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Biomedical subjects

A A Asindi

Publications and source records attributed to A A Asindi.

At least 19 recordsLinked to original sources
PubMed2003

Antenatal intrauterine fetal death: a prospective study in a tertiary hospital in south-western Saudi Arabia.

This study was conducted to determine the frequency of antenatal intrauterine fetal death (IUFD) and the associated maternal and fetal risk factors in women who presented at a regional tertiary hospital in Saudi Arabia. Over a 5-year period, 191 consecutive cases of IUFD presented and were studied prospectively. Relevant maternal and fetal data were obtained. The stillbirth rate during the period was 10 per 1000 deliveries. In 41% of the cases, the associated causal factors could not be determined. There was a significant (P = 0.00122) linear trend showing an increased risk of IUFD above the age of 20 years and, similarly, a significant (P = 0.00047) linear trend after the first pregnancy. Lack of antenatal care (88.5%), hypertensive diseases in pregnancy (12%) and diabetes mellitus (8%) were associated risk factors while 'major congenital malformation' (14%) was an outstanding fetal factor. The risk factors of antenatal stillbirth in our community seem to be avoidable. Health education to encourage the utilisation of the available antenatal care services, family planning and genetic counselling are being advocated strongly as possible preventive measures.

Adult↗
PubMed2000

Screening for asthma and associated risk factors among urban school boys in Abha city.

OBJECTIVE: The objective of the present study was to measure the prevalence of asthma and asthma-related symptoms among male school children in Abha City and to determine some of the possible risk factors influencing its occurrence. METHODS: A randomly selected sample of 4300 male school children aged 7 to 15 years in Abha were subjected to a previously validated questionnaire for asthma to be completed by parents. Asthma was identified based on the Rush Medical College and International Study of Asthma and Allergies in Children questionnaire. Information of asthma family history, asthma related symptoms, and other atopic conditions, smokers in the family, pets ownership and monthly family income were collected. RESULTS: The overall prevalence of asthma was 9% (95% Confidence Interval: 7.73%-9.67%). Doctor-diagnosed asthma was reported by 4%, exercise-induced asthma by 4% and wheeze in the past year by 8%. Multiple logistic regression analysis showed that positive family history of atopic condition (Odds Ratio=437.11, P<0.001), pets ownership (Odds Ratio=2.91, p<0.001), and lower monthly family income (Odds Ratio=2.00, P<0.02) were significant factors influencing the development of asthma. CONCLUSION: In conclusion, the screening methodology adopted in this study could be applied for all children at the beginning of the school year, being simple and non-invasive measure. The prevalence of asthma in school children in Abha is greater than that reported from most developing countries and closer to the rates reported in developed countries. Avoidance of pets ownership at home, improving social class and premarital counselling for atopic persons are all recommended.

Adolescent↗
PubMed2000

Neonatal meningitis.

OBJECTIVE: To determine the prevalent bacterial agents of neonatal meningitis and their antibiotic susceptibility in a referral intensive care unit in Assir Central Hospital, Saudi Arabia, during the years 1993-1998. METHODS: Records of newborn infants with positive cerebrospinal fluid culture during the period were retrospectively studied. RESULTS: There were 1473 nursery admissions, of which 32 episodes of meningitis occurred amongst 31 neonates. Klebsiella pneumoniae (31%) and Serratia marcescens (21%) were the main pathogens. The incidence of concurrent septicemia among these infants was 58%. Klebsiella pneumoniae appears to dominate in both early and late onset infections. The sex incidence was equal and the mortality rate was 48%. CONCLUSION: The survey identifies Klebsiella pneumoniae and Serratia sp. as the leading bacterial agents of neonatal meningitis in our environment. The relatively high frequency of Serratia infection in the present survey appears unique as this organism is comparatively rare in other reports across the globe. No Group B Streptococcus was isolated, which is in contrast to reports obtained in Europe, America and Australia where it is the predominant organism of neonatal sepsis or meningitis. Antibiogram identified imipenem and cefotaxime as the empirical antibiotics in infants with a clinical diagnosis of neonatal sepsis in our hospital; no more conventional use of ampicillin. In view of the changing bacterial pattern of infant infection with time even in the same environment, a periodic review of this subject is advocated.

