ABSTRACT
OBJECTIVES: To assess the utilization and efficiency of the primary health care (PHC) centres in the delivery of care to epileptic patients. DESIGN: Sixty health centres were randomly selected to represent various socioeconomic classes and urban/ rural population in Riyadh. The study was conducted during August 1993. A predesigned data form was used to ascertain socio-demographic characteristics of patients, clinical features, health centre profile and health care resources available to epileptic patients. PHC doctors completed these forms for all epileptic patients found in their health centre register which entered in PC computer for analysis. RESULTS: At the end of the study, 131 epileptic patients were found in the health centre register which accounted for 0.05% (0.03% in urban and 0.1% in rural). The majority of patients 80.2% were 30 years old or below. Out of all patients 77.1% attended health centres for up to six times. At least one referral to hospital or admission were recorded in 53.4% and 20.6% of patients respectively. PHC doctors thought that 31.3% were not compliant. Family history of epilepsy was positive in 12.9% of patients. CONCLUSION: The number of epileptic patients registered as epileptic at health centres were too low. There is a need to design a policy for detection of cases, training of PHC doctors and cost effective mobilization of resources to PHC centres so to attract more epileptic patients to use the health centres.
Subject(s)
Epilepsy/epidemiology , Patient Care Team/statistics & numerical data , Primary Health Care/statistics & numerical data , Adolescent , Adult , Child , Child, Preschool , Cost-Benefit Analysis , Cross-Sectional Studies , Epilepsy/drug therapy , Epilepsy/economics , Female , Humans , Incidence , Infant , Male , Patient Care Team/economics , Primary Health Care/economics , Saudi Arabia/epidemiology , Treatment OutcomeABSTRACT
A 45 year-old man presented with a rapid onset of memory impairment Brain computed tomography showed multiple abnormal low density areas in the deep cerebral white matter. Magnetic resonance imaging revealed bilateral thalamic infarcts and extensive thrombosis of the vein of Galen and the straight sinus, which was confirmed by cerebral angiography. The only potential cause was protein S deficiency. Heparin therapy was started only after the occurrence of a pulmonary embolism. The outcome was excellent Deep cerebral venous thrombosis must be considered as a possible cause of amnestic syndrome. Clinical awareness and early use of anticoagulation may alter the usual fatal outcome.
