ABSTRACT
Neurological emergencies are life-threatening central nervous system disorders, significantly contributing to childhood morbidity and mortality. The sequelae may be irreversible and may impact negatively on the quality of life of affected children and their families. This study identified the morbidity pattern and determinants of the outcomes of children with neurological emergencies in the Children Emergency Room (CHER) of the Rivers State University Teaching Hospital (RSUTH). Method: A 4-year retrospective study was carried out in the CHER. Data on demography, diagnosis and outcomes of children with neurological disorders were extracted from the records. Data analysed with SPSS 24 were expressed in percentages and frequency tables. Results: Of the 3040 children admitted in the CHER, 364(12%) aged 0-15 years had neurological emergencies, commoner among males (59.3%) and children aged less than five years (70.9%). Meningitis (40.2%) and febrile convulsion (28.2%) were the topmost diagnoses made. Raised intracranial pressure (17.4%) and head injuries (25.5%) were significantly more prevalent among children aged five years and above. The mortality rate was 61(16.8%) and more among adolescents (30.6%). All the mortalities took place within the first 48hours of admission especially among those with head injuries (46.5%) and perinatal asphyxia (95%), (p < 0.05). Conclusion: Meningitis and febrile convulsion were the commonest neurologic emergencies seen in this study. Mortality rate was high, especially in the first 48 hours of admission and mainly from perinatal asphyxia and head injuries. Education on the prevention and management of neurologic emergencies should be strengthened
Subject(s)
Humans , Child , Emergency Service, Hospital , Outcome Assessment, Health Care , Diagnostic Techniques, Neurological , Tertiary Care CentersABSTRACT
Background: Health literacy plays a crucial role in enabling individuals to navigate and make informed decisions within the healthcare system. It encompasses the ability to understand, interpret, and act upon medical information and instructions, as well as the capacity to source and analyse relevant health information for preventive measures and self-care. This paper explores the interventions aimed at improving health literacy in Nigeria and synthesizes policy recommendations for the Nigerian government. Method: A systematic literature review based on the PRISMA methods was carried out to identify published interventions and reported effectiveness in the Nigerian population. A search strategy using key words health literacy and health interventions was executed in PubMed, Embase and African Index Medicus. A total of 268 records were screened for relevance and 18 were identified. Results: Of the 18 reports identified, 13 interventions were effective, 3 interventions had mixed results reporting effectiveness in some domains and ineffectiveness in other important domains, while 2 interventions were not effective. The nature of effectiveness in the interventions was based on the outcomes as reported in the identified studies. Conclusion: The health literacy situation in Nigeria provides a background into some of the challenges faced in achieving universal health coverage and promoting health in Nigeria. Low literacy rates, particularly in its many rural areas, the lack of functional, communicative, and critical health literacy competencies among many adults, as conceptualised in literature pose a significant obstacle to health literacy development in Nigeria. Many of the health literacy interventions have been effective to address various aspects of health literacy on a rather small scale. To comprehensively address the problem, collaborative efforts involving the government, healthcare professionals, non-governmental organisations, media, and the community are necessary.
Subject(s)
Humans , Male , Female , Health Literacy , Systematic Review , Health Promotion , Health PolicyABSTRACT
Background: Neurological emergencies are life-threatening central nervous system disorders, significantly contributing to childhood morbidity and mortality. The sequelae may be irreversible and may impact negatively on the quality of life of affected children and their families. This study identified the morbidity pattern and determinants of the outcomes of children with neurological emergencies in the Children Emergency Room (CHER) of the Rivers State University Teaching Hospital (RSUTH). Method: A 4-year retrospective study was carried out in the CHER. Data on demography, diagnosis and outcomes of children with neurological disorders were extracted from the records. Data analysed with SPSS 24 were expressed in percentages and frequency tables. Results: Of the 3040 children admitted in the CHER, 364(12%) aged 0-15 years had neurological emergencies, commoner among males (59.3%) and children aged less than five years (70.9%). Meningitis (40.2%) and febrile convulsion (28.2%) were the topmost diagnoses made. Raised intracranial pressure (17.4%) and head injuries (25.5%) were significantly more prevalent among children aged five years and above. The mortality rate was 61(16.8%) and more among adolescents (30.6%). All the mortalities took place within the first 48hours of admission especially among those with head injuries (46.5%) and perinatal asphyxia (95%), (p < 0.05). Conclusion: Meningitis and febrile convulsion were the commonest neurologic emergencies seen in this study. Mortality rate was high, especially in the first 48 hours of admission and mainly from perinatal asphyxia and head injuries. Education on the prevention and management of neurologic emergencies should be strengthened.
