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Biomedical subjects

A O Olowu

Publications and source records attributed to A O Olowu.

9 recordsLinked to original sources

Current trends in the prevalence and aetiology of childhood congestive cardiac failure in Sagamu.

Congestive cardiac failure (CCF) is a common paediatric emergency with diverse aetiologies. The objective of this study is to define the current prevalence rate and common causes of CCF among children hospitalized in a Nigerian Tertiary Hospital. The study was prospectively done over a 1-year period in the Paediatric Wards of the hospital. Consecutive children aged 0-14 years, who fulfilled the standard diagnostic criteria for CCF were recruited. Data obtained from them included the age, sex, duration of illness and the socioeconomic status of the parents. Each subject was given a specific diagnosis based on the clinical, laboratory and radiological features. Out of a total of 1552 admissions, 109 had CCF giving the prevalence of 7.02%. The mean age of children with CCF was mean of 2 +/- 3.1 years (range: 1 day to 14 years). Ninety-five (91%) of them were concentrated in the lower socioeconomic classes III-V. The aetiologies of CCF identified in this study were as follows: severe anaemia occurring alone (48; 46%), lower respiratory tract infections (LRTI) (30; 29%), anaemia with LRTI (12; 11.5%), congenital heart diseases (CHD) (11; 10.5%), rheumatic heart disease (1; 1%), myocarditis (1; 1%) and chronic renal disease (1; 1%). Malaria was the commonest cause of anaemia while bronchopneumonia was the commonest form of LRTI in the subjects. Measles infection was associated with LRTI in 10 (23.8%) children. Three children had HIV-related anaemia. Infants formed the bulk of the subjects with CCF due to anaemia, LRTI and CHD. Ventricular septal defect was the commonest CHD identified. The prevalence obtained from this study was higher than rates obtained from some previous studies in the country. Severe anaemia is the commonest cause of CCF probably from the effects of severe malaria and increasing poverty. Stringent attention to poverty alleviation and malaria control may reduce the burden of CCF among Nigerian children.

Adolescent↗

Electrocardiographic changes in measles.

Electrocardiograms (ECGs) were recorded in 100 Nigerian children with measles admitted to our paediatric wards or treated on an out-patient basis. The patients were aged 5 months-8 years (mean, 19 months) and the male:female ratio was 1.3:1. Similar recordings were obtained in 100 age- and sex-matched controls. The electrocardiographic changes observed include T wave inversion in 28 patients and prolonged P-R interval in 22. Other changes are prolonged Q-Tc (13 patients), low QRS amplitude (13 patients), abnormal QRS axes in the frontal plane (5 patients) and T wave flattening (4 patients). A statistically significant difference between patients and controls with respect to the above changes was demonstrated in T wave inversion and prolonged P-R interval--the latter in the 5 months-1 year age group. Hence, 35 patients had at least one statistically significant ECG change, giving a prevalence rate of 35%. The implications of the above findings are discussed and the need to intensify efforts aimed at immunizing all children against measles is stressed.

Child↗

Electrocardiographic changes after recovery from measles.

Children with measles seen at our hospital had an initial electrocardiogram (ECG) and a repeat after 3 months. The patients were aged 5 months to 8 years (mean 19 months). The ECG changes observed after clinical recovery included T-wave inversion in eight patients (16%), flattening in eight patients (16%), prolonged PR interval in six (12%), prolonged Q-Tc in three (6%) and low QRS amplitude in four (8%). At least one ECG change was present in 18 patients (36%) after recovery, 14 of these were due to persistence of the changes noted during measles. The implication of above findings and the need for a longer-term follow-up study are discussed.

Cardiomyopathies↗

Congenital adrenal hyperplasia due to 11-hydroxylase enzyme deficiency in three siblings. A brief report.

To appraise clinicians of the presence of an uncommon cause of congenital adrenal hyperplasia in a Nigerian family, we present case reports of three siblings comprising two males (aged 4 years 10 months and 3 years 10 months) and a female (aged 16 months). The male patients presented with features of precocious pseudopuberty and had body weights and heights that were above the 95th percentiles on a standard growth chart. There was radiologic evidence for an advanced bone age of over 11 years in both patients, together with findings of sustained systemic hypertension. The female patient was discovered to have an abnormal hormonal profile during a screening of the unaffected children of their non-cosanguinous monogamous parents. The three siblings had morning plasma cortisol concentrations in the lower range of reference values together with markedly elevated levels of plasma androgens. These biochemical abnormalities together with the clinical features of precocious pseudopuberty in the two male patients led to the clinical suspicion of congenital adrenal hyperplasia (CAH). The enzymatic defect was believed to be due to 11-hydroxylase enzyme, because of the presence of sustained systemic hypertension in the male subjects. As routine family screening was instrumental in the discovery of the subclinical CAH in the female subject, it is thus suggested that clinicians should endeavour to undertake a detailed hormonal screening of family members of patients.

Adrenal Cortex Hormones↗