Ai Frank-Briggs

Congenital rubella syndrome: pattern and presentation in a southern Nigerian tertiary hospital

BackgroundCongenital rubella syndrome (CRS) resulting from maternal rubella infection can result in miscarriages, still birth and rubella infection of the infant. The aim of this study was to evaluate the pattern and presentation of CRS over an 8-year period as seen in the University of Port-Harcourt Teaching Hospital (UPTH), Nigeria.MethodsThe medical records of all cases of CRS presenting to the Pediatric Department of UPTH from January 2000 to December 2007 were reviewed.ResultsThere were 16 394 babies delivered in UPTH from January 2000 to December 2007. Of these babies, 19 were clinically diagnosed as having CRS, but none had laboratory confirmation. They had a mean age of 5.1 ±3.2 months (range: 1–11 months). Seventy-five percent of their mothers had presumed rubella infection during the first trimester of pregnancy. Cataract was noticed to be the most prominent systemic manifestation in 18 of the 19 babies. Other common manifestations included hearing impairment (n=14), microcephaly (n=13), patent ductus arteriosus (n=11), and low birth weight (n=10). A surge was observed in the number of babies with CRS from 2004 to 2007; however, this was not statistically significant (χ2=8.68, P=0.28). Unfortunately, long-term outcome of the 19 babies was not available.ConclusionCRS is commonly diagnosed at our center. Thus, mounting effective surveillance for CRS and considering the inclusion of rubella vaccine in Nigeria are of extreme importance.

Attention deficit hyperactivity disorder (ADHD)

Attention deficit hyperactivity disorder (ADHD or AD/HD) is a neurobehavioral developmental disorder, primarily characterized by the co-existence of attention problems and hyperactivity. It affects about 3 to 5% of children globally, with symptoms starting before 7 yr of age and in about 50% of cases continuing into adulthood. It is a source of concern to the clinicians as it is often comorbid with other mental disorders, particularly anxiety, conduct disorder, depression, epilepsy and learning disabilities. The aim of this review is to draw close attention to the disorder, highlight its causes, features and the challenges in management. Data was sourced from literature in Medline publications, World Health Organization and other medical journals. ADHD affects all races, ethnic groups and socioeconomic levels, the cause is unknown and there is no cure for it. Management is multidisciplinary including behavioral therapy, psychotherapy and drug treatment. There is dearth of information about ADHD in our environment but the disorder is not uncommon. The combined problems of malaria, malnutrition, pneumonia, human immunodeficiency virus and acquired immune deficiency syndrome and other infectious illnesses may be masking emphasis on this neurodevelopmental condition. ADHD is a common neurodevelopmental disorder worldwide. Management of the condition is challenging. Awareness of the general populace, skills in the diagnosis and optimal management are currently low in developing countries like Nigeria. There is need for improvement in these areas.

Neonatal hypoglycaemia: prevalence and clinical manifestations in Port Harcourt, Nigeria

Background: Neonatal hypoglycaemia is associated with significant long term neuro-developmental sequelae. The signs and symptoms are often non-specific. Some are completely asymptomatic. Many cases therefore remain undiagnosed. This study was therefore designed to determine the prevalence, obstetric and peri-natal factors associated with neonatal hypoglycaemia at the University of Port Harcourt Teaching Hospital, Nigeria. Methods: All neonates delivered between 1st January and 31st May 2006 were recruited. Cord blood specimen was obtained from the placental end of the cord at delivery and assayed for plasma glucose. Relevant obstetric and neonatal data were obtained for each subject. Hypoglycaemia was defined as cord blood glucose level ≤ 2.2 mmol/L. Results: Three hundred and four neonates were recruited. Of this number, 86 were hypoglycaemic giving a prevalence of 28.3%. Out of the 86, 43(50%) were symptomatic while 43(50%) were asymptomatic. The commonest symptoms were respiratory distress (46.5%), cyanosis (20.9%) and lethargy (18.6%). The mean cord plasma glucose for the symptomatic group (1.99+ 0.11 mmol/L) was significantly lower than that of the asymptomatic group (2.07+ 0.06 mmol/L) (p Keywords : Neonatal hypoglycaemia; Clinical manifestations PHMJ Vol. 2 (2) 2008: pp. 166-170