Subject(s)
Emergency Service, Hospital , Nervous System DiseasesABSTRACT
Durante los últimos años se ha observado un incremento en el número de consultas en los servicios de emergencias pediátricas de forma proporcional al incremento de las consultas por motivos neurológicos. Objetivos: Analizar la demanda de la actividad asistencial neuropediátrica y conocer los motivos de consultas más frecuentes y su distribución epidemiológica. Métodos: Estudio observacional de cohorte histórica mediante el registro prospectivo durante un año en el servicio de Emergencia Pediátrica del Hospital Universitario de Maracaibo. Resultados: Se solicitó evaluación neuropediátrica a 172 pacientes constituyendo el 0,17 % de todas las emergencias entre 0 y 15 años de edad, predominando los lactantes (39%) y niños varones (53,5%). Las crisis convulsivas son el motivo de consulta más frecuente (45%), seguidas del retraso psicomotor y la sospecha de encefalopatías estáticas. La epilepsia fue el principal diagnóstico de ingreso (23%) y egreso (25%) seguido de meningitis bacteriana aguda. Conclusiones: Las urgencias neurológicas constituyen un porcentaje significativo del total de las urgencias pediátricas. Son muchos los motivos de consulta y es rol del pediatra de emergencias solicitar la valoración especializada. Las crisis convulsivas, retraso psicomotor, infecciones del sistema nervioso central, síncope y cefalea constituyen los cinco principales motivos de consulta. Sin embargo la demora psicomotora no constituye una urgencia, por lo que el pediatra debe estar en capacidad de tomar la decisión acertada a quien debe derivar y solicitar la consulta por el especialista de forma inmediata.
In recent years there has been an increase in the number of consultations in pediatric emergency services in proportion to the increase in consultations for neurological reasons.Objectives: To analyze the demand of neuropaediatric care, and to determine the most frequent reasons for neuropediatric consultations. Methods: Historical cohort observational study by means of a prospective registry during one year in the Pediatric Emergency Service of the University Hospital of Maracaibo, Venezuela. Results: Neuropediatric evaluation was requested for 172 patients, 0.17% of all emergencies, ages from 0 to 15 years, predominantly infants (39%) and boys (53.5%). Seizures were the most frequent reason for consultation (45%), followed by psychomotor retardation and suspected static encephalopathies. Epilepsy was the most frequent diagnosis at admission (23%) and discharge (25%), followed by acute bacterial meningitis. Conclusions: Neurological emergencies constitute a significant percentage of all pediatric emergencies. There are many reasons for consultation and the pediatrician's role is to decide who deserves specialized neurologic care or who may be derived for an outpatient emergency assessment. Seizures, psychomotor retardation, central nervous system infections, syncope and headache, were the five main reasons for consultation; however psychomotor delay does not constitute an emergency, so the pediatrician should be able to decide which patient should be derived to the neuropediatrician.
ABSTRACT
Introducción: Las urgencias neurológicas constituyen el 10-15% de las urgencias médicas. Los principales motivos de consulta son la enfermedad cerebrovascular, crisis epilépticas y cefalea. El Hospital Dr. Hernán Henríquez A. (HHHA) comenzó con neurólogos en el Servicio de Urgencia Adultos (SUA) en horario hábil, en abril de 2011. En julio de 2013 se iniciaron turnos con neurólogo 24/7, presenciales en el SUA. Objetivo: Describir el perfil clínico de las consultas neurológicas en el SUA de nuestro centro. Método: Muestra noprobabilística, por conveniencia, de las consultas realizadas en el Turno N°1, del SUA-HHHA, entre octubre de 2013 y septiembre de 2014. El análisis estadístico se realizó con el software STATA 12.0. Resultados: Se registraron 1.080 consultas en el período. 51,2% fueron mujeres. Promedio de edad = 58 años (DE = 20,2). El 36,7% de las consultas se realizó en horario inhábil. Los diagnósticos más frecuentes fueron infarto cerebral (30,7%), epilepsia (15%) y cefalea (11,3%). El 34,6% de los pacientes fue dado de alta; 25,8% se hospitalizó en el Servicio de Medicina Interna; 21% fue derivado a otros hospitales; 12% fue derivado a otros especialistas y 5,7% ingresó a la Unidad de Paciente Crítico. 0,83% de los pacientes falleció en el SUA. Conclusiones: Los principales motivos de consulta neurológica en nuestro Servicio de Urgencia fueron enfermedades cerebrovasculares, epilepsia y cefalea. Debido a que más de un tercio de las consultas ocurre en horario inhábil, se justifica el sistema de neurología 24/7 presencial en el Servicio de Urgencia.
Introduction: Neurological emergencies constitute 10-15% of medical emergencies. The main reasons for consultation are cerebrovascular disease, seizures and headaches. Dr. Hernan Henriquez Hospital (HHHA) began with neurologists in the Adult Emergency Service in April 2011. In July 2013 24/7 neurology shifts at emergency room were added. Objective: To describe the clinical profile of neurologic consultations at our emergency center. Method: A convenience sample of consultations on shift No. 1, at the Adult Emergency Service HHHA between October 2013 and September 2014. The statistical analysis was performed using STATA 12.0 software. Results: 1,080 consultations were recorded in theperiod. 51.2% were women. Mean age = 58 years (SD = 20.2). 36.7% of consultations are conducted in a non-business hour. The most frequent diagnoses were stroke (30.7%), epilepsy (15%) and headache (11.3%). 34.6% ofpatients were discharged; 25.8% were hospitalized in the Internal Medicine dept; 21% were referred to other hospitals; 12% were referred to other specialists and 5.7% were admitted to Critical Patient Unit. 0.83% of the patients died in the SUA. Conclusions: The main reasons for neurological consultation at our Emergency Service were cerebrovascular disease, epilepsy and headaches. Because more than a third of consultations occur on non-schedule hours, neurology system 24/7 shifts are justified in the Emergency Service.