Rangpur医学院附属医院成人急性脑膜炎的临床研究

M. Ali, Md Zakir Hossain, B. Bidhu, Amaresh Chandra Shaha, Md. Ashraful Haque, A. Alam, Umme Habiba, Md Ruhul Amin Sarkar
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摘要

背景:脑膜炎是一种涉及脑膜和脊髓的炎症性疾病。急性脑膜炎是一种全球性疾病负担,病死率高,幸存者可能有严重的终身残疾。它可能有传染性原因,如细菌、分枝杆菌、病毒、真菌或寄生虫,或与自身免疫、癌症或药物反应有关。使个人易患脑膜炎和流行病的危险因素包括营养不良、家庭过度拥挤、艾滋病毒感染、缺乏免疫接种、室内空气污染和镰状细胞病。细菌性脑膜炎可迅速致命,并导致幸存者严重残疾。本研究的目的是对成人急性脑膜炎的临床研究。材料与方法:本横断面观察性研究在Rangpur医学院附属医院内科进行,在100例出现脑膜炎体征症状的患者中进行。详细的病史,临床检查和彻底的调查完成,结果记录在表格上。利用SPSS软件和excel软件对数据进行处理和分析。结果:16 ~ 20岁和31 ~ 40岁为主要发病人群。平均年龄33.04(±18.08 SD)岁。总体上以男性为主,男女比例为2.12:1。发热、头痛、呕吐是最常见的症状。80%的病例出现意识改变,10%的病例出现局灶性神经功能缺损和皮疹。脑脊液的检查结果是诊断各种类型脑膜炎的标志。本研究发现脑脊液颜色、脑脊液葡萄糖和蛋白浓度与最大权威相关。在病原学评估中,66%的病例为细菌,24%的病例为结核,10%的病例为病毒。化脓性脑膜炎的预后良好,死亡率为6%。尽管经治疗,24例结核性脑膜炎患者中仍有8例(33%)死亡。随访中遗漏细菌性脑膜炎1例,病毒性脑膜炎1例。结论:脑膜炎是发病和死亡的主要原因。建议提供适当的保健支助、快速检测和其他调查设施,以减少残疾。上海医科大学医学院;月(1);2022年1月;页面36-40
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A Clinical Study of Acute Meningitis in Adults in Rangpur Medical College Hospital
Background: Meningitis is an inflammatory condition involving the meninges of the brain and spinal cord. Acute meningitis is global burden of disease, has a high casefatality rate and survivors can have severe lifelong disability. It can have infectious causes, such as bacteria, mycobacteria, viruses, fungi, or parasites, or be associated with autoimmunity, cancer, or reactions to medication. Risk factors that predispose individuals to meningitis and epidemics include malnutrition, household overcrowding, HIV infection, absence of immunisation, indoor air pollution, and sickle cell disease. Bacterial meningitis can rapidly become fatal and lead to severe disability in those who survive. Purpose of this study was clinical study of acute meningitis in adults. Materials and methods: This cross sectional observational study was conducted in Department of medicine, Rangpur Medical College Hospital, among the 100 patients who presented with sign symptoms of meningitis. Detailed history, clinical examination and thorough investigations were done and the findings were recorded on a proforma. Data was processed and analysed with the help of computer program SPSS and Microsoft excel. Results: The mostly affected groups were 16-20 and 31-40 years. Mean age was 33.04 (±18.08 SD) years. There was an overall male preponderance with a male to female ratio 2.12:1. Fever headache, and vomiting was most common symptoms. Altered consciousness was present in 80% of cases, focal neurological deficit and rash were present in 10% cases. CSF findings are the hallmark of diagnosing various types of meningitis. Colour of CSF, glucose and protein concentration of CSF found in this study correlates with maximum authority. On evaluation of aetiology, 66% cases were due to bacteria and 24% and 10% cases were tuberculous and viral aetiology respectively. Outcome of pyogenic meningitis was good and mortality was 6%. Inspite of treatment 8 out of 24 (33%) tuberculous meningitis patient’s were died. One case of bacterial and one case of viral meningitis were missed during follow up. Conclusion: Meningitis is foremost causes of morbidity and mortality. It is recommended that provision of proper health care support, rapid detection and other investigation facilities reduce the disability. Chatt Maa Shi Hosp Med Coll J; Vol.21 (1); January 2022; Page 36-40
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