scholarly journals Paediatric brought-in-dead at a tertiary health facility in South western Nigeria: Patterns and drivers

2021 ◽  
Vol 48 (2) ◽  
pp. 66-73
Author(s):  
Oladele S. Olatunya ◽  
Adefunke O. Babatola ◽  
Adewuyi T. Adeniyi ◽  
Adebukola B. Ajite ◽  
Isaac O. Oluwayemi ◽  
...  

Background: ‘Brought- in-dead’ (BID) refers to the demise of an individual before presentation to a health facility. This study assessed the pattern of paediatric BID cases seen at a tertiary health facility in southwest Nigeria. Method: A cross-sectional, descriptive study was done at the Children Emergency Ward (CEW) of the hospital between January 2014 and December 2018. The patterns of BID cases and presumed causes of death were determined using a standardized checklist adapted from the WHO verbal autopsy instrument. Results: Ninety-eight BID cases were seen during the study, constituting 2.5% of total patients seen during the period. The median (IQR) age of cases was 24.0 (8.75 – 63.0) months and 72.4% were under-fives. Most had symptoms related to the haematologic (36.7%), respiratory (24.5%) or digestive (20.4%) systems. Severe anaemia 31(31.6%), gastroenteritis 19 (19.4) and aspiration 17 (17.3%) were the most common causes of death. The median (IQR) duration of illness before presentation was 3.0 (1.0 – 7.0) days but most presented from 4 – 7 days of illness. A significant relationship was found between the duration of illness and whether or not pre-hospital treatment was received (p < 0.0001). Unprescribed drugs purchased over the counter were the most commonly used treatment in 79.1% of cases (p < 0.0001). Conclusion: This study has highlighted the prevalence and pattern of paediatric BID in a tertiary health facility in southwest Nigeria and the factors that were associated with it. More efforts need to be geared towards community sensitization and pediatric health care to prevent factors drivingits menace.

1970 ◽  
Vol 40 (1) ◽  
pp. 18-21 ◽  
Author(s):  
MN Hossain ◽  
Z Rahman ◽  
S Akhter

A cross sectional study was carried out at the department of Forensic Medicine in Dhaka Medical College during the period of January 2008 to December 2009. Data were collected from 3rd copy of the post mortem reports which were preserved in the department of Forensic Medicine with the verbal consent of the doctors who performed autopsy report. During this period total 5114 autopsies were conducted. Out of this 970 cases (19%) were suicidal in nature. It was noticed that all suicidal deaths occurred from 10 years to all age group respectively, but top amongst age group of suicidal deaths occurred in between 21 to 30 years of people. Suicidal deaths are more common in female than male. Suicidal deaths due to hanging is highest, next common causes of death due to organophosphorus compund poisoning. Suicidal deaths by hanging is more in female than male but in poisoning cases male are more lvictimised than female. Objectives of our study are to see the occurrence and methods of suicidal death. DOI: http://dx.doi.org/10.3329/bmj.v40i1.9957 BMJ 2011; 40(1): 18-21


2018 ◽  
Vol 9 (1) ◽  
pp. 23-25
Author(s):  
Surayea Bul Bul ◽  
Zobaida Sultana Susan ◽  
Raunak Jahan ◽  
Abu Nayeem ◽  
Farzana Rahman ◽  
...  

