Journal of the Medical Association of Thailand = Chotmaihet thangphaet
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Comparative Study
Comparison among 3 techniques of spinal and epidural anesthesia for caesarean section.
When comparing spinal block and epidural block groups, spinal block is simpler, easier and more reliable and it is useful for urgent Caesarean sections because of its rapid onset. In the spinal group, 0.4 per cent heavy bupivacaine is more reliable than 0.5 per cent plain bupivacaine. ⋯ In epidural block with 2 per cent lidocaine (20 ml) time to get to T4 was more than 20 minutes after block and failure rate was higher. It should then be used in elective cases and by an experienced anesthesiologist.
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A case of life-threatening chronic diarrhea, caused by Cryptosporidium spp., was reported. The patient was a seven month old boy from an orphanage suffering from voluminous watery diarrhea, fever and vomiting three days before admission. He presented with severe dehydration and severe hypokalemia. ⋯ At the end of the third week, spontaneous remission was observed. The overall diarrheal period lasted twenty-five days. In this case, cryptosporidiosis manifested as severe chronic diarrhea in the immunocompetent and supportive management was very important because an effective drug is not available at present.
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Obesity increased complications during the antenatal period, labour and delivery as well as puerperium. This study aimed to investigate the complications during labour and delivery among obese primiparous and obese multiparous parturients. ⋯ The study and the control group consisted of 741 parturients who delivered during the 3 year period, 1986-1988. There were significant increases in the incidence of antenatal complications especially hypertensive disorders of pregnancy, obstructed labour, primary cesarean delivery, and macrosomic infant among both the obese primipara and obese multipara.
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The natural course, related complications and factors affecting prognosis of traumatic hyphema in 149 Thai patients were reported. