South Asian Journal of Emergency Medicine最新文献

{"title":"Pakistani Populations Knowledge, Attitude and Practices of Emergency Medical Care","authors":"Arslaan Javaeed, M. Malik, Maira Yaseen, T. Abbasi","doi":"10.5455/SAJEM.184-1533501091","DOIUrl":"https://doi.org/10.5455/SAJEM.184-1533501091","url":null,"abstract":"","PeriodicalId":389251,"journal":{"name":"South Asian Journal of Emergency Medicine","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115264104","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Presentation, Prognostic Factors, and Outcomes of Pediatric patients Diagnosed with Acute Myocarditis: A 10-Year Experience from the Emergency Department of a Tertiary Care Hospital.","authors":"Emad Siddiqui, S. Haider, Noor Baig, Tooba Siddiqui, N. Ali, A. Khan","doi":"10.5455/sajem.040210","DOIUrl":"https://doi.org/10.5455/sajem.040210","url":null,"abstract":"Background: Myocarditis is a rare inflammatory disease of the myocardium with an annual incidence of 1 to 2 per 100,000 children. Patients with myocarditis present with variable signs and symptoms ranging from subclinical disease to arrhythmia, heart failure, and sudden cardiac arrest. This study is aimed to determine the clinical presentations and outcome of children diagnosed with acute myocarditis in the emergency department of a tertiary care hospital.\u0000\u0000Methods: This single center cross-sectional study was conducted in the emergency department of the Aga Khan University Hospital from January 2005 to December 2015. All children from six months to sixteen years of either gender admitted with a probable or definitive diagnosis of acute myocarditis from the emergency department were included. All the data were entered and analyzed on SPSS v20. The continuous variables were expressed as mean +/- SD and frequencies, and percentages were computed for categorical data. Univariate and multivariate analysis was done with a p-value of less than 0.05 was considered significant.\u0000\u0000Results: A total of 52 children were diagnosed with myocarditis during the study period. The mean age was 34.33 months with slightly higher preponderance of females (52%). More than half of the patients had a history of upper respiratory infection. The most common presenting symptoms were shortness of breath (46%), followed by irritability and drowsiness (38%). Forty-seven patients (90%) needed inotropic support and 33 patients (63%) required ventilatory support during hospital stay. Thirteen patients (25%) expired during hospital stay.\u0000\u0000Conclusion: Myocarditis in pediatric patients has higher mortality and may present with acute onset of symptoms that may be vague and overlapping. Early identification and prompt management by experienced pediatric emergency physicians may reduce morbidity and mortality.","PeriodicalId":389251,"journal":{"name":"South Asian Journal of Emergency Medicine","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124706833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Application of machine learning in predicting Attention Deficit Hyperactive Disorder (ADHD) in school going children of Pakistan","authors":"S. Mansoor, Shoab Saadat, Sarah Noaman, H. Khan, Salman Assad","doi":"10.5455/sajem.040104","DOIUrl":"https://doi.org/10.5455/sajem.040104","url":null,"abstract":"","PeriodicalId":389251,"journal":{"name":"South Asian Journal of Emergency Medicine","volume":"50 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126964837","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Massive Transfusion Protocol - Is Pakistan ready to implement it?","authors":"A. Khan, S. Ghauri","doi":"10.5455/sajem.040101","DOIUrl":"https://doi.org/10.5455/sajem.040101","url":null,"abstract":"","PeriodicalId":389251,"journal":{"name":"South Asian Journal of Emergency Medicine","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130413599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dengue fever leading to unilateral panophthalmitis resulting in corneal perforation","authors":"Umaira Aftab, Kiran Azizi, Madiha Ismail","doi":"10.5455/sajem.040211","DOIUrl":"https://doi.org/10.5455/sajem.040211","url":null,"abstract":"ABSTRACT:\u0000\u0000Dengue Fever is a viral disease caused by the flavivirus family and is usually self-limiting; however, in some cases, it may lead to complications such as dengue hemorrhagic fever or dengue shock syndrome, including hepatic, neurologic, cardiac, and ocular manifestations. Here we present a case of 19 years old female who presented to ED with complaints of fever for ten days and