Background : Complications of pregnancy and childbirth have always been one of the leading causes of death and disability among women of reproductive age in developing countries .Globally, postpartum haemorrhage is the single most important cause of maternal death, accounting for about 25% of the total and claiming an estimated 1,50,000 lives annually. Among the postpartum hemorrhage, the primary postpartum hemorrhage is more prevalent, but sufferings from secondary postpartum hemorrhage have been emerging. With the rising trend of cesarean section rate, the incidence of secondary postpartum hemorrhage is also rising.Objective: The objectives of this study is to evaluate secondary postpartum hemorrhage cases following cesarean section and vaginal delivery with the aim of reducing the maternal mortality at child bearing age.Methods: This is a cross sectional observational study in the department of Obstetrics and Gynaecology, DMCH , by purposive sampling method. Total 100 cases of secondary PPH were observed during 1st January 2013 to 31 December 2013.Result: In this study, among the cases 67% were following cesarean section and 33% were following vaginal delivery, mean age of the patients were 29 year, parity ranges from 1 to 5. Regarding the outcome of secondary PPH, severe anaemia, anaemic heartfailure, renal failure and DIC were common in cesarean sections along with hazards of massive blood transfusion and jaundice. 7 patients were died in post cesarean cases and 2 died in post vaginal delivery cases. Causes of death were due to hemorrhagic shock & septicemia.Conclusion: In this is study, the rate of secondary PPH is 67% following cesarean section which is very much alarming . The outcome of secondary PPH following cesarean section is worse than vaginal delivery.J Shaheed Suhrawardy Med Coll, June 2017, Vol.9(1); 23-25


2020 ◽  
Vol 40 (3) ◽  
pp. 247-254
Author(s):  
Oladele Simeon Olatunya ◽  
Adewuyi Temidayo Adeniyi ◽  
Adefunke Olarinre Babatola ◽  
Odunayo Tolulope Fatunla ◽  
Oyebanji Anthony Olajuyin ◽  
...  

Introduction: Teething is a physiologic process that begins during infancy. However, some mothers often attribute certain symptoms to teething. In this study, we assessed the opinions and practices of mothers attending a tertiary health facility in Nigeria on teething. Methods: This was a cross-sectional, descriptive study conducted among caregivers of children presenting to the out-patient department of a tertiary hospital, Southwestern Nigeria. Results: Five hundred and sixteen mothers were studied. The leading symptoms attributed to teething were fever 420 (81.4%), reduced food intake / appetite 320 (62.0%), diarrhoea 314 (60.9%) and vomiting 294 (57.0%). Some believed that teething is associated with convulsion 102 (19.8%), mouth ulcers 69 (13.4%), ear discharge 68 (13.2%), and no symptoms 41 (7.9%). Majority of the mothers 374 (72.5%) believed that teething requires treatment. Two hundred and four (39.5%) mothers had given their children oral analgesics for teething while 194 (37.6%) administered teething mixtures. These medications were more likely to be prescribed at the hospital or purchased over the counter (p < 0.05). Other treatments given included herbal concoction 46 (8.9%), local tooth extraction 22 (4.3%), enema 17 (3.3%), body scarifications 14 (2.7%), gum fomentation 14 (2.7%) and gum incision 12 (2.3%). Responders who attributed convulsion to teething were more likely to have incised their children’s gums (p < 0.05). Conclusions: This study revealed that sundry symptoms were attributed to teething and harmful home interventions were done for teething. There is a need to educate the society on teething and discourage harmful practices for teething by caregivers.


Author(s):  
Ntambwe Malangu ◽  
Yvonne Karamagi

Background: Outcomes of antiretroviral treatment have been documented in both developed and developing countries. It has been reported consistently that the treatment is associated with many adverse events. However, little is known about their impact on the quality of life, clinical management, and survival in children aged less than 6 years in Uganda.Objectives: The purpose of this study was to determine the prevalence of the adverse events of antiretroviral treatment, their impact on mortality and the change in regimens prescribed to children treated at Mildway Centre in Uganda.Method: A retrospective chart review was performed for children younger than 6 years, treated since the Mildway Centre was opened in 1999. In order to achieve a larger sample, the records of children treated from January 2000 to July 2005 were included in the study. A pre-tested data collection form was used to collate socio-demographic and clinical data of the patients. These included the documented adverse events, causes of death, stage of infection, duration of treatment, regimen prescribed, year of enrolment into the treatment program, as well as whether or not they were still alive. Descriptive statistics were used in the analysis of data.Results: Of the 179 children, the majority were males and had a median age of 4 years. The majority (58.8%) of children had suffered from severe immune depression since they met the WHO clinical stage III and IV, 73.8% had a baseline CD4T of less than 15%. Four regimens were prescribed to the children. The most common was a regimen containing zidovudine, lamivudine, and nevirapine (34.6%), followed by a regimen containing stavudine, lamivudine, and nevirapine (27.9%). Eleven children (6.1%) had their regimen changed, of which six (54.5%) were due to adverse events. The prevalence of adverse events was 8%; of the 14 documented adverse events, the most common were severe anaemia (3), vomiting (3), and skin rashes (3). After 12 months on treatment, 8% of the patients had died. The most common causes of death were infectious diseases (28.6%), severe anaemia (21.4%), and severe dehydration (21.4%).Conclusion: The prevalence of adverse events was 8%; they were responsible for 54.5% of regimen changes and 21.4% of deaths in children treated at the study site. These findings suggest the need for incorporating pharmacovigilance practices into the provision of antiretroviral treatment.


