Search

Objectives: Serum creatinine levels are often used to diagnose acute kidney injury (AKI), but may not necessarily accurately reflect changes in glomerular filtration rate (GFR). This study aimed to compare the prevalence of AKI in children with severe malaria using diagnostic criteria based on creatinine values in contrast to cystatin C. Methods: This prospective cross-sectional study was performed between June 2016 and May 2017 at the University of Ilorin Teaching Hospital, Ilorin, Nigeria. A total of 170 children aged 0.5–14 years old with severe malaria were included. Serum cystatin C levels were determined using a particle-enhanced immunoturbidmetric assay method, while creatinine levels were measured using the Jaffe reaction. Renal function assessed using cystatin C-derived estimated GFR (eGFR) was compared to that measured using three sets of criteria based on creatinine values including the Kidney Disease: Improved Global Outcomes (KDIGO) and World Health Organization (WHO) criteria as well as an absolute creatinine cut-off value of >1.5 mg/dL. Results: Mean serum cystatin C and creatinine levels were 1.77 ± 1.37 mg/L and 1.23 ± 1.80 mg/dL, respectively (P = 0.002). According to the KDIGO, WHO and absolute creatinine criteria, the frequency of AKI was 32.4%, 7.6% and 16.5%, respectively. In contrast, the incidence of AKI based on cystatin C-derived eGFR was 51.8%. Overall, the rate of detection of AKI was significantly higher using cystatin C compared to the KDIGO, WHO and absolute creatinine criteria (P = 0.003

Sickle cell anaemia (SCA) and type 1 diabetes mellitus (type 1 DM) are chronic medical conditions whose co-existence is uncommon in childhood. Furthermore, complications of SCA such as mesenteric crisis typically present with abdominal pain, which is also common in children with diabetic ketoacidosis (DKA) and this may possess diagnostic challenge. Herewith in, we report a rare case of a nine-year-old child with homozygous sickle cell anaemia, who presented with features of mesenteric crisis and diabetic ketoacidosis. The DKA was diagnosed based on the presence of hyperglycaemia (32.2 mmol/L), ketonaemia (4.6 mmol/L) and acidosis (11.6 mmol/L). The fluids deficit was corrected over 24 hours, with improvement in the vaso-occlusive crises (VOC) without precipitating cerebral oedema.

Background: A proper evaluation of cardiovascular status, with a view to ensuring early diagnosis of cardiac dysfunction and prompt intervention where necessary, is a recognized approach in the management of asphyxiated neonates. Hence, we determined the levels of a cardiac biomarker (troponin I), its relationship with disease severity, and mortality in asphyxiated neonates with hypoxic–ischemic encephalopathy (HIE). Methods: This was a descriptive study that involved 85 asphyxiated, term appropriate-for-gestational age newborn babies with HIE (subjects) and 85 healthy controls within the first 72 h of life. Asphyxiated neonates were classified into HIE stages using Sarnat and Sarnat staging. Blood samples were collected between 24 and 72 h of life to determine the level of troponin I using enzyme-linked immunosorbent assay. The asphyxiated babies were followed up till discharge or death. Results: The median interquartile range level of troponin I in the subjects was higher compared with the controls, 1.26 (0.97–3.16) ng/ml versus 0.79 (0.79–1.42) ng/ml, P

Diabetes mellitus in coronavirus disease 2019 (COVID-19) patients is associated with poor outcomes due to poorly understood reasons inclusive of blood sugar patterns. Hence, we report a case of a 52-year-old Nigerian man known hypertensive heart disease patient, previously undiagnosed diabetes mellitus patient with difficulty in blood sugar control, heart failure, and persistent severe acute respiratory syndrome coronavirus 2 8 weeks after he tested positive. A 52-year-old male civil servant obese, known hypertensive heart disease patient presented with complaints of fever, cough, difficulty with breathing, headache, and generalized body weakness. At presentation, he had respiratory distress with low oxygen saturation of 78% and hyperglycemia (blood sugar of 40 mmol/l). His body mass index was 35.9 kg/m2. Chest radiography showed ground-glass appearance with cardiomegaly. Over the next 10 days on admission, his blood sugar fluctuated between hyperglycemia and an episode of hypoglycemia with occasional euglycemia and had glycated hemoglobin of 10.8%. The full blood count was normal, electrolyte, urea and creatinine showed mild elevation of the urea and creatinine, other parameters were normal, while the lipid profile showed hypercholesterolemia. He received multiple doses of insulin, anti-hypertensive, lopinavir/ritonavir, methylprednisolone, and azithromycin. The patient was weaned off oxygen after 10 days and discharged home 15 days after admission. This case report highlighted the challenges that may face a patient with undiagnosed diabetes mellitus and COVID-19. It also brings forth the need to expand research options in COVID-19 and risk factors associated with the disease as the world strives to control the global pandemic.

Deep neck space infections (DNSIs) are rare in neonates. When they do occur, the infections are more aggressive than in older children and adults and can lead to life-threatening complications. Thus, a high index of suspicion is important for early diagnosis and prompt treatment. We report a rare case of DNSIs (retropharyngeal and parapharyngeal abscesses) in a 7-day-old neonate. The baby presented with fever, neck swelling, and difficulty in breathing. Plain neck radiograph showed widening of the retropharyngeal space and β-hemolytic Streptococcus was cultured from the aspirate. He was successfully managed with incision and drainage as well as broad-spectrum antibiotics (cefuroxime and metronidazole for 14 days and gentamicin for 7 days).

Context: Oscillometric devices are preferred method for measuring blood pressure (BP) among children. Aims: This study measured BP among school-age children using a validated oscillometric device (Omron 705 IT®) and correlated the findings with the anthropometric parameters, with a view to determine the predictors of BP. Settings and Design: This was a cross-sectional, descriptive study. A multistage stratified random sampling technique was used in the selection of pupils from primary schools in Ilorin, Nigeria. Subjects and Methods: Two serial BPs were measured used using Omron 705 IT® with appropriate cuffs using “the fourth report” guideline and standard methods were used for measurement of anthropometrics. Statistical Analysis Used: Data were analyzed using SPSS version 20. Results: A total of 1745 primary school-aged children comprising of 873 males and 872 females were recruited. Anthropometric parameters were comparable between males and females. Mean systolic and diastolic BPs were 103.8 ± 11.0 mmHg and 61.3 ± 8.4 mmHg, respectively. Mean systolic BP was lower in males compared with females (102.9 ± 10.6 mmHg vs. 104.7 ± 11.3 mmHg, respectively,P= 0.001). Mean diastolic BP in males was lower compared with females (60.7 ± 8.3 mmHg vs. 61.8 ± 8.5 mmHg, P= 0.009). Most of the anthropometric parameters correlated with the BPs. Independent predictor of BP was weight, height, and body mass index (BMI), P < 0.001. Conclusions: There was a weak correlation between the oscillometric BPs and anthropometric parameters with weight, height, and BMI been the independent predictors of BP.

Dilated cardiomyopathy (DCM) may be associated with formation of intracardiac thrombi which may embolize and result in life-threatening complications. We present a 19-month-old female child with DCM who presented with a right hemispheric cerebrovascular accident. Urgent echocardiography revealed poor left ventricular systolic function and a thrombus attached to the interventricular septum along the left ventricular outflow tract. There was resolution of the thrombus following the use of warfarin.