2.Thrombolysis in ischaemic stroke in rural North East Thailand by neurologist and non-neurologists
Kannikar Kongbunkiat ; Narongrit Kasemsap ; Somsak Tiamkao ; Verajit Chotmongkol ; Kittisak Sawanyawisuth ; Pawut Mekawichi ; Kasemsin Pavakul ; Pisit Soison ; Janhom Jattawanin ; Panadda Kaitchanon ; Weera Yaowapruek ; Arkom Arayawichanon ; Thanun Thanwiset
Neurology Asia 2016;21(4):325-331
Background & Objective: Acute ischemic stroke (AIS) has been shown to be effectively treated
with thrombolytic therapy. Thailand and other developing countries have limited stroke specialists to
prescribe this treatment. Data regarding stroke outcomes in AIS patients who received thrombolytic
therapy prescribed by neurologists compared with non-neurologists are limited. Methods: This was a
large, multicenter, retrospective study conducted in 9 hospitals across the northeastern part of Thailand.
The inclusion criteria were AIS patients who were admitted and treated with thrombolytic therapy
between January 2010 and December 2012. Patients were categorized into two groups by physician
specialty; neurologist and non-neurologist. Clinical outcomes and in-hospital mortality were compared
between the groups. Results: There were 915 AIS patients who participated in the study; 175 patients
were treated by the non-neurologists (19.1%). The mean age of all patients was 64 years and 55.1%
were men. The median onset to needle time in both groups were similar at 180 minutes. The National
Institutes of Health Stroke Scale (NIHSS) at discharge were significantly higher in neurologist group
than non-neurologist group (NIHSS 6 vs 3, p value 0.03). The in-hospital mortality was also higher
in neurologist group (9.5% vs 4.0%; p value 0.02).
Conclusions: Non-neurologists may be able to thrombolyze AIS patients safely and effectively.
Stroke
;
Thrombolytic Therapy
3.Clinical Manifestations of Eosinophilic Meningitis Due to Infection with Angiostrongylus cantonensis in Children.
Kittisak SAWANYAWISUTH ; Jarin CHINDAPRASIRT ; Vichai SENTHONG ; Panita LIMPAWATTANA ; Narong AUVICHAYAPAT ; Sompon TASSNIYOM ; Verajit CHOTMONGKOL ; Wanchai MALEEWONG ; Pewpan M INTAPAN
The Korean Journal of Parasitology 2013;51(6):735-738
Eosinophilic meningitis, caused by the nematode Angiostrongylus cantonensis, is prevalent in northeastern Thailand, most commonly in adults. Data regarding clinical manifestations of this condition in children is limited and may be different those in adults. A chart review was done on 19 eosinophilic meningitis patients aged less than 15 years in Srinagarind Hospital, Faculty of Medicine, Khon Kaen University, Thailand. Clinical manifestations and outcomes were reported using descriptive statistics. All patients had presented with severe headache. Most patients were males, had fever, nausea or vomiting, stiffness of the neck, and a history of snail ingestion. Six patients had papilledema or cranial nerve palsies. It was shown that the clinical manifestations of eosinophilic meningitis due to A. cantonensis in children are different from those in adult patients. Fever, nausea, vomiting, hepatomegaly, neck stiffness, and cranial nerve palsies were all more common in children than in adults.
Adolescent
;
Adult
;
Aged
;
Angiostrongylus cantonensis/*isolation & purification
;
Animals
;
Child
;
Child, Preschool
;
Eosinophilia/complications/etiology/*pathology
;
Female
;
Humans
;
Male
;
Meningitis/complications/etiology/*pathology
;
Middle Aged
;
Patient Outcome Assessment
;
Strongylida Infections/parasitology/*pathology
;
Thailand
;
Young Adult