Journal of the Medical Association of Thailand = Chotmaihet thangphaet
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Auditing the return visit charts of patients who returned within 48 hours is a very important method of quality assurance. Several factors can be possible causes of unscheduled emergency return visits. Therefore, identifying these factors is critical to decreasing the number of unnecessary visits in this group. ⋯ Unscheduled ED return visit patients represent high risk patients. Patients in this group are associated with various factors. The present study indicates that the most common factor behind return visits were illness-related. Illness-related and patient-related factors were significantly associated with discharged patient. Observational units could reduce unnecessary return visit in this group. Doctor-related and healthcare-related factors were significantly associated with admitted return visit patients. Emergency physician training system and guideline implementation for doctors could reduce unexpected early discharge in this group.
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The present study aimed to determine inter-rater reliability and intra-rater reliability of the 66-item version of the Gross Motor Function Measure (GMFM-66) in assessing motor ability of Thai children with cerebral palsy. ⋯ The present study confirms high inter-rater and intra-rater reliability of the GMFM-66 measured by Thai pediatric physical therapists. Therefore, in clinical practice, we recommend Thai pediatric physical therapists to use the GMFM-66 in assessing motor ability of cerebral palsy patients.
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Selective nerve root block (SNRB) is the accepted procedure for diagnostic and therapy in lumbar radicular back pain management. The present study was to determine the accuracy of needle-tip under ultrasound guidance subsequently confirmed with fluoroscopy in patients who underwent SNRB. To date, no study comparing these two techniques has been performed. ⋯ To position the needle-tip under ultrasound guidance is feasible and has good safety profile. The accuracy could be achieved individually. However, because the accuracy of ultrasound guidance technique depends on the operator a steep learning curve and larger prospective clinical study is needed.
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Therapeutic hypothermia is a recommended treatment by standard guidelines for patients after cardiac arrest but it is not distinguished in Thailand. The present report aimed to demonstrate feasibility of its use in Thailand. ⋯ This initial experience of therapeutic hypothermia after cardiac arrest with surface cooling method implicates feasibility of its use in Thailand.
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Full endoscopic lumbar discectomy via interlaminar approach: 2-year results in Ramathibodi Hospital.
To present the surgical outcome of the full-endoscopic lumbar discectomy via interlaminar approach. ⋯ Full-endoscopic lumbar discectomy is a safe and effective procedure for lumbar disc herniation. Patients can expect less postoperative pain, early recovery, and a short period of work absence. However, the learning curve is steep. Proper surgical training and careful patient selection in the early cases are the keys to success.