scholarly journals Ophthalmological Findings in Paediatric Non-Traumatic Coma in Enugu State University Teaching Hospital, Parklane, Enugu, Nigeria

Author(s):  
Ikenna Kingsley Ndu ◽  
Ifeoma N Asimadu ◽  
Benedict Onyeka Edelu ◽  
Obinna Chukwuebuka Nduagubam ◽  
Ogechukwu F Amadi ◽  
...  

The ophthalmological examination is a vital aspect of the central nervous system examination in comatose children. Several authors have documented different findings with disparities in their recommendations about making ophthalmological examination a routine in the management of the unconscious child. This study sought to evaluate the relevance of routine ophthalmological examination in the management of unconscious children admitted into the paediatric emergency room of Enugu State University Teaching Hospital, Parklane, Enugu, Nigeria. This was a prospective longitudinal study conducted from April 2018 to March 2019. Unconscious patients whose caregivers gave consent were recruited into the study. Traumatic causes of coma were excluded. Demographic features of the patients were obtained. The ophthalmologic examination and diagnoses were made by an ophthalmologist, while the emergency room pediatrician made clinical assessment and diagnoses. Sixteen unconscious children had ophthalmologic examinations done. The Glasgow coma scale scores ranged from 3 to 11, with a mean of 6.6±2.2. Thirteen (81.3%) of the children were classified as severe unconsciousness while the rest were moderate. The degree of unconsciousness was significantly associated with the outcome (χ2 =16.0, P = 0.03). A total of six (37.5%) ophthalmologic diagnoses were made, which included cerebral malaria, degenerative myopia, orbital cellulitis, and exposure keratopathy. The presence of an abnormal ophthalmologic finding was not significantly associated with outcome (χ2 =0.36, P = 0.55). Routine ophthalmologic examination may not be justified as a management protocol in unconscious children but may be considered in selected cases.

Author(s):  
Ndu I. K. ◽  
Asinobi I. N. ◽  
Nduagubam O. C.

Aims: This study aimed to compare the difference in admission rates and severity of illness in 2019 and during the peak time period of the global SARS-CoV-2 pandemic of 2020 in children presenting at the Children’s emergency room (CHER) of Enugu State University Teaching Hospital, Enugu. Study Design: This was a cross-sectional study. Place and Duration of Study: Children’s emergency room (CHER) of Enugu State University Teaching Hospital, Enugu, from June 1 to August 31, 2019 and 2020 were reviewed, respectively. Methodology: The admission records of all the children that were admitted into CHER of Enugu State University Teaching Hospital (ESUTH), Enugu, over a three-month period from June 1 to August 31, 2019 and 2020 respectively were reviewed. Results: A total of 310 and 184 patients were seen during the study period for 2019 and 2020, respectively (40.6% decrease). A significant number of patients spent two days on admission in the children’s emergency room in 2020 than in 2019 (P < .001). Emergency admissions were 3 times more in year 2020 than in year 2019 (OR = 2.624, 95% C.I = 1.797 – 3.833, P < .001). Conclusion: Although this study reported decreased emergency room admissions, there was an increase in the mortality rate and emergency presentations.


2021 ◽  
Vol 3 (1) ◽  
pp. 36-43
Author(s):  
Ikenna Kingsley Ndu ◽  
Ugo Nnenna Chikani ◽  
Benedict Onyeka Edelu ◽  
Obinna Chukwuebuka Nduagubam ◽  
Adaobi Ijeoma Bisi-Onyemaechi ◽  
...  

Diabetic ketoacidosis (DKA) is the most severe complication in pediatric cases of type 1 diabetes and also the leading cause of death in these children. There is a broad geographic variation in the frequency of DKA at the onset of diabetes. This study sought to determine DKA's prevalence and pattern in Enugu and review the treatment and outcome over ten years. This retrospective study conduct in the Children Emergency Rooms (CHER) of the two tertiary institutions in Enugu State, southeast Nigeria: Enugu State University Teaching Hospital (ESUTH) and the University of Nigeria Teaching Hospital (UNTH). The biochemical criteria for the diagnosis of diabetic ketoacidosis (DKA) base on the presence of hyperglycemia (blood glucose > 11 mmol/L), acidosis (serum bicarbonate < 15 mmol/L), and ketonuria (urine ketone ?1+). A total of 16,488 children were admitted during the ten years, of which 21 children presented with DKA, representing a prevalence of 0.13%. Six (28.6%) of the patients were newly diagnosed diabetics, while fifteen (71.4%) known diabetics, of which 9 (60%) were presenting with DKA for the first time. A total of two patients died, giving a mortality rate of 9.5%. The rest treated and discharged. The total hospitalization duration ranged from 1–31 days, with a mean duration of 13.3 ± 7.5 days. This study has revealed some of the challenges with the management of children with DKA and the unacceptably high mortality rate.


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