RESUMEN
Serum electrolytes urea and creatinine of 80 clinically stable normal newborn comprising 60 preterm and 20 term appropriate for gestational age babies were prospectively studied. A negative correlation between the serum sodium, potassium, urea, creatinine and the gestational age was found. A statistical significant difference in the mean values of serum urea and creatinine in both preterm and term babies was obtained but there was no statistical significant difference in the mean value of serum sodium and potassium.
Asunto(s)
Creatinina/sangre , Potasio/sangre , Sodio/sangre , Urea/sangre , Análisis de Varianza , Femenino , Edad Gestacional , Humanos , Recién Nacido , Masculino , NigeriaRESUMEN
A 10-week prospective study was undertaken to document the antibiotic susceptibilities of klebsiella organisms which were responsible for an outbreak of septicaemia on the neonatal units of the University College Hospital, Ibadan, Nigeria. The thirty-nine isolates obtained comprised K. pneumoniae, 18 (46.2%), K. aerogenes, 17 (43.6%), K. edwardsii, 3 (7.7%), and K. oxytoca, 1(2.5%). All the strains were sensitive to ciprofloxacin and ofloxacin, but resistant to ampicillin. The percentage of qualitative sensitivities of the klebsiella species to other available drugs were 41% for ceftazidime, 36% for cefotaxime, 31% for ceftriazone, 23% for cefuroxime, 21% for gentamycin, and 15% for kanamycin. Quantitative sensitivities of the three most commonly isolated sub-types to netilmycin were 63%, 36%, and 33%, respectively. A comparison with a previous antibiotic susceptibility study still showed persistent resistance to the available aminoglycosides.
Asunto(s)
Brotes de Enfermedades , Infecciones por Klebsiella/epidemiología , Klebsiella/efectos de los fármacos , Sepsis/epidemiología , Resistencia a la Ampicilina , Antibacterianos/uso terapéutico , Antiinfecciosos/uso terapéutico , Cefotaxima/uso terapéutico , Ceftazidima/uso terapéutico , Ceftriaxona/uso terapéutico , Cefuroxima/uso terapéutico , Cefalosporinas/uso terapéutico , Ciprofloxacina/uso terapéutico , Farmacorresistencia Microbiana , Gentamicinas/uso terapéutico , Humanos , Recién Nacido , Kanamicina/uso terapéutico , Klebsiella/clasificación , Infecciones por Klebsiella/tratamiento farmacológico , Klebsiella pneumoniae/efectos de los fármacos , Netilmicina/uso terapéutico , Nigeria/epidemiología , Ofloxacino/uso terapéutico , Estudios Prospectivos , Sepsis/tratamiento farmacológicoRESUMEN
Total leukocyte counts were done in 180 apparently healthy rural school children aged 6-12 years in a malaria endemic area in southwestern Nigeria. Total leukocyte counts and their distribution in aparasitaemic and asymptomatic parasitaemic children were similar. Total leukocyte counts, and the relationship between the density of parasitaemic and total leukocyte counts were studied in 55 consecutive children presenting with acute symptomatic falciparum malaria. Children without parasitaemia were older and had lower total leukocyte counts when compared with children with parasitaemia (7.61 +/- 4.11 x 10(9)/L Vs 9.04 +/- 5.0 x 10(9)/L), but the difference was not statistically significant (P > 0.05). In non-hyperparasitaemic children and in hyperparasitaemic children with percentage infected red cells < 10%, there was poor correlation between density of parasitaemia and total leukocyte counts. However, at > or = 10% parasitaemia, there was a positive correlation (r = 0.55; P = 0.032) between increasing parasitaemia and leukocytosis. Combination of hyperparasitaemia ( > 5% parasitaemia) and leukocytosis ( > 12 x 10(9)/L) occurred in 15% of the children and was not a poor prognostic index in the absence of other evidence of severe or complicated disease, as response to oral mefloquine was prompt. This would suggest that in African children from an endemic area, this combination is not a reliable indicator of severity or poor prognosis in falciparum malaria.
Asunto(s)
Recuento de Leucocitos , Malaria Falciparum/sangre , Salud Rural , Salud Urbana , Enfermedad Aguda , Distribución por Edad , Estudios de Casos y Controles , Niño , Preescolar , Femenino , Humanos , Lactante , Malaria Falciparum/epidemiología , Malaria Falciparum/parasitología , Masculino , Nigeria/epidemiología , PronósticoRESUMEN
A female pre-term infant was delivered to a teenage mother who had fresh "meconium-stained" liquor during labour. At resuscitation, the baby had copious amount of greenish effluent coming from and also sucked out of the pharynx and stomach. She was subsequently diagnosed as having ileal atresia; the initially thought "meconium stained" liquor was the result of in-utero bilious vomiting, secondary to the intestinal obstruction. She had resection of the atretic bowel and end to back anastomosis; she died 24 days post-operatively.