worsening right eye pain, vision blurring, and redness for the preceding two days. On MRI, she was diagnosed with right-sided panophthalmitis, periorbital, and retro-orbital cellulitis. Her hospital course was complicated by posterior vitreous hemorrhage and detachment, leading to corneal perforation and complete visual loss. Unfortunately, evisceration was done, followed by the dermis implant. In light of the above case, performing a thorough ocular examination of such patients is highly recommended. Even minor complaints should be taken into account earnestly to avoid disastrous complications.","PeriodicalId":389251,"journal":{"name":"South Asian Journal of Emergency Medicine","volume":"77 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115275626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Uropathogens and their Susceptibility to Common Antibiotics in Adult Patients Presenting to the Emergency Department of a Tertiary Care Hospital in Pakistan","authors":"A. Sattar, K. Mustafa, Ahmed Khan, Hafsa Khan","doi":"10.5455/sajem.020210","DOIUrl":"https://doi.org/10.5455/sajem.020210","url":null,"abstract":"OBJECTIVE \u0000To identify the prevalence of uropathogens and their susceptibility patterns to different antibiotics in adult patients presenting to the emergency department with lower urinary tract symptoms so that treating physicians can identify common pathogens and select a reasonable empirical antibiotic if needed. \u0000 \u0000METHODOLOGY \u0000The study is a retrospective chart review conducted in the emergency department of Shifa International Hospital, Islamabad, Pakistan. All the patients diagnosed with urinary tract infection through dipstick in the emergency department whose urine cultures were positive were included in the study. The chart review was done from January 1st, 2018 to 31st December 2018. \u0000 \u0000RESULTS \u0000Out of 203 patients with positive urine dipstick, whose cultures sent from emergency only 64(31.3%) samples showed significant bacterial yield. Most patients included in the study were above 50 years of age (79.7%) with a male predominance (males 36, females 28). The most common organisms isolated was E.coli 44 (68.8%) followed by Klebsiella spp. 09(14%) and Enterococcus spp. 03 (4.7 %) respectively. Antibiotics which were found most sensitive against pathogens in our study included Imipenem (78.1 %), Nitrofurantoin (76.6 %) and Fosfomycin (76.6 %) respectively. On the other hand most of microbial growth was highly resistant to both penicillins (Co-amoxiclave 80.8 %) and cephalosporin (Cefixime 84.4%, Ceftazidime 78.1 %, and Ceftriaxone 81.2 %). Moderately resistance was seen to antibiotics such as Co-Trimoxazole (71.4%), Ciprofloxacin (73.4%) and Gentamicin (48.4%) respectively. A high prevalence of carbapenem resistance (9.4% to imipenem) was also observed in this study \u0000 \u0000CONCLUSION \u0000Most uropathogens identified in patients presenting to the emergency department with urinary complains are sensitive to Fosfomycin, Nitrofurantoin, Gentamycin, and Imipenem which may be considered as empirical therapy in our settings.","PeriodicalId":389251,"journal":{"name":"South Asian Journal of Emergency Medicine","volume":"69 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125945962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Rapid response Sepsis Initiative (RrSI) - An innovative concept for sepsis management in Low to Middle Income nations (LMIC)","authors":"M. Baig, E. Hussain, Syed Mustehsan, S. Kazmi","doi":"10.5455/sajem.020206","DOIUrl":"https://doi.org/10.5455/sajem.020206","url":null,"abstract":"Sepsis management continues to update and improve essentially allowing patient survival however low to middle income nations are still struggling with high morbidity and mortality of such cases. The timely management of sepsis is crucial therefore, for our setting we propose the concept of a “Rapid response Sepsis Initiative (RrSI) team” within the hospital which would be comprised of various specialists aiming to institute rapid, calculated and appropriate patient management as soon as possible. We believe that with an introduction of a RrSI team, the hospital would immensely benefit from focused management of critically ill septic patients.","PeriodicalId":389251,"journal":{"name":"South Asian Journal of Emergency Medicine","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129933316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medical Errors in the Emergency Department","authors":"A. Khan","doi":"10.5455/sajem.020201","DOIUrl":"https://doi.org/10.5455/sajem.020201","url":null,"abstract":"Emergency