Journal of the Medical Association of Thailand = Chotmaihet thangphaet
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Multicenter Study
The Thai anesthesia incidents study (THAI Study) of perioperative death in geriatric patients.
The study was part of the Thai Anesthesia Incidents Study (THAI Study), a multi-centered study conducted by the Royal College of Anesthesiologists of Thailand, aiming to survey anesthetic related complications in Thailand. ⋯ The present study showed an incidence of 24-hr perioperative death of 1:254 in geriatric patients receiving anesthesia, which is comparable to other countries. Mortality in elderly patients operated under anesthesia can be predicted by ASA physical status, current medications, and emergency condition.
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Venous thromboembolism (VTE) is a common and potential serious complication in lower extremity surgeries, especially in hip and knee arthroplasty. Pulmonary embolism is one of the most fatal complications. The recognition of VTE in the lower limb has been considered as an indication for anticoagulation. Many studies have shown that thrombophilia is one factor of VTE and the most common causes are protein C, protein S and antithrombin III deficiency, factor V leiden and dysfibrinogenemia. VTE is a disease of Western populations because of well documentation of incidence and many studies about thrombophilia. In Thailand, the prevalence of VTE has been unclear. ⋯ Patients who have total knee arthroplasty performed are at high risk for deep venous thrombosis. Although fetal pulmonary embolism rarely occurs in Thai populations, mechanical prevention was routinely used and prophylactic regimen should be a part of management of patients who undergo total knee arthroplasty.
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Bungarus candidus (Malayan krait) snake is a neurotoxin snake. Previous treatment after snakebite was mainly respiratory support until the patient had spontaneous breathing. Recently specific antivenom for the Bungarus candidus snake was produced by the Queen Saovabha Memorial Institute and distributed in June 2004. The present article is the first report on the clinical response to the specific antivenom for Bungarus candidus. ⋯ The patients who received specific antivenom had more rapid improvement ofsigns and symptoms comparing to the patient who did not receive the antivenon.
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To validate the Thai version of the Oswestry low back pain disability questionnaire. ⋯ The Thai version of the Oswestry low back disability questionnaire was qualified with good internal consistency for measuring acute low back pain in Thai patients.
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Randomized Controlled Trial Clinical Trial
Combined spinal-epidural analgesia and epidural analgesia in labor: effect of intrathecal fentanyl vs. epidural bupivacaine as a bolus.
To compare the clinical effects of intrathecal fentanyl with conventional epidural bupivacaine bolus before the same continuous epidural infusion for labor analgesia. ⋯ Intrathecalfentanyl as part of CSE did not produce statistically a significant faster onset compared to epidural bupivacaine bolus. Most of the patients in the CSE group required epidural bolus after intrathecal fentanyl with a higher incidence of pruritus.