Papers by Alphonsus Onyiriuka
Archives of Diabetes and Endocrine System
Nigerian Postgraduate Medical Journal
To examine the relationship, if any, between the geographical season in which a baby is born and ... more To examine the relationship, if any, between the geographical season in which a baby is born and the baby's birth weight and sex. The birth weights and sexes of 6141 babies delivered over a five- year period in a Nigerian mission hospital were prospectively recorded according to the month and year of delivery. The mean birth weights and sexes of infants born in the wet season (May to October) were compared with those of their counterparts born in the dry season (November to April). Comparison of the mean birth weight during the wet and dry seasons showed that for male infants it was 3333 (542)g versus 3197 (566)g (p<0.01), while for female infants it was 3203 (559)g versus 3110 (601)g (p<0.01). When both sexes were combined, the mean birth weights were 3249 (488)g and 3164 (524)g in wet and dry seasons respectively(p<0.01). Slightly more boys than girls were born in the dry season compared with the wet season (p>0. 05). Irrespective of gender, babies born during the wet season were significantly heavier than their counterparts born during the dry season. There was a higher probability of a boy birth in the dry season.
International journal of child and adolescent health, 2011
IntroductionCigarette-smoking which often begins during adolescence is on the rise and constitute... more IntroductionCigarette-smoking which often begins during adolescence is on the rise and constitutes a public health problem, not only because of the preventable morbidity and mortality it causes, but also, because of its socioeconomic implications (1,2). The prevalence rate of cigarette smoking is declining in developed countries (3), but rising in developing countries (4). Despite this trend, there is paucity of information on cigarette smoking among adolescents in most developing countries (5). Cigarette smoking commonly begins during adolescence when several factors such as peer pressure, family influences, social class, curiosity, defiance of social norms and the desire to imitate others influence a youth to start smoking and maintain the habit (6,7).Adverse effects of cigarette smoking may occur during adolescence. For instance, increased prevalence of chronic cough, sputum production, wheezing, bad breath and yellowish discoloration of the teeth have been documented (8). Cigare...
International journal of child and adolescent health, 2015
IntroductionHypertension is one of the cardinal features of 11-beta hydroxylase deficiency (11-be... more IntroductionHypertension is one of the cardinal features of 11-beta hydroxylase deficiency (11-beta OHD) (1, 2).The hypertension is believed to be due to elevated levels of deoxycorticosterone (DOC), a steroid with 3 to 5 percent of the activity of aldosterone's salt retaining property (3). Hypertension is common but not universal in 11-beta-hydroxylase deficiency and it is usually noted in later childhood or adolescence (1). Newborn infants often manifest transient salt loss (4, 5), presumably as a result of the normal newborn resistance to mineralocortocoids. Hypertension, seen in both sexes, is a distinctive clinical feature but is absent in the first few years of life (3). Patients with blood pressure values 5-10 mmHg above the 99th percentile are usually considered to have severe hypertension (6). Other cardiovascular manifestations include left ventricular hypertrophy and retinopathy and death from cerebrovascular accidents has been documented (7). Biochemically, 11-beta O...
