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Biomedical subjects

A I Airede

Publications and source records attributed to A I Airede.

At least 19 recordsLinked to original sources
PubMed1998

Serial copper and ceruloplasmin levels in African newborns with emphasis on the sick and stable preterm infant, and their antioxidant capacities.

Literature on serum copper (Cu) and its antioxidant protein (ceruloplasmin) in the African newborn is infrequent, and more reports are evident from developed or affluent societies. We, therefore, studied longitudinally our newborns to delineate their Cu and ceruloplasmin (CLP) status. All infants were born between July 1st, 1991 and June 30th, 1992 at the University of Maiduguri Teaching Hospital, Maiduguri, Nigeria. The preterm infants (PI) (gestational age < or = 36 weeks) were divided into 2 cohorts; A, sick and B, stable; commencing with n = 30 in each group. The groups were matched in respect to gender, gestational age, birthweight, Apgar scores and socioeconomic class. Cu levels were contemporaneously also determined in 30 (M:F, 17:13) stable full-term infants (appropriate-for-dates). Cu determination was made with atomic absorption spectrophotometry and CLP according to colorimetric P-phenylenediamine assay. Sick PI (cohort A) had significantly lower mean (SD) Cu and CLP levels at birth; 0.1 (0.2) micromol/ml and 0.5 (0.8) micromol/dl vs 0.6 (0.2) micromol/ml and 12.5 (1.2) micromol/dl in stable PI (cohort B), respectively; P < 0.05. Cu level was significantly increased by 4 weeks in cohort A; P < 0.001 (n = 25) and approached levels of the stable PI (0.7 (0.3) vs 0.8 (0.2) micromol/ml). Concerning CLP, however, catch-up of levels was delayed till 8 weeks, and a triphasic pattern of linear rise in Cu (both cohorts, but more prominent in A) and CLP (cohort A) was discernible by 24 weeks. The sick PI had mean (SD) serum CLP levels of 0.5 (0.8) micromol/dl, 5.9 (1.4), 15.2 (2.6), 17.3 (2.9), 21.2 (3.8), 25.1 (4.7) and 23.7 (3.8) micromol/dl at birth, 4, 8, 12, 20, and 24 weeks, respectively and were similar from 8 weeks in cohort B. Generally, CLP paralleled serum Cu levels. Cu levels in the full-term infant (FI) were higher at birth and became similar to PI's from 12 weeks, but were overtaken by levels in PI (both cohorts) at 24 weeks. The FI's Cu was significantly elevated by 8 weeks; mean (SD), 0.81 (0.16) micromol/ml vs 1.25 (0.19) micromol/ml; P < 0.01, paired t-test. Decreased growth rate, nonpitting pedal edema, exaggerated physiological anaemia and chronic lung disease were few morbidities noted in association with very low Cu and CLP levels (n = 15). Newborns with serum Cu and CLP>0.2 micromol/ml and >2.3 micromol/dl, respectively, did not have a poor outcome. It is tempting to suggest that absent serum CLP activity may portend a poor prognosis. Our findings (number albeit small) could be taken as a preliminary normative data for further comparisons.

Antioxidants↗
PubMed1997

Zinc levels in the Nigerian full-time newborn from birth to six months.

Zinc(Zn) remains an important micronutrient needed by the growing foetus and newborn. We are unaware of a previous study delineating the longitudinal evolution in the African fullterm (FT) infant. Hence we prospectively studied thirty randomly selected stable FT infants (M:F; 17:13) born between July 1991 and April, 1992. Serum Zn was determined by atomic absorption spectrophotometry on unhaemolysed sera. Eighty per cent of the babies were exclusively breastfed up to the age of six months. The mean birthweight was 3490 g(range, 2950-3950) with a mean gestational age 39.7 weeks(range, 38-42). The cohort included two sets of twins. Mean (SD) serum zinc was 2.4 (0.2) mumol/ml at birth and declined significantly (p < 0.01) over the subsequent eight weeks to a nadir of 1.2 (0.2)mumol/ml. Levels later rose to 1.6(0.3)mumol/ml at 12 weeks whilst peaking 2.2(0.3)mumol/ml in 16 weeks. It remained fairly constant at 2.0(0.2) and 2.1(0.2)mumol/ml between 20 and 24 weeks, respectively. The zinc evolution had a triphasic pattern. Our trend compare favourably with previous literature from affluent societies, but our levels were one and a half to two fold higher. The findings may serve as normative reference against which serum zinc concentration in the African infant could be compared. Our findings(number albeit small) could be taken as a preliminary report.

Age Factors↗
PubMed1995

Birth asphyxia: a review.

Birth asphyxia occurs world wide and remains a serious cause of morbidity of the newborn. Its incidence and associated sequelae have remained high in the developing world with an attendant high mortality as compared to more affluent societies or the developed world. We have attempted in this review, to proffer an assessment, prevention strategies and detailed management of birth asphyxia with particular reference to the tropics and sub-tropics. A continuous surveillance of this problem is highly essential and so is the strict use of facilities at our disposal; clinical screening and partography for example, as these could keep a rising incidence in check.

