Prevalence and outcome of hypoglycemia in children attending emergency pediatric unit of a specialist hospital in Nigeria

Background: Hypoglycemia is a common metabolic problem encountered in pediatric emergency admissions. The absence of clinical symptoms does not preclude the presence of hypoglycemia as presentation may vary from asymptomatic to central nervous system and cardiopulmonary disturbances. If untreated, hypoglycemia can result in permanent neurological damage or even death. Objectives: The objective of the study is to determine the prevalence, associated factors and outcome of hypoglycemia in pediatric emergency admissions at Ahmad Sani Yariman Bakura Specialist Hospital, Gusau, Nigeria. Materials and Methods: The study was a prospective cross­sectional study involving children aged 1 month­13 years. Blood glucose was determined at admission using Accu­Chek® Active Blood Glucose Meter, and hypoglycemia was defined as blood glucose levels <2.8 mmol/L (<50 mg/dL). Age of the patients, sex, interval of last meal, presenting complaints diagnoses were recorded. Results: A total of 154 children were studied.Thirty (19.5%) were infants and 71 (46.1%) were under­fives. Eighty­seven (56.5%) were males with male to female ratio of 1.3:1.The prevalence of hypoglycemia was 22.1%. The predominant disease conditions the children with hypoglycemia presented with were severe malaria, acute diarrheal disease, and sepsis. The prevalence of hypoglycemia was significantly higher among children whose last meal was 8 h and above before presentation (42.9%). Children who presented with hypoglycemia were significantly more likely to die (odds ratio [OR] =13.3; 95% confidence interval [CI] =4.6­38.7). Among those with hypoglycemia, males were significantly more likely to die (OR = 4.2, 95% CI = 1.0­18.0). Hypoglycemia was significantly associated with mortality in children with severe malaria and pneumonia (P = 0.04 and 0.01, respectively). Conclusion: The prevalence of hypoglycemia is still high in our emergency admissions. It is associated with significant mortality especially among male children and those presenting with severe malaria and pneumonia. We recommend that hypoglycemia sought for and promptly treated in children presenting to emergency to reduce mortality

Perceived and real histopathology turnaround time: A teaching hospital experience

Background: This study aims to audit analytic turnaround time (TAT) in a histopathology laboratory with a view to assessing the timeliness of its reports, identify causes of delay in its TAT, and compare this with client perception of its performance. Materials and Methods: Records of 1440 batches of specimens processed over a 5-year period in the histopathology laboratory of a teaching hospital were retrieved from archives. From these, median and mean TATs were calculated and causes of delay identified. Questionnaires were also deployed to assess physicians' perception of the laboratory's performance. Results: Analytic TAT was 3.6 ± 2 days, with 86.7% of reports being ready within 5 working days. The delays in timeliness of report generation were due mainly to residency training-related factors; tissue processing-related factors, and inadequate clinical information among others. Client perception of TAT rated the laboratory below average by 18.4%; average by 57.5%; good by 20.7%, and excellent in its performance by 3.4% of respondents. Conclusion: Even though physicians perceived the laboratory's TAT to be just average, its analytic TAT for reports is within acceptable international standards but with room for improvement in its performance