Drug Resistance, Microbial↗
PubMed1999

Faecal excretion of Vibrio cholerae during convalescence of cholera patients in Calabar, Nigeria.

The pattern of faecal excretion of Vibrio cholerae was studied over a duration of eight months among 13 cholera convalescents by two-weekly surveillance cultures. Stools and rectal swabs were cultured on Thiosulphate citrate bile salts sucrose (TCBS) agar for the recovery of vibrio pathogens. Clinical phase and convalescent phase V. cholerae strains were compared for antibiogram profiles. The population of vibrios recovered from faecal inocula was usually scanty (<10(3) vibrios/g). All clinical isolates except three were concordant with convalescent phase strains. Sensitivity to tetracycline was uniform for concordant V. cholerae strains, with minimum inhibitory concentration (MIC) ranging from 0.54-4.0 microg/ml. Nine (69.2%) of the convalescents had positive faecal cultures for periods ranging from two weeks to more than seven months. Two adults whose excretions lasted several months also tested positive for human immuno-deficiency virus (HIV) infections. The significance of stool surveillance cultures for identifying asymptomatic infections among convalescents who may need chemotherapy to abolish excretion is emphasised. However, it could not be established with certainty if vibrios excreted during convalescence were from enteric colonization by the causative strains, or re-infections with the common strains in circulation.

Adolescent↗
PubMed1997

The pattern of neurological sequelae of childhood cerebral malaria among survivors in Calabar, Nigeria.

OBJECTIVE: To determine the pattern and long term outcome of neurological complications following cerebral malaria (CM) in a group of Nigerian children treated in Calabar. DESIGN: Prospective, follow up study. SETTING: Children's emergency room (CHER) of the University of Calabar Teaching Hospital (UCTH) located in a malaria-holoendemic rainforest belt of south eastern Nigeria. SUBJECTS: Survivors among 45 children with CM treated between February and December, 1991. All received intravenous quinine infusion and supportive care. Survivors (39) were followed up until detected neurological sequelae had resolved. RESULTS: Case fatality rate was 13.3%, 95% CI. Eleven (28.2%) of the survivors developed neurological sequelae. Prolonged coma, focal seizures and abnormal posturing (decorticate/decerebrate) were associated with increased risk of sequelae. Commonest neurological sequelae were cortical blindness (3/11), speech disorders (3/11: aphasia or echolalia) and motor abnormalities (5/11: dyskinesia/hemiplegia). Eight cases recovered completely from the neurological deficits within a mean period of three (1.3) weeks. One persisted with hyperactivity and attention deficit, had a remarkable improvement at the sixth month of follow up but developed secondary dyslexia and other learning disabilities by the third year of follow up. CONCLUSION: Although short lived, neurological sequelae of CM appear common among these Nigerian children. This problem could significantly add to the burden of childhood disability in Nigeria. Early diagnosis, use of appropriate drugs and large scale malaria control programmes can prevent malady.

Central Nervous System Diseases↗
PubMed1995

Hyperventilation in febrile Nigerian children without pneumonia: an evaluation of the influence of anaemia.

A total of 225 pre-school Nigerians were studied to evaluate the effect of anaemia on the respiratory rate of febrile children, and the influence of this on the reliability of the WHO criteria for the clinical diagnosis of pneumonia in the primary health care setting. Malaria was the commonest cause of febrile illness (63.1 pc). The prevalence of severe anaemia was 28.0 pc. The mean respiratory rate of anaemic children (53.9 +/- 12.8/min) was significantly higher than that of the non-anaemic (48.4 +/- 12.7/min; p = 0.011). Mean body temperature was not significantly different in both groups. Haematocrit was negatively correlated with respiratory rate. The positive correlation observed between temperature and respiratory rate was enhanced by decreasing haematocrit. More of the severely anaemic children (68.6 pc) exceeded the WHO respiratory rate threshold for diagnosis of pneumonia than the moderately anaemic (55.4 pc) or non-anaemic (36.1 pc). The specificity of the WHO criteria for clinical diagnosis of pneumonia decreased with decreasing haematocrit.

