University Teaching Hospital Research Articles

Descriptive analysis of durvalumab use in unresectable stage III non-small cell lung cancer in patients treated in Quebec’s University teaching hospitals

Descriptive analysis of durvalumab use in unresectable stage III non-small cell lung cancer in patients treated in Quebec’s University teaching hospitals

Correlation Between Magnesium and HbA1C in Type 2 Diabetes Mellitus

Background: Magnesium (Mg) is most abundant electrolyte with unlimited physiologic importance in the body, playing a vital role in many fundamental processes. Cellular magnesium is an essential cofactor for various enzymes involved in glucose transport, insulin release and glucose oxidation. Mg has potential role in improving insulin sensitivity and preventing diabetes and its complications. Hypomagnesemia promotes to the initiation and progression of DM and its macrovascular and microvascular complications. Objectives: The aim of this study was to evaluate the correlation of magnesium with HbA1C in T2DM. Material and Methods: This cross sectional study conducted at Tribhuvan University Teaching Hospital, included 85 diagnosed with type 2 diabetes Mellitus visiting Medicine OPD and 85 apparently healthy controls. Clinical and anthropometric characteristics were documented using clinical proforma. The fasting blood samples were collected for estimating serum glucose, HbA1C and magnesium. Results: The mean values of BMI, FBG, HbA1C were found to be significantly elevated in T2DM, but that of Mg were higher in healthy controls (p<0.05). The prevalence of hypomagnesemia in T2DM was found to be 32.94%. The Serum magnesium levels were moderate negatively correlated (r = -0.544, P<0.001) with HbA1C. Conclusion: Patient with Type 2 Diabetes Mellitus showed significantly low magnesium levels compared to heathy controls as well as uncontrolled HbA1C levels also showed significantly low magnesium level than controlled HbA1C level. There was significant inverse correlation between serum Mg level and HbA1C level in patients with T2DM. So if serum magnesium values are made to rise, HbA1C values will fall.

Outcomes of adults hospitalized with COVID-19 at the University Teaching Hospital of Butare in Rwanda and validation of the Universal Vital Assessment (UVA) mortality risk score.

There are few data regarding clinical outcomes from COVD-19 from low-income countries (LICs) including Rwanda. Accordingly, we aimed to determine 1) outcomes of patients admitted to hospital with COVID-19 in Rwanda, and 2) the ability of the Universal Vital Assessment (UVA) score to predict mortality in patients with COVID-19 compared to sequential organ failure assessment (SOFA) and quick (qSOFA) scores. We conducted a retrospective study of patients aged ≥18 years hospitalized with laboratory-confirmed COVID-19 at the University Teaching Hospital of Butare (CHUB), Rwanda, April 2021-January 2022. For each participant, we calculated UVA, SOFA, and qSOFA risk scores and determined their area under the receive operating characteristic curve (AUC). We used logistic regression to determine predictors of mortality. Of the 150 patients included, 83 (55%) were female and the median (IQR) age was 61 (43-73) years. The median (IQR) length of hospital stay was 6 (3-10) days. Respiratory failure occurred in 69 (46%) including 34 (23%) who had ARDS. The case fatality rate was 44%. Factors independently associated with mortality included acute kidney injury (adjusted odds ratio [aOR] 7.99, 95% confidence interval [CI] 1.47-43.22, p = 0.016), severe COVID-19 (aOR 3.42, 95% CI 1.06-11.01, p = 0.039), and a UVA score >4 (aOR 7.15, 95% CI 1.56-32.79, p = 0.011). The AUCs for UVA, qSOFA, and SOFA scores were 0.86 (95% CI 0.79-0.92), 0.81 (95% CI 0.74-0.88), and 0.84 (95% CI 0.78-0.91), respectively, which were not statistically significantly different from each other. At a UVA score cut-off of 4, the sensitivity, specificity, positive predictive value, and negative predictive value for mortality were 0.58, 0.93, 0.86, and 0.74, respectively. Patients hospitalized with COVID-19 in CHUB had high mortality, which was accurately predicted by the UVA score. Calculation of the UVA score in patients with COVID-19 in LICs may assist clinicians with triage and other management decisions.

