Diagnostic and Treatment Features of Stroke Patients Based on RAPID Artificial Intelligent (RAPID AI) Software Analysis in Phu Tho Provincial General Hospital in Vietnam (Preprint)

2021 ◽  
Author(s):  
Ngoc Huy Nguyen ◽  
Minh Van Hoang ◽  
An Quang Nguyen ◽  
Thong Van Nguyen ◽  
Luc Quang Tran ◽  
...  
Keyword(s):  
Blood Pressure ◽  
General Hospital ◽  
Cerebral Circulation ◽  
Clinical Signs ◽  
Case Series ◽  
Diagnosis And Treatment ◽  
Stroke Patients ◽  
Permanent Disability ◽  
Software Analysis ◽  
Number Of Patients

BACKGROUND Stroke is the second leading cause of death and the leading cause of permanent disability global-ly. Vietnam is a developing country with a high prevalence of stroke. This study was conducted from October 2019 to October 2020 at Phu Tho Provincial General Hospital, Vietnam. OBJECTIVE The study aimed to determine and describe the characteristics of 54 acute ischemic stroke patients for whom Rapid AI technology was used for imaging analysis for diagnosis and treatment. METHODS This study was a case series based on data from the electronic medical records of stroke patients admitted to Phu Tho Provincial General Hospital between October 2019 and October 2020, for whom Rapid AI was used to analyze images of stroke. RESULTS The highlighted results showed that the mean age of patients was 73.39 ± 12.46 years and males comprised 57.4 of the sample. The most common risk factor identified was hypertension (75.9%), followed by atrial fibrillation (24.1%), diabetes (20.4%), alcohol habits (14.8%), and smoking (9.3%). The most common clinical signs were hemiparesis, observed in 75.9% of the patients, fol-lowed by dysphasia in 50.0% and memory loss in 27.8% of the sample. Small numbers of stroke patients had clinical presentations of dizziness (7.4%) and headache (7.4%). In total, 5.6% of stroke patients had a bad prognosis, presenting with unconsciousness and near death. The sub-clinical characteristics included high blood pressure in 48 (88.9%) patients, and the median score for blood pressure was 151.22 ± 22.89 mmHg. The red blood cells and triglyceride were mostly at normal concentrations. The prevalence of elevated blood glucose was 40.7%, while the preva-lence of high cholesterol was 33.3%. A small number of patients showed an abnormal platelet count (5.6%) and INR (3.7%). ASPECTS evaluation showed that 24 (44.4%) patients had good ASPECTS scores of 8–10, 17 (31.5%) patients had bad ASPECTS scores of 5–7, and 13 (24.1%) patients had the worst ASPECTS scores of 0–4. The number of patients with an infarct core vol-ume <70 mL was 50 (92.6%), while a mismatch volume of >15 mL was observed in 31 (54.7%) patients and 22 (40.7%) patients had a mismatch ratio >1.8. The assessment of CT imaging of thrombi showed 51 cases of anterior cerebral circulation, including 13 (24.07%) cases diagnosed as ICA, 30 (75.93%) cases diagnosed as MCA, and 8 (14.81%) cases diagnosed as SA. There were 10 cases of MCA-M1 (18.52%), 7 cases of MCA-M2 and MCA-M4 (12.96%) cases and 6 cases of MCA-M3 (11.11%), respectively. There were only three cases of posterior cerebral circulation, comprising one (1.85%) case of PCA and two (3.72%) cases of BA. CONCLUSIONS These are the first results regarding the clinical and subclinical features of patients with stroke investigated using Rapid AI for diagnosis and treatment in Vietnam in general, and specifically in Phu Tho Provincial General Hospital.

Clinical features and neuroimaging findings in acute cerebral infarction patients using RAPID Artificial Intelligent (RAPID AI) Software Analysis – a series of 54 cases (Preprint)

2021 ◽  
Author(s):  
Ngoc Huy Nguyen ◽  
Minh Van Hoang ◽  
An Quang Nguyen ◽  
Luc Quang Tran ◽  
Thong Van Nguyen
Keyword(s):  
Cerebral Infarction ◽  
Clinical Features ◽  
Cerebral Circulation ◽  
Clinical Signs ◽  
Acute Cerebral Infarction ◽  
Stroke Patients ◽  
Permanent Disability ◽  
Artificial Intelligent ◽  
Software Analysis ◽  
Number Of Patients

BACKGROUND Stroke is the second leading cause of death and the leading cause of permanent disability globally. Vietnam is a developing country with a high prevalence of stroke. OBJECTIVE This study aimed to present the clinical features and neuroimaging findings in acute cerebral infarction patients using RAPID Artificial Intelligent (RAPID AI) Software Analysis METHODS A case series of 54 stroke patients based on data from the electronic medical records who admitted between October 2019 and October 2020, for whom Rapid AI was used to analyze images of stroke. RESULTS The results showed that the mean age of patients was 73.39 ± 12.46 years and males comprised 57.4 of the sample. The most common risk factor identified was hypertension (75.9%), followed by atrial fibrillation (24%), diabetes (20%), alcohol (15%), and smoking (9%). The most common clinical signs were hemiparesis in 76% of the patients, followed by dysphasia in 50% and memory loss in 28% of the sample. 7% presented with dizziness and 7% with headache. 6% were unconscious on admission. ASPECTS evaluation showed that 24 (44%) patients had good ASPECTS scores of 8-10, 17 (32%) patients had ASPECTS scores of 5-7, and 13 (24%) patients had ASPECTS scores of 0-4. The number of patients with an infarct core volume <70 mL was 50 (93%), while a mismatch volume of >15 mL was observed in 31 (55%) patients and 22 (41%) patients had a mismatch ratio >1.8. The assessment of CT imaging of thrombi showed 51 cases of anterior cerebral circulation, including 13 (24%) cases diagnosed as ICA, 30 (76%) cases diagnosed as MCA, and 8 (15%) cases diagnosed as SA. There were 10 cases of MCA-M1 (19%), 7 cases of MCA-M2 and MCA-M4 (13%) cases and 6 cases of MCA-M3 (11%), respectively. There were three cases of posterior cerebral circulation, comprising one case of Posterior cerebral artery (PCA) and two cases of Basilar artery (BA) territory infarction. CONCLUSIONS A collection of clinical features and neuroradiological assessment based on RAPID Artificial Intelligent (RAPID AI) Software Analysis can be used in identify stroke patients in the hospitals.

scholarly journals Clinical Features And Neuroimaging Findings In Acute Cerebral Infarction Patients Using RAPID Artificial Intelligent (RAPID AI) Software Analysis – A Series Of 54 Cases

2021 ◽  
Author(s):  
Ngoc Huy Nguyen ◽  
Minh Van Hoang ◽  
Anthony Rudd ◽  
An Quang Nguyen ◽  
Thong Van Nguyen ◽  
...  
Keyword(s):  
Cerebral Infarction ◽  
Cerebral Circulation ◽  
Clinical Signs ◽  
Memory Loss ◽  
Case Series ◽  
Infarct Core ◽  
Permanent Disability ◽  
Artificial Intelligent ◽  
Software Analysis ◽  
Number Of Patients

Abstract Background: Stroke is the second leading cause of death and the leading cause of permanent disability globally. Vietnam is a developing country with a high prevalence of stroke but is under-resourced in terms of specialist staff able to interpret complex brain imaging. Methods: A case series of 54 stroke patients admitted between October 2019 and October 2020 where thrombectomy was being considered and where ‘Rapid’ Artificial Intelligence (AI) was used to analyze images of stroke. Results: The mean age of patients was 73.39 ± 12.46 years with 57% male. The most common risk factors were (76%), atrial fibrillation (24%), diabetes (20%), alcohol (15%), and smoking (9%). The most common clinical signs were hemiparesis in 76% of the patients, followed by dysphasia in 50% and memory loss in 28% of the sample. 7% presented with dizziness and 7% with headache. 6% were unconscious on admission. ASPECTS evaluation showed that 24 (44%) patients had good ASPECTS scores of 8-10, 17 (32%) patients had ASPECTS scores of 5-7, and 13 (24%) patients had ASPECTS scores of 0-4. The number of patients with an infarct core volume <70 mL was 50 (93%), while a mismatch volume of >15 mL was observed in 31 (55%) patients and 22 (41%) patients had a mismatch ratio >1.8. The assessment of CT imaging of thrombi showed 51 cases of anterior cerebral circulation, including 13 (24%) cases diagnosed as ICA, 30 (76%) cases diagnosed as MCA, and 8 (15%) cases diagnosed as SA. There were 10 cases of MCA-M1 (19%), 7 cases of MCA-M2 and MCA-M4 (13%) cases and 6 cases of MCA-M3 (11%), respectively. There were three cases of posterior cerebral circulation, comprising Posterior Cerebral artery (PCA) infarction and two cases of Basilar Artery (BA) territory infarction. Conclusions: RAPID Artificial Intelligent (RAPID AI) Software Analysis combined with clinical assessment can be used in identify the size and site of cerebral infarction and diffusion perfusion mismatch in routine clinical practice in Vietnam.

scholarly journals EXPERIENCE WITH USING RAPID MOLECULAR TESTING IN DIAGNOSING PULMONARY AND EXTRA-PULMONARY PEDIATRIC TUBERCULOSIS IN A NON-ENDEMIC SETTING - A RETROSPECTIVE CASE SERIES

2018 ◽  
Vol 23 (suppl_1) ◽  
pp. e44-e45 ◽  
Author(s):  
Hana Mijovic ◽  
Yossef Al-Nasser ◽  
Ghada Al-Rawahi ◽  
Ashley Roberts
Keyword(s):  
Case Series ◽  
Pericardial Fluid ◽  
Diagnosis And Treatment ◽  
Molecular Testing ◽  
Retrospective Case ◽  
Detection Rates ◽  
Endemic Setting ◽  
Number Of Patients ◽  
Small Patient Population ◽  
Extra Pulmonary

Abstract BACKGROUND Tuberculosis (TB) is a rare but potentially devastating infection among Canadian children. Accurate diagnosis and initiation of treatment are limited in part by the fact that it takes 2–6 weeks for culture results to be confirmed. Xpert MTB/RIF (Xpert) is a rapid, automated molecular assay that has been validated for diagnosing pulmonary but not extra-pulmonary TB in children. OBJECTIVES This was a retrospective study of children investigated for active TB at our facility in order to: 1.Outline demographic characteristics and describe clinical presentations of children diagnosed with active TB. 2.Compare performance of molecular testing (Xpert) to stain and Mycobacterium tuberculosis culture on pulmonary and extra-pulmonary specimens. DESIGN/METHODS We conducted a retrospective chart review of all paediatric patients investigated for active TB at our facility with stain, culture and molecular (Xpert) testing between January 2015 and August 2017. Due to a small number of patients, our data analysis was limited to narrative summary and descriptive statistics. RESULTS A total of 10 children were diagnosed with active TB, including 3 cases of pulmonary, 4 extra-pulmonary and 3 disseminated disease. Age range at diagnosis was 2 months to 16 years, with 3 children younger than 1 year. Most children contracted TB while travelling to and/or being exposed to an index case from endemic areas, including East Asia/Western Pacific (5), South Asia (2) and Africa (1). All children were HIV negative. Time from symptom onset to TB diagnosis and treatment ranged from approximately 4 days to 5 months. Multi-drug resistant TB was confirmed in 1 child. Sadly, 1 child passed away from TB related complications. AFB stain was positive on at least one specimen in 4/10 cases, cultures were positive in 8/10 and molecular testing (Xpert) in 7/10 cases. Time to positive cultures ranged from 10 to 35 days, with an average of 19 days. All cases positive on Xpert were also culture positive. Xpert test diagnosed TB in 5/6 of extra-pulmonary specimens submitted, including pericardial fluid, lymph node tissues and cerebrospinal fluid. CONCLUSION Many paediatric TB patients at our facility are children who have traveled to/have contacts from TB endemic regions, emphasizing the need for obtaining thorough exposure and travel history. Culture and molecular testing demonstrated similar TB detection rates, albeit based on a small patient population. While cultures remain the most reliable diagnostic method, molecular testing may facilitate rapid diagnosis and treatment of pulmonary and extra-pulmonary paediatric TB in a non-endemic setting.

Abstract TP332: Utilizing a Neuro Intermediate Unit in Caring for Post-Thrombolysis Stroke Patients

Stroke ◽  
2013 ◽  
Vol 44 (suppl_1) ◽  
Author(s):  
Leah C Ramos ◽  
Cynthia Steffen ◽  
Sarah Gay ◽  
Julio Chalela
Keyword(s):  
Blood Pressure ◽  
Medical Center ◽  
Academic Medical Center ◽  
Case Series ◽  
Stroke Care ◽  
Stroke Patients ◽  
Retrospective Case ◽  
Case Series Study ◽  
Intermediate Unit ◽  
The Mean

Background: Historically stroke patients receiving intravenous tPA are admitted to an intensive care unit (ICU). Providing post-tPA care in a non-ICU setting could result in cost reduction and allow allocation of ICU beds to other critically ill patients. We sought to determine if care can be provided safely and effectively for post-tPA patients in a Neuro Intermediate Unit (NIU). Materials and Methods: This is a retrospective case series study performed in a tertiary academic medical center with a comprehensive, accredited, stroke program. We analyzed ischemic stroke patients admitted to our NIU during a 24-month period. A standardized data collection form was used to abstract data from medical records. Results: During a 24-month period 104 patients were admitted for post-tPA stroke care. The sample is composed of 60 males and 44 females. The median age was 69.5 and the mean age was 67.96. The sample is composed of 72 (69%) White and 32 (31%) Black patients. The mean admission NIHSS was 9.32. The most common stroke risk factors were hypertension (76%), diabetes mellitus (25%), hyperlipidemia (51%), tobacco use (21%), atrial fibrillation (21%), prior stroke (26%), congestive heart failure (20%), and coronary artery disease (21%). Mean admission systolic blood pressure was 143.5 mm Hg. For blood pressure management, 18% of the patients received medication by intravenous push and 5.7% by continuous infusion to meet established goals. Gastrointestinal hemorrhage was seen in 1.9%, intracranial hemorrhage in 3.8%, and blood transfusions needed in 1.9%. Insulin drips were needed to control persistent hyperglycemia in 3.8%. Sepsis occurred in 0.96% patients. The rate of fatality was 3.8%. Excellent functional outcome as defined as Modified Rankin Score (mRS) less than 2 was seen in 46% of patients and minimal to no disability (mRS < 1 ) was seen in 35.6%. Conclusions: In this retrospective study, stroke patients receiving intravenous tPA admitted to an NIU had similar outcomes and complications to that described in previous data. Significant cost savings can be accomplished by admitting thrombolysis patients to an NIU without compromising patient safety. Specialized nursing care available in a stroke unit is a key component in improving patient outcome.

scholarly journals ACTIVITIES RESULTS AIMED AT IMPROVED MEDICAL ASSISTANCE TO THE VASCULAR PATIENTS IN TOMSK REGION

2013 ◽  
Vol 12 (5) ◽  
pp. 87-98
Author(s):  
D. M. Plotnikov ◽  
O. A. Ivannikova ◽  
A. M. Alifirova ◽  
L. N. Alekseyeva ◽  
Yu. V. Petlin
Keyword(s):  
Cerebral Circulation ◽  
Medical Support ◽  
Medical Assistance ◽  
Stroke Patients ◽  
Number Of Patients ◽  
Tomsk Region ◽  
Active Implementation ◽  
Implementation Data ◽  
Further Development ◽  
Vascular Center

Acute disorders of cerebral circulation remain serious medical and social problem associated with high disability and mortality rates. Since 2011 Tomsk oblast is a participating member of the medical campaign aimed at improved medical services to the vascular patients. The preliminary implementation data analysis for 2012 revealed improvement of most of the indices of medical support to patients suffering from acute cerebral circulation; increased number of the in-patient cases (Regional Vascular Center and primary vascular department), decreased lethality rates from strokes, specifically hemorrhagic cases. Strict observance of the Regulations on Medical Assistance for stroke patients and the using of modern methods of therapy allowed to decrease hospital mortality in the Primary Vascular Departments and early mortality in the Regional Vascular Center. The active implementation of neurorehabilitation approaches resulted in the increased number of patients who do not require third parties’ assistance. Analysis of the work of the departments helped to identifying current problems and perspectives of further development of special medical care for stroke patients.

scholarly journals Survey On Methanol Poisoning Epidemic in Rafsanjan City in Year 2013

2017 ◽  
Vol 2 (3) ◽  
pp. 84
Author(s):  
Vahid Mirzaee ◽  
Zahra Riahi ◽  
Zahra Sharifzadeh ◽  
Moein Kardoust Parizi ◽  
Amir Adinehpour
Keyword(s):  
Metabolic Acidosis ◽  
Gastrointestinal Symptoms ◽  
Case Series ◽  
Morbidity And Mortality ◽  
Diagnosis And Treatment ◽  
High Morbidity ◽  
Methanol Poisoning ◽  
Arterial Blood ◽  
Number Of Patients ◽  
Case Series Study

Background: Examination and early detection of the methanol toxicity epidemic are very important, so identification and initiation of appropriate therapy can significantly reduce morbidity and mortality. Therefore, this study was aimed to investigation methanol poisoning epidemic in  Rafsanjan city.Methods: This case series study was conducted in 252 patients with methanol poisoning in 2013 in the Ali-ibn-Abi-Talib hospital of Rafsanjan. Data were through interviews and records that were collected at hospital admission. Due to the large number of patients and the possible lack of ability of rapid measurement of serum levels of methanol and need of rapid intervention, treatment to reduce any further complications, early diagnosis and treatment were carried out by clinical history and interpretation of arterial blood gas test results. Data record on provided checklists and then analyzed using SPSS version 19.Results: The mean pH was 0.13±7.27. The most frequent clinical features were visual disturbances (39.7%), dyspnea (1.2%), and gastrointestinal symptoms (7.1%). There was a trend towards decreasing PCO2 with decreasing pH amongst the patients surviving. The opposite trend was demonstrated in the dying; the difference was highly significant by linear regression analyses (P< 0.001).Conclusions: Methanol poisoning still has a high morbidity and mortality, mainly because of late diagnosis and treatment. Respiratory arrest, coma and severe metabolic acidosis upon admission were strong predictors of poor outcome. Early admission and ability of respiratory compensation of metabolic acidosis were associated with survival.

scholarly journals CASE SERIES::: AMITRAZ POISONING:CLINICAL PROFILE AND MANAGEMENT::: IS STOMACH WASH AN ANTIDOTE??

2021 ◽  
Vol 9 (01) ◽  
pp. 200-202
Author(s):  
Deepak K. ◽  
◽  
Nobul Rao ◽  
Rama Devi ◽  
Muneeswar Reddy ◽  
...  
Keyword(s):  
Emergency Department ◽  
General Hospital ◽  
Andhra Pradesh ◽  
Clinical Signs ◽  
Case Series ◽  
Toxic Compound ◽  
Time Period ◽  
Life Saving

Amitraz compound is a triazapentadiene compound of amidine chemical family and is used as an insecticide/acaricide for controling the ectoparasites in animals.It has been found to be consumed for suicidal poisoning in the region near Tirupati, Andhra Pradeash, India. Here we report a case series of 17 patients who presented to emergency department of SVRR Govt General Hospital Tirupati, Andhra Pradesh with consumption of pure amitraz compound without combination of any other compounds during the time period from JAN 20 to NOV 20. The clinical signs, investigation workup and treatment of these patients is dealt in this case series. A stomach wash done within the golden hours of consumption of this toxic compound proves to be life saving in these patients.

scholarly journals Predictors of In-Hospital Mortality in Stroke Patients

2022 ◽  
Author(s):  
Vindya Shalini Ranasinghe ◽  
Manoji Pathirage ◽  
Indika Bandara Gawarammana
Keyword(s):  
Blood Pressure ◽  
Hospital Mortality ◽  
Demographic Data ◽  
Clinical Signs ◽  
Multivariate Logistic Regression Analysis ◽  
Haemorrhagic Stroke ◽  
Receiver Operating Curve ◽  
Stroke Patients ◽  
Tertiary Referral Center ◽  
Gcs Score

Abstract Background: In-hospital mortality is a good indicator to assess the efficacy of stroke care. Identifying the predictors of in-hospital mortality is important to advance the stroke outcome and plan the future strategies of stroke management. Methods: This was a prospective observational study conducted at a tertiary referral center in Sri Lanka to identify the possible predictors of in-hospital mortality. The study included 246 confirmed stroke patients. The diagnosis of stroke was established on the clinical history, examination and neuroimaging. The differentiation of stroke in to haemorrhagic type and ischaemic type was based on the results of computed tomography. In all patients, demographic data, comorbidities, clinical signs (pulse rate, respiratory rate, systolic blood pressure, diastolic blood pressure, on admission Glasgow Coma Scale (GCS) score) and imaging findings were recorded. Serum electrolyte test was performed in all stroke patients and hyponatremia was defined as serum Na+ less than 131mmol/l. All patients were followed up throughout their hospital course and the in-hospital mortality was recorded. In hospital mortality was defined as the deaths which occurred due to stroke after 24 hours of hospital admission. Results: The incidence of in-hospital mortality was 11.7% (95% confidence interval 8-16.4). The mean day of in-hospital deaths to occur was 5.9 days (SD±3.8 Min 2 Max 20). According to multivariate logistic regression analysis on admission GCS score (Odds Ratio (OR)-0.71) and haemorrhagic stroke type (OR-5.12) predict the in-hospital mortality. The area under the curve of receiver operating curve drawn for the on admission GCS score was 0.78 with a sensitivity of 96.31% and specificity of 41.38% for a patient presented with the GCS score of <10. Conclusion: On admission GCS and haemorrhagic stroke are independent predictors of in-hospital mortality. Patients with on admission GCS <10 have a moderate predictive ability in predicting the in-hospital mortality. Thus, a special attention should be given to the patients with low GCS score and haemorrhagic strokes for reducing rates of in-hospital mortality.

Neuromyelitis optica spectrum: novel concept of pathogenesis, diagnosis and treatment of Devic’s disease

2009 ◽  
Vol 150 (46) ◽  
pp. 2101-2109 ◽  
Author(s):  
Péter Csécsei ◽  
Anita Trauninger ◽  
Sámuel Komoly ◽  
Zsolt Illés
Keyword(s):  
Neuromyelitis Optica ◽  
Water Channel ◽  
Diagnostic Procedures ◽  
Diagnosis And Treatment ◽  
Clinical Settings ◽  
Permanent Disability ◽  
Therapeutic Decisions ◽  
Novel Concept ◽  
The Brain

The identification of autoantibodies generated against the brain isoform water channel aquaporin4 in the sera of patients, changed the current diagnostic guidelines and concept of neuromyelitis optica (NMO). In a number of cases, clinical manifestation is spatially limited to myelitis or relapsing optic neuritis creating a diverse. NMO spectrum. Since prevention of relapses provides the only possibility to reduce permanent disability, early diagnosis and treatment is mandatory. In the present study, we discuss the potential role of neuroimaging and laboratory tests in differentiating the NMO spectrum from other diseases, as well as the diagnostic procedures and therapeutic options. We also present clinical cases, to provide examples of different clinical settings, diagnostic procedures and therapeutic decisions.

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