Asian Journal of Pediatric Research

Despite advances in obstetric and neonatal care, subgaleal haemorrhage continues to create significant challenges to health personnel, especially in poor human resource/ facility settings, where a specialist may not always be readily available, thereby contributing significantly to morbidity and mortality. This study was undertaken to highlight the different methods of presentation of subgaleal haemorrhage and the need for early identification and management to improve the outcomes. A confirmed case of ruptured subgaleal haemorrhage was documented over a 12-month periods where no mortality was recorded. The high index of suspicion is the key to early diagnosis. Identification of risk factors, early diagnosis, and prompt and aggressive treatment of hypovolemia will reduce morbidity and mortality.

Post-traumatic dislocation of the radial head is a rare injury, generally described in the case of the Monteggia fracture associating a fracture of the ulnar diaphysis and a dislocation of the radial head.

We report an exceptional case of an isolated post-traumatic dislocation in a 6-year-old child, who presented to our emergency department following a fall from a bike with a reception on the outstretched left arm.

Clinical examination showed a swollen left elbow painful to palpation with a limited and painful range of motion of the elbow especially pronation-supination. Plain radiographs of the left elbow and forearm showed an isolated anterior dislocation of the radial head.

Reduction was carefully performed followed by an above-the-elbow cast for 4 weeks with good functional and radiological outcome. Through this case report we insist on a systematic careful interpretation of plain radiographs of the elbow in children. With these precautions, diagnosis is not overlooked and an early management is initiated when the closed reduction is still possible.

Aims: There paucity of studies on asphyxia, one of the three main reasons for newborn deaths in Democratic Republic of Congo (DRC). In this country, newborn mortality is among the highest in Africa. This study was conducted to identify the clinical features and outcome of perinatal asphyxia. Risk factors associated with asphyxia were also determined.

Study Design: A cross-sectional study.

Place and Duration of Study: It was conducted in the pediatric department of Hôpital du Cinquantenaire of Kisangani (HCK), from March 2013 to March 2017.

Methodology: Clinical and biologic parameters (prenatal, perinatal and postnatal) of term newborns, hospitalised for perinatal asphyxia in the HCK were retrospectively collected and analysed. Data of dead newborns were compared to those who survived to determine risk factors associated with asphyxia mortality. One case matched three controls of the same sex.

Results: During the period above, 612 newborns were received in the HCK, and 146 died. One hundred and nineteen out of 612 had perinatal asphyxia (19.4%), and 26 out of 119 died (17.8% of all newborn deaths and 21.8% of all asphyxia cases). The most frequent perinatal antecedents were premature rupture of the membranes, meconium-stained amniotic liquid, pre-eclampsia and eclampsia. In bivariate analysis, factors associated with asphyxia lethality were low birthweight (P=.02), reference from another hospital (P =.01), age more than 24 hours (P =.02), associated sepsis (P =.003), asphyxia severity (P<.001) and the Stage 3 of Sarnat (P<.001).

Conclusion: The frequency of the asphyxia is high in the HCK and its mortality associated with avoidable factors. Networking newborn referral, improving skills of nurses about obstetrical and neonatal emergency cares, and making available equipment for newborn resuscitation can reduce that mortality.

Introduction: Birth weight is an important determinant of infant morbidity and mortality. Its effect extends upto adult life and may explain some non-communicable diseases that may occur in adult life. In general, males weigh more than females. Birth weight is categorised into three levels, viz., low, normal and high. This study analysed the relationship between gender and the categories of birth weights.

Materials and Methods: Data on babies’ gender and birth weights from 961 term life deliveries in a private general practice hospital were analysed. Test on equality of the mean weight of males and females at the three categorical levels were done using z test and t-tests, as necessary.

Results: Mean birth weight was found to be 3.30 ± 0.495 kg. Males weighed significantly heavier than females at mean weights of 3.343 ± 0.495 kg and 3.258 ± 0.490 kg, respectively. In the low birth weight category, males weighed 1.844 ± 0.297 kg and females weighed 1.992 ± 0.397 kg. There was no significant difference. Similarly, the mean weight of males and females in the high birth weight category were 4.462 ± 0.343 kg and 4.342 ± 0.219 kg, respectively with no significant difference. In the normal weight category, males weighed significantly more than the females with the mean weight of 3.30 ± 0.359 kg and 3.248 ± 0.392 kg, respectively.

Conclusion: Male babies weighed more than female babies only in the normal birth weight category. The factor that selectively affected the birth weight of male babies must be acting under the category of normal birth weight only.

More studies are necessary to identify the factors and the reasons, for which they act only at the level of the normal birth weight.

Background: Adherence to antiretroviral therapy is a key factor in the successful treatment of people living with HIV infection. Use of reminder system has been shown to improve adherence to antiretroviral therapy. This study was conducted to identify the reminder systems used by the HIV-infected adolescents in our health facility and determine the relationships with adherence using self-report and pill count.

Study Design: This was a cross sectional study.

Place and Duration of Study:  The study was done at Paediatric Special Treatment Clinic of the University of Abuja Teaching Hospital, Nigeria. The data collection was over a six month period, September 2015 to February, 2016.

Methodology: This was a face-to-face interviewer administered pretested questionnaire-based study. Adherence was measured using three-day recall self report and pill count, with convenience sampling method employed.

Results: One-hundred and forty-five adolescents aged 10 years to 19 years participated in the study, 80(55.2%) were males, 78(53.8%)%) were between the ages of 10-13 years, 111(76.6%) were Christians, 91(62.7%) had secondary level of education, and 61(42.1%) were from the middle socio-economic class. The most common reminder systems used were the alarm devices 43(29.7%), timers 34(23.4%) and parents 39(26.9%). Twenty-two (15.2%) participants did not use any form of reminders for their self-care. Use of reminder systems had a statistically significant relationship with gender (P= .031), social class (P = .003) and self-report (P = <0.001).

Conclusion: The alarm system was mostly used by adolescents for their medication adherence and was associated with gender, social class and self-reporting.  It is hoped that interventional studies will be carried out on the use of types of electronic reminder devices to ARV medications with the aim of its integration into the routine care of HIV-infected adolescents in Nigeria.