Evaluating access to National Health Insurance Scheme Services

Access to health insurance is vital for achieving Universal Health Coverage, yet barriers such as high costs, inadequate coverage, and systemic inefficiencies often impede access to necessary health care. This study evaluated access to the National Health Insurance Scheme-provided services among enrollees at the outpatient department (OPD) of Levy Mwanawasa University Teaching Hospital (LMUTH) in Lusaka, Zambia, chosen for its role as a pioneering NHIS-accredited facility and its significance as a major publicly funded referral hospital. Data were collected in May 2024 from 270 systematically sampled NHIS enrollees at the OPD of LMUTH using an interviewer-administered questionnaire. Descriptive analysis revealed a balanced gender distribution, with most respondents aged 35 and above, married, holding tertiary education, and earning a monthly Zambian Kwacha (ZMW) of 20,000 or less. The thematic analysis using NVivo uncovered positive and negative experiences with NHIS services, highlighting issues such as medical service availability, drug shortages, service delays, technological problems, communication challenges, equity in service delivery, and coverage gaps. The key policy implications for improving access to NHIS services include enhancing supply chains, digital infrastructure, coverage to rural areas, staff training, public awareness of the NHIS, and information technology systems.

Assessment of healthcare students’ knowledge, attitudes, and perceptions towards pharmacogenomics at Olabisi Onabanjo University, Sagamu Campus, Ogun State, Nigeria

Background: Pharmacogenomics explores how genetic variations affect drug responses, crucial for personalised medicine. Understanding healthcare students’ perspectives is vital for advancing awareness in this field. This study aimed to assess healthcare students’ knowledge, attitudes, and perceptions towards pharmacogenomics at Olabisi Onabanjo University, Sagamu Campus, Ogun State. Methods: A cross-sectional survey was conducted among healthcare students (medicine, pharmacy, and nursing) at Olabisi Onabanjo University Teaching Hospital, Sagamu Campus, Ogun State, using purposive sampling. Results: Respondents from medicine, nursing, and pharmacy demonstrated a moderate level of confidence in pharmacogenomics knowledge (38.1%, 75.9%, and 42.6%, respectively). They also indicated that their curricula inadequately cover pharmacogenomics (p < 0.001), highlighting the need for curriculum revisions to incorporate pharmacogenomics training. Conclusion: Healthcare students exhibited fair knowledge and favourable attitudes towards pharmacogenomics, yet further education is essential for a comprehensive understanding of its fundamentals and clinical implications.

Bacterial Etiology of Lower Respiratory Tract Infection that Isolated from Tripoli University Hospital (TUH) Units in 2019

Introduction: Lower respiratory tract infection (LRTI) is one of the common major health problems, causing morbidity and mortality. Aims: The study was conducted to determine the current trends of bacterial etiology of LRTIs among patients who attended the University Teaching Hospital (UTH) and their antimicrobial susceptibility profile with special interest on drug resistance. Study Design: The study was a Cross sectional study. All patients’ files were selected as diagnosed with LRTIs and their demographic data, other illness, prescribed treatment /antibiotic used previously. Place and Duration of Study: This study is designed to collect data from files of lower respiratory tract infection patients following in units of university hospital in Tripoli. Methodology: The study was conducted between January to December 2019. at the unit in university hospital in Tripoli city in Libya. Sputum samples of 465 patients with suspected LRTIs were received, after obtaining patients' informed consent and ethical clearance from the UNTH. The samples were collected and processed according to standard laboratory procedures. Results: Of the total 465 sputum samples, 366 (78.7%) were positive for micro-organisms. Four main types of bacteria have been identified: acinetobacter spp. 25.6%, Klebsiellla pneumoniae 25.6%, P. saeroginosa (1.39%), Candida (9.03%). The distribution of lower respiratory tract infections within the hospital department indicated that the isolated strains revealed a higher infection rate of Gram-negative bacteria in the Pediatric Intensive Care Unit (PICU) and General Surgical Intensive Care Unit (GSICU) compared to other departments, with statistical significance. Notably, there was a significant difference in the infection rates of Pseudomonas in the Special Care Baby Unit (SCBU) with 7 cases, and in the Medical Intensive Care Unit (MICU) with 6 cases, as well as in the Neonatal Intensive Care Unit (NICU) with 2 cases. The infection rates for Candida and Streptococcus pneumoniae in the NICU were recorded at 2, 1, and 2, respectively, which were significantly different from those observed in other departments. The prevalence of antimicrobial resistance among Gram-negative and Gram-positive bacterial isolates indicated a very high resistance rate (98–100%) among Acinetobacter baumannii isolates to various antibiotics including AK, AMC, ATM, CAZ, CRO, CIP, GN, MEM, TOB, PRL, and CZ. However, for SXT, the isolate demonstrated the highest sensitivity, with a resistance rate of less than 53%. Conclusion: Understanding the variety of pathogens that cause lower respiratory tract infections (LRTIs) and their patterns of susceptibility to antibiotics, in addition to monitoring antibiotic resistance, is crucial for the effective management of LRTIs. This includes timely clinical and laboratory diagnoses, as well as the implementation of the appropriate treatment strategies.

