) and pediatric practitioners (50.6%, P = 0.000). Perception score was 58.4% overall, and performances were also similar in both groups; females and southerners performed better (59.2%, P = 0.014 and 59.6%, P = 0.000, respectively). Practice score was 67.0% overall; nurses performed better (68.3% vs. 65.6%, P = 0.005) and postbasic nurses had the best score (70.9%, P = 0.000). Conclusions: Overall, our respondents' knowledge of child rights was poor. Their performances in perception and practice were good but not sufficient. Even though our findings may not apply to all health workers in Nigeria, we believe teaching child rights at various levels of medical and nursing education will be beneficial. Stakeholder engagements involving medical practitioners are crucial

Navigating through Nigeria's struggling health system: The staggering experience of a struggling family

She was born at 28 weeks of gestation and weighed 800g. Following delivery, her mother suffered wound dehiscence and was re-admitted for a prolonged period. For the care of the little baby, the father had preferred a public health facility where the cost is less prohibitive. Incidentally, Nigerian resident doctors were 23 days into a nationwide industrial action at the time; health workers were on strike during the two previous births. With no one available to help out with household chores, the father alone combined the care of two children and the logistics of two hospitals. Having to pay hospital bills out of pocket, the financial burden became unbearable, and the baby's siblings soon dropped out of school. Though the prolonged stay in the hospitals eventually ended on a happy note, it came at a huge social and economic cost that may linger for some time.