Asunto(s)
Bilis , Íleon/anomalías , Obstrucción Intestinal/etiología , Vómitos/etiología , Anomalías Congénitas/diagnóstico por imagen , Anomalías Congénitas/cirugía , Errores Diagnósticos , Resultado Fatal , Femenino , Humanos , Recién Nacido , Síndrome de Aspiración de Meconio/diagnóstico , RadiografíaRESUMEN
The report concerns an outbreak of neonatal Klebsiella septicaemia at the University College Hospital, Ibadan, Nigeria, between October and November 1991. Mortality, 35.7%, was higher in the preterm babies than in the term babies (p < 0.05). The important predisposing factors to infection identified were birth asphyxia, necessitating active resuscitation, prematurity, prolonged rupture of the membranes and maternal intrapartum pyrexia. The Klebsiella species isolated from the babies and the hospital environment during the outbreak were of the multiple drug resistant type. Preventive measures and the need for a continual bacteriological surveillance are highlighted.
Asunto(s)
Bacteriemia/epidemiología , Infección Hospitalaria/epidemiología , Brotes de Enfermedades , Infecciones por Klebsiella/epidemiología , Bacteriemia/complicaciones , Bacteriemia/mortalidad , Bacteriemia/prevención & control , Infección Hospitalaria/complicaciones , Infección Hospitalaria/mortalidad , Infección Hospitalaria/prevención & control , Femenino , Humanos , Recién Nacido , Infecciones por Klebsiella/complicaciones , Infecciones por Klebsiella/mortalidad , Infecciones por Klebsiella/prevención & control , Masculino , Nigeria/epidemiología , Salas Cuna en Hospital , Factores de RiesgoAsunto(s)
Mefloquina/efectos adversos , Trastornos Mentales/inducido químicamente , Adulto , Niño , Preescolar , Esquema de Medicación , Femenino , Enfermedades Gastrointestinales/inducido químicamente , Humanos , Malaria Falciparum/tratamiento farmacológico , Masculino , Mefloquina/uso terapéutico , Persona de Mediana EdadAsunto(s)
Antimaláricos/uso terapéutico , Cloroquina/farmacología , Malaria Falciparum/tratamiento farmacológico , Complicaciones Parasitarias del Embarazo/tratamiento farmacológico , Pirimetamina/uso terapéutico , Sulfadoxina/uso terapéutico , Adulto , Animales , Combinación de Medicamentos , Resistencia a Medicamentos , Femenino , Humanos , Técnicas In Vitro , Inyecciones Intramusculares , Plasmodium falciparum/efectos de los fármacos , EmbarazoRESUMEN
OBJECTIVE: To ascertain the effect of isotonic saline and glucose infusions of oxytocin on neonatal bilirubin levels. METHOD: Eighty-two parturient Nigerian women requiring oxytocin infusion in labor were randomized into two groups receiving 0.9% saline or 5% glucose, respectively. A group of 82 women not requiring oxytocin were recruited for comparison. All had sodium and bilirubin estimations in cord plasma and neonatal bilirubin assay on Day 3. RESULT: Analysis of variance revealed higher mean cord and neonatal bilirubin levels in the glucose group compared with the other two (P < 0.05). Significant inverse correlation was observed between cord plasma sodium and neonatal bilirubin levels in all groups. Hyperbilirubinemia occurred in 55% of babies in the glucose group compared with 21% and 22% in the saline and control groups, respectively (P < 0.001). CONCLUSION: The use of isotonic saline rather than 5% glucose solution as vehicle for oxytocin infusion in labor appears to be associated with lower neonatal bilirubin levels.
