Journal of the Medical Association of Thailand = Chotmaihet thangphaet
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A 21-year retrospective review of operative obstetrics at the Department of Obstetrics and Gynaecology, Ramathibodi Hospital was reported from January 1, 1970 to December 31, 1990. There were a total of 128,630 deliveries, of which 41,724 (32.4%) were abnormal deliveries. Forceps, vacuum and cesarean section still increased, but vaginal breech deliveries have lost their popularity in this institution.
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A 25-year-old pregnant women with cryptococcal meningitis treated with itraconazole during the first few weeks and 12th-16th week of pregnancy is reported. She delivered a normal baby. Itraconazole should be another drug for treatment of fungal infection in pregnancy.
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Randomized Controlled Trial Comparative Study Clinical Trial
Direct epidural morphine injection during lumbar discectomy for postoperative analgesia.
A double-blind controlled study was done on 42 patients to test the analgesic activity of epidural morphine after lumber laminectomy for single level disc herniation. Sixteen patients received 3 mg preservative-free morphine. ⋯ The patients given epidural morphine had a longer postoperative pain-free period (6.28 vs 2.37 hours) and needed less postoperative analgesia (0.2 vs 0.9 times for paracetamol, and 0.16 vs 0.51 times for morphine). Epidural morphine injection under direct vision during discectomy operation is an effective and safe method for postoperative pain relief.
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Randomized Controlled Trial Comparative Study Clinical Trial
A comparative study of isobaric and hyperbaric solution of bupivacaine for spinal anaesthesia in caesarean section.
Though hyperbaric solution of bupivacaine following intrathecal injection had satisfactory spread of analgesia, it regressed rapidly with more side effects. Isobaric bupivacaine seemed to provide a slow regression of analgesia with fewer undesirable effects except for its inadequate spread of analgesia. As a result, if the dosages as well as the time of administration of isobaric solution are well adjusted, we believe that it is safe and reliable with an excellent level of analgesia for caesarean section.
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Cyanide poisoning is a life threatening condition. But specific antidotes exist and can be easily prepared from available substances in hospital. Administration of antidotes will produce methemoglobin, which itself causes hypoxia. ⋯ Before administering the antidotes, the diagnosis should be confirmed. Nitrite should not be given if the poisoning is mild or diagnosis is uncertain, to avoid excessive methemoglobin, dosage of sodium nitrite must be adjusted according to hemoglobin level (Table 1). Usage of sodium nitrite and sodium thiosulfate in the recommended doses are safe and effective for cyanide poisoning.