Anemia↗
PubMed1995

Urinary symptoms and blood pressure of children with Schistosoma haematobium infection in south-eastern Nigeria.

The urinary symptoms and blood pressures of 510 children (aged 5-15 years) with Schistosoma haematobium infection in Ijiman community, Cross River State of Nigeria, were studied in 1992. The prevalence rate of infection was 44%, a majority of the children presenting with light infection. Significant symptoms were visible haematuria, dysuria, suprapubic pain and strangury. The sensitivity and specificity of these symptoms were too low for them to be recommended as distinct clinical diagnostic criteria. The impact of the disease could not be demonstrated on blood pressures of the children. Nevertheless, urgent control measures with emphasis on the provision of ventilated improved pit toilets and potable water are strongly recommended for the control of the disease as persistent infection is known to mask manifestation of severe complications till an older age.

Adolescent↗
PubMed1995

Neonatal seizures in Nigerian infants.

Nigerian newborns presenting with convulsion in University of Calabar Teaching Hospital, Calabar during the period January 1989 to December 1990 were prospectively studied to determine the aetiology and pattern of their seizures. There were 60 patients representing 4% of admissions into the Newborn Unit during the period. Birth asphyxia, infections and hypoglycaemia were the important identifiable aetiological factors which operated either singly (48% of cases) or in concert (in another 48%) of the infants. Detectable infections included meningitis and septicaemia caused predominantly by coliforms and Staphylococcus aureus. Hypocalcaemia and electrolyte imbalance did not feature. There was an unusually high prevalence (63% of cases) of the generalised type of seizures probably due to the high frequency of mixed aetiology. The mortality rate of 50% encountered appears to be related to the underlying aetiology and prematurity. Detectable caused of neonatal seizures in our environment appear to be potentially preventable by improved obstetric and neonatal care. There is dire need also to provide modern facilities for investigating newborn seizures in order to improve upon the diagnostic yield.

Age of Onset↗
PubMed1994

Community-based surveillance of paediatric deaths in Cross River State, Nigeria.

A house-to-house survey of paediatric deaths which occurred from January to December 1991 in the village of Nko, Cross River State, Nigeria, was carried out. Among the 471 total deaths recorded, the leading causes were malaria (29%), protein-energy malnutrition, pneumonia and diarrhoeal disease (11% each). Neonatal deaths were largely due to septicaemia, tetanus and birth asphyxia. Poor domestic and human waste disposal, lack of portable water and basic health facilities appear to be the important related factors to child health problems in this community. The provision of public toilets, safe water, primary health care centres and health education can definitely improve the health status of this rural community. Events in other rural communities in Nigeria are most likely to be similar to that in Nko. Such populations need to be identified and their problems urgently addressed.

Adolescent↗
PubMed1994

Intestinal obstruction in southeastern Nigerian children.

In a 10-year (1981-1990) retrospective study of acute intestinal obstruction in the University of Calabar Teaching Hospital, Calabar, Nigeria, of the 295 paediatric cases reviewed, the major causes were ascaris worms (25%) and intussusception (22%). Other important lesions include imperforate anus (11%), volvulus (10%), external hernias (9%) and adhesions (7%) each. Ascaris-induced and hernial obstruction were most rampant in children aged above 5 years while intussusception had its peak frequency at the ages one to 12 months. Intussusception was largely (95%) ileo-caecal; volvulus involved mainly the ileum and ileo-caecum in 50% of cases each. The obstructed hernias were more common in the umbilicus (59%) than the groin (41%). The mortality (13%) was chiefly due to associated infection but lack of expertise in management of cases cannot be ignored. Generally, the pattern of intestinal obstruction among children in this region appears markedly different from that seen in Europe and North America. There is a need to create a specialist paediatric surgical unit as a means of reducing morbidity and mortality from this condition.

Acute Disease↗
PubMed1994

Effect of Schistosoma haematobium infection on the physical growth and school performance of Nigerian children.

