Journal of the Medical Association of Thailand = Chotmaihet thangphaet
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Data on the L3/4 andL4/5 interspinous distances are important in performing a lumbar puncture. This has not been studied in Thais. ⋯ The present study confirms that the intercrestal line is most commonly at the lower half of the L4 spinous process. Mean interlaminar and the narrowest distances at the L3/4 and L4/5 interspinous spaces were unrelated to gender or body type. The elderly had more narrow interspinous process distances which may be benefitfrom having lumbar puncture done in the sitting andfeet supported position.
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Randomized Controlled Trial Comparative Study
A randomized trial between different suture materials (polydioxanone vs. poliglecaprone 25) and different suturing techniques (running subcuticular suture alone vs. with running horizontal mattress) in prevention of hypertrophic scar development in median sternotomy wound.
Hypertrophic scar development after median sternotomy wound in cardiac surgery patients is quite common in surgical practice and becomes a major concern nowadays. ⋯ There were no significant differences in cosmetic outcomes between different suture materials and different suture techniques.
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Clinical Trial
Effectiveness of contextual education for self-management in Thai Muslims with type 2 diabetes mellitus during Ramadan.
Fasting in Ramadan has adverse effects on health of Muslims with diabetes. Key strategies to prepare the patients are to provide appropriate health education to the patients prior to Ramadan and to adjust anti-diabetic medicines during Ramadan. ⋯ Specific health care service by providing health education prior to Ramadan and adjustment ofanti-diabetic medicine application resulted in a positive effect as the patients tended to consume less sweetenedfood to keep blood sugar level in control. Fasting could affect the patients 'health in apositive way as it helps to control blood pressure, while in parallel, adjustment of anti-diabetic medicine application helps to prevent hypoglycemia. This health care service, which can be achieved in collaboration with a health care team and Islamic leaders, is useful and suitable for Thai Muslims with diabetes mellitus type 2.
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Comparative Study Clinical Trial
The efficacy of 2% chlorhexidine gluconate in 70% alcohol compared with 10% povidone iodine in reducing blood culture contamination in pediatric patients.
Blood culture is the gold standard for diagnosis of septicemia. However; false-positive blood cultures are associated with increased health care costs due to unnecessary treatment. ⋯ Use of2% chlorhexidine gluconate in 70% alcohol as an antiseptic seems to reduce the risk of blood culture contamination compared to use of 10% povidone iodine. In addition, neither of the antiseptic solutions resulted in adverse skin reactions.
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Septic shock is a major healthcare problem effecting people worldwide with high mortality rate. Administering early and appropriate interventions can help improve the outcome. The 6-hour bundle, launched by the Surviving Sepsis Campaign committee was part of efforts to incorporate evidence-based guideline to clinical practice. There were many reports on outcome improvement of septic shock patients after implementation of the 6-hour bundle at the emergency department. ⋯ Septic shock mortality was decreased after implementation of the 6-hour sepsis protocol at the emergency department of Thammasat University Hospital.