A Comparative Analysis of Hydroxyurea Treatment on Coagulation Profile Among Sickle Cell Anaemia Children in Lagos, Nigeria.

Hydroxyurea (HU) is a disease-modifying therapy with significant clinical and laboratory efficacy among individuals living with sickle cell anaemia (SCA). This is evident through increased fetal haemoglobin, higher packed cell volume, improved red cell hydration, reduced leukocytes, and platelet function. The effect on the coagulation pathway and pathophysiologic mechanism remains unclear, especially in children living with SCA.

Psychosocial dysfunction and delayed sexual development among adolescents living with HIV in Lagos, Nigeria.

Unlabelled: With increasing survival following the use of antiretroviral therapy, adolescents living with Human Immunodeficiency Virus (ALHIV) could have complications such as delayed puberty and psychological complications. In Nigeria, there is limited data on the association between delayed sexual maturation and psychosocial dysfunction in ALHIV. The objective of this study was to determine the prevalence and the association between delayed sexual development (DSD) and psychosocial dysfunction (PSD) in ALHIV and compare it with uninfected adolescents.

Increasing pediatric radiation oncology capacity in sub-saharan Africa using technology: a pilot of a pediatric radiation oncology virtual training course.

Background: The shortage of skilled healthcare professionals in pediatric oncology and the limited access to training programs remain significant challenges in Nigeria and sub-Saharan Africa. The the Pediatric Radiation Oncology (Virtual) Course, 'PedROC' project aims to contribute to improving pediatric cancer outcomes in Nigeria by increasing the capacity of radiation oncology professionals. To address the gap in access to pediatric radiation oncology professional development, the PedROC project was created, harnessing technology to improve radiation oncology training via a curriculum delivered through web-conferencing.

In-hospital psychoeducation for family caregivers of Nigerian children with cancer (The RESCUE Study).

Objectives: High levels of caregiver burden (CB) are experienced by informal caregivers of pediatric patients with cancer. There is increasing evidence highlighting the extent of CB across sub-Saharan African countries, although there remains lack of interventions that target improvements in their experience. This study aimed to determine the impact of a structured psychoeducation program on caregivers' outcomes relating to preparedness to provide care, burden of caregiving, and quality of life (QoL).

Feasibility and Safety of Implementing Volumetric Arc Therapy (VMAT) for Pediatric Craniospinal Irradiation in a Low-Middle-Income Region: The Nigerian Experience.

Purpose: Volumetric modulated arc therapy (VMAT) is a relatively new treatment technique in sub-Saharan Africa. Although craniospinal irradiation (CSI) in the pediatric population has been practiced in Nigeria for many years, the use of VMAT to deliver this treatment is previously undocumented. We reviewed the first set of patients to undergo CSI at a cancer center in Nigeria, detailing the treatment technique, the progress experienced, dose statistics achieved, treatment toxicities, and cancer outcomes to date.

Precise Pediatric Cancer Diagnosis Using Immunohistochemistry: Reducing Cost of Care and Improving Outcomes in a Low and Middle-Income Setting.

Childhood cancer is a significant cause of morbidity and mortality worldwide. It is the second-leading cause of non-communicable deaths among children worldwide with more than 90% of childhood cancer-associated mortality occurring in low-income and middle-income countries. Disparity in mortality rates has been linked to late presentation, inaccurate diagnosis, treatment abandonment and poor access to appropriate therapy.

Prevalence and impact of tobacco use disorder on in-hospital mortality in patients hospitalized with non-group 1 pulmonary hypertension: a nationwide propensity score-matched analysis, 2019.

Numerous studies indicated that patients with tobacco use disorder (TUD) are inversely associated with mortality in what is known as the smoker's paradox. However, limited studies have been conducted on the impact of TUD on the in-hospital mortality rates of patients with secondary pulmonary hypertension (PH, Non-Group 1 PH). Using the 2019 National Inpatient Sample, we identified PH and divided it into TUD and non-TUD to compare the comorbidities and in-hospital mortality between the two after 1:1 propensity-score matching.

Acute kidney injury is more common in hospitalised children with sickle cell anaemia in Africa.

Aim: To document the prevalence, severity, hospital outcome and factors associated with acute kidney injury (AKI) in hospitalised children with sickle cell anaemia (SCA).

Methods: In this prospective observational study involving children aged 0.5-17 years with SCA requiring hospitalisation, we used serum creatinine level at 0 and 48 h of hospitalisation to determine the presence of AKI.

Climate Change and Force Majeure on Childhood Oncology Services in a Low Resource Setting: Experience from a Tertiary Institution in Nigeria.

Childhood cancer patients are a vulnerable population who are adversely affected by any disaster that disrupts the healthcare ecosystem. The objective of this study was to describe the impact of flooding on access to care for childhood cancer patients in Bayelsa state, southern Nigeria. We review the effect of the 2022 flooding on childhood cancer care at the paediatric oncology unit of the Niger Delta University Teaching Hospital, southern Nigeria.

Nasopharyngeal Carcinoma in Childhood: Evidence of a Malfunctioning Oncology Ecosystem: A Case Series from a Low Resource Setting.

Nasopharyngeal carcinoma (NPC) refers to malignancy arising from the epithelium of the nasopharynx. It is a rare tumor globally but seen in higher prevalence in certain populations associated with the endemicity of Epstein- Barr Virus. It is usually seen in clinical settings in developing countries in late stages majorly due to poor health-seeking behavior, healthcare costs, and misdiagnosis arising from its vague and ambiguous symptoms.

