An audit of a decade of acute peritoneal dialysis in children with acute kidney injury: A single-center experience.

Background: Acute peritoneal dialysis (PD) is the modality of choice to manage children with acute kidney injury (AKI). However, its use remains underutilized, despite the unquestionable advantages. Aims: This study, therefore, aimed to audit the complications, outcomes, and challenges encountered with PD as well as indications for PD and causes of AKI among under-5 children that had PD in a Nigerian tertiary hospital over a decade. . Patients and Methods: : A retrospective study of children with AKI, aged 0 to 5 years, managed with PD. In all the children, a PD catheter was inserted at the bedside by surgeons. PD was performed manually. Data were presented in descriptive statistics and a P value <0.05 was considered significant. Results: Twenty-nine (29) children had PD over a decade (January 2009 to December 2018). There were 12 males and 17 females aged 4-60 months (mean ± SD 18.8 ± 16.9). The PD yearly frequency was 2-7 times/year, mean of 2.9/year. The major identified indication for PD was difficulty of vascular access (86.2%) while the causes of AKI were sepsis 21 (43.8%); gastroenteritis 11 (22.9%); severe malaria 9 (18.8%); toxins/herbal medications 5 (10.4%); multiple congenital anomalies 2 (4.2%). Multiple causes of AKI occurred in some children. The major observed PD complications were catheter lockage 9 (37.5%); dialysate fluid retention 4 (16.7%); and peritonitis 4 (16.7%). The short-term outcome of the 29 children that had PD showed 20 (69%) discharged and 9 (31%) deaths over the period. The major challenge encountered was PD-related sepsis evidenced by the prevalence of peritonitis and catheter site infection. Conclusion: The predominant PD complications were catheter-related, mostly catheter blockage in a manually performed PD while the leading cause of AKI in our center was sepsis, affecting a large population of children requiring PD.

Attitude of medical students towards occupational safety and health: a multi-national study.

BACKGROUND: Work-related diseases contribute immensely to the global burden of diseases. Better understanding of attitudes of health care workers towards occupational safety and health (OSH) is important for planning. OBJECTIVE: To assess the attitude of medical students towards OSH around the globe. METHODS: A questionnaire assessing the attitude towards OSH was administered to medical and paramedical students of 21 Medical Universities across the globe. In the current study 1895 students, aged 18-36 years, from 17 countries were included. After having performed a principal components analysis, the associations of interest between the identified components and other socio demographic characteristics were assessed by multivariate linear regression. RESULTS: Principal component analysis revealed 3 components. Students from lower and lower-middle-income countries had a more positive attitude towards OSH, but the importance of OSH was still rated higher by students from upper-income countries. Although students from Asian and African continents showed high interest for OSH, European and South-Central American students comparatively rated importance of OSH to be higher. Paramedical students had more positive attitude towards OSH than medical students. CONCLUSION: The attitude of students from lower-income and lower-middle-income towards importance of OSH is negative. This attitude could be changed by recommending modifications to OSH courses that reflect the importance of OSH. Since paramedical students showed more interest in OSH than medical students, modifications in existing health care system with major role of paramedics in OSH service delivery is recommended.

Toxicological studies on the short term exposure of Clarias albopunctatus (Lamonte and Nichole 1927) to sub-lethal concentrations of roundup.

The short term toxicity in Clarias albopunctatus (Lamonte and Nicole, 1927) exposed to sub-lethal concentrations of Roundup was studied. A total of 36 fish were divided into 3 groups in a static bioassay model. Fish in 2 test groups were exposed to 5 and 15 ppm, respectively, of Roundup while fish in the control group were not exposed to the toxicant. Six fish per group were bled exhaustively (each) at 48 h and at 96 h while the livers and gills were harvested at 96 h for histological studies. The results showed that serum concentrations of total and conjugated bilirubin increased significantly (p<0.05) in a dose-and time-dependent manner. Serum concentrations of alanine and aspartate aminotransferases and alkaline phosphatase were also significantly (p<0.05) elevated in the test fish. Similarly, serum concentrations of creatinine and urea were significantly (p<0.05) elevated in a dose-dependent manner. Histomorphologic studies of the liver and gills showed marked destruction of their architecture in the test fish, thus corroborating the data from the biochemical analyses. Short term exposure of Clarias albupunctatus to sub-lethal concentrations of Roundup was found to be toxic to the fish.