No abstract

Newborns admitted with convulsion in the University of Calabar Teaching Hospital, Calabar during the period 1 st May 2004 to 30 April 2006 were studied prospectively. The aim was to determine the place of birth in relation to the cause of seizures, the current situation in terms of the aetiology, clinical spectrum and outcome. There were 55 neonates with convulsion representing 5% of admissions into the newborn unit during the period. Birth asphyxia, sepsis, and hypoglycaemia were important identifiable aetiological factors which operated either singly (45.5%) of cases) or in concert (54.5% of cases) in causing seizures. Hypocalcaemia and hyponatraemia contributed less. These results are similar to that of a previous study carried out in this centre ten years earlier . There was no statistical significant difference between home and hospital deliveries in relation to causes of seizures. Septicaemia was caused mainly by staphylococcus aureus, enterobactericae and unclassified coliforms. No neonatal meningitis was diagnosed. Surprisingly, there was a high prevalence of generalized seizures (76.4%). The mortality of 34.0% was related to onset of the seizures within 4 days of life but not the place of birth. The causes of neonatal seizures in our environment are mostly preventable. There is need to provide modern facilities for investigating newborn seizures, training and retraining of Traditional Birth Attendants, health education of expectant mothers.

The urine samples of pupils from 4 Primary schools in Calabar were studied for asymptomatic proteinuria. The aim was to determine the prevalence of asymptomatic proteinuria in children in calabar. For each pupil, two urine samples were tested for proteinuria using the dipstick. The first urine sample was collected at school and the second was an early morning urine sample brought from home. A total of one thousand two hundred and seventy five children (1,275) were screened. Two hundred and thirty eight (18.6%) children had varying degrees of proteinuria ranging from trace to 500gm/dl in the daytime. Of these, only twenty (1.6%) had significant proteinuria of 30mg/dl to 500mg/dl. A repeat testing with early morning urine still showed significant proteinuria in 1.6% of these children. The prevalence of asymptomatic proteinuria was more in girls (65%) than in boys (35%), giving a male to female ratio of 1:1.9. The study identifies the need to always screen all children for proteinuria before admission into schools, as this will facilitate early detection of nephropathies in them and permit early investigation, treatment and follow-up.

Treatment methods used were m e d i c a t i o n (1. 6 %) , w a t e r restriction (42.8%), awaking for voiding (27.3%) use of alarm bell (0.5%), herbal medication (8.0%), while 19.8% received no form of treatment. Help seeking behavior for this condition was poor as only 2.1% of this study population ever sought medical attention for this condition. The frequency of enuresis was similar to most reports in literature. Help-seeking behavior was poor. Parental education, advocacy and awareness creation on the availability of medical help for enuresis are suggested. Nocturnal enuresis, Treatment, School children. Conclusion:

Enema is largely used and widely abused in our community for various ailments including fever, constipation; abdominal pains vomiting and even diarrhoea. Objectives: To describe the abuse of enema at home in the Calabar area, and the associated findings among children who received enema. Method: Children admitted to the Children Emergency Unit of the University of Calabar Teaching Hospital with history of enema use at home were recruited into the study. The presenting symptoms, type of enema used and associated findings were documented. Relevant investigations were carried out where necessary. Tables and simple proportions were used to analyze the data. Results: Twenty two children were seen with enema abuse over a six months period. Diarrhoea diseases and fever were the predominant reasons why enema was given. Types of enema given were herbal concoctions in 13(59.1%) plain water enema in 8(36.4%) and salt water enema in one (4.5%) child. Electrolytes derangements were the commonest associated findings. Others were convulsions/coma, intestinal perforation, acute renal failure and severe dehydration from diarrhoea. Conclusion: Enema abuse is a continuing cultural phenomenon in the Calabar area. It is associated with severe consequences including intestinal perforation. Enema abuse should form part of history taking in this environment and child care practitioners should actively search for possible complications. Most importantly, health education to stem this widespread practice