Journal of the Medical Association of Thailand = Chotmaihet thangphaet
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The inferior vena cava (IVC) diameter is often used to estimate central venous pressure (CVP); however, the correlation and the cutoff of IVC compared with CVP have not yet been described in a Thai-population. ⋯ The present study indicate that the measurement of the IVC diameter has a good correlation with CVP in Thai-population and useful for assessment of the volume status. The measurement of the IVC by ultrasonography may be an important additional evaluation of critically ill patients.
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Randomized Controlled Trial Comparative Study
Dexmedetomidine compare with fentanyl for postoperative analgesia in outpatient gynecologic laparoscopy: a randomized controlled trial.
Low-dose dexmedetomidine provides postoperative analgesia with anti-emetic and anti-shivering. This prospective, randomized, double-blind study was designed to evaluate intraoperative infusion of dexmedetomidine and fentanyl in postoperative analgesia in outpatient gynecologic diagnostic laparoscopy under general anesthesia. ⋯ The present study demonstrates that intravenous infusion of 0.5 microg/Kg of dexmedetomidine after induction of anesthesia was better analgesia than 0.5 microg/Kg of fentanyl in the postoperative period without delayed discharge and provided perioperative hemodynamic stability during gynecologic diagnostic laparoscopy.
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Randomized Controlled Trial Comparative Study
Randomized controlled trial of high dose bolus versus continuous intravenous infusion pantoprazole as an adjunct therapy to therapeutic endoscopy in massive bleeding peptic ulcer.
After therapeutic endoscopy is performed in high-risk patients with peptic ulcer bleeding, rebleeding occurs in about 25 to 30%. High dose intravenous proton pump inhibitors (PPI) have been recommended for the use in high-risk patients to prevent rebleeding following successful therapeutic endoscopy. ⋯ In the present study, both PPI drug administration methods showed an equally effective for massive peptic ulcer bleeding. Further studies with a larger sample size are recommended.
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Hyponatremia (serum sodium < 135 mEq/L) is the most common electrolyte abnormality in hospital and has impact on patient morbidity and mortality. The accuracy of volume status assessment is a major problem for the treatment planning especially to discriminate mild hypovolemic from euvolemic patients. ⋯ Plasma NT-pro-BNP levels provide objective information with respection to volume status in hyponatremia patients and can be used in clinical diagnosis of hypovolemic vs. euvolemic hyponatremic hyponatremia.
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Identify the various factors that predict a Focused Assessment with Sonography for Trauma (FAST) positive result and a subsequent therapeutic laparotomy. ⋯ Patients with blunt abdominal injuries who present with decreased oxygen saturation and an abnormal abdominal examination have a high probability of FAST-positive result. Patients with the time of injury of less than one hour before reaching the emergency room, and a FAST-positive are important predictors of the need for therapeutic laparotomy.