departments across South Asia are prone to medical errors like the rest of the world. Due to the nature of work, the chance of medical error is much more as compared to other areas of health care. The wide spectrum of disease presentation coupled with acuity and timeliness of the condition, multiple treatment plans, and multiple specialties makes a good recipe for medical errors. Most of these medical errors are related to adverse drug events, improper transfusions, mis-diagnosis, under and over-treatment, and mistaken patient identities. Adequate training of the physician and nursing staff working in the Emergency Department is our best insurance against these errors.","PeriodicalId":389251,"journal":{"name":"South Asian Journal of Emergency Medicine","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133988236","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Triaging - Prioritizing emergency care","authors":"A. Khan","doi":"10.5455/SAJEM.020101","DOIUrl":"https://doi.org/10.5455/SAJEM.020101","url":null,"abstract":"The people working in the emergency department have the toughest job to match their resources with the problems the patients are presenting with. Similarly, the expectations of the patients and their attendants are at times misguided regarding the emergency situation and the expected treatments. The art of emergency care is in balancing the resources made available to the emergency departments with the patient load presented to them as well as their expectations. This can only be done through proper triaging – the process to see who needs to be seen first.","PeriodicalId":389251,"journal":{"name":"South Asian Journal of Emergency Medicine","volume":"43 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117020899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The causes of visits of non-urgent patients to an emergency department in King Fahad Hospital-Albaha-Kingdom of Saudi Arabia","authors":"Abdulhakam Ahmed, Mohammed Abdulla Alyani, A. Alzahrani, H. Alghamdi, Fatima Saud Albakri, A. Alghamdi, Ahmed Minqash","doi":"10.5455/SAJEM.030212","DOIUrl":"https://doi.org/10.5455/SAJEM.030212","url":null,"abstract":"OBJECTIVE: The use of the emergency department by patients presenting with non-urgent conditions has become an important problem that is faced by all local and global health systems. The main objective of this article is to determine the causes of non-urgent emergency department visits by patients. \u0000 \u0000METHOD \u0000This is a retrospective, descriptive study, conducted in the emergency department from January to April 2020. All patients triaged according to the Canadian Triage and Acuity Scale (CTAS) as CTAS -5 (non-urgent conditions) were included during the study period and their data such as demographics and presenting complaints were extracted from the hospital electronic files. Ethical approval was taken from the hospital's ethical review board. \u0000 \u0000RESULTS \u0000Out of 1308 patients that visited the emergency department (ED), 327 (25%) patients were categorized as non-urgent visits (CTAS-5) according to the triage system. There was a slight female predominance of 165(50.5%) as compared to males 162(49.5%). 71% of patients were between 20-40 years of age. It was identified that 92% of the selected patients had non-urgent conditions, did not need any treatment in ED, and could be treated and followed up in primary health clinics or hospital polyclinics. 32.7% of patients had no chronic illness and 32.1 % of the patients had visited the ED before at least one time for the same complaint. The most common complaints at presentation for non-urgent visits were musculoskeletal system pain (30.5%), mild non-surgical abdominal pain (17.7%), Upper respiratory tract infection (9.5%), and fever (3.7%). It was found that 5.8% needs to be upgraded to CTAS 3-4 zone for further assessment and management. \u0000 \u0000CONCLUSION \u0000The majority of non-urgent visits at the emergency department could be treated in other facilities like primary health care and hospital polyclinics. Proper, safe application of triage system and necessary education to the patients can reduce the emergency department overcrowdedness which will ensure patients safety and improve patients' clinical outcome.","PeriodicalId":389251,"journal":{"name":"South Asian Journal of Emergency Medicine","volume":"19 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123357516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}