Applicability and accuracy of Bacterial Meningitis Score in a resource-limited hospital setting in Thailand

2016 ◽  
Vol 8 (4) ◽  
pp. 130-133
Author(s):  
Wassana Pattarawanich ◽  
Rachanee Saksawad ◽  
Montida Veeravigrom
Keyword(s):  
Bacterial Meningitis ◽  
Hospital Setting ◽  
Resource Limited

scholarly journals Predictors of Bacterial Meningitis in Resource-Limited Contexts: An Angolan Case

PLoS ONE ◽  
2011 ◽  
Vol 6 (10) ◽  
pp. e25706 ◽  
Author(s):  
Cristina Lussiana ◽  
Sofia Vanda Lôa Clemente ◽  
Ivan Alejandro Pulido Tarquino ◽  
Isabel Paulo
Keyword(s):  
Bacterial Meningitis ◽  
Resource Limited

scholarly journals Trans-anal protrusion of intussusception (TAPI) revisited: managed successfully in a resource limited hospital setting

2018 ◽  
Vol 6 (1) ◽  
pp. 310 ◽  
Author(s):  
Shouptik Basu
Keyword(s):  
Pediatric Surgery ◽  
Single Case ◽  
Hospital Setting ◽  
Female Child ◽  
Late Presentation ◽  
Infants And Toddlers ◽  
Teaching Institution ◽  
Resource Limited ◽  
High Index Of Suspicion ◽  
Anal Protrusion

Intussusception is the most common cause of Acute bowel obstruction in infants and toddlers. However, a Trans-anal protrusion of an intussusception (TAPI) is relatively rare and is not well reported in literature. A high index of suspicion is essential as the diagnosis is purely clinical, and often confused with rectal prolapse. Most patients present late due to neglect on the part of the parents or the primary treating physician. A late presentation usually results in a poor outcome and increased morbidity and mortality. Uncommonly these children may present early, where a prompt surgical management is desirable. The author reports a single case of a Trans anal protrusion of intussusception (TAPI) in a 1-½ -year old female child who was successfully managed in the author's resource-limited teaching institution without a dedicated pediatric surgery unit.

scholarly journals 1403. Infectious Causes of Acute Meningitis Among Thai Adults: A University Hospital Setting

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S510-S511
Author(s):  
Kittipat Aimbudlop ◽  
Sasisopin Kiertiburanakul
Keyword(s):  
Bacterial Meningitis ◽  
Hiv Infection ◽  
White Blood Cells ◽  
Clinical Manifestations ◽  
Hospital Setting ◽  
Polymorphonuclear Neutrophils ◽  
Medical Emergency ◽  
Acute Bacterial Meningitis ◽  
Clinical Presentations ◽  
Acute Meningitis

Abstract Background Acute meningitis is a medical emergency which needs immediate assessment and treatment. Knowing the epidemiology of acute meningitis may guide the physician for promptly empirical therapy as well as minimize morbidity and mortality. In Thailand, there are few studies regarding acute meningitis in adults and most of them have not been updated. We aimed to determine etiology, clinical manifestations, cerebrospinal fluid (CSF) findings and outcomes of patients with acute meningitis. Methods A retrospective cohort study was conducted among adult (age >15 years) patients with acute meningitis who were treated at Ramathibodi Hospital between 2013 and 2017. The list of the patients was retrieved from the hospital database using the International Classification of Diseases, 10th revision (ICD-10) codes. Comparisons of clinical presentations and laboratory investigations between patients with bacterial meningitis and those with non-bacterial meningitis were analyzed. Results A total of 89 patients were included. Of all, 48 (53.9%) patients were men and median age (interquartile range; IQR) was 49 (32.1–63.8) years. The most common coexisting condition was HIV infection (30%), receiving prednisolone (16.9%), and diabetes mellitus (15.7%). Causes of acute meningitis were Cryptococcus neoformans (37%), bacteria (31.5%), Mycobacterium tuberculosis (27%), and virus (4.5%). Common clinical presentations were fever (74%), headache (70.8%), and confusion (31.5%). Older age, higher proportion of patients with diabetes, lower proportion of HIV infection, higher median white blood cells (WBCs) in complete blood count (CBC), lower median platelet, higher median aspartate aminotransaminase, higher median alkaline phosphatase, higher median WBCs, and polymorphonuclear neutrophils (PMNs) percentage in CSF were found in patients with acute bacterial meningitis. By multivariate logistic regression, predicting factors of acute bacterial meningitis were WBCs in CBC (OR 1.02 per 100 cells/mm3 increased; 95% CI 1.01–1.04, P = 0.001), WBCs in CSF (OR 1.04 per 10 cells/mm3 increased; 95% CI 1.01–1.07, P = 0.012) and PMNs percentage in CSF (OR 1.21 per 5% increased; 95% CI 1.07–1.37, P = 0.002). Overall, the median (IQR) duration of hospitalization was 23 (11–29) days. A total of 26 (29%) patients had a complication, such as septic shock, hydrocephalus, seizure, and brain edema. The mortality rate was 7.9%. Conclusion In this setting, the most common cause of acute meningitis in adults is cryptococcosis. In addition, tuberculosis is not uncommon. Awareness of update epidemiology may guide the physicians to initiate appropriate antimicrobial therapy. Disclosures All authors: No reported disclosures.

scholarly journals Adjunctive dexamethasone therapy in unconfirmed bacterial meningitis in resource limited settings: is it a risk worth taking?