Apgar Score↗
PubMed1993

Neonatal bacterial meningitis in the middle belt of Nigeria.

A three-year prospective study of neonatal meningitis in a tertiary hospital in Nigeria was carried out to determine its clinical spectrum and particular characteristics. The 36 infants studied represented a high incidence of 1.9 per 1000 live births, and the infection was significantly higher among low-birthweight babies. Non-specific signs and symptoms were common, and temperature instability was a constant finding. Specific neurological manifestations were noted that differed from other reports in the literature and contributed significantly to outcome. The most common aetiological pathogen isolated was Gram-positive Staphylococcus aureus and the most common Gram-negative organisms were Klebsiella spp: there was no case of group B streptococci. The pathogens isolated were also at variance with other reports. The mortality rate was 33 per cent and was higher for females. There was no significant difference in outcome between inborn and referred infants, nor between early onset and late onset of the disease. A bulging anterior fontanelle was a significant indicator of poor prognosis. Gentamicin and ceftazidime were the most appropriate antibiotics.

Female↗
PubMed1992

Urinary-tract infections in African neonates.

During a 4-year period between January 1987 and December 1990, 41 high-risk neonates with proven urinary tract infections (UTIs) were studied prospectively and compared with 55 control neonates. An incidence of 2.6 UTIs per 1000 live births was noted, amongst whom no obvious radiological abnormalities of the urinary tract were found. Significantly, more males than females developed UTIs, the ratio being 4.5:I. Low-birth-weight babies were significantly more often affected than those of normal weight (P less than 0.05). Staphylococcus aureus and Klebsiella spp. were the predominant pathogens isolated. Aetiologically, bacteraemia from sepsis was important. Most of the infants presented with a significantly higher incidence of pyrexia, abdominal distension, lethargy and jaundice (P less than 0.01). The overall mortality rate of 17.1% was closely related to these associated problems. The relatively high incidence of UTI and the rarity of radiological abnormalities of the urinary tract in the African neonate contrast with previous reports in the literature and the reason is worthy of consideration. Despite the rarity of urinary-tract anomalies, a continuous surveillance of the trend of neonatal UTI and its outcome is recommended.

Bacterial Infections↗
PubMed1992

Relation of peak total serum bilirubin concentrations to neurodevelopmental outcome at 2 years of age in premature African neonates.

As part of a wider survey of the neurodevelopmental outcome of neonates who received intensive care for various morbidities in the Middle-Belt region of Nigeria, the relationship between peak total serum bilirubin (PTSB) concentrations in the neonatal period and neurodevelopmental status at 2 years of age was evaluated in 159 children available for follow-up and assessment. The prevalence of handicaps (minor and major) increased consistently with increase in the PTSB concentration, commencing in the range of 151-200 mumol/l. Major handicaps evolved in association with PTSB concentrations above 201 mumol/l. The handicaps consisted mainly of cerebral palsy and mental retardation. Children with handicaps (minor and major) experienced greater PTSB concentrations than those with a normal neurodevelopmental outcome. The emergence of major handicaps from a mean (SD) moderate peak hyperbilirubinaemia of 241.1 (35.9) mumol/l in the African neonate is worthy of note and cause for concern.

Bilirubin↗
PubMed1992

Prolonged rupture of membranes and neonatal outcome in a developing country.

The neonatal outcomes in 109 pregnancies complicated by prolonged rupture of the fetal membranes were studied over a 3-year period. The overall neonatal mortality was 29 (26.6%). Nineteen of these deaths were from infections, of which 12 were pneumonia. There was also a high morbidity rate of 68.8%. Neonatal sepsis, cardiorespiratory depression at birth and prematurity were the most significant complications. Forty-eight (44%) of the infants in the study group had an infection, in contrast with three (2.9%) in the control group (p < 0.0001). No protective effect or benefit from prolonged rupture of fetal membranes in relation to the development of respiratory distress syndrome was demonstrated.

Developing Countries↗
PubMed1992

Pathogens in neonatalomphalitis.

During a 3-year study period, 33 neonates with omphalitis (with proven cultures) were encountered; aerobic and anaerobic cultures were obtained. An incidence of 2/1000 live births was recorded, with a high prevalence rate of 15.6/1000 admissions noted. Aerobes were isolated from 23 (70 per cent) specimens, whilst anaerobes were recovered alone in five (15 per cent) cases. There were 40 (1.2 per specimen) and 31 (0.9 per specimen) aerobic and anaerobic isolates, respectively. There was a significant detection of anaerobic pathogens such as the B. fragilis group (14), Gram-positive cocci (4) and Clostridium perfringens (3). Beta lactamase production was seen in 25 isolates, recovered from 25 newborns.

Bacterial Infections↗
PubMed1992

Neonatal septicaemia in an African city of high altitude.