A cross-sectional study of urinary schistosomiasis among 510 primary school children in Ijiman community in south eastern Nigeria was undertaken in May 1992. Schistosoma prevalence and intensity of infection including the impact of the disease on the physical growth and school performance of the subjects aged 5-15 years was assessed. Prevalence of Schistosoma haematobium was 44 pc with the rate rising progressively with age, with a peak prevalence at 10-15. The ova burden was of light intensity (1-49 ova/10 ml) in a majority (73 pc) of the cases. No significant impact of the disease could be demonstrated regarding anthropometric parameters, school attendance and academic performance among the infected children compared with the controls. The lack of discernable effect of S. haematobium infection on these parameters is similar to the general pattern in the west African sub region and is attributed to the generally light ova burden among these children. It is also suggested that differences in the strains of the parasite between regions may be important determinants of morbidity.

Absenteeism↗
PubMed1993

Upsurge of malaria-related convulsions in a paediatric emergency room in Nigeria. Consequence of emergence of chloroquine-resistant Plasmodium falciparum.

From January through December 1988 the causative factor of each case of childhood seizure seen in the Children's Emergency Room of the University of Calabar Teaching Hospital, Calabar, Nigeria, was prospectively studied with a focus on the relative importance of malaria-related seizures. Of the 134 seizure cases seen, febrile convulsion (FC) formed the majority (55%) with cerebral malaria (CM) as the only major (33%) rival. Other conditions such as meningitis, epilepsy, hypoglycaemia and drug poisoning together (12%) played a minor role. Malaria was the dominant cause (73%) of FC; 81% of these cases did not respond to chloroquine. On comparing the number of cases of CM accumulated in the same unit from 1986, there was a significant increase (P < 0.001) in the proportion of yearly CM admissions from 1986 through 1988. The study confirms the premier position of malaria in the causation of childhood seizures and also suggests a possible upsurge in the prevalence of CM in the environment. This upsurge probably derives from the emergence of chloroquine-resistant Plasmodium falciparum (CRPF) reported in Nigeria which appeared to have been identified in the present study. While more studies are needed to confirm this hypothesis, clinicians in areas of CRPF are alerted about a possible upsurge in CM in their locality.

Age Factors↗
PubMed1992

Acquired immunodeficiency syndrome: education exposure, knowledge and attitude of Nigerian adolescents in Calabar.

The knowledge of and attitude to acquired immunodeficiency syndrome (AIDS) of 738 secondary school youths in Calabar were studied by questionnaire in March 1991. Most (92%) of the adolescents had heard about AIDS, largely through the mass media (79-85%), with parents and teachers contributing in less than 40%. About 30% did not know that AIDS exists in Nigeria. Most of them knew that promiscuity, blood transfusion and sharing injection needles and syringes are the major modes of transmission, but a number still incriminate toilet seats, eating utensils, hand-shaking and kissing. Only 31% were aware that condoms provide protection. For self-protection the youths prefer abstinence (45%) and confinement to one sex partner (19%). Only 3.6% would adopt the use of condoms. To prevent the spread of AIDS, the youths prescribe isolation (37%), treatment (34%), and killing (14%) of diagnosed cases. Most youths (77%) will stop seeing friends and 63% will reject relatives who develop AIDS. The study reveals that while general awareness of AIDS is fairly good, detailed knowledge is riddled with misconceptions and confusion. It is recommended that physicians in the community should assist in disseminating accurate information, with the support of parents, teachers and the youths themselves.

Acquired Immunodeficiency Syndrome↗
PubMed1992

Penicillinase-producing Neisseria gonorrhoeae conjunctivitis on some Nigerian children.

