Journal of the Medical Association of Thailand = Chotmaihet thangphaet
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Many steps of myocardial preservation during open heart surgery are practical after the development of the heart-lung machine. A cardioplegia solution, infused after aortic cross clamping, is an important aspect. Two-thirds of cardioplegia solutions are an intracellular solution (such as HTK or Bretschneider solution) or extracellular solution (such as blood cardioplegia). Intracellular cardioplegia solution can provide protection for 3-4 hours after one-time infusion, which differs from extracellular cardioplegia solution requiring intermittent use every 20-30 minutes. ⋯ There was significantly more spontaneous ventricular fibrillation after release of cross clamping in HTK group. Clinical outcome of single doses of antegrade, cold Custodiol-HTK cardioplegia solution in CABG surgery protected the myocardium equally well as repetitive antegrade, cold blood cardioplegia.
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Digital subtraction angiography (DSA) is the gold standard to diagnose cerebral vasospasm but it is usually not available due to lack of expertise and proper equipment. The present study aimed to compare the diagnostic accuracy of brain computerized tomographic angiography (CTA) in detecting cerebral vasospasm after intracranial aneurysmal rupture. ⋯ Compared to the DSA, the CTA can be used for detecting cerebral vasospasm in patients with ruptured intracranial aneurysms with high sensitivity, specificity, and diagnostic accuracy.
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Oxygen Saturation is one of the important data to determine patient status and worldwide applied in several situations. Evaluation about status of immediate perinatal period of the infant usually uses clinical assessment, Apgar scoring, which had been used for a long time without other scientific measurement. Pulse oximeter the non-invasive measurement of oxygen saturation, may play role for oxygen saturation evaluation in newborn that immediately change from intra to extra uterine environment. ⋯ A newly born infant has to take 6.5 minutes (2-10) after birth to adjust their oxygen saturation to reach normal higher level of extra uterine life, median SpO2 of 90%. Furthermore, mode of delivery makes a significant difference of oxygen saturation status; the cesarean route takes significantly longer time than the vaginal route to achieve SpO2 ≥ 90%.
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Randomized Controlled Trial
Postoperative Pain Relief in Major Gynaecological Surgery by Perioperative Parecoxib Administration: Thammasat University Hospital Study.
To study postoperative pain relief in major gynaecological surgery by perioperative parecoxib administration in Thammasat University Hospital. ⋯ Intravenous postoperativeparecoxib injection could relief pain and reduced meperidine consumption. Parecoxib could be safely used in gynaecological surgery for postoperative pain relief
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Randomized Controlled Trial Comparative Study
Efficacy of High vs. Conventional Ergocalciferol Dose for Increasing 25-Hydroxyvitamin D and Suppressing Parathyroid Hormone Levels in Stage III-IV CKD with Vitamin D Deficiency/Insufficiency: A Randomized Controlled Trial.
Vitamin D deficiency/insufficiency is common in chronic kidney disease (CKD) patients and it contributes to secondary hyperparathyroidism, which occurs early in CKD. It is not clear whether the Kidney Disease Outcomes Quality Initiative (K/DOQI) recommended doses of ergocalciferol are adequate for correction of vitamin D insufficiency and hyperparathyroidism. ⋯ In addition to improving vitamin D levels, oral high-dose ergocalciferol was safe and had a beneficial effect in decreasing PTH in patients with stage III-IV of CKD.