BMC Neurology ◽  
2016 ◽  
Vol 16 (1) ◽  
Author(s):  
Esayas Kebede Gudina ◽  
Markos Tesfaye ◽  
Aynishet Adane ◽  
Kinfe Lemma ◽  
Tamiru Shibiru ◽  
...  
Keyword(s):  
Bacterial Meningitis ◽  
Resource Limited Settings ◽  
Resource Limited ◽  
Dexamethasone Therapy

scholarly journals Pre-hospital advanced life support resuscitation – a curriculum for pre-hospital education

2020 ◽  
Vol 17 ◽  
Author(s):  
David Reid ◽  
Moira Sim ◽  
Shelley Beatty ◽  
Hugh Grantham ◽  
Mike Gale
Keyword(s):  
Healthcare Professionals ◽  
Life Support ◽  
Hospital Setting ◽  
Advanced Life Support ◽  
First Responders ◽  
Evidence Base ◽  
Hospital Environment ◽  
Lay Persons ◽  
Resource Limited ◽  
Interprofessional Healthcare

IntroductionThere is a broad evidence base to support advanced life support (ALS) education for healthcare professionals being structured, realistic and inclusive of a range of human factors. This paper outlines a curriculum for ALS resuscitation education for providers working in the pre-hospital or resource-limited settings. The focus on pre-hospital ALS education is important because actions taken by pre-hospital healthcare professionals have a critical impact on the likelihood of patient survival.MethodsThe pre-hospital ALS curriculum developed in this research was derived from a survey and interviews with pre-hospital healthcare professionals and first responders, and input from resuscitation, medical and education experts. Following completion of the interviews an expert panel of resuscitation experts was consulted. ResultsInformation collected indicated that a pre-hospital ALS course should follow current recommendations of the Australian Resuscitation Council and that the course should be delivered in a mixed mode comprising of online pre-reading and a quiz followed by one day of face-to-face teaching. Equipment should reflect that used in the pre-hospital environment and a pre-hospital ALS course should include scenarios relevant to the pre-hospital setting involving varying numbers of interprofessional healthcare teams as well as first responders and lay persons. Candidates should be assessed on a continual basis and certificates of participation be valid for 2 to 3 years. ConclusionTo improve pre-hospital resuscitation education and maximise the likelihood of patient survival, ALS education for pre-hospital providers should follow Australian Resuscitation Council guidelines, include pre-course reading, case studies and practical simulation in situations that are likely to be encountered by pre-hospital professionals.

Pattern of medication errors among inpatients in a resource-limited hospital setting

2017 ◽  
Vol 93 (1105) ◽  
pp. 686-690 ◽  
Author(s):  
M Thirumagal ◽  
M A R Ahamedbari ◽  
N R Samaranayake ◽  
C A Wanigatunge
Keyword(s):  
Medication Errors ◽  
Hospital Setting ◽  
Resource Limited

scholarly journals Pre-hospital advanced life support resuscitation training: A pilot of an evidence-based curriculum

2020 ◽  
Vol 17 ◽  
Author(s):  
David Reid ◽  
Moira Sim ◽  
Shelley Beatty ◽  
Hugh Grantham ◽  
Mike Gale
Keyword(s):  
Healthcare Professionals ◽  
Life Support ◽  
Patient Survival ◽  
Expert Panel ◽  
Hospital Setting ◽  
Advanced Life Support ◽  
Evidence Base ◽  
Hospital Environment ◽  
Resource Limited ◽  
Resuscitation Training

Introduction There is a broad evidence base to support advanced life support (ALS) education for healthcare professionals being structured, realistic and inclusive of a range of human factors. This paper outlines the results of a pilot ALS resuscitation course tailored for providers working in pre-hospital resource-limited settings. The focus on the pre-hospital ALS environment, team mix, techniques, skills and equipment are important because actions taken by pre-hospital healthcare professionals have a critical impact on the likelihood of patient survival. Methods A pre-hospital ALS course was piloted following research into the need for a course and development of a pre-hospital-specific curriculum, based on Australian Resuscitation Council (ARC) guidelines. There were 13 pilot courses run, involving 66 participants. Participants all worked in the pre-hospital environment and held qualifications ranging from a Certificate IV in Healthcare through to postgraduate paramedicine qualifications. The pre-hospital ALS course consisted of theory and practical elements, pre-reading and a pre- and post-course quiz. Feedback was sought from course participants and an expert panel was consulted on the findings. Results Participants and the Expert Panel indicated that a pre-hospital ALS course should follow current recommendations of the ARC and be delivered to persons with sufficient underpinning knowledge of ALS resuscitation. The course should include pre-reading on ALS protocols and a pre-test followed by one day of face-to-face teaching using equipment reflective of the pre-hospital environment. Scenarios should be relevant to the pre-hospital setting and involve varying numbers of responders. Participants should be assessed on a continual basis during the course. Conclusion To improve participant confidence in the delivery of ALS and maximise the likelihood of patient survival, pre-hospital ALS resuscitation education for pre-hospital providers should follow ARC guidelines, include pre-course reading and practical simulation that reflects participants’ day-to-day employment.