Neurological Recovery Following Surgical Intervention in Patients with Traumatic Spinal Cord Injury at the University Teaching Hospital in Zambia

Introduction Traumatic spinal cord injuries cause long-term disability and functional impairment. Timely and proper surgical treatment improves neurological recovery and functional outcomes. However, in low-resource setting countries, surgical intervention is usually delayed raising concerns about the recovery of patients. Hence, this study investigated the neurological improvement of patients undergoing surgery for traumatic spinal cord injuries at the University Teaching Hospital in Lusaka, Zambia. Methods This was a retrospective study that included all eligible patients with traumatic spinal cord injury managed surgically at the University Teaching Hospital between 2018 and 2022. The study assessed neurological improvement by comparing the American Spinal Injury Association’s neurological grading before surgery to that at discharge. Data was analysed using Stata 17, and the level of significance was set at 5%. Results Out of the 96 patients in the study, 45.8% showed neurological improvement of at least one grade after surgery. Patients with thoracic injuries showed lower improvement rates (25.0%) than those with cervical (55.0%) or lumbar injuries (65.0%), while those with incomplete injuries showed higher improvement rates (78.7%) (p <0.05). Thoracic injuries were associated with reduced neurological improvement (AOR 0.21; 95% CI: 0.04 – 0.95, p = 0.043), while incomplete injuries were associated with higher neurological improvement (AOR 18.58; 95% CI: 6.11 – 56.51, p < 0.001). Conclusion Neurological improvement was poor for thoracic injuries and complete injuries, highlighting the necessity for further investigation into the specific structural features and mechanisms of injury that contribute to poor neurological improvement in thoracic injuries and the identification of effective recovery approaches for these patients.

Genetic Profiling of Raoultella spp. in Pediatric Clinical Samples: Insights from Bauchi, North East Nigeria

Background: Raoultella species, are gram-negative bacteria of Enterobacteriaceae family, originally classified under Klebsiella, were reclassified in 2001 as a distinct genus. Members have emerged as notable pathogens, mostly in hospitalized and immunocompromised patients. Though once considered opportunistic, Raoultella spp. are now linked to various infections, including bacteremia, urinary tract infections, and neonatal sepsis, with antibiotic-resistant strains posing significant challenges in clinical settings. The true prevalence of Raoultella infections may be underreported due to diagnostic challenges, making early identification crucial for improved management in high-risk populations, particularly pediatrics. Raoultella species, emerging pathogens are increasingly linked to pediatric and neonatal infections in clinical settings. Aim: isolation and accurate identification of Raoultella species from pediatric clinical samples to address challenges in identification and genetic characterization. Study Design: This is a prospective, cross-sectional study involving pediatrics aged 0-5 years. Place and Duration of Study: Pioneering study in Bauchi, North-East Nigeria, from August 2021 to January 2022. Methodology: Samples from 262 pediatric patients with septicemia symptoms were processed at Abubakar Tafawa Balewa University Teaching Hospital (ATBUTH). The VITEK 2 Compact system was used for initial identification, while PCR amplification of the 16S rRNA gene confirmed Raoultella species. The genomic DNA of identified isolates underwent sequence and bioinformatics analysis. Results: The phylogenetic tree constructed using the 16S rRNA sequences of the isolates and reference strains visually represent the genetic relationships. The high homology observed in the sequence alignment is reflected in the phylogenetic clustering, with isolates RoP_2 (PQ213811), RoP_3 (PQ213812), and RoP_4 (PQ213813) grouping closely with known Raoultella planticola strains. This close genetic relationship further supports the species identification suggested by the gel electrophoresis and homology data. However, RoP_1 (PQ213810), identified as Proteus mirabilis through BLAST analysis of its 16S rRNA sequence, shows slightly lower homology with Raoultella planticola reference strains. In the phylogenetic tree, RoP_1 is positioned slightly apart from the other isolates, indicating some genetic variability. This discrepancy suggests that while RoP_1 shares characteristics with Raoultella, the distinct genetic makeup warrants further investigation to confirm its identification as R. planticola or otherwise. Conclusion: The phylogenetic analysis supports the identification of isolates RoP_2, RoP_3, and RoP_4 as Raoultella planticola, showing close genetic relationships. However, RoP_1 exhibits genetic variability, clustering separately and aligning more closely with Proteus mirabilis, suggesting the need for further investigation to confirm its species identification.

