HCV co-infection is associated with metabolic abnormalities among HAART naive HIV-infected persons.

OBJECTIVES: To determine the metabolic abnormalities among Hepatitis C Virus (HCV) co infected HAART naïve HIV infected persons within the adult ARV clinic of the University College Hospital/University of Ibadan, Ibadan, Nigeria Methods: This was a retrospective study involving the review of clinical records of newly recruited HIV-infected persons in the adult antiretroviral (ARV) clinic over a 12 month period (January - December 2006). Baseline results for fasting plasma glucose (FPG) and fasting lipid profile were retrieved. RESULTS: Out of the 1,260 HIV infected persons seen during the study period, HCV co-infection was found in 75 (6%) persons. The median values for total cholesterol, LDL-cholesterol and HDL-cholesterol were lower in the HCV co-infected persons. HIV-HCV co-infection was associated with a 0.31 mmol/L depression in Total Cholesterol (TC). The median FPG concentration was significantly higher in HIV-HCV co-infected than HIV only infected persons (5.33mmol/L vs. 5.00mmol/L, p = 0.047). However, regression analysis showed there was no relationship between the HIV-HCV co infected state and fasting glucose levels. CONCLUSION: HIV-HCV co-infection may be associated with a predictable decline in plasma cholesterol, but FPG may not be sufficient to demonstrate insulin resistance in these persons.

Challenges of caregivers and needs of children with parents in a Nigerian prison.

Background: Separation of a parent from the family as a result of incarceration has both short-term and long-term effects on the family, even after release from prison. This study is a report of factors and challenges of the family left to adapt to the changed circumstances of separation from parent(s) who are incarcerated. Methods: This was a cross sectional study carried out on 89 caregivers of children whose parents are incarcerated at the Agodi prison, Ibadan who gave informed and written consent to interview their families. Results: Most caregivers had little or no formal education (69.7%) and 67.4% are into petty trading or subsistence farming. A majority of the caregivers reported the need of schooling (85.4%), provision of food (84.3%) and medical care (71.9%) as major challenges, only 25% received any form of support to meet these needs. Twenty-nine (32.6%) respondents reported receiving financial support to provide for the child's feeding. Some caregivers 21 (23.6%), obtained loans to cope with the financial needs of the children while only 3 (3.4%) received support from family or other non-governmental organisations. Conclusion: The caregivers of children of prison inmates face significant challenges in meeting the needs of feeding, health and schooling. Support structures and policies to address these gaps are required.

Co-existing sickle cell anaemia and inflammatory bowel disease: case report and review of the literature.

Sickle cell anaemia (SCA) is a chronic haemolytic anaemia associated with vaso-occlusive painful crises which may affect several systems including the gastro-intestinal system, resulting in abdominal pain. The concurrence of inflammatory bowel disease and haemoglobinopathy is rare. No previously reported concurrent cases of both SCA and ulcerative colitis (UC) in sub-Saharan Africa were found in the literature. A 16-year-old girl with concurrent SCA and UC is presented. She was admitted to University College Hospital, Ibadan with a 1-year history of recurrent peri-umbilical pain and bloody stools. These symptoms were mainly attributed to SCA at the referring hospital, and she was managed for chronic tropical diarrhoea without a remarkable clinical response. This case illustrates the concurrent presentation of SCA and ulcerative colitis which led to the missed and delayed diagnosis of ulcerative colitis.

Paediatric endocrine disorders at the university college hospital, ibadan: 2002 - 2009.

