Search

Background: Sleep deprivation and disruptions are associated with both psychological and physiological disorders. Medical students have an increased risk for sleep deprivation. This study aimed to determine the quality of sleep among clinical medical students of Bayero University Kano (BUK). Materials and Methods: This is a cross-sectional study that was conducted between February and March 2019 among clinical students of BUK. The data were obtained using sociodemographic questionnaire as well as the Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS) self-administered questionnaires. Two hundred questionnaires were administered to the students in their 4th, 5th, and 6th academic year. SPSS version 20 was used for the statistical analysis of the data collected. Results: A total of 181 questionnaires were completed out of the 200 that were administered, making a response rate of 90.5%. There were 114 males (63%) and 67 females (37%), giving a male-to-female ratio of 1.7:1, which is in keeping with the gender distribution of the students. The mean age (± standard deviation) of the students was 23.8 ± 2.9 years. The overall poor sleep quality was found to be 53.0% based on the PSQI, whereas the overall excessive daytime sleepiness was found to be 38.3% using the ESS. Poor sleep quality was found to be 61.1%, 51.7%, and 42.9% among the students in the 4th, 5th, and 6th academic years, respectively (P = 0.14). Excessive daytime sleepiness was found to be 45.8%, 41.7%, and 22.9% among the students in the 4th, 5th, and 6th academic years, respectively (P = 0.03). Conclusion: The prevalence of poor sleep quality is high among the clinical students of BUK.

Background: The risk of cardiac anomalies, both acquired and congenital, is high in children undergoing noncardiac surgeries. These cardiac anomalies are associated with increased risk of perioperative complications. Objectives: This study, therefore, determined the common indications as well as the echocardiographic findings findings in children undergoing noncardiac surgery in Aminu Kano Teaching Hospital (AKTH), Kano. Materials and Methods: This is a retrospective descriptive study. The echocardiographic records of 25 children that underwent noncardiac surgery in AKTH over a 4 year period (from January 2015 to December 2018) were retrieved. The data obtained were analyzed using SPSS version 20 and the result was displayed using a frequency distribution table and bar chart. Results: There were 14 males and 11 females, with male to female ratio of 1.3:1. The ages of the patients range from 5 days to 8 years (median age of 8 months). The most common indication for echocardiography is orofacial cleft (cleft lip and/or palate), followed by adenotonsillar hypertrophy. The overall cardiac anomaly was found in 28% of the patients, with the highest anomaly being the atrial septal defect. Conclusion: The prevalence of cardiac anomaly was high in children with noncardiac surgical conditions.

Sickle cell anemia is an autosomal recessive disorder resulting from insertion of the valine codon at position sixth of beta-hemoglobin gene instead of glutamate leading to the production of insoluble beta-hemoglobin chain. Although sickle anemia is mostly associated with bone pain and anemia, other manifestations also occur. Acute head syndrome is an uncommon complication resulting from skull bone infarction, cortical osteopenia, and rupture of tortuous periosteal blood vessels leading to extravasation of blood into the subgaleal space. This report therefore intends to create awareness that nontraumatic scalp swelling is an uncommon complication in sickle cell disease and no traditional practice or surgical excision should be employed in managing it.

Levamisole-induced thrombocytopenia and vasculitis are rare entities in children. Here, we report a 5-year-old male who presented with complaints of purpuric rashes and nasal and gum bleeding for 24 h following intake of single high-dose levamisole for presumptive treatment of helminthiasis. No preceding symptoms of viral infection or bleeding into closed spaces were noted. He was clinically stable except for maculopapular and patchy purpuric rashes on the face, neck, and trunk. No hepatosplenomegaly or lymphadenopathy was observed. Full blood count and blood film showed severe thrombocytopenia of 6.00 × 109/L and platelets left shift with dysplastic neutrophils. He was commenced on prednisolone and transfused with fresh whole blood. The patient improved remarkably and showed reversal of hematological parameters within 48 h. Further, full blood count examination showed reactive thrombocytosis. Levamisole induces reversible thrombocytopenia by immune-mediated cytotoxic destruction of the platelets and white blood cells.