COMPARISON OF D-DIMER LEVEL AND PLATELET COUNT IN INDIVIDUALS WITH AND WITHOUT SICKLE CELL ANAEMIA

Aim: This study aimed to assess the D-dimer levels and platelet count in sickle cell anaemia patients and compare with those of the control subjects. Materials and Methods: This study is a cross–sectional comparative study which enrolled 58 sickle cell anaemia patients (25 males and 33 females) in a stable state at the Obafemi Awolowo University Teaching Hospital in Ile-Ife, Osun State, Nigeria, as well as 25 healthy controls (11 males and 24 females). Venous blood (4.5 mL) was collected from both the patient and control into a vial containing 0.5 ml of 3.2% trisodium citrate. D-dimer levels was analysed using ELISA method. Platelet counts were determined (from 5ml venous sample collected with EDTA) using haematology autoanalyzer. Results: There was a significant rise in D-dimer levels in sickle cell patients, with mean values of 1771.86 ng/mL and 1986.00 ng/mL for males and females, respectively, in the steady state compared to the D-dimer levels of controls, with mean values of 199.24 and 322.21 ng/mL for males and females, respectively. Platelet count was significantly higher in SCA patients than in the control subjects. There is perfect correlation between D-dimer and platelet counts in both patients and control (r=1, n=57, P=0.000) and (r=1, n=30, P=0.000) Conclusion: This study showed the hypercoagulable state and thrombotic risk associated with SCA. The strong correlation between D-dimer levels and platelet counts suggests a potential interplay between platelet activation and coagulation activation in SCA, warranting further investigation into therapeutic interventions targeting these pathways.

A qualitative enquiry into lived experience and coping strategies of undergraduates with sickle cell disease in Nigeria

BackgroundSickle cell disease (SCD) is of serious public health concern. Paucity of literature exists on qualitative experiences of people with SCD, despite substantial research on the clinical signs and management of the disease. This study examined how SCD affects a range of undergraduate students’ experiences, their academic achievements, relationships, mental health and healthcare utilization.MethodsThis was an exploratory qualitative study that interviewed 22 participants selected by thematic saturation between September 2023 and February 2024. The study was conducted in Bowen University, Iwo, Osun State and Bowen University Teaching Hospital, Ogbomoso, Oyo State, annex of Bowen University, Nigeria. Thematic analysis of qualitative data was conducted.ResultsEight distinct themes emerged and were linked to the study objectives. Findings show resilience and determination of the students in navigating the complexities of living with sicknesses while pursuing their academic goals and daily activities. This underscores the need for increased community awareness, support for undergraduates living with SCD, and access to effective healthcare to better assist undergraduates with SCD in managing their health and academic responsibilities effectively.ConclusionHealth professionals and lecturers working with undergraduates with SCD should be aware of diverse coping strategies for them and prioritize integrating such into clinical conversations and support in appropriate contexts.

Characteristics and Risk of Incident Diabetic Nephropathy between Early-onset versus Late-onset Type 2 Diabetics of Nigerian Origin

Background: Diabetic nephropathy (DN), the most common complication of type 2 diabetes (T2DM), has been reported to occur more often among the early-onset type 2 diabetes (ET2DM) compared to the late-onset type 2 diabetes (LT2DM) in the Western populations with no previous data on this subject in Nigeria. Hence, the current study evaluated the incidence and risk of DN between ET2DM versus LT2DM. Methods: This was a retrospectively designed cross-sectional observational study conducted at the Rivers State University Teaching Hospital, Southern Nigeria. Socio-demographic, anthropometric, clinical, and laboratory data for 10 years (2014–2023) were obtained from medical records of T2DM patients with similar DM duration and analyzed using descriptive/inferential statistics. Results: During the studied period, 3,111 adults were diagnosed with T2DM of which 352 (11.3%) presented with incident DN. T2DM cohorts with incident DN were mostly those with ET2DM diagnosis (n = 218; 61.9%) compared to the LT2DM. The ET2DM cohorts were relatively younger with higher proportions of positive DM family history, overweight/obesity status, blood pressure, plasma creatinine/glucose, urine albumin-to-creatinine ratio, and HbA1c but lower eGFR at presentation than the LT2DM cohorts. The ET2DM was significantly associated with incident DN following crude (HR: 6.986; 95%CI: 3.476–9.518; p < 0.001) and confounder-adjusted (HR: 4.684; 95%CI: 2.270–7.114; p < 0.001) Cox proportional regression models compared to the LT2DM cohorts. Conclusion: DN is common among patients with T2DM and more particularly prevalent among younger patients with metabolic condition. Hence, aggressive exploration of renal status should be made mandatory during the initial evaluation of T2DM among younger patients.

