Despite meager scientific evidence, emphasis on availability of natural light in the ICU environment is universal [35]. An interesting single center study tested the hypothesis that care in an ICU room with a window contributes to better outcome in patients with SAH [36]. This was a retrospective study that mined data on 789 patients from a large prospective SAH database at Columbia University. Care in a room with a window had no effect on outcome, measured by modified Rankin Scale score at discharge, 3 months and 1 year. Furthermore, it had no effect on other secondary endpoints like length of mechanical ventilation (MV), delirium, ICU length of stay, and mortality. The results were the same in a subgroup analysis that included patients admitted during the months of the year with more than 12 hours of daylight, and those with better Hunt-Hess grade SAH.
Another paper investigated the early diagnosis of meningitis [47]. Appropriate therapy of bacterial meningitis relies on early diagnosis. Direct cerebrospinal fluid (CSF) examination only identifies a bacterial pathogen in 60 to 80% of cases, and results of cultures are delayed for days [48, 49]. An earlier study by Viallon and colleagues [50] suggested that serum procalcitonin and CSF lactate levels could differentiate bacterial from viral meningitis on presentation in patients who have negative direct CSF examination. Their current study was aimed at validating the value of these markers in accurately making the diagnosis of bacterial meningitis upon admission. This was an observational study comparing patients with bacterial (n = 35) to those with viral (n = 218) meningitis treated at one hospital over a span of 12 years. The authors concluded that a CSF lactate level of 3.8 mmol/L had a sensitivity of 94% and a specificity of 97% when differentiating the two types of meningitis. Similarly, the sensitivity and specificity of a serum procalcitonin of 0.28 ng/ml was 97% and 100%, respectively. Although the number of patients with bacterial meningitis in this study is small, the results are nonetheless clinically relevant, especially when other parameters like leucocyte count, glucose and protein levels, albeit less sensitive, are also suggestive of a bacterial etiology. Thus, these findings could offer some hope for an earlier diagnosis, and therefore timely appropriate therapy, in those patients with unrevealing CSF, or blood, culture results.
2011 grade 12 results examination council of zambia pdf
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ECZ Grade 9 Results 2022 Zambia : Examinations Council of Zambia Grade 9 Results 2022 can view on ECZ Web Portal www.exams-council.org.zm also known as Junior Secondary School Leaving Examination (JSSLE). One of the most important functions of the Examinations Council of Zambia to conduct G9 examinations and published the grade 7 results.
NOTE: Candidates, however, are advised to go and collect the original transcripts of results from the SCHOOL OR EXAMINATION CENTRE where they wrote the examinations, and NOT from the Examinations Council of Zambia or any Ministry of General Education Offices. 2ff7e9595c
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