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Biomedical subjects

H Wilde

Publications and source records attributed to H Wilde.

At least 109 records · Page 6Linked to original sources
PubMed1989

Failure of rabies postexposure treatment in Thailand.

Three failures of postexposure rabies treatment using imported purified duck embryo cell and Vero cell rabies vaccines are reported from Thailand. Reference is made to eight additional previously reported Thai patients, six of whom had received human diploid cell vaccine. An analysis of these cases reveals that there were serious flaws in management in all of these patients. It is stressed that 45% of human rabies deaths in Thailand occur within 20 days of being bitten and 71% are dead within 28 days. This short incubation period does not allow much time to start immunotherapy. Of Bangkok dogs found to have rabies at autopsy, approximately 8% have a rabies immunization history. Once a dog has bitten a patient immunotherapy should not be delayed in countries with a high incidence of dog rabies. Patients with chronic disease, alcoholics and drug addicts may have an impaired immune response to postexposure rabies vaccines.

Adolescent↗
PubMed1989

Postexposure rabies vaccination during pregnancy: experience with 21 patients.

Twenty-one pregnant rabies exposed patients received postexposure vaccination using purified Vero cell rabies vaccine. Twelve of these with severe exposures were also given equine rabies immune globulin. Adverse reactions were mild, transient and required no treatment. Fifteen per cent of the patients reported side-effects such as myalgia, malaise, erythema and swelling at injection sites, urticarial rashes, and mild regional lymphadenopathy. The vaccine series was completed in all cases and none of the mothers or infants developed rabies after one year of follow-up. No congenital malformations were detected. All infants were well after one year. One patient experienced a spontaneous abortion.

Adolescent↗
PubMed1989

Purified equine rabies immune globulin: a safe and affordable alternative to human rabies immune globulin.

Reported are the results of a retrospective study of 3156 patients who were treated at the Queen Saovabha Memorial Institute, Bangkok, with equine rabies immune globulin (ERIG). Only 51 patients (1.6%) exhibited serum-sickness-like reactions, none of which persisted for more than a week, and only 8 of these patients (15%) were treated with a short course of steroids. One patient, whose skin test was negative, had an immediate anaphylactic reaction to ERIG that responded to parenteral therapy with epinephrine and hydrocortisone sodium succinate. Serum-sickness-like reactions were more frequent among females and over 21-year-olds but were exceedingly rare (0.086%) among children under 10 years of age.

Adolescent↗
PubMed1985

A report of three cases of AIDS in Thailand.

Acquired immune deficiency syndrome (AIDS) has been rarely reported as occurring primarily in Asia. We report here on first three cases of AIDS diagnosed at Chulalongkorn Hospital Medical School. One case was an American who had been in Thailand for two years; the other two were Thai. The American and one of the Thai patients were male homosexuals but they had no connection with one another. The latter Thai male homosexual had sexual contact with a German man who showed no evidence of the disease. The other Thai patients was the mistress of the male Thai patient, which underlies the importance of heterosexual transmission of the disease. The two male patients had opportunistic infections whereas the female patient had only generalised lymphadenopathy (Pre-AIDS). Delayed type hypersensitivity response, T-cell subsets enumeration and the in vitro T-cell mitogen response served as diagnostic tools when combined with the clinical history. The diagnosis was made even before the results of tests to determine the presence of antibodies to HTLV-III were known. The presence of anti-HTLV-III simply confirmed our diagnosis.

Acquired Immunodeficiency Syndrome↗
PubMed1983

Surgical management of an epidemic of penile amputations in Siam.

Thailand recently experienced an epidemic of penile amputations. These were usually performed by angry wives on philandering husbands. This outbreak appeared to have been fueled by graphic press reports and fortunately seems to have abated. A technique for reanastomosis of the amputated penile segment was first described by McRoberts et al [5] in 1968. It was modified further so that it can be performed in any general hospital with an acceptable result. Experience with this procedure in 18 patients has been described.

Adult↗
PubMed1983

Doctoring in eastern Europe.

Health care in Eastern Europe has not achieved world standards nor the goals of planners of socialist societies. With luck, perseverance, bribes or good connections, it is possible to obtain good medical and surgical care in Eastern Europe for a major illness. Primary and even secondary care usually are substandard, however, and often completely unacceptable to most Western foreigners. The reasons for this are complex but mainly rooted in different attitudes of health workers towards their patients, poor physical plants, poor salary structures, inadequate advancement opportunities for health care workers, poor social status and professional recognition for nurses and almost complete isolation of the average primary care doctor from hospital medicine.

Attitude of Health Personnel↗