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Trends in the histopathology of childhood nephrotic syndrome in Ibadan Nigeria: preponderance of idiopathic focal segmental glomerulosclerosis
Published 2015
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Demographic and Psycho-Social Background as Correlates of Parents’ Perception of Causes of Mental Retardation among School Children in South-Western Nigeria
Published 2011
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Background: Reports on the histopathology of childhood nephrotic syndrome (NS) had emanated from our Centre since the 1960s and by the late 1980s and early 1990s, a change was observed and reported. Taking into consideration the worldwide changing trend in the histopathology of the NS and our Unit policy change in the indications for renal biopsy, a change was envisaged. We therefore evaluated the current histologic pattern of childhood NS in Ibadan with the view to highlighting any variations from the past and comparing the findings with regional and global trends. Methodology: We reviewed our database and analyzed the renal biopsy findings in patients who were biopsied before treatment was administered between 1997 and 2001 and those with mostly idiopathic steroid resistant NS (SRNS) and secondary NS, managed between 2006 and 2013. A comparative analysis of the findings from the present study was carried out with two previous reports from our Unit in the 1970s and early 1990s and also with reports from other Centres. Results: A total of 78 patients had successful biopsies done during the study period in children aged between 2 ½ and 16 years. In both pre-treatment biopsy era (1997–2001) and post-treatment biopsy era (2006–2013), focal segmental glomerulosclerosis (FSGS) predominated. 75 % of the patients had idiopathic NS and among the patients that had idiopathic steroid resistant NS, FSGS was the most common followed by MPGN. For secondary NS, MCD was the most common but could be the early stages of either membranous nephropathy (MN) or FSGS. Chronic pyelonephritis and chronic interstitial nephritis occurred in 25 % of the study population but they were more prevalent in secondary nephrotic syndrome. Conclusion: FSGS is the most common histopathology in children requiring renal biopsy in Ibadan presently. FSGS is also the most common histopathology in idiopathic SRNS, which is in keeping with reports from most parts of the world. There has been a transition from the preponderance of Quartan Malarial Nephropathy (QMN) in the 1960s to MPGN in the 1980s to FSGS presently. This has great implications with regards to searching for new aetiologic factors, providing more efficacious treatment modalities and ensuring facilities for immunofluorescence, electron microscopic and genetic studies.
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Childhood nephrotic syndrome
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Demographic
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FSGS
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Ibadan Nigeria
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MCD
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MPGN
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Mental retardation
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Psycho-social background and Child‘s development
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Renal histopathology
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There are contradictory opinions surrounding the causes of mental retardation among parents of children with mental retardation. The causes on one hand may be genetic and on the other may be largely attributed to mystical forces. Previous studies have tried to ascertain the causes of mental retardation in families but they have not been able to establish the actual etiology. However, demographic and psychosocial factors are also important factors worthy of investigation in identifying the causes of mental retardation. This study, therefore, investigated the demographic and psycho-social background as correlates of parents‘ perception of the causes of mental retardation in 15 special education primary schools in South-Western, Nigeria. This study adopted a descriptive survey design of the ex-post facto type. Purposive sampling technique was used to select 606 respondents, 338 women and 268 men who were parents of children with mental retardation. These parents were met during Parent Teacher Association meeting at different occasions in all the schools. Data were collected using Parents‘ Perception of Mental Retardation Scale (r=0.68) and Mental Retardation Determinant Scale (r=0.77). Six research questions were answered and three hypotheses tested at the 0.05 level of significance. Data collected were analysed using multiple regression and analysis of variance. The psycho-social variables have a multiple correlation with the dependent variable (chances of giving birth to a child with mental retardation) (R=0.86). This joint correlation is shown to be significant (F(7,598)=247.48; p<0.05). The psycho-social variables accounted for 74.3% of the total variances in the chances of giving birth to a child with mental retardation. Three of the psycho-social variables have significant (p<0.05) relative contribution to the chances of giving birth to a child with mental retardation. These are cultural practices (β=0.36; t=15.92; p<0.05); birth order (β=0.09; t=3.65; p<0.05) and birth trauma (β=0.07; t=2.921; p<0.05). Socio-economic status and disease during the child‘s development have no significant relative contribution. It was also discovered that one in every three women that have children with mental retardation is between age 35 and 40. Large proportion of women (77.7%) that have children with mental retardation had no complication during pregnancy and (72.3%) had no difficulties during labour. Demographic and psycho-social variables were perceived to have jointly contributed to predicting mental retardation in children. Therefore, there is need for public enlightenment on the causes of mental retardation. Efforts should be made to educate and counsel parents of children with mental retardation on the causes and proper management of the condition.
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