Immune-virological status in people with HIV from naïve to six months on cART at Ahmadu Bello University Teaching Hospital Zaria, Nigeria.

Immune-virological status in people with HIV from naïve to six months on cART at Ahmadu Bello University Teaching Hospital Zaria, Nigeria.

Difference of Neck Shortening in Femoral Neck Fracture between Femoral Neck System and Multiple Cannulated Cancellous Screws: Single Center, Prospective Randomized Controlled Trial.

Fracture union after osteosynthesis of a fracture neck femur (FNF) occurs by compression of the fracture ends and potential neck shortening. Selection of an implant for fixation of a femoral fracture of the neck can be challenging when making management decisions. Femoral neck shortening after internal fixation of FNFs using a femoral neck system (FNS) or multiple cannulated cancellous screws (MCS) was compared. This prospective interventional single-blinded randomized controlled trial was conducted at a university teaching hospital. Sixty patients undergoing internal fixation for management of sub-capital or trans-cervical FNFs were randomized and assigned, to one of the two groups-the test group (FNS group) and the control group (MCS group). Primary outcome was determined by measuring the difference in 1-year shortening of the femoral neck on radiographs between FNS and MCS. The secondary objective was to determine the correlation between neck shortening with patient reported outcome measures (PROMs) at the end of the final follow-up. At the final follow-up, shortening of the femoral neck was 3.77±1.87 mm in the FNS group, significantly lower compared with the MCS group, 6.53±1.59 mm. Significantly less shortening of the femoral neck was observed in the FNS group compared with the MCS group. No statistically significant difference in PROMs was observed at 1-year follow-up. The findings of the study suggest that FNS can be regarded as a suitable alternative for internal fixation in young adults (<60 years) with trans-cervical and subcapital FNFs.

Corrigendum to “POS-074 SERUM NEUTROPHIL GELATINASE ASSOCIATED LIPOCALIN, EARLY BIOMARKER OF ACUTE KIDNEY INJURY IN ASPHYXIATED TERM NEONATES AT LAGOS STATE UNIVERSITY TEACHING HOSPITAL” [Kidney International Reports Volume 7, Issue 2, Supplement, February 2022, Page S31

Corrigendum to “POS-074 SERUM NEUTROPHIL GELATINASE ASSOCIATED LIPOCALIN, EARLY BIOMARKER OF ACUTE KIDNEY INJURY IN ASPHYXIATED TERM NEONATES AT LAGOS STATE UNIVERSITY TEACHING HOSPITAL” [Kidney International Reports Volume 7, Issue 2, Supplement, February 2022, Page S31

Optimizing Diagnosis of Pediatric Streptococcus pyogenes Infections: A Clinical Prediction Model

Group A Streptococcus (GAS) infections, caused by Streptococcus pyogenes, are a major health concern among children under 12 years, leading to conditions such as tonsillitis, rheumatic fever, and post-streptococcal glomerulonephritis. Accurate diagnosis is essential for effective treatment and prevention. This study aimed to develop and validate a Clinical Prediction Rule (CPR) for predicting the presence of S. pyogenes in throat swabs from children under 12. We analyzed clinical and laboratory data from 1,015 pediatric patients presenting with symptoms suggestive of GAS infection at Federal University Teaching Hospital, Owerri, Imo State, between January 2019 and December 2022. S. pyogenes was first isolated from throat swabs cultured on blood agar, and 233 positive isolates were further identified using Polymerase Chain Reaction (PCR) targeting the Spy 1258 gene, with DNA extracted via boiling and confirmed through phenotypic methods. Data from these 233 identified cases were used to develop and validate the CPR. Variables examined included gender, age, ward of admission, clinical diagnosis, and antibiotic susceptibility. Logistic regression modeling identified significant predictors of S. pyogenes presence, with potential biases minimized through systematic case review, standardized data extraction and cross-checking by multiple reviewers. Among the 233 cases analyzed, the mean age was 4 ± 0.25 years, with 62.7% under age 3. Tonsillitis was the predominant diagnosis, with GAS prevalence ranging from 56.7% to 69.3%. Antibiotic susceptibility test result varied, with significant predictors including Sepsis/Tonsillitis and ear discharge/tonsillitis (p < 0.001). The CPR model demonstrated a sensitivity of 95.4% and a specificity of 36.8%, highlighting its potential to enhance clinical diagnosis and management of GAS infections. This study offers valuable insights into predictors of S. pyogenes infection in pediatric patients and highlights the CPR’s potential for improving clinical diagnosis and management.

Evaluation of the paraspinal muscles mophology using magnetic resonance imaging in adult patients with nonspecific chronic low back pain in Port Harcourt Rivers State Nigeria

Background: Nonspecific chronic low back pain (CLBP) is a major public health concern globally and the leading cause of musculoskeletal disability, affecting mainly adults in their productive years with a high economic impact in the society. Objective: This study was designed to evaluate the changes in the paraspinal muscles (lumbar multifidus) morphology using data obtained from MRI of the lumbosacral spine in adult participants with non-specific chronic low back pain. Materials and methods: This was a cross-sectional study, involving 200 adult participants with non-specific chronic low back pain undergoing MRI of the lumbosacral spine at the Department of Radiology, Rivers State University Teaching Hospital (RSUTH), Port Harcourt, Nigeria, during a six months period. Data recorded include lumbar multifidus muscle (LMM) morphology and lumbar spine pathologies Results: The LMM CSA for L1, L2, L3, L4 and L5 were 2.24±0.84, 3.59±1.15, 5.18±1.60, 6.66±1.75 and 7.27±2.62 respectively. The frequency distribution of LMM fatty infiltration in percentage showed Grade 0 was highest at L1 (86.5%, n= 173) and lowest at L5 (6.5%, n=13); Grade 1 was highest at L4 (73%, n=146) and lowest at L1 (13.5%, n=2) and Grade 2 was highest at L5 (22.5%, n=45) and lowest at L1 (0.0%, n=0). The lumbar pathologies noted were 200(100%) disc abnormalities, while 178(89.0%) had neural foraminal narrowing, nerve root compression and spinal canal stenosis each. Facet joint arthrosis and spondylosis were 177(88.5%) and 176(88.0%) respectively. Conclusion: Dysfunctional LMM was observed to increase with advancing age, severe in females and individuals with elevated BMI and cuts across various occupations. Measures aimed at improving and maintaining the quality of the LMM should be encouraged, as this will help in reducing the prevalence of nonspecific CLBP

Acute diarrhoeal disease among under-five children presenting at a paediatric referral Facility in Lagos, Nigeria

Background: The morbidity and mortality from acute diarrhoeal disease remain significantly high especially in low and middle income countries. Aim: This study was carried out to determine the prevalence of acute diarrhoea, and the associated risk factors among under-five children seen at a paediatric referral facility in Lagos, Nigeria. Methods: This was a cross-sectional descriptive study of under-five children who presented with acute diarrhoeal disease at the Children Emergency Room and General Out-Patient Clinic of Lagos State University Teaching Hospital (LASUTH), Ikeja, Lagos, South-Western Nigeria. Information was obtained on socio-demographic characteristics, environmental/ hygienic practices, feeding practices and immunization status. Results: The prevalence of acute diarrhoea was 400 of 4836(8.3%) under-five children. Three hundred and ninety-five (73.7%) of these children were aged less than two years. The identified associated risk factors for acute diarrhoea among children aged less than two years were use of feeding bottles (OR 12.4; 95% CI 1.8-7.2; p= 0.000), failure to complete immunization(OR 13.0; 95% CI 3.1-43.3; p= 0.000), attendance of crèches (OR 47.1; 95% CI 15.6-141.1; p= 0.000), failure to exclusively breastfeed (OR 6.7; 95% CI 1.3-6.7; p= 0.010) and malnutrition (OR 3.9; 95% CI 1.0-20.3; p= 0.049). Conclusions: Acute diarrhoea remain a significant public health burden affecting majorly children aged less than two years. Efforts at prevention of diarrhoeal disease burden should focus on improvement of hygienic and feeding practices.

