Background:Childhood bacterial meningitis is a neurologic emergency that continues to kill and maims children particularly in developing countries with poor immunization coverage.Objective:This study set out to assess the hospital incidence, pattern of presentation, etiologic agents, outcome and determinants of mortality among the children admitted with bacterial meningitis at the Wesley Guild Hospital (WGH), Ilesa.Patients and Methods:We carried out a retrospective review of admitted cases of bacterial meningitis in children aged one month to 15 years at the WGH, Ilesa over a three year period by looking at the hospital records. Factors in the history and examinations were compared among survivors and those that died to determine factors significantly associated with mortality in these children.Results:Eighty-one (5.5%) of the 1470 childhood admissions during the study period had bacterial meningitis. Male preponderance was observed and two-thirds of the children were infants. More cases were admitted during the wet rainy season than during the dry harmattan season. Haemophilus influenzae type B and Streptococcus pneumoniae were the leading etiologic agents and ciprofloxacin and ceftriaxone adequately cover for these organisms. Twenty-two (27.2%) of the 81 children died, while 34 (42.0%) survived with neurologic deficits. Children with multiple seizures, coma, neck retraction, hyponatremia, hypoglycorrhachia, turbid CSF as well as Gram positive meningitis at presentation were found to more likely to die (P < 0.05). None of these factors however independently predict mortality.Conclusion:Childhood bacterial meningitis often results in death and neurologic deficit among infants and young children admitted at the WGH, Ilesa. Children diagnosed with meningitis who in addition had multiple seizures, neck retraction and coma at presentation are at increased risk of dying.

Spinel ferrites nanomaterials are magnetic semiconductors with excellent chemical, magnetic, electrical, and optical properties which have rendered the materials useful in many technological driven applications such as solar hydrogen production, data storage, magnetic sensing, converters, inductors, spintronics, and catalysts. The surface area of these nanomaterials contributes significantly to their targeted applications as well as the observed physical and chemical features. Experimental doping has shown a great potential in enhancing and tuning the specific surface area of spinel ferrite nanomaterials while the attributed experimental challenges call for viable theoretical model that can estimate the surface area of doped spinel ferrite nanomaterials with high degree of precision. This work develops stepwise regression (STWR) and hybrid genetic algorithm-based support vector regression (GBSVR) intelligent model for estimating specific surface area of doped spinel ferrite nanomaterials using lattice parameter and the size of nanoparticle as descriptors to the models. The developed hybrid GBSVR model performs better than STWR model with the performance improvement of 7.51% and 22.68%, respectively, using correlation coefficient and root mean square error as performance metrics when validated with experimentally measured specific surface area of doped spinel ferrite nanomaterials. The developed GBSVR model investigates the influence of nickel, yttrium, and lanthanum nanoparticles on the specific surface area of different classes of spinel ferrite nanomaterials, and the obtained results agree excellently well with the measured values. The accuracy and precision characterizing the developed model would be of immense importance in enhancing specific surface area of doped spinel ferrite nanomaterial prediction with circumvention of experimental stress coupled with reduced cost.

Background The occurrence of adverse events following immunization (AEFI) in national immunization programmes is very rare; however, if they occur causality assessment is conducted to identify the associated cause. In the report, we describe a case of severe necrotizing fasciitis in the left arm of a 9-month old boy following administration of the measles vaccine. Case presentation A 9-month old boy presented with swelling on the left upper arm and adjoining the chest area, low-grade continuous fever, frequent passage of loose watery stool and persistent cries 24 h after measles vaccine was administered on the left upper arm. On examination, he was mildly pale, febrile, anicteric. Extensive erythema of the left upper arm occurred thereafter with extensive scalded skin lesions involving the deltoid area, the upper chest wall and arm. This was followed by desquamation of the affected areas and severe necrosis. A diagnosis of severe necrotizing fasciitis was made. A causality assessment was conducted by the state AEFI committee using the detailed AEFI investigation forms to identify the cause of the incidence. Conclusion Here we present a rare case of necrotizing fasciitis which could have been caused by incorrect use of reconstituted measles vaccine. Hence we recommend training of routine immunization service providers on proper vaccine management as well as intensified supervision of immunization sessions.

ObjectiveTo evaluate the effectiveness of intermittent pulse oximetry in guiding oxygen therapy in neonates in a low-resource setting.Design and settingProspective validation study at three hospitals in southwest Nigeria. We performed concealed continuous pulse oximetry on participants to evaluate intermittent SpO2 monitoring.PatientsWe recruited all preterm or low birthweight neonates, and all term neonates who required oxygen therapy, who were admitted to the neonatal ward(s) of the study hospitals during the study period.Main outcome measuresProportion of time preterm/low birthweight neonates on oxygen spent within, above and below the target SpO2 range of 90%–95%; and the proportion of time term neonates and neonates not on oxygen spent within and below the target range of 90%–100%.ResultsPreterm/low birthweight neonates receiving oxygen therapy (group A) spent 15.7% (95% CI 13.3 to 18.9) of time in the target SpO2 range of 90%–95%. They spent 75.0% (63.6–81.1) of time above 95%, and 2.7% (1.7–5.6) of time below 85%. Term neonates and all neonates not receiving oxygen (group B) spent 97.3% (95% CI 96.4 to 98.6) of time within the target range of 90%–100%, and 0.9% (0.3–1.4) of time below 85%. Guidelines recommended SpO2 monitoring 3 times per day for all patients, however neonates in groups A and B were monitored an average of 4.7 and 5.3 times per day, respectively.ConclusionsTo better maintain SpO2 within the target range, preterm/low birthweight neonates on oxygen should have their SpO2 monitored more frequently than the current 4.7 times per day. In all other neonates, however, monitoring SpO2 5.3 times per day appears suitable.

The members of the writing committee assume responsibility for the overall content and integrity of this article. The full names, academic degrees, and affiliations of the members of the writing committee are listed in the Appendix.