scholarly journals 1749. A Nationwide Survey of Cytomegalovirus Prevention Strategies in Kidney Transplant Recipients in a Resource-Limited Setting

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S641-S641
Author(s):  
Jackrapong Bruminhent ◽  
Asalaysa Bushyakanist ◽  
Susarak Kantachuvesiri ◽  
Sasisopin Kiertiburanakul
Keyword(s):  
Kidney Transplant ◽  
Hospital Setting ◽  
Nationwide Survey ◽  
Strategy Implementation ◽  
Prevention Strategy ◽  
Preemptive Therapy ◽  
Prevention Strategies ◽  
Kidney Transplant Recipients ◽  
Infectious Disease Physician ◽  
Resource Limited

Abstract Background Cytomegalovirus (CMV) causes morbidity in kidney transplant (KT) recipients. Strategies to prevent this infection in resource-limited settings have been unreliably implemented and under-explored. We investigated CMV prevention strategies utilized among transplant centers in Thailand. Methods A questionnaire on CMV prevention strategies for KT recipients was developed using a web-based electronic survey website (www.surveymonkey.com). The survey was delivered to 31 transplant centers in Thailand. One infectious disease physician (ID) and one nephrologist (NP) from each center were included. Results There were 43 respondents from 26 (84%) transplant centers including 26 (60%) IDs and 17 (40%) NPs. The majority worked in a public hospital setting (63%) and had encountered KT recipients for at least 2 years (74%). Forty-one (98%) physicians agreed on the necessity of CMV prevention. Of these, 34 (81%) physicians implemented prevention strategies for their patients. Interventions included preemptive approaches (47%), prophylaxis (44%), hybrid approaches (3%); surveillance after prophylaxis (3%), and CMV-specific immunity-guided approaches (3%). For CMV-seropositive KT recipients, use of preemption (84%) exceeded prophylaxis (12%). However, 81% of the former preferred targeted prophylaxis in patients receiving anti-thymocyte globulin therapy. Sixty-five and 93% of physicians started preemptive therapy when plasma CMV DNA loads reached 2,000 and 3,000 copies/mL (1,820 and 2,730 IU/mL), respectively. A significantly greater percentage of NPs initiated preemptive therapy at a plasma CMV level of 1,820 IU/mL compared with IDs (88% vs. 50%, [P = 0.02]). The most common barrier to prevention strategy implementation was financial inaccessibility of oral valganciclovir (67%) and quantitative CMV DNA testing (12%). The majority (81%) felt that a guideline would allow physicians to implement CMV prevention strategies for their patients. Conclusion Most physicians agreed on a need for preemptive approaches, although prophylaxis was targeted in those receiving intense immunosuppression. Guidelines and financial accessibility could improve CMV prevention strategy implementation in Thai KT recipients. Disclosures All authors: No reported disclosures.

scholarly journals The Impact and Burden of Neurological Sequelae Following Bacterial Meningitis: A Narrative Review

2021 ◽  
Vol 9 (5) ◽  
pp. 900 ◽  
Author(s):  
Nicoline Schiess ◽  
Nora E. Groce ◽  
Tarun Dua
Keyword(s):  
Bacterial Meningitis ◽  
Vision Loss ◽  
Middle Income ◽  
Neurological Sequelae ◽  
Middle Income Countries ◽  
Resource Limited ◽  
Behaviour Changes ◽  
Outcome Knowledge ◽  
The Impact

The burden, impact, and social and economic costs of neurological sequelae following meningitis can be devastating to patients, families and communities. An acute inflammation of the brain and spinal cord, meningitis results in high mortality rates, with over 2.5 million new cases of bacterial meningitis and over 236,000 deaths worldwide in 2019 alone. Up to 30% of survivors have some type of neurological or neuro-behavioural sequelae. These include seizures, hearing and vision loss, cognitive impairment, neuromotor disability and memory or behaviour changes. Few studies have documented the long-term (greater than five years) consequences or have parsed out whether the age at time of meningitis contributes to poor outcome. Knowledge of the socioeconomic impact and demand for medical follow-up services among these patients and their caregivers is also lacking, especially in low- and middle-income countries (LMICs). Within resource-limited settings, the costs incurred by patients and their families can be very high. This review summarises the available evidence to better understand the impact and burden of the neurological sequelae and disabling consequences of bacterial meningitis, with particular focus on identifying existing gaps in LMICs.

Sign in / Sign up

Export Citation Format

Share Document