Background: Tetanus continues to threaten the survival of children in spite of it being a vaccine preventable disease. The objective of this study was to determine the prevalence of post-neonatal tetanus, review the vaccination of affected children, complications encountered and the outcome among affected children in a tertiary health institution in southwestern Nigeria. Methods: The study was a retrospective study. Case notes of children outside neonatal life admitted to the Paediatric ward with clinical diagnosis of tetanus between January 2012 and October 2018 were retrieved and evaluated to identify socio-demographic and clinical characteristics. A review of the immunization history and cards was done where the immunization cards were available. Results: 21children with post-neonatal tetanus were admitted over a period of six years (November 2012 to October 2018) with a prevalence of 0.3%. The M:F was 3.2:1. The mean age in years was 10.14 ±3.44 while the age range of the subjects was 4 to 16years. None of the patients had booster doses of tetanus toxoid (TT) outside the infancy period. Nine (42.9%) subjects had no previous TT vaccination, 2 (9.5%) had 3 doses of TT vaccine in infancy but developed tetanus at age ≥9 years, 1(4.8%) subject had a dose of TT while the remaining 9subjects had no proof of previous TT vaccination. The percentage mortality was 19% (4 out of 21). All the patients that died had no prior record of TT vaccination. Complications identifi ed included laryngeal spasm and autonomic dysfunction. Conclusion: Post-neonatal tetanus is still common in our locality because booster doses of Tetanus Toxoid are not part of the national immunization schedule. Complete dose of tetanus toxoid vaccination during infancy and booster doses at school entry is necessary and should be part of school health programme to forestall post-neonatal tetanus.

Type 2 diabetes in children and adolescents is an emerging clinical problem globally in the last three decades. Previously it was thought that type 2 DM does not affect children and adolescents. There is need for high index of suspicion especially in obese children and adolescents who have positive family history of type 2 diabetes. We present a case of a newly diagnosed type 2 DM in a female adolescent previously thought to have type 1 DM. She presented with weight loss, polyuria, polydipsia and polyphagia. She had a positive family history of type 2 DM. She was previously managed as Type 1 DM but when hyperglycaemia was not responding to insulin therapy and fasting serum C-Peptide was within normal limit, a diagnosis of type 2 DM was made and she has since been doing well on oral hypoglycaemic agent.

Background: Childhood and adolescents obesity is a public health challenge. Studies on predictors of obesity among children in developing countries are very few. The aim of the index study is to determine the predictors of childhood obesity in Ekiti State, Nigeria. Methods:The index study was a cross-sectional study among secondary school adolescents in Ekiti State. After receiving Government approval and school permission to enter the schools, structured questionnaires were administered to students whose parents gave consent to participate in the study. Measurement of weight, height, waist circumference, blood pressure, and fasting blood glucose were done following standard procedures. Binary logistic regression was employed to determine the predictors of obesity Results: 346 (55.1%) males and 282 females (44.9%) participated in the study. More females than males were in the low/middle social class (25.2% vs. 14.2%, p <0.001), consumed more snacks (91.8% vs. 85.5%, p=0.014), and had general obesity (13.2% vs. 2.3%, P < 0.001). The mean BMI, SBP, DBP and FBG were significantly higher (P < 0.

Steroids are widely used in all sub-specialties of medicine as anti-inflammatory or immunosuppressive agents. Glucocorticoid-induced diabetes mellitus is a known but poorly reported complication of steroid therapy in developing countries. We report a case of steroid-induced diabetes mellitus in a 14 year old female nephritic adolescent who developed diabetic ketoacidosis while on prednisolone therapy for nephrotic syndrome. She presented with two day history of abdominal pain, one day history of frequent loose stool and vomiting. She was restless on admission, had random blood glucose of 32mmol/L and 3+ of ketonuria. She was successfully managed with insulin therapy over a four month period while she was gradually weaned off prednisolone. Diabetes mellitus is a common life-threatening complication of steroid therapy which requires good clinical surveillance and prompt management.