Romanian Journal of Diabetes Nutrition and Metabolic Diseases, 2016
This paper reports a case of a male infant born to a 32-year-old multiparous mother with overweig... more This paper reports a case of a male infant born to a 32-year-old multiparous mother with overweight (BMI 28.5kg/m
IntroductionA snack is a light food eaten in between the main meals; breakfast, lunch and dinner.... more IntroductionA snack is a light food eaten in between the main meals; breakfast, lunch and dinner. Snacking is a key characteristic of the diet of majority of adolescents and it has been estimated to provide one-fourth to one-third of their daily energy intake (1). The choice of snacks in adolescents is based mainly on taste rather than nutrition, resulting in the tendency to choose salty, high-sugar or high-fat foods as snacks instead of healthier alternatives (2). Soft drinks are one of the most common snack choices among adolescent schoolgirls (3). Among adolescents, fruits and vegetables are chosen less frequently as snacks (2). The dramatic rise in the prevalence of obesity in the paediatric age group in the past three decades has led to concerns about the dietary pattern of children and adolescents (4,5). In addition, habits acquired during adolescence tend to persist into adulthood. In this context, dietary behaviour developed in adolescence may have a major effect on the risk of chronic disease later in life. It has been emphasized that health-care providers should not only be alert toward unhealthy eating habits and nutrition-related issues among adolescents, but also, provide adequate and timely counselling (6). Health education and promotion in the schools cannot succeed in the absence of a carefully conceived school health programme based on data on snacking pattern. Yet these data are neither well known nor documented (7).The prevalence of snacking among adolescents varies widely. The report of one study indicated that 80-90% of adolescent females consumed at least one snack per day, with a range of one to seven snacks daily (1). Different snacking rates have been reported from various countries. For instance, 87-88% in USA (2,8), 62.1% in India (9) and 54.1% in Malaysia (10). A rising trend in the prevalence of snacking among adolescents has been reported (8). Generally speaking, adolescents as a group, are highly receptive to new food products and snack-type meals.Some undesirable health outcomes that have been linked to snacking include obesity, skipping of meals, unhealthy food choices and poor nutrient intake (11- 14). Despite the recognized undesirable health outcome of snacking among adolescents, published studies reporting pattern of snack consumption among Nigerian adolescents is very scarce. A search of the literature indicated that information on the specific contexts in which adolescent Nigerians snack is grossly lacking. The aim of the present study was to describe the pattern of snack consumption among adolescent Nigerian secondary schoolgirls. The knowledge derived from this study will assist those involved in health education and promotion of healthy eating habits among adolescents.MethodsThis descriptive-cross-sectional study was conducted in two public secondary schools located in Oredo Local Government Area (OLGA), Edo State, Nigeria. The two schools were for girls only. According to Edo State Ministry of Education Statistics, there are nine public secondary schools in the LGA comprising 4 females-only, 3 co-educational and 2 males-only (15). Consent for the study was obtained from the school authorities. The teachers distributed parental consent forms to parents via the students asking for permission for the child to participate in the study. Of the four girls' secondary schools, two were randomly selected by ballot. The total population of students in the two schools selected was school A 1,605 and school B 772, giving a grand total of 2,377, which was the target study population. The survey was designed to include all the students in the two schools (schools A and B). As a consequence, no sampling was performed. The principal of each of the two schools introduced the authors during the morning assembly. Subsequently, we addressed the students in their classrooms on the objectives of the study as well as on how to accurately fill the questionnaire. We also emphasized to the students that the questionnaires were anonymous and that their participation was voluntary. …
Nigerian Hospital Practice, 2008
ABSTRACT
Nigerian Postgraduate Medical Journal
To determine the incidence of low birth weight deliveries in a Nigerian mission hospital. A descr... more To determine the incidence of low birth weight deliveries in a Nigerian mission hospital. A descriptive analysis of the records of 332 live, low birth weight babies delivered between 1st January, 1999 to 31st December, 2001 in a Nigerian mission hospital in Benin City was carried out. A standardised questionnaire was used and the mothers of low birth weight (LBW) babies were interviewed soon after delivery. The overall incidence of LBW was 8.1% with a female preponderance. Of the 332 LBW babies, 3.9% were extremely LBW, 12.0% very LBW, 20.5% moderately LBW while 36.4% of the babies weighed less than 2000 g. Preterm babies were significantly more frequent than term small-for-gestational age babies. A lower incidence was found in the year 2001 compared with the immediate preceding two years. A significantly greater number of LBW babies were born during the dry season compared with the wet season. The leading maternal factor associated with delivery of LBW infants was absent or inadequate antenatal care. Using the World Health Organisation definition of low birth weight of < 2500 g, a lower incidence of LBW was found compared with other studies that defined LBW as birth weight < 2500 g.