Author(s):  
Rashma Sanichar ◽  
Bibi Alladin

Objectives: To identify common causes and patterns of mortality and associated modifiable factors in Paediatric medical services, GPHC for 2016 and 2017. Design and Methods: Descriptive, Cross-sectional retrospective study of all Paediatrics deaths for 2016 and 2017 from the Paediatrics Medical Ward and ICU at GPHC. Data were analysed using IBM SPSS version 23 for descriptive statistics. Results: The Paediatrics Medical Ward saw 2419 admissions in 2016 and 2168 in 2017. There were 86 deaths recorded in the death registry during the two years, of which 57 deceased patient charts were reviewed, 29 charts (33.7%) were missing. Of the 57 charts reviewed, 42.1% were males and 57.9% were females. The most common final diagnosis was bronchopneumonia/pneumonia (n=1 (22.8%), followed by sepsis (n= 12 (21.0%). This pattern was seen in both the general sample population and the patients ≤ 5 years. Some of the modifiable factors which showed clinical significance when compared with length of hospitalization were; lack of routine reviews on the ward (p value 0.016), poor documentation of consultation information on referral notes (p value 0.032) and poor or no pre-hospital treatment before transfer (p value 0.017). Conclusions: Factors associated with mortality are mainly hospital-related and should, therefore, be given urgent attention for resolution which may reduce childhood mortality. In addition, the common causes of death are preventable and treatable respiratory and infectious diseases. Recommendations: Develop referral, transfer and management protocols for critical patients. Sensitization of staff on modifiable factors to effect positive behavioural change.


2018 ◽  
Vol 16 (3) ◽  
pp. 285-290 ◽  
Author(s):  
Anika Dahal ◽  
Raj Kumar Meheta

Background:  Cancer is considered one of the foremost common causes of death. Fatigue is among the distressing symptoms for cancer patients receiving chemotherapy. Adequate coping is essential for individual to deal with the effects of cancer related treatment. The objective of the study was to find out the fatigue experience and coping strategies among cancer patients receiving chemotherapy.Methods: A descriptive, cross-sectional research design was used for the study. The samples was taken from day care and medical oncology ward of BP Koirala Memorial Cancer Hospital, Bharatpur. A total of 120 cancer patients receiving chemotherapy of 18 years and above were selected by using non probability consecutive sampling technique. Data was collected by using standard tool, Fatigue Symptom Inventory and Brief Cope. Data analysis was done by descriptive and inferential statistics.Results: The study revealed that 82.5% of respondents had experienced fatigue and 50.8% respondents had used adequate coping strategies where “self distraction”(2.76±1.02) was the most used coping strategy by the respondents. Fatigue experience and coping strategies had negative correlation (r=-0.490, p=<0.001).Conclusions: Majority of the respondents had experienced fatigue, and half of the respondents used adequate coping strategies. The different methods of coping strategies for fatigue and chemotherapy related effects should be expanded as per the best available evidence to lower fatigue and other adverse effects.