Asunto(s)
Ictericia Neonatal/prevención & control , Oxitocina/administración & dosificación , Adulto , Bilirrubina/sangre , Sistemas de Liberación de Medicamentos , Femenino , Glucosa , Humanos , Recién Nacido , Soluciones Isotónicas , Embarazo , Cloruro de SodioRESUMEN
The prevalence of Plasmodium falciparum parasitaemia was evaluated in 59 neonates admitted to the University College Hospital, Ibadan in South-western Nigeria between August and December 1991--a period spanning part of both wet and dry seasons. Peripheral parasitaemia was present in 14 (23.7%) neonates; of these, four were preterm (4/26, 15%) and ten were term babies (10/33, 30.3%). The difference in the prevalence of P. falciparum parasitaemia in the two groups was not statistically significant (chi 2 = 1.78; p = 0.10). Parasite densities in all neonates were uniformly low (< 2000 asexual forms/microliters blood), and only four of the neonates had fever within 48 hrs of birth. Infected neonates weighed 200 g more than non-infected neonates, but the difference was not statistically significant. Maternal weekly pyrimethamine prophylaxis did not appear to be effective in preventing infection as six (21.4%) of the 28 neonates whose mothers had regular prophylaxis had parasitaemia compared with seven (26.9%) of the 26 neonates whose mothers had no prophylaxis (chi 2 = 0.22; p > 0.05). These data indicate that congenital malaria is not as uncommon as was previously thought and that the recent increase in reported cases may be due to an interplay of several factors.
Asunto(s)
Países en Desarrollo , Malaria Falciparum/congénito , Cloroquina/administración & dosificación , Estudios Transversales , Esquema de Medicación , Femenino , Humanos , Incidencia , Recién Nacido , Malaria Falciparum/epidemiología , Malaria Falciparum/prevención & control , Masculino , Tamizaje Neonatal , Nigeria/epidemiología , Pirimetamina/administración & dosificaciónRESUMEN
An outbreak of skeletal infections associated with neonatal Klebsiella septicaemia seen over a 6-month period at the Special Care Baby Unit, University College Hospital, Ibadan is reported. It involved 12 neonates, and the significant antecedent events included perinatal asphyxia, fetal distress and prolonged rupture of membranes. All the babies had septic arthritis and ten cases had osteomyelitis in addition: multiple joint involvement occurred in 50% of cases. All the babies exhibited severe systemic disturbance and the Klebsiella isolated demonstrated multiple antibiotic resistance. The epidemic coincided with a period of severe water shortage which affected the hospital. The probable nosocomial acquisition of the infection is highlighted.
Asunto(s)
Artritis Infecciosa/epidemiología , Infección Hospitalaria/epidemiología , Países en Desarrollo , Brotes de Enfermedades , Enfermedades del Prematuro/epidemiología , Infecciones por Klebsiella/epidemiología , Osteomielitis/epidemiología , Sepsis/epidemiología , Artritis Infecciosa/diagnóstico , Artritis Infecciosa/tratamiento farmacológico , Ceftazidima/administración & dosificación , Cefuroxima/administración & dosificación , Cloxacilina/administración & dosificación , Infección Hospitalaria/diagnóstico , Infección Hospitalaria/tratamiento farmacológico , Estudios Transversales , Quimioterapia Combinada , Femenino , Gentamicinas/administración & dosificación , Humanos , Incidencia , Recién Nacido , Enfermedades del Prematuro/diagnóstico , Enfermedades del Prematuro/tratamiento farmacológico , Infecciones por Klebsiella/diagnóstico , Infecciones por Klebsiella/tratamiento farmacológico , Masculino , Nigeria/epidemiología , Osteomielitis/diagnóstico , Osteomielitis/tratamiento farmacológico , Sepsis/diagnóstico , Sepsis/tratamiento farmacológicoRESUMEN
Influence of maternal bio-social factors; including age; pre-pregnancy weight/height; social class; birth-order; birth-spacing; educational level and use of antenatal-care facilities; on birthweights of 1;238 singletons was studied over a period of six months at three hospitals in Ibadan. There was a significant (p0.001) influence on birthweight by the age of the mother; such that teenage mothers gave birth to lighter babies than older mothers. The study also revealed that the most appropriate period in life for a woman to have normal size babies was between 25 and 29 years of age. There was a significant difference (p0.05) between the mean birthweight of babies delivered by mothers weighing less than 70kg and those whose weights were 70kg and above
Asunto(s)
Peso al Nacer , Recién Nacido de Bajo Peso , Problemas SocialesRESUMEN
A case of severe falciparum hyperparasitaemia with trophozoites in greater than 35% of the patient's erythrocytes, relative lack of clinical symptoms and no organ complication is described. The patient, a 26-month old African child, was treated with oral mefloquine with prompt clearance of fever and parasitaemia in 24 and 48 hours respectively. No untoward sequelae was observed during 75 days of periodic clinical assessment.