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Background Nigeria has the largest number of global under-five deaths and almost half of these occur in the newborn period in an almost 50:50 ratio across hospital facilities and communities. We examine and describe risk factors for newborn mortality at a busy neonatal unit of a referral tertiary hospital in North-central Nigeria. Methods We conducted a retrospective cohort analysis of all newborn admissions to the Dalhatu Araf Specialist Hospital between September 2018 and March 2020. We determined the newborn mortality rate (NMR) and case fatality rates (CFRs) for individual diagnostic categories and determined risk predictors for mortality using cox-proportional hazard models. Results Of 1171 admitted newborn infants, 175 (14.9%) died with about half of these occurring within 24 h of admission. Extremely low birth weight infants and those with congenital anomalies had the highest CFRs. Identified risk factors for mortality were age at admission [adjusted hazard ratio (AHR): 0.996, 95% CI: 0.993–0.999], admitting weight (AHR: 0.9995, 95% CI: 0.9993–0.9997) and home delivery (AHR: 1.65, 95% CI: 1.11–to 2.46). Conclusions Facility-based newborn mortality is high in North-central Nigeria. Majority of these deaths occur within the first 24 h of admission, signifying challenges in acute critical newborn care. To improve the current situation and urgently accelerate progress to meet the sustainable development goal NMR targets, there is an urgent need to develop human and material resources for acute critical newborn care while encouraging facility-based delivery and decentralizing existing newborn care. Lay summary Nigeria now has the greatest number of deaths in children below the age of five globally. Almost half of these occurred in the newborn period and these deaths occur within hospital facilities and also in communities in an almost 50:50 ratio. As such, the country might not attain global newborn mortality rates that were set as targets for the sustainable development goals (SDGs). In this article, we examine and describe the risk factors for newborn deaths occurring at a typical newborn unit in North-central Nigeria. During the period under review, we found that about 175 (14.9%) died and about half of these deaths occurred within 24 h of admission. Extremely small babies and those who were born with physical defects had the highest death rates. Older babies and those who weighed more at admission had decreased risks of dying while being delivered at home increased the risk of death. Hospital newborn deaths remain high in North-central Nigeria and the pattern of early admission deaths signifies challenges in stabilizing critically ill newborn infants. There is an urgent need to develop human and material resources for acute critical newborn care while encouraging institutional delivery and decentralizing of existing newborn care.

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Background: Nephrotic syndrome is a clinical condition caused by alteration of glomerular membrane permeability resulting in a net loss of protein, and vitamin D binding proteins in urine leading to hypoalbuminaemia and hypocalcaemia. A positive correlation between serum albumin and ionized calcium in childhood nephrotic syndrome has been described but the correlation between total serum calcium or corrected serum calcium and serum albumin has not been extensively described.Methods: This study was carried out at Dalhatu Araf Specialist Hospital, Lafia Nigeria. Fifteen children with idiopathic nephrotic syndrome were recruited consecutively as the cases, 15 age and gender matched healthy children were recruited as the controls. Total serum calcium and albumin was assayed in all these children. Corrected serum calcium was calculated for the cases. Tests of correlation was carried out to see if there was any relationship between corrected or total serum calcium and serum albumin.Results: The mean total serum calcium and serum corrected calcium levels in the cases was 2.04±0.34 mmol/l and 2.5 mmol/l respectively. The mean total serum calcium was 2.12±0.32 mmol/l for the controls. The mean serum albumin level was 14.7±4.1 g/l and 34.6±2.7 mmol/l for the cases and controls respectively. A negative and weak correlation was found between serum albumin and corrected serum calcium and a similar negative correlation between serum albumin and total serum calcium.Conclusions: The common reports of a positive correlation between serum ionized calcium and serum albumin cannot be applied to total or corrected serum calcium and serum albumin.