Persistent left superior vena cava (PLSV) is an abnormality of drainage of the embryological left cardinal vein, persisting as left superior vena cava and commonly emptying into the right atrium through the coronary sinus. Other drainage patterns include draining into the left pulmonary vein or into the left atrium through its roof and sometimes through the coronary sinus when the defect exists between the coronary sinus and the left atrium. The aim of this report is to indicate the existence of PLSV in this environment and as one of the rarest abnormal venous connections limitedly reported in Nigeria. PLSV is a systemic venous drainage abnormality. Although it may be asymptomatic, it can also present with cardiac failure and severe life-threatening arrhythmias. Dilated coronary sinus during transthoracic echocardiography should be a pointer to a suspected PLSV.

Objective: To determine if there was any difference in SpO2 readings during exchange blood transfusion (EBT). Methods: A prospective cross-sectional study of neonates with severe neonatal jaundice requiring EBT was conducted. Oxygen saturation was recorded before, immediately and 15 minutes after EBT by using a pulse oximeter. Results: This study included 30 neonates with 20 males and 10 females. The age ranged from 1 to 12 days with a mean of (5.4 ±2.9) days. Pre-EBT SpO2 ranged from 90% to 98% with a mean value of (94.3 ± 2.2)%; SpO2 in the end of EBT ranged from 85% to 99% with a mean value of (94.1 ± 3.2)%; SpO2 at 15 minutes after EBT ranged from 77% to 99% with a mean value of (94.8 ± 4.1)%. There was no significant difference between SpO2 values at onset of EBT and either immediately or 15 minutes after EBT (P=0.770 and 0.422, respectively). SpO2 showed no significant difference between neonates who were infused with blood of different storage times (0.999) and 15 minutes after EBT (P=0.887). Besides, SpO2 values were compariable in neonates with hematocrit

Accidental poisoning in children, though underreported in our environment, is common and could prove fatal. It is important to identify the primary chemical agent that is responsible for the poisoning. We present a case of accidental ingestion of fish poisoned with aluminum phosphide (AlP) used as rat poisoning by a 14-month-old girl. At presentation, the actual chemical content of the poison was not available and clinical features were suggestive of organophosphate poisoning. She was commenced on atropine together with other treatment, on which she made remarkable improvement. The atropine was continued with complete resolution of symptoms on the third day of admission. We, therefore, report a serendipitous use of atropine in the management of AlP poisoning with successful outcome.

Introduction: Chronic heart disease in children imposes a great burden in most developing countries, especially among those with congenital heart disease where early surgical intervention is difficult because of limited medical facilities. Most of our patients survive on long-time oral medications, some of which are sweetened. Therefore, there is a heightened risk of dental caries. This study sought to determine if there were more caries in children with chronic heart disease than those without heart disease.Materials and Methods: This study was cross-sectional, and oral examinations were done using mouth mirror. A convenient sampling method was adopted. Children were recruited over an 8-month period (May–December 2017). Results: This study compared 130 children with varied forms of cardiac defect with 130 children who had no chronic morbidity or any cardiac lesion. Their ages ranged from 1 to 14 years, with a mean of 5.85 +/- 3.30. The prevalence of dental caries was generally low in this report; dental caries was identified in 20.8% of all the children. Among those with cardiac defect, 30 (25.2%) had dental caries. Furthermore, caries was observed more frequently among cardiac patients on chronic medication when compared with the control, and this observation was statistically significant (X2 = 18.846, df = 1,P= 0.00). The mean decayed, missing, and filled teeth (dmft, 2.03 +/- 0.85) and (DMFT, 1.22 +/- 0.44) for primary and permanent dentition were higher among those with cardiac defect; those without cardiac lesion had a mean dmft of 1.31 +/- 0.48 and DMFT of 1.00 +/- 0.00. Conclusion: Dental caries was low in this study though most cases were reported among patients with cardiac disease.