2018 ◽  
Vol 16 (3) ◽  
pp. 285-290 ◽  
Author(s):  
Anika Dahal ◽  
Raj Kumar Meheta

Background: Cancer is considered one of the foremost common causes of death. Fatigue is among the distressing symptoms for cancer patients receiving chemotherapy. Adequate coping is essential for individual to deal with the effects of cancer related treatment. The objective of the study was to find out the fatigue experience and coping strategies among cancer patients receiving chemotherapy.Methods: A descriptive, cross-sectional research design was used for the study. The samples was taken from day care and medical oncology ward of BP Koirala Memorial Cancer Hospital, Bharatpur. A total of 120 cancer patients receiving chemotherapy of 18 years and above were selected by using non probability consecutive sampling technique. Data was collected by using standard tool, Fatigue Symptom Inventory and Brief Cope. Data analysis was done by descriptive and inferential statistics.Results: The study revealed that 82.5% of respondents had experienced fatigue and 50.8% respondents had used adequate coping strategies where “self distraction”(2.76±1.02) was the most used coping strategy by the respondents. Fatigue experience and coping strategies had negative correlation (r=-0.490, p=<0.001).Conclusions: Majority of the respondents had experienced fatigue, and half of the respondents used adequate coping strategies. The different methods of coping strategies for fatigue and chemotherapy related effects should be expanded as per the best available evidence to lower fatigue and other adverse effects.Keywords: Cancer; chemotherapy; coping strategies; fatigue.


2019 ◽  
Vol 186 (14) ◽  
pp. 451-451 ◽  
Author(s):  
Dan G O'Neill ◽  
Hermien C Craven ◽  
David C Brodbelt ◽  
David B Church ◽  
Joanna Hedley

BackgroundThe domestic rabbit is a common pet species, but limited research exists on the health of pet rabbits. This study aimed to characterise common disorders of pet rabbits and reasons for mortality as recorded by veterinary practices in England.MethodsThis cross-sectional study covered anonymised clinical records of 6349 rabbits attending 107 primary veterinary care clinics.ResultsThe median age was 3.2 years (interquartile range (IQR) 1.6–5.1), and the median adult bodyweight was 2.1 kg (IQR 1.7–2.6). The most common breed types were domestic (n=2022, 31.9 per cent), lop (1675, 26.4 per cent) and Netherland dwarf (672, 10.6 per cent). For those rabbits that died during the study period, the median age at death was 4.3 years (IQR 2.1–7.0). The most common causes of death were recorded as myiasis (prevalence 10.9 per cent, 95 per cent confidence interval (CI): 7.4 to 15.2), anorexia (4.9 per cent, 95 per cent CI: 4.0 to 10.4), recumbency/collapse (4.9 per cent, 95 per cent CI: 4.0 to 10.4) and ileus (4.3 per cent, 95 per cent CI: 3.5 to 9.5). The most prevalent specific disorders recorded were overgrown claw/nails (16.0 per cent, 95 per cent CI: 14.5 to 17.5), overgrown molar(s) (7.6 per cent, 95 per cent CI: 6.6 to 8.7), perineal soiling (4.5 per cent, 95 per cent CI: 3.7 to 5.4), overgrown incisor(s) (4.3 per cent, 95 per cent CI: 3.5 to 5.2) and ileus (4.2 per cent, 95 per cent CI: 3.4 to 5.0).ConclusionsThis study augments the limited evidence base on rabbit health and can assist veterinarians to better advise owners on optimal animal husbandry priorities.


Author(s):  
Mahfouz R. Nath ◽  
C. Kanniammal

Malnutrition remains one of the most common causes of morbidity and mortality among children throughout the world. Malnutrition has been responsible, directly or indirectly for 60% of the 10.9 million deaths annually among children under five. The research study was aimed to assess the knowledge and practice of mothers of preschool children regarding the prevention and management of malnutrition. The design used was descriptive cross sectional survey. The study was conducted in a coastal setting of Trivandrum district with a sample size of 115. Data collection was done by self administered structured questionnaire by conducting mothers meeting at selected Anganwadis. According to the results of the study 19.1% of mothers had good knowledge and 34.8 % of mothers had poor knowledge. Regarding practice only 24.3 % of mothers reported good practice while 36.6 % of mothers reported poor practice. There was a strong association between the knowledge and Practice of mothers and selected socio demographic variables such as educational status of mothers and socio economic class (p less than 0.01)). The study findings can be used for planning targeted nursing interventions in coastal areas for mothers of preschool children.


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