Effects of Maternal Age on Fetus and Perinatal Outcomes in a Tertiary Care Center: An Observational Study

Introduction: The early and late pregnancy both can be hazardous for mother and child. The study aims to explore the maternal age group among Nepalese women who delivered in Tribhuvan University Teaching Hospital and its effects on perinatal outcomes.Methods: An observational cross-section study was carried out from February to September, 2023 with the records of maternity cases at a tertiary care hospital after receiving ethical approval from the Institutional Review Committee [Reference number: 130(6-11) E2-2 079/080]. The records of maternity cases of four years duration from April, 2018 onwards were included. Data was entered in Microsoft Excel 2016 and descriptive analysis was done.Results: Out of 13062 maternity cases, the prevalence of pregnancy in normal reproductive age was 12035 (92.13%). A total of 882 (6.67%) maternity cases were in advanced age and 145 (1.11%) were in teen age. The alive newborns which were more in normal reproductive age was 12008 (99.77%) and stillbirth which was more in teen age pregnancy was 4 (2.75%). The low-birth-weight newborns distributed more in teen age pregnancy was 44 (30.34%) and high birth weight newborns distributed more in advanced age pregnancy was 18 (2.04%).Conclusions: The abnormal birth weight and stillbirths were common in teen age and advanced age pregnancy.

KNOWLEDGE AND SKILLS IN MANAGEMENT OF COMMON PAEDIATRIC EMERGENCIES AMONG HEALTH WORKERS IN PRIMARY HEALTH CARE CENTRES IN ZARIA

Every day, Nigeria witnesses the loss of approximately 2,300 children under the age of five, primarily due to preventable and treatable conditions such as pneumonia, malaria, and diarrhoea. These high mortality rates are disproportionately higher in rural areas compared to urban regions, where primary health care (PHC) centres often represent the only accessible medical services. Given that PHC centres serve as the first point of contact with the healthcare system for most Nigerians, it is imperative to assess the capabilities of health workers in these facilities, particularly in the management of paediatric emergencies. This study aimed to evaluate the knowledge and skills of health workers in PHC centres in Zaria concerning the management of common paediatric emergencies. A cross-sectional descriptive study was conducted among 139 health workers in PHC centres, randomly selected through a multi-stage sampling technique from both Sabon Gari and Zaria Local Government Areas. Data collection was performed using a pre-tested, semi-structured, self-administered questionnaire. The collected data were analysed using SPSS version 21, with the chi-square test applied to assess associations, and results presented in tables and charts. The findings revealed a generally low level of knowledge and skills in managing common paediatric emergencies among the health workers surveyed. Specifically, 66 (48.5%) of the respondents exhibited very poor knowledge of the causes of common paediatric emergencies, 32 (23.5%) had poor knowledge, 34 (25.0%) demonstrated good knowledge, and only 4 (2.9%) had excellent knowledge. In terms of treatment knowledge, 46.7% of respondents had very poor knowledge, 34.1% had poor knowledge, 16.3% had good knowledge, and only 3.0% had excellent knowledge. Diagnostic skills were similarly deficient, with 41 (37.3%) of respondents displaying very poor skills, 39 (35.5%) poor skills, 26 (23.6%) good skills, and only 4 (3.6%) exhibiting excellent skills. Additionally, 24.8% of respondents had very poor skills in the treatment of paediatric emergencies, 42.3% had poor skills, and 32.8% had good skills, with none achieving excellent skills. A statistically significant relationship was observed between academic qualification and knowledge of causes (p=0.004) and treatment (p=0.000), as well as between academic qualification and diagnostic skills (p=0.006). The pervasive low level of knowledge and skills among PHC health workers is alarming, particularly given Nigeria's already dire childhood mortality statistics. These findings underscore the urgent need for a strategic partnership between the Department of Paediatrics at Ahmadu Bello University Teaching Hospital and the Department of Primary Health Care in Zaria and Sabon Gari Local Governments. Such collaborations could facilitate quarterly training sessions and workshops aimed at enhancing the management of paediatric emergencies in these critical frontline health centers.

The Relationship between the Severity of Atopic Dermatitis and Sleep Quality in Widya Mandala Surabaya Catholic University Teaching Hospital Patients

The Relationship between the Severity of Atopic Dermatitis and Sleep Quality in Widya Mandala Surabaya Catholic University Teaching Hospital Patients