Sri Lanka Journal of Diabetes Endocrinology and Metabolism, 2018
Background/Aim: Community-acquired electrolyte disorders have been associated with poor prognosis... more Background/Aim: Community-acquired electrolyte disorders have been associated with poor prognosis following hospitalization and treatment for various illnesses. The aim of the study was to estimate the prevalence of abnormalities of serum sodium and potassium concentrations in patients with new-onset type 1 diabetes with ketoacidosis at presentation in the paediatric emergency departments of two Nigerian teaching hospitals. Method: A retrospective medical records review was performed on all paediatric patients with new-onset type 1 diabetes complicated by ketoacidosis seen in two Nigerian hospitals (University of Benin Teaching Hospital and Lagos University Teaching Hospital) over a period of 5 years. Information obtained included age at diagnosis, gender, presenting complaints and outcome (dead or alive). Data on serum electrolyte concentrations (sodium, potassium, chloride, bicarbonate) as well as blood glucose before initiation of fluid resuscitation and insulin therapy were extracted. The anion gap and effective osmolality were computed. Results: Overall, 25(53.2%; 95% Confidence interval, CI= 38.9-67.5) of the 47 patients had abnormalities in serum sodium, potassium or a combination of both. With regard to serum sodium, isolated abnormalities were found in 14(29.8%; 95% CI =16.7-42.9) of 47 patients. Hyponatremia occurred in 25.5% (95% CI=19.1-31.9) and hypernatremia occurred in 2.1% (95% CI = 0.01-4.2). Of the 47 patients, 10(21.3%; 95% CI =15.3-27.3) had isolated serum potassium abnormalities. The frequency of hypokalemia and hyperkaliemia were 8.5% (95% CI= 4.4-12.6) and 10.6%(95% CI= 6.6-15.1), respectively. The hypokalemia was severe (< 2.5mmol/L) in 2.1% of cases. The frequency of combined hyponatremia and hypokalemia was 2.1%. The mean anion gap was 18.6±0.6 (95% CI =18.4-18.8). The mean time for resolution of ketoacidosis was 2.8±0.6 days (95% CI= 2.6-3.0). Five (10.9%) of the 47 patients were toddlers (1 to 3 years old). Polyuria, weakness and anorexia were the key presenting complaints in toddlers with DKA. Of the 28 patients from UBTH, one (3.4%) died and the patient had severe mixed electrolyte disturbances (hyponatremia, hypokalemia and acidosis). Conclusion: At point of hospitalization for paediatric new-onset diabetes with ketoacidosis, disturbances in serum sodium and potassium concentrations were common. Polyuria, weakness and anorexia were the key presenting complaints in toddlers with DKA.
Galle Medical Journal, 2016
Dyslipidaemia is one of the major risk factors for cardiovascular disease (CVD) in diabetes melli... more Dyslipidaemia is one of the major risk factors for cardiovascular disease (CVD) in diabetes mellitus. However, the magnitude and characteristic features of dyslipidaemia among Sri Lankans with newly diagnosed diabetes is not yet known. We aimed to study the prevalence and pattern of dyslipidaemia in a cohort of patients with newly diagnosed type 2 diabetes mellitus (T2DM). This study was carried out in 403 newly diagnosed T2DM patients attending a specialist diabetic clinic in Southern Sri Lanka. Dyslipidaemia was diagnosed if patients had one or more parameters of lipid profile outside the target values recommended by theAmerican DiabetesAssociation (ADA). Diabetic dyslipidaemia was observed in 90% of patients with females having higher prevalence (94.7%) than males (87.0%, P=0.04). The most prevalent type of dyslipidaemia was isolated elevation of low density lipoprotein (LDL) cholesterol (84.3%) Raised triglyceride (TG) and low high density lipoprotein (HDL) were comparatively less common and observed in less than 20% subjects. Factors such as obesity, waist circumference, age and degree of hyperglycaemia at presentation had no significant effect on the pattern and prevalence of dyslipidaemia. This study revealed a higher prevalence and a different pattern of dyslipidaemia among newly diagnosed patients with T2DM. Finding of raised LDL with relatively low TG observed in this study was different to the pattern of diabetic Dyslipidaemia described in Caucasians. Prevalence and pattern, diabetic dyslipidaemia, newly diagnosed, type 2 diabetes mellitus, Asian ethnicity .
Tropical Medicine and Health, 2015
Background/Objective: Fluid, electrolytes and acid base disturbances are responsible for most dea... more Background/Objective: Fluid, electrolytes and acid base disturbances are responsible for most deaths due to acute diarrhoea. The aim of this study is to describe the point-of-admission serum electrolyte profile of children with dehydration due to acute diarrhoea. Methods: In this cross-sectional study, the serum electrolyte levels of 185 children with dehydration due to acute diarrhoea were assessed at the point of admission at the Diarrhoea Treatment and Training Unit of the University of Benin Teaching Hospital. The age of the study population ranged from 29 days to 59 months. Results: Out of a total of 185 subjects, 30 (16.2%), 114 (61.6%), and 41 (22.2%) had severe, moderate and mild dehydration, respectively. In addition, hyponatraemic dehydration was the most common type of dehydration, accounting for 60.5% of cases. Metabolic acidosis and hypokalaemia occurred in 59.5% and 44.3% of cases, respectively. Only the serum bicarbonate level was significantly affected by degree of dehydration (p = 0.001). Age of more than 12 months and presence of vomiting were significantly associated with hyponatraemia (p = 0.005 & p = 0.02), while age of less than or equal 12 months and absence of vomiting were associated with metabolic acidosis (p = 0.04 & p = 0.03). Conclusion: The degree of dehydration appears to be a good predictor of the occurrence of metabolic acidosis while age is a risk factor for hyponatraemia and metabolic acidosis.
Nigerian Quarterly Journal of Hospital Medicine, 2008
The incidence of twin delivery in Nigeria may have changed, in view of the worldwide increase in ... more The incidence of twin delivery in Nigeria may have changed, in view of the worldwide increase in the rates of twinning attributed to increasing maternal age and use of fertility therapies. To determine the current incidence of twin delivery in Benin City and document the foetal outcome in twins. A four-year descriptive (cross-sectional) study of twin deliveries in a Nigerian mission hospital was conducted. The foetal outcome in 115 sets of twin was compared with that of 230 singleton controls. The current incidence of twin delivery was 25.3 per 1000 deliveries or one in 40 births, representing a reduction by 24.2%. Sex ratio was 0.98 : 1 in favour of females. Seasonal variation was observed in the incidence of twin delivery with a significantly higher incidence in wet than in dry season (p &amp;amp;amp;amp;amp;amp;lt; 0.001). Twin pregnancies are at a significantly higher risk of adverse foetal outcome such as low birth weight (LBW), preterm delivery, birth asphyxia and Caesarean delivery compared to singleton pregnancies (p &amp;amp;amp;amp;amp;amp;lt; 0.001). Although the incidence of twin delivery remains high in Benin City, it appears to have dropped. Twin pregnancy is associated with increased risk of adverse foetal outcome.
Nigerian Quarterly Journal of Hospital Medicine, 2010
In Nigeria, perinatal mortality remains a major health problem with the balance heavily tilted to... more In Nigeria, perinatal mortality remains a major health problem with the balance heavily tilted towards the stillbirth component. Knowledge of the relative importance of the different causes of stillbirth is lacking, even in hospital settings. To determine the stillbirth rate in a Nigerian mission hospital and document its risk factors. In this retrospective study, the case records of 131 mothers who had stillbirths were studied and the data obtained analyzed. The relevant hospital delivery registers were also examined. Stillbirth rate was 39.7 per 1000 births with 51.9% and 48.1% being macerated and fresh stillbirths respectively. Antepartum haemorrhage, pre-eclampsia/ eclampsia and prolonged/obstructed labour were the three leading risk factors for stillbirth. Low birthweight babies were also at increased risk of foetal death. Majority (61.8%) of mothers whose babies were still-born belonged to low social class. Our stillbirth rate remains unacceptably high and strategies to reduce it must focus on antenatal and intrapatum emergency obstetric care and early referrals in hospital setting.