Background: The teething process is part of normal development of the skeletal system; however, different tribes and ethnic groups seem to have a list of symptoms they believe are linked to teething. Could it be that health professionals also hold to these false believes concerning teething? This is important to find out because when systemic problem is misdiagnosed as teething and nothing is done, it may result in death. This study aims to assess the level of knowledge of infants' teething and associated myths among health professionals, to ascertain the attitude of health professionals toward teething in infants, and to identify practices by health professional toward “teething problems.” Materials and Methods: This study was cross-sectional study, conducted from August to September 2016, and multistage sampling method was adopted. Results: Four hundred and fifty health workers participated in the study; however, 427 of them correctly completed the questionnaire giving a response rate of 94.9%. There were 213 (49.9%) males and 214 (50.1%) females with m:f ratio of 1:1. Most respondents (322; 77.8%) believed teething was associated with significant systemic symptoms, 92 (21.5%) did not associate teething with any significant systemic complaint, while only 3 (0.7%) of them were not sure if teething causes systemic illness. Fever and loss of appetite were the most common symptoms associated with teething followed by stooling while skin rash was the least common complaint associated with teething. Conclusion: Teething myths are still prevalent among health-care workers; common illnesses attributed to teething included fever, loss of appetite, excessive salivation, and diarrhea.

Introduction: Much have been achieved in improving the quality of life of asthmatic children such as providing efficient treatment and preventive measures; however, acceptability of these treatments such as metered-dose inhalers (MDI) by caregivers desires to be studied. Materials and Methods: This study was cross-sectional involving caregivers of asthmatic children aged 5–14 years. Results: One hundred and nineteen caregivers were recruited, consisting of 93 mothers (78.1%), 22 fathers (18.5%), and 4 relations (3.4%). However, 88 (73.9%) of the respondents believed asthma was inheritable. Sixty-five (54.6%) of the respondents had counseling on asthma but majority of the respondents will accept MDI if prescribed for their wards; however, among the 33 (27.7%) that will reject, majority believed MDI will make asthma chronic (51.5%). However, 69.7% of them agreed to accept MDI if properly counseled on the advantages and effectiveness of MDI. Although majority of those that had counseling on childhood asthma would accept MDI, this observation was not statistically significantly (χ2 = 2.741; df = 1; P = 0.11); however, most of those with a family history of asthma would accept MDI and this observation was statistically significant (χ2 = 14.312; df = 1; P = 0.00). Similarly, maternal education showed statistically significant association with willingness to accept MDI (Fisher's exact test = 15.444; P = 0.01). Oral medications were the preferred route by the respondents (66.4%) if given the choice to choose. Conclusion: Most respondents believed that asthma is heritable, and majority will accept MDI if prescribed by a physician but they will prefer oral medication as a matter of choice; however, maternal education had significant relationship with the willingness to accept MDI.

Background: Excessive left ventricular mass (LVM) and diastolic dysfunction are associated with higher morbidity and mortality among patients with chronic kidney disease (CKD). Objective: The objective of the following study is to determine the prevalence of increased LVM index (LVMI), pattern of abnormal LV geometry, and diastolic dysfunction in Nigerian CKD children and to establish a relationship of these with estimated glomerular filtration rate (eGFR). Subjects and Methods: Cross-sectional comparative study of LV structure and diastolic function of 21 children with CKD age- and sex-matched and controls asymptomatic for cardiac disease. Results: The median LVMI was 62.19 (34.7) g/m2 in CKD patients compared with 52.89 (30.2) g/m2 in controls (P = 0.04). Excessive LVMI was present in 3 (14.3%) individuals compared with none (0%) of the controls P < 0.001. The prediction equation for LVMI using eGFR is: LVMI = 123.11+ (−0.48) × eGFR ml/m2/min. Abnormal LV geometry was present in 19.05% of the CKD patients and none of the controls (P = 0.04). CKD stages differed significantly with respect to the presence of abnormality with LV geometry (P = 0.04). LV diastolic dysfunction was present in 4 (19.1%) individuals (2 each had impaired relaxation and restrictive patterns) compared with 1 (4.8%) control (restrictive pattern)-P

