Primary pediatric brain tumours in Barbados: 10-year analysis (1978-1988).

The case notes of 29 children ranging in age between 6 months and 17 years were reviewed for the period 1978-88. This study was done to determine if there were any differences when compared with other series in the developed countries. In addition, the distribution, tumour type, clinical presentations, and outcome were reviewed. Of the 29 tumours, 15 tumours were confined to the posterior fossa (52 per cent), and tumours were located supratentorially (48 per cent). Of the 15 tumours in the posterior fossa, five were medulloblastomas, four brain stem astrocytomas, and six cerebellar astrocytomas. The supra-tentorial tumours included, five astrocytomas, two pituitary tumours, two cranio-pharyngiomas, one hypothalamic glioma, and four intraventricular tumours. Clinical presentation was confined to symptoms and signs related to raised intracranial pressure, ataxia, seizures, and cranial nerve involvement. All the tumours were resected surgically except for the brain stem tumours, which were treated in most cases with radiation therapy. The overall mortality was 48 per cent (14 patients died). We were unable to comment on long-term survival except for a 100 per cent survival in patients with pituitary and cerebral tumours, and 67 per cent in patients with cerebellar astrocytomas.

The long-term effects of early kwashiorkor compared with marasmus. IV. Performance on the national high school entrance examination.

This is one of a series of studies on the long-term effects of early childhood malnutrition in Barbadian school children. This is the first report of the relationship between early malnutrition and later performance on a national examination administered to all 11-y-old children in Barbados to assign high school seats. We compared scores achieved on the 11-plus examination by 103 boys and girls with histories of marasmus or kwashiorkor with those obtained by 63 healthy comparison children and also with scores obtained by the total island population of children during the same years. We report that children with histories of either type of malnutrition confined to infancy had significantly lower scores on the national high school examination than healthy comparison children. Reduced 11-plus scores were closely associated with teacher reports of attention deficits in the classroom documented when the children were as young as 5 to 8 y of age and also with IQ and academic performance. Early malnutrition had independent effects on performance on the 11-plus examination even when home environmental conditions were controlled for. These findings have important implications for future opportunities available to children with histories of infantile malnutrition.

Further seizures following febrile seizure: assessment of risk factors

Retrospective evaluation of records pertaining to 316 children admitted to the Queen Elizabeth Hospital for febrile seizures showed a recurrence rat of 24 per cent. Age at onset of first febrile seizure, a positive family history and atypical initial seizzure were identified as risk factors for subsequent seizures. Other factors, namely abnormal pregnancy, gestational age, birthweight, neonatal problems and neurological abnormality, did not affect the chances of recurrence

Routine investigations in first febrile seizures

Retrospective evaluation of records pertaining to 338 children presenting with a first episode of febrile seizure revealed a high performance rate of routine haemoglobin levels, total white cell and differential count, blood glucose, serum electrolyte and urea levels, lumbar puncture for cerebrospinal fluid examination and blood cultures. Lumbar puncture emerged as the most useful investigation in detecting eight children with meningitis, three of whom were over the age of two years. Transient elevation in blood glucose levels hyponatraemia and low serum bicarbonate levels were noted in some children but their significance is not known. Routine haemoglobin estimation detected sixteen children with unsuspected anaemia, but the remaining investigations were largely unhelpful

Feeding practices of infants, and beliefs of mothers in Western Jamaica.

PIP: An infant feeding survey was carried out in 3 parishes in Cornwall county, Jamaica, from March to August, 1984, in an attempt to determine the feeding patterns of infants and beliefs of mothers in Western Jamaica. 41 Enumeration districts (EDs), were randomly selected from 2 strata, urban and rural, in proportion to the population distribution. 614 households with children under 36 months of age were selected from 41 EDs. The results showed that the presence of breastfeeding was 98%. Despite the high frequency of breastfeeding, infant formula was introduced very early, and only about 1/2 of the mothers introduced semi-solids and solids within a month of the recommended time. The most popular foods, identified as good foods, were also popular weaning foods. There is need for adequate training of both primary and 2ndary health-care staff, and reinforcement of nutrition messages by frontline health workers. The collection of adequate baseline data in evaluating the effectiveness of nutrition education programs is also important.^ieng

Feeding practices of infants, and beliefs of mothers in Western Jamaica

An infant feeding survey was carried out in three parishes in Cornwall County, Jamaica, from March to August, 1984, in an attempt to determine the feeding practices of infants and beliefs of mothers in Western Jamica Forty-one Enumeration Districts (EDs were randomly selected from two strata. urban and rural, in proportion to the population distribution. Six hundred and fourteen households with children under 36 months of age were selected from 41 EDs. The results showed that prevalence of breastfeeding was 98.0%. Despite the high frequency of breastfeeding, infant formula was introduced very early, and only about half of the mothers introduced semi-solids and solids within one month of the recommended time. The most popular foods, identified as good foods, were also popular weaning foods. It is concluded that there is need for adequate rraining of both primary and secondary health-care staff, and reinforcemen of nutrition messages by frontline health workers. The collection of adequate baseline data in evaluating the effectiveness of nutrition education programmes is also important