Nigerian Medical Practitioner, 2005
This paper presents a case of an emotionally deprived child with some evidence of child neglect r... more This paper presents a case of an emotionally deprived child with some evidence of child neglect resulting from husband-wife violence and subsequent separation of parents. It, also, further confirms the long recognized fact that the most successful treatment of growth failure and weight loss due to psychosocial deprivation is restoration of a normal social environment. In particular, it highlights the need for a high index of suspicion and awareness on the part of medical personnel with regard to emotional disorders in children.
Journal of Institute of Medicine, 2013
Introduction: $W KRPH PRWKHUV DUH XVXDOO\ WKH ¿UVW WR LGHQWLI\ V\PSWRPV LQ WKHLU FKLOGUHQ DQG ini... more Introduction: $W KRPH PRWKHUV DUH XVXDOO\ WKH ¿UVW WR LGHQWLI\ V\PSWRPV LQ WKHLU FKLOGUHQ DQG initiate treatment but there is paucity of information on these initial steps taken by these mothers. The objective of the study is to examine how mothers treat common childhood symptoms at home before presentation in the hospital. Methods: A hospital-based cross-sectional study along with a structured interviewer-administered questionnaire was used for data collection from 307 consecutive mothers. Data obtained included their children's presenting symptoms, drugs administered, dosage regimen, source of the drugs, person who prescribed the drugs and storage of drugs. The axillary temperature of all the children ZHUH PHDVXUHG XVLQJ D PHUFXU\ WKHUPRPHWHU ZLWK WKH DUP KHOG ¿UPO\ WR WKH ERG\ Results: Fever either alone or in association with other symptoms was the commonest (75.6%) presenting symptom. Among the 232 children reported as feverish by their mothers, 119 (51.3%) had normal body temperature (<37.5 0 C) while the remaining 113 (48.7%) had elevated axillary temperature equal or greater than 37.5 0 C. Analgesics, antimalarials and antibiotics were the three leading classes of drugs administered by the mothers, together accounting for 62.3% of all drugs. Antimalarials was the class of drug whose dosage regimen was most frequently incorrect, being correct in only 21.4% of cases. Mothers and patent medicine dealers accounted for 67.4% of all the prescriptions. The principal source of drugs was the patent medicine stores (62.2%). Of the 307 mothers, 64 (20.8%) administered left over drugs prescribed for a previous ailment. These drugs were stored mostly in closed cupboards and drawers (67.2% of cases) for a period of three WR HLJKW ZHHNV PHDQ ZHHNV 7KH PRWKHUV KDG GLI¿FXOW\ LQ FRUUHFWO\ LGHQWLI\LQJ IHYHU with 51.3% of cases reported as feverish by their mothers having normal axillary temperature. Conclusions: The present home-treatment practices by mothers regarding their children's V\PSWRPV LV JUHDWO\ GH¿FLHQW ,QWHUYHQWLRQ DLPHG DW LPSURYLQJ WKH VLWXDWLRQ VKRXOG LQFOXGH WHDFKLQJ PRWKHUV KRZ WR JLYH RUDO GUXJV FRUUHFWO\ WUHDW ORFDO LQIHFWLRQV IHHG DQG JLYH ÀXLGV during illnesses as well as ways of recognizing signs indicating immediate return to the health facility. Training of patent medicine dealers on the basics of drug action is also essential.
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Papers by Alphonsus Onyiriuka