No abstract

Background: Prematurity accounts for 25% of Neonatal mortality in Nigeria and Respiratory Distress Syndrome is responsible for half of these deaths. Introducing continuous positive airway pressure for the treatment of RDS in Nigeria where health care financing is predominantly out-of-pocket is quite challenging. It was hypothesized that applying the principle of underwater seal pressure generation could convert a simple oxygen delivery system into an effective Bubble CPAP device. Objectives: To provide evidence in support of the immediate clinical effectiveness of the NH-BCPAP device. Design/Methods: At the neonatal unit of the National Hospital Abuja, we assembled a circuit of tubing connecting a gas source (oxygen concentrator or cylinder) through an interface (nasal prongs) to the baby and this was further connected through an expiratory tube to an under-waterseal bottle to generate CPAP. The device is activated by turning on the oxygen source. The device was applied to preterm babies with RDS as well as some term babies with respiratory distress admitted into the neonatal intensive care units. Respiratory rate, SPO2 and other signs of respiratory distress were monitored before and at 1 hour, 6 hours and 12 hours after the application. Results: Forty eight newborn babies with respiratory distress were treated with the device out of whom twenty three (48%) were very low birth weight with respiratory distress syndrome. The mean respiratory rate dropped from 64.5 (19.2)/min before commencement of CPAP to 59.5(11.6)/min, 56.6 (10.5), and 56.6(10.7) at 1, 6 and 12 hours respectively, p<0.05. The corresponding values for SPO2 were 84.5(14) before and 95.9 (5.3), 95.9(6.5) and 96.9(6.4) at 1, 6 and 12 hours respectively, p<0.05. The respiratory changes were however less marked among very low birth weight babies. Conclusion: The simplified customized device produces clinical responses similar to those reported for the conventional CPAP devices.

Background: Although the official age of fetal viability in Nigeria is 28 weeks, there are pockets of reports some anecdotal, of survival of babies  delivered at younger gestational age (GA) from different parts of the country. The routine resuscitation and management of premature infants born before the official age of fetal viability (28 weeks) is likely to generate important ethical and medical concerns that are bound to influence our  approach to the management of such infants. Aim: To determine the GAspecific neonatal mortality and survival among preterm deliveries at the National Hospital Abuja. Subjects and Methods: A retrospective review of relevant data from the National Hospital Neonatal Registry Database based on the Research Electronic Data Capture software (REDCap) was undertaken to determine the mortality rate of preterm babies managed in the neonatal intensive care unit (NICU) from January 2017 to February 2018. Disaggregated GA specific mortality rates were also computed to determine the fetal age at which extra uterine neonatal survival rate was at least 50%. Gestational age estimation was based on mothers’ last menstrual period (LMP) in over  96% of cases.Results: Sixty-three (63) of 305 preterm babies admitted died during hospitalization giving a mortality rate of 20.7%. This was significantly higher than the mortality rate among term babies (7.5%, P=0.01) hospitalized over the same period. Antenatal corticosteroid use was low (11.2%), 188  (25.8%) received CPAP for Respiratory Distress Syndrome (RDS), and none of the babies received surfactant or mechanical ventilation. There were no survivors among babies delivered at GA of 22-25 weeks (11, 3.6%). However, the survival rate at 26 weeks gestation was 53.8%, and this  subsequently increased, reaching a peak of 96.5% survival at 35 weeks. RDS accounted for 53.9% of all deaths. Conclusion: It is concluded that the survival rate (53.8%) of babies at GA of 26 weeks despite minimal antenatal interventions and limited postnatal  respiratory support was reasonably high, and this could serve the basis for discussions for a downward review of the age of fetal viability in Nigeria. Key words: Gestational age. Fetal viability

Objective: To determine the prevalence and pattern of malnutrition among adolescents in senior secondary schools in The Abuja Municipal area council Methods: Study design: this is a cross-sectional study conducted among adolescents (10-19 years) in secondary schools. A multistage sampling technique was employed to select a total of 1700 students from classes in selected schools. All schools in the Abuja Municipal Area council (AMAC) were stratified into urban and rural schools. Eight schools were selected by balloting from a list of schools obtained from the Education centre. A school was selected from each of the four major districts of AMAC and four schools were selected from the rural making a total of 8 schools. Although the consent of the school authorities was obtained, individual subject also consented to the study before being enrolled. The study excluded those adolescents who were physically challenged thus limiting physical activity. Information was obtained via the use of questionnaires that were administered by trained personnel. Subject's height and weight was taken using the floor-type height (H) and weight (W) measuring scale model ZT-120 using Massachusetts department of public health protocol. The nutritional status was determined using the formula: BMI= W/H 2 , where W =weight (in kilograms) and H= height (in meters). The age and sex specific height and BMI percentile for each subject was determined using the 2007 WHO Height and BMI growth charts for age 5-19years. The students were then classified into one of the following categories using previously used standards: normal, stunted, wasted, overweight or obese. Data was analyzed using SPSS version 17 statistical package. Results: The mean age was 14.43±1.94 years; male 688, female 862, M:F ratio 1.1.3. Mean BMI, weight and height were 20.31±3.07kg/m 2 , 51.07± 10.80 kg, and 157.88±9.33 cm. The prevalence of wasting, stunting, overweight and obesity was documented as 1.7% (27/1550), 11.3% (175/1550), 13.2% (205/1550), and 2.6% (41/1550) respectively. Those in urban schools had higher mean BMI (20.91±3.22 kg/m2 versus 19.71±2.78 kg/m2) and height (160.41±9.14 cm versus 155.32±8.81 cm) and p values <0.05. Conclusion: There is a double burden of over-nutrition (overweight and obesity) and under-nutrition (stunting and wasting) among adolescents in Nigeria.

We report prune belly syndrome, a rare congenital malformation, in a set of twins delivered to a young couple with a history of three previous first trimester spontaneous abortions, discordant HIV seropositivity and antenatal ultrasound report that indicated renal abnormalities in only one of the twins. The challenges of management are discussed.