Primary percutaneous coronary intervention in acute myocardial infarction at Siriraj Hospital: the improvement over time.

OBJECTIVE: To evaluate the efficacy of the acute ST segment elevation treatment guidelines in reducing the door-to-balloon time at Siriraj Hospital. MATERIAL AND METHOD: Retrospective analysis of the data and records obtained from one hundred and twenty eight patients who underwent primary percutaneous intervention for acute ST segment elevation myocardial infarction at Siriraj Hospital between June 2002 and February 2006. Control chart analysis was applied to evaluate the efficacy of the guidelines. RESULTS: The mean door-to-balloon time was consistently reduced from 243.23 minutes before to 137.13 minutes after the guidelines implementation. Control chart analysis showed that this reduction in door-to-balloon time reached statistical significance. CONCLUSION: The guidelines developed by a multidisciplinary approach could effectively reduce the door-to-balloon time.

Roseomonas gilardii subsp rosea, a pink bacterium associated with bacteremia: the first case in Thailand.

Roseomonas is a pink-pigmented, non-fermentative, gram-negative coccobacillus bacterium. Human infections caused by Roseomonas are very rare. We report the first case of bacteremia associated with Roseomonas gilardii subsp rosea in Thailand. The bacterium was isolated from blood culture and identified by cellular morphology, characteristics of colonies on blood agar, extensive biochemical tests and 16S ribosomal DNA sequencing.

Sudden cardiac death in athlete : A case report and review of literature.

A 21 year old man was successfully resuscitated from sudden cardiac arrest during sports training. Cardiac investigations revealed that he had pre-excitation syndrome. He was scheduled to cardiac electro physiologic study and radiofrequency ablation. The bypass tract was located at left posteroseptal site, the procedure was successful. The detailed history and investigations are reported, as well as review of the literatures.

Streptococcus suis meningitis: A case report.

We reported 51 year old man from Kanchanaburi Province presented with acute bacterial meningitis. The pathogenic bacteria was identified as g-haemolytic streptococci ( non gr D ). The cerebrospinal fluid (CSF) showed lymphocytic pleocytosis which were indistinguishable to tuberculous or fungal infections. After treatment with penicillin and third generation cephalosporin for 2 weeks, CSF culture for bacteria was negative, but the symptoms were still persisting and later on developed sensorineural hearing loss. Antibiotics were continued for another 6 weeks. Patient responsed to medication well but complicated with hydrocephalus and sensorineural hearing loss that both were treated promptly. The most likely pathogenic organism in this patient is Streptococcus suis.