Ninety-nine cases of neonatal septicaemia prospectively seen over a 3-year period in a large cosmopolitan African city of high altitude is presented. An incidence of 6.5 per 1000 live births was noted. Though the most important pathogens were Klebsiella spp. and Staphylococcus aureus, Citrobacter difficile and Alkalegenes faecalis were the pathogens associated with a high mortality rate. Low birth weight infants were significantly more affected. The overall mortality rate was 27.3 per cent. The commonest predisposing perinatal factors were birth asphyxia and prolonged rupture of fetal membranes. On the basis of the trend of organisms isolated and their sensitivity pattern, it is suggested that the initial use of gentamicin alone is satisfactory.

Africa↗
PubMed1992

Neonatal tetanus: incidence and improved outcome with diazepam.

During a four-year prospective study at a referral hospital, 61 patients with neonatal tetanus were encountered and the contribution of continuous intravenous diazepam was noted. The over-all incidence during the study was 21.8/1000, with a mortality rate of 8.2 per cent. Signs associated with fatal outcome were hypothermia, generalized rigidity and opisthotonus. The mean dose of diazepam used was 25.8 mg/kg/day, in combination with sodium phenobarbitone (mean dose 10.7 mg/kg/day). The results suggest that high-dose intravenous (continuous) diazepam is effective, economical and feasible for reducing mortality in neonatal tetanus. Side-effects were minimal.

Developing Countries↗
PubMed1992

Febrile convulsions: factors and recurrence rate.

One hundred and forty-seven children admitted consecutively with their first febrile convulsion were studied to assess the influence of certain factors on the recurrence rate of seizures. The younger the age at first occurrence the more likely the recurrence rate. Those with moderate degree of pyrexia (39-39.9 degrees C) were found to be ten times more likely to have subsequent recurring convulsions compared to those with high degree of pyrexia (40 degrees C and above) or those with mild degree of pyrexia (38-38.9 degrees C). Furthermore, the recurrence rate was five times higher in first-born compared to siblings second-borne or more. The overall recurrence rate was 29.3% with the frequency varying between 1 to 2 times. A male preponderance was observed. These factors might be of prognostic value in terms of risk for recurrence.

Age Factors↗
PubMed1991

Congenital malaria with chloroquine resistance.

A preterm infant with possible congenital clinical malaria is described. The infant developed persistent pyrexia, hyperbilirubinaemia, anaemia, increasing gastric residuals and hepatosplenomegaly from the 7th day of life. Thick and thin smears of the infant's blood were heavily loaded with various asexual stages of Plasmodium falciparum. The parasite exhibited R1 resistance. There was no satisfactory response to chloroquine, but response to intravenous quinine therapy was achieved on day 15. The initial 6-month follow-up period was uneventful. The mother had apparently had chloroquine-resistant malaria which responded to sulfadoxine-pyrimethamine (Fansidar).

Chloroquine↗
PubMed1991

Birth asphyxia and hypoxic-ischaemic encephalopathy: incidence and severity.

Clinically significant birth asphyxia was assessed over a 3-year period in a tertiary referral hospital in Nigeria. The overall incidence was 26.5/1000 live births of whom 12.1/1000 showed severely abnormal features comprising persistent seizures and coma. There was no appreciable difference in incidence for the consecutive years of the study. There was a marked involvement of infants who had suffered intrauterine growth retardation: 51 (30.7%) of these were asphyxiated, whereas only 3% were large for gestational age. The Apgar scoring system seemed not to have compared well with the clinical presentation of hypoxic-ischaemic encephalopathy from birth asphyxia. Much needs to be done to improve health care delivery and reduce the incidence of birth asphyxia.

Apgar Score↗
PubMed1991

Rickets of prematurity: a case report.

A case report is given, and an attempt made to summarize our knowledge about this disorder. An extremely premature infant (birth weight 750 grammes) developed progressive rickets resulting in fractures despite phosphate, calcium and calciferol (vitamin D) supplementation. The patient had mild respiratory distress syndrome but later developed broncopulmonary dysplasia. Initial biochemical evidence of rickets occurred by the 6th week of post-natal life (or 31 weeks post-conceptional age). Although the serum levels of vitamin D or 1-alphahydroxy vitamin D were not determined, it is assumed that the levels of the active metabolite was probably low since clinical, biochemical and radiologic cure of the rickets occurred following its usage.

Bronchopulmonary Dysplasia↗
PubMedDate not supplied

Birth weights of Nigerian newborn infants--a review.

Birthweight (BW) is an important denominator for a continuing re-appraisal of a Nation's health care delivery and neonatal viability. A constant surveillance of BW is therefore of utmost importance and a decline, when detected should allow for selecting areas at great risk, identifying causes for the decline and proffering possible corrections. The mean BWs of Nigerian babies differ within the country and, in general, are lower than those of caucasian counterparts. Information is accruing that low BWs are created by factors most of which can be prevented or significantly modified. Mean BWs in Nigeria are highest in the South (lagos: 3380g) and the Middle-Belt (Jos: 3280g: male, 3186g: female). The goal of this synopsis is to summarize and critically analyse the information available to us and to show the lacunae in our knowledge where future research is imperative.

Birth Weight↗