April 20, 2016
Well, we are off to a running start with our work at Masindi-Kitara Medical Center (MKMC). We only arrived on Monday but had volunteered to give some presentations, so they said, “how about Wednesday?” which is their normal CME (continuing medical education day). Of course we said yes. So right away Monday and Tuesday the students began preparing talks on Antibiotic Use, a review on the use of Antibiotics and Infectious Diseases seem to always be desired. Due to a couple of glitches, no power for the projector in the new Education Wing, and not being able to open up one of the power point presentations on my computer, we ended up having only 2 of the students present. But, we can finish next Wednesday. So Casey talked about Antimicrobial Prophylaxis before Dental Procedures. She suggested this topic herself, since we had just found out that the clinic would be opening up a dental visit part soon. Antimicrobial Prophylaxis is where you give 1 dose of an antibiotic prior to the dental procedure to prevent the development of a serious heart infection called Endocarditis. Only some patients are at risk of this and are primarily those with pre-existing heart conditions of certain types or if you had endocarditis in the past.
Lauren’s talk was on Sepsis. When a person gets a really serious infection, his/her body can overreact as it tries to manage the infection and this causes the blood pressure to become to0 low, causes increases in respiratory rates and confusion and if not treated appropriately, this can lead to death from the shutdown of organs. This is called Sepsis. It is very important to identify patients who might have Sepsis along with their infection very early since the sooner targeted treatment is given, the better the chance for a good outcome for the patients. Recently the guidelines for diagnosing Sepsis have changed and Lauren reviewed this with the group. But there still is a problem in that these guidelines were derived using patients in studies that took place in the USA and Europe where all kinds of lab tests are available and the treatments are almost unlimited, at least they seem so as compared to what is available in Uganda and other parts of the developing world. We had a discussion about this at the clinic and it is even more important that sepsis is identified early so that basic treatments, like fluids and antibiotics, can be given before the patient gets worse.