During 21 month study of bacterial conjunctivitis among 121 children in two health care centres in Calabar, Nigeria, a total of 90 (74.4%) cases were culturally confirmed. Neonates had the highest age-specific attack rates with 48 (53.3%) cases. Neisseria gonorrhoeae, the predominant pathogen, was recovered from 32 (35.6%) infections; 21 (65.6%) of them from neonates. Cultures of genital swabs of consenting parents of infected neonates as well as those of three female children aged 2-12 years with concurrent vulvo-vaginitis yielded N. gonorrhoeae. Younger women, mostly primi-gravidae were more frequently found to have benefited from peri-natal health care services than older multi-gravidae. Nevertheless, such access to health care services did not appear to influence the frequency of gonococcal conjunctivitis in neonates from the two maternal groups (P < 0.01). Sexual abuse and contaminated fomites were the possible modes of gonococcal infection transmission to older children. Overall, 22 (68.8%) strains of gonococci were resistant to penicillin; 19 (59.4%) were penicillinase-producing Neisseria gonorrhoeae (PPNG), while 5 (15.6%) had chromosomally-mediated resistance. All isolates were sensitive to erythromycin. This study recommends a review of gonorrhoea surveillance in pregnancy to include routine examination of cervical swabs just before delivery.

Adolescent↗
PubMed1992

Malignant childhood tumours in Calabar, Nigeria.

Children suspected with cancers seen during a 5-year period (Jan 1983-Dec 1987) in the University of Calabar Teaching Hospital (UCTH) Calabar, Nigeria were prospectively studied. A total of 60 cases were confirmed in those aged below 15 years with a majority (38.3%) of the children under 3 years. The pattern shows a preponderance of Burkitt's lymphoma followed by nephroblastoma and soft tissue sarcoma as the commonest malignancies. A low relative frequency of leukaemias (8.3%) and no intracranial tumours were encountered. This pattern closely resembles that of other Nigerian reports but contrasts with the situation in Britain and America, with their high leukaemia and intracranial tumour frequency ratios. Generally, there appears to be a low prevalence of malignancies among children in Calabar and presumably the south-eastern part of Nigeria. Difficulties in their management are attributable to late presentation, high patient default rate, complete lack of radiotherapy, and shortage of chemotherapeutic agents.

Adolescent↗
PubMed1992

Painless peripheral lymphadenopathy in Nigerian children.

We conducted a diagnostic biopsy during a period of 8 years (January 1981 - December 1988) on 74 consecutive children (aged under 16 years) who attended the University of Calabar Teaching Hospital, Calabar, for chronic enlarged painless lymphadenopathy, with a view to determining the diseases that commonly present with this symptom in our environment. Histological diagnoses returned were predominantly tuberculosis, neoplasms and nonspecific reactive changes. Each of these conditions was evenly distributed among the entire age group. Neoplasms were mainly Hodgkins and non-Hodgkins lymphoma, with Burkitt's tumour the commonest childhood tumour in Nigeria not contributing significantly to the neoplastic lymphadenopathy. Regional enlargement rather than generalised lymphadenopathy seems to be dominant, the commonest sites of involvement being the cervical followed by the inguinal regions. Chronic lymph node enlargement appears to be rare in our environment and only a few disease conditions manifest with peripheral nodes despite the large number of infections and other inflammatory diseases in Nigerian children.

Adolescent↗
PubMed1992

Clinical and bacteriological study on childhood empyema in south eastern Nigeria.

Forty-eight children with empyema thoracis were seen over a seven-year period (December, 1982 to November 1989) in the University of Calabar Teaching Hospital, Calabar, Nigeria. This number accounted for 0.2% of all paediatric admissions during the period. The peak age incidence was 2 years and under. Pneumonia was the antecedent illness in about all cases, but surprisingly, measles played an insignificant role. Late consultation and severe morbidity were constant feature with anaemia and cardiac failure as frequent complications of the disease. Staphylococcus aureus, the predominant causative organism was resistant to penicillin and ampicillin but sensitive to gentamicin, cloxacillin and erythromycin. The initial use of the parenteral gentamicin or cloxacillin in treating children with empyema is therefore recommended. This study demonstrates the rarity and low fatality (6%) of childhood empyema in Calabar, but protracted hospitalisation and exorbitant medication involved make it an important disease. Perhaps, it can be completely eliminated if parents are educated enough to avoid late reporting of childhood respiratory disease.

Adolescent↗