Background: Sleep problems, especially in the adolescent stage of development, may be associated with excessive daytime sleepiness, impaired neurocognitive function, and a host of others leading to suboptimal performance. Objectives: To determine the pattern of sleep problems in school-going adolescents based on the bedtime problems; excessive daytime sleepiness; awakenings during the night and problems falling back asleep; regularity and duration of sleep; sleep-disordered breathing (BEARS) sleep screening algorithm. Materials and Methods: This is a cross-sectional descriptive study involving 353 secondary school-going adolescents in Kano metropolis. Subjects were selected for the study using multistage sampling technique. The study lasted from March 2015 to July 2015. Sleep problems were screened for using the BEARS sleep screening algorithm. Tables were used to present the qualitative data. The various BEARS sleep patterns were assessed, and comparison between stages of adolescence was done using Chi-square test (and Fisher's exact test where necessary). A significant association was considered at P < 0.05. Results: Of the 353 adolescents studied, 61.8% were males while 38.2% were females with male, female ratio of 1.6:1. Early, middle, and late adolescents constituted 13.9%, 39.9%, 46.2% respectively. BEARS sleep screening revealed awakenings during the night (34.6%) as the most common sleep-related problem reported, and this was followed by excessive daytime sleepiness (21.0%). Age-group dependent sleep duration was 7.19 ± 1.26, 7.13 ± 1.13, 7.16 ± 1.28, with P > 0.05. Although 62.9% of all the adolescents watched TV/play video games until 1 h before going to bed and this was highest in late adolescence, it was not statistically significantly associated with any of the sleep problems. Conclusion: Both the quality and quantity of sleep in Nigerian adolescents in Kano is suboptimal. Adolescent and sleep medicine should receive more attention in our environment.

The anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital heart anomaly; this occurs in 1/300,000 live births. ALCAPA syndrome was first described in 1933 by Bland and co-authors in autopsy specimens; however, further description of its clinical manifestations resulted in the naming of Bland–White–Garland syndrome. The case of a 2-year-old boy who was referred for echocardiographic investigation due to recurrent cough, catarrh, and occasional noisy breathing is reported in this communication; his chest X-ray was normal, while electrocardiogram showed Q-waves on limb leads I and aVL and the echocardiographic study showed ALCAPA.

Background: Mentoring is vital to the maturation of individuals, especially early in their careers and aids professional growth. This study was conducted to find out the views of final year students of Bayero University Medical School on mentoring. Materials and Methods: This was a cross-sectional observational study. The students were given a self-administered questionnaire after a careful explanation and consent obtained. Data were analyzed by SPSS version 16 using Chi-square (χ2) and Fischer exact test (F) with a P< 0.05 considered to be significant. Results: There were a total of 84 students with a male:female ratio of 3.4:1. The age range was between 22 and 42 years with a mean age of 26.4 ± 2.99 years. All the students had formal mentors assigned to them, but none had mentors in the 1st year of school, and only two (2.3%) were assigned mentors in the 2nd year of study. Religion, ethnicity, gender, or specialties of the mentors were not considered important characteristics of mentors by majority of the students, and there was no gender difference in these views. Developing career goals and time management were the priority mentor topics. During the initiation of formal mentoring, only 7 (8.3%) of the students were asked for their goals before being assigned to mentors. Conclusion: Mentoring should be commenced in the 1st year of study, and mentoring goals should be clearly defined for a successful mentee – mentor relationship.

In the Western world, cases of purulent pericarditis have become almost nonexistent with progress and advent of new immunizations against many causative organisms. We report Klebsiella pneumoniae pericarditis, a rare cause of this uncommon disease, hitherto unreported in Nigeria. K. pneumoniae, which is a rod-shaped, Gram-negative, facultative anaerobe, produces extended-spectrum beta-lactamases; hence, it is usually resistant to a lot of antibiotics and is associated with a significant case fatality rate. Our 13-year-old male patient had septic arthritis of the right hip joint came with a 3 weeks complaint of difficulty with breathing. He had respiratory distress, tachypnea, and tachycardia. Although blood pressure was normal, he had pulsus paradoxus, elevated jugular venous pressure, diffuse apex beat, and heart sounds were distant. Chest radiograph revealed an increased cardiothoracic ratio (0.86) with “water bottle” appearance. Transthoracic echocardiography confirmed pericardial effusion with cardiac tamponade. Echo-guided pericardiocentesis was done, and 340 ml of foul-smelling and creamy pus with greenish tinge was aspirated and this grew K. pneumoniae sensitive to ciprofloxacin and gentamycin but resistant to other conventional antibiotics. Recovery was complete after a week of pericardial tube drainage and 3 weeks of treatment. To the best of our knowledge, this is the first case of Klebsiella - induced pyopericardium and with successful management in a Nigerian child. Pyopericardium may follow rare causes such as K. pneumoniae infection with its unique antibiogram.