Association Between the Use of Wearable Devices and Physical Activity Among US Adults With Depression and Anxiety: Evidence From the 2019 and 2020 Health Information National Trends Survey.

Objective The objective of this study was to examine the relationship between wearable device (WD) use and physical activity (PA) levels among US adults with self-reported depression and anxiety. Methods Data were pooled from 2026 adults who self-reported depression and anxiety from the 2019 and 2020 Health Information National Trends Survey. The explanatory variable was WD use, and the outcomes were weekly PA levels and resistance strength training.

Storytelling of Young Adults with Chronic Rheumatologic Illnesses: A Pilot Study.

Background: Narrative medicine allows patients to reconstruct medical experiences through written portrayals of perspectives, building a mutual depiction of illness while creating a sense of belonging. This modality has not been previously studied in youth with rheumatologic illnesses, a population with high mental health burden and worse health-related quality of life. We aimed to assess the feasibility of a storytelling intervention in this patient population.

Coagulation abnormalities in children with uncorrected congenital heart defects seen at a teaching hospital in a developing country.

Background: Coagulation abnormality is a significant complication and cause of mortality in children with uncorrected congenital heart defects (CHD). The aim of this study was to determine the prevalence of coagulation abnormalities and the associated factors in children with uncorrected CHD.

Method: A cross sectional study conducted to determine the prevalence of coagulation abnormalities among 70 children with uncorrected CHD aged six months to 17 years and 70 age and sex matched apparently healthy controls.

Reduction in seroprevalence of viral transfusion-transmitted infections in southwest Nigeria in children with sickle cell disease using an enhanced screening strategy.

Blood transfusion is an integral component in the management of children and adults with sickle cell disease (SCD). Concerns about blood safety due to the high risk of bloodborne infections in sub-Saharan Africa limits the application of this cost-effective strategy in the management of individuals with SCD. In a single-centre, retrospective, longitudinal study in southwest Nigeria, we hypothesised that the use of stringent blood donor selection, along with very sensitive enzyme-linked immunosorbent assay (ELISA) screening methods would reduce transfusion-transmitted infections (TTIs).

Oncology Education in the Nigerian Medical Curriculum: A Cross-Sectional Review.

Background: The quality of a physician is arguably related to the depth and quality of medical education received. As cancer devastates the health and economy of developing countries like Nigeria, it becomes increasingly important for physicians in these countries to be equipped with basic knowledge and skill to adequately detect, diagnose, refer and manage common cancers. This study reviewed exposure to oncology training as a component of the medical school's curriculum in Nigeria from the trainee's perspective.

Cholelithiasis in children and adolescents with sickle cell disease: Experience in a resource-limited setting.

Background: Sickle cell disease (SCD) remains prevalent in Nigeria and can be complicated by cholelithiasis even in children. There is still a dearth of knowledge about the occurrence of cholelithiasis in these children. The present study is aimed to determine the prevalence of cholelithiasis in pediatric SCD in Lagos and documents relevant socio-demographic and clinical correlates.

A 5-year multidisciplinary care outcomes in children with wilms' tumour managed at a tertiary centre: A retrospective observational study.

Background: Over the last two decades, there has been significant improvement in the outcomes of children with Wilms' tumour (WT) in high income countries (HICs) with approximately 85% survival rate globally. This is partly attributable to a multi-disciplinary team approach to care and the evolution of more robust treatment measures. A previous review in our centre prior to multi-disciplinary team shows a survival rate of 31.

Hepatobiliary Findings in Nigerian Children with Sickle Cell Anaemia.

Introduction: Hepatobiliary abnormalities occur commonly in sickle cell anaemia and these have been extensively reported in the adult patients. However, complications have been sparsely reported in children especially in the sub-Saharan African continent. This study aimed to highlight the hepatobiliary complications in this group of children using clinical examination, laboratory testing and abdominal ultrasonography.

Disparities in Pediatric Rheumatic Diseases.

Health and health care disparities in pediatric rheumatology are prevalent among socially disadvantaged and marginalized populations based on race/ethnicity, socioeconomic position, and geographic region. These groups are more likely to experience greater disease severity, morbidity, mortality, decreased quality of life, and poor mental health outcomes, which are in part due to persistent structural and institutional barriers, including decreased access to quality health care. Most of the research on health and health care disparities in pediatric rheumatology focuses on juvenile idiopathic arthritis and childhood-onset systemic lupus erythematosus; there are significant gaps in the literature assessing disparities associated with other pediatric rheumatic diseases.

Health insurance and the financial implications of sickle cell disease among parents of affected children attending a tertiary facility in Lagos, south-west Nigeria.

Introduction: there is a paucity of data on the financial implications of sickle cell disease on households of affected children and their use of health insurance in Nigeria. This study assessed the awareness of health insurance, patterns of health service utilization and financial implications of sickle cell disease among children seeking care at a tertiary facility in Nigeria.

Methods: a structured questionnaire was administered to parents of 314 children with sickle cell disease attending the pediatric hematology unit of the Lagos University Teaching Hospital between May and December 2019.

Challenges with medical education in Nigeria in the COVID-19 era.

On March 20 2020 the Federal Government of Nigeria ordered the closure of all educational institutions, this was inclusive of all medical schools in the country. During the initial phases of this closure, most institutions were at a loss on how to proceed with learning as universities in Nigeria use mainly the didactic lecturing model. As the lockdown progressed it became imperative to the institutions to set up e-learning media for continued instruction of students.