ObjectiveTo describe admission pattern and outcome with its predictor variable on the mortality of children admitted to pediatric intensive care unit (PICU), Ayder Referral Hospital, Northern Ethiopia, from September 2012 to August 2014.ResultFrom 680 admitted patients, 400 patients were analyzed. Average age at admission was 62.99 ± 60.94 months, with F:M ratio of 1:1.2. Overall (from infectious and non-infectious) the most commonly affected systems were respiratory (90/400 pts., 22.5%) and central nervous system (83/400 pts., 20.75%). Most were admitted due to meningitis (44/400 pts., 11%), post-operative (43/400 pts., 10.8%) and acute glomerulonephritis (41/400 pts., 10.3%). The overall mortality rate was 8.5%. Multivariable logistic regression shows, use of inotropes (p = 0.000), need for mechanical ventilator (p = 0.007) and presence of comorbid illness (p = 0.002), infectious cause (p = 0.015) and low level of Glasgow coma scale less than eight (p = 0.04) were independent predictors of mortality. From this study, common cause of PICU admission and death was meningitis. This highlights the importance of focusing on the preventable methods in the public such as vaccine, creating awareness about hygiene, and expanding ICU for early detection and for treatment acutely ill children.Electronic supplementary materialThe online version of this article (10.1186/s13104-018-3432-4) contains supplementary material, which is available to authorized users.

Background Iron folate supplementation is a cost-effective way of reducing iron deficiency anemia, low birth weight, and neural tube defects in resource-limited countries like Ethiopia. Late to start and poor adherence to iron-folate supplement has restricted its effectiveness. The aim of this study was to determine the time to start and adherence level of iron-folate supplementation to pregnant women attending at the Ayder Comprehensive Specialized Hospital. Methods Two hundred pregnant women were recruited in cross-sectional study design between February and April 2018. Results From the total participant pregnant women the urban dweller constituted the major proportion of 182 (91%). Seventy-eight (39%) of the participants had two antenatal care visits, whereas only, 21 (10.5%) of them had an antenatal care visit three and above. One hundred fifty-five (77.5%) participants women had knowledge about the cause of anemia in pregnancy. In this study, 143 (71.5%) of the pregnant women started their iron folate supplement in the second and third trimester. The adherence of iron folate intake was 10.5%. Healthcare education and counseling about iron-folate supplementation (AOR =4.55, 95% CI =[1.534, 13.512]), number of pregnancies (AOR =6.941, 95% CI =[1.511, 31.09]), and number of antenatal visit (AOR =0.242, 95% CI =[0.069, 0.852]) were significantly associated with adherence to iron-folate supplementation. Conclusion Time to start iron folate supplement in the first trimester was low and the adherence level was also very poor, which can be attributed by the number of antenatal care visits, frequency of pregnancy and healthcare education and counseling about iron folate supplement.

Background An umbilical granuloma is one of the common umbilical masses in young children which appears after the cords fall off, mainly due to an inflammatory reaction to subclinical infections. Though there are different recommendations of treatment modalities, which management modality is the best is not clear yet. Objective This systematic review aimed to assess the effectiveness of salt treatment in terms of complete resolution of the granuloma, any adverse effect, and any recurrence risk in those patients treated as inpatient or outpatient care. Methodology The literature search was done using search engines including Google scholar, PubMed, and Medlin. Articles published since 1990 and written in the English language with a target population of young children (less than 24 months) were included. To retrieve the articles, umbilical granuloma, treatment of umbilical granuloma, salt treatment, and neonatal umbilical disorder were used as keywords. Results This systematic review indicated that the majority of the studies done on salt treatment for umbilical granuloma show excellent response (complete resolution of the granuloma/discharge) with no adverse effect and no recurrence in the subsequent follow-up of the patients in almost all cases of the treatment group. Salt inside the occluded hyperosmolar chamber causes shrinkage of granuloma by a desiccant effect. Conclusion Cooking salt treatment for umbilical granuloma is effective, cheap, available, and easy to apply by non-health professionals. No side effects have been reported yet and a recurrence of the granuloma after treatment seems to be null.

Introduction: Umbilical granuloma (UG) is the most common cause of umbilical mass and it is formed in the first few weeks of life after the umbilical cord separates. Though there are different options of treatment described in the literature, there is no clear consensus on the best option of treatment. In our case, we will describe the complete resolution of granuloma with salt treatment with no adverse effect. Case Presentation: An 18-day-old female infant presented to the outpatient department (OPD) with concerns of swelling over the umbilicus with a yellowish discharge of one-day duration noticed after separation of the umbilical cord. The discharge was, initially, odorless, with no fecal or urine content, no pain, and behavioral change in the neonate. The mother was advised on sponge wash and to apply silver nitrate or liquid nitrogen. After five days, the patient presents with purulent discharge from the umbilical swelling of two-day duration but no other complaint. Discharge was noted to be purulent but no erythema in the surrounding skin. The patient had no leukocytosis on labs. A teaspoon of cooking salt was applied to cover the whole granuloma and packed the umbilicus for 30 minutes with gauze. After 30 minutes on the pack, the salt was removed and cleaned with normal saline. Subsequently, after the salt was applied, the granuloma changed from red to blush hue. After three applications of salt pack, the granuloma decreased in size, became dry, and separated. There was no side effect noted and the infant was followed up with no recurrence noted at 3 months of age. Conclusion: Salt treatment appears to be an effective, available, and less costly treatment option for an umbilical granuloma.

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