BACKGROUND: Until recently, most published research focus more on infectious diseases and malnutrition giving the impression that endocrine disorders are uncommon. Reports on endocrine disorders in children in developing countries are few compared to developed countries reflecting the different level of prevalence in the different geographical locations and or level of awareness and availability of facilities for proper diagnosis. OBJECTIVE: This study aims at defining the burden of paediatric endocrine disorders in Ibadan. SUBJECTS/METHODS: A review of records of children who presented at University College Hospital, Ibadan with paediatric endocrine disorders from 2002 to 2009 was carried out. RESULTS: During the eight-year period, a total of 110 children presented with various endocrine disorders but only 94 had complete data for this study. There were 47(50%) males and 37(39.4%) females, and in 10(10.6%) of them, had genital ambiguity at presentation. Patients' ages ranged from 2 weeks to 15 years with a median of 3 years. Many (35%) patients were malnourished with weight less than 80% of the expected weight for age and only 9% were overweight. Yearly distribution of cases showed a steady increase in number of cases from 2005. Rickets and metabolic disorders constituted 56.4% of patients; Diabetes mellitus was diagnosed in 12.8%, adrenal disoders in 10.6%, pubertal disorders in 5.3% and growth disorders in 4.3% of the patients. Thyroid disorders were present in 6.4%, obesity in 3.2% while the least common disorder was Diabetes insipidus (1%). About 58% of the children had parents in the low socioeconomic status and the management of the cases were severely hampered by lack of funds. About 60.6% of these patients were lost to follow up, during the period. CONCLUSIONS: Paediatric endocrine disorders are associated with a high incidence of malnutrition. Most patients presented with rickets which is a preventable condition.

Knowledge and Views of Paediatricians about Pulse Oximetry: a Nationwide Online Survey in Nigeria

Pulse oximetry is a non-invasive method of measuring oxygen saturation in clinical settings. This study was carried out to determine the level of knowledge and competencies relating to pulse oximetry and the ability to interpret the information.We conducted a nationwide, multi-centre, and questionnaire-based online survey between January and June 2010. A 32-item questionnaire relating to the use of pulse oximetry in children was answered by 224 in-training and 157 qualified paediatricians (median duration of practice 6 years) working in 24 states in Nigeria. Knowledge of pulse oximetry was evaluated on a scale of 0­100%. Data were analysed using Chisquare and t-test statistics at 5% level of significance.The overall mean test score was 36.6±20.8% (range0­76.5%). The mean knowledge score among intraining and qualified paediatricians was 35.4±19.1%and38.3±23.1%,respectively(p>0.05). Only 16.3% of the respondents answered all three questions correctly relating to the relationship between oxygen saturationand partial pressure of oxygen. Pertaining to the accuracy of pulse oximeters, 3.9% of the respondents answered all 14 questions correctly. On indications for use of pulse oximetry, 29% correctly answered all nine questions. Only 18% of respondents correctly answered the seven questions on interpretation of pulse oximeter reading. Some 73% of respondents believed that training in the use of pulse oximetry was inadequate.A significant proportion of the paediatricians were untrained in pulse oximetry, lacked knowledge of basic principles, and made serious errors in interpretation of readings from pulse oximeters. We suggest that medical schools and residency training programmes place more emphasis on teaching the principles and uses of pulse oximetry

Paediatric Endocrine Disorders at the University College Hospital; Ibadan: 2002 - 2009

Background: Until recently; most published research focus more on infectious diseases and malnutrition giving the impression that endocrine disorders are uncommon. Reports on endocrine disorders in children in developing countries are few compared to developed countries reflecting the different level of prevalence in the different geographical locations and or level of awareness and availability of facilities for proper diagnosis. Objective: This study aims at defining the burden of paediatric endocrine disorders in Ibadan. Subjects/Methods: A review of records of children who presented at University College Hospital; Ibadan with paediatric endocrine disorders from 2002 to 2009 was carried out. Results: During the eight-year period; a total of 110 children presented with various endocrine disorders but only 94 had complete data for this study. There were 47(50) males and 37(39.4) females; and in 10(10.6) of them; had genital ambiguity at presentation. Patients' ages ranged from 2 weeks to 15 years with a median of 3 years. Many (35) patients were malnourished with weight less than 80 of the expected weight for age and only 9 were overweight. Yearly distribution of cases showed a steady increase in number of cases from 2005. Rickets and metabolic disorders constituted 56.4 of patients; Diabetes mellitus was diagnosed in 12.8; adrenal disoders in 10.6; pubertal disorders in 5.3 and growth disorders in 4.3 of the patients. Thyroid disorders were present in 6.4; obesity in 3.2 while the least common disorder was Diabetes insipidus (1). About 58 of the children had parents in the low socioeconomic status and the management of the cases were severely hampered by lack of funds. About 60.6 of these patients were lost to follow up; during the period. Conclusions: Paediatric endocrine disorders are associated with a high incidence of malnutrition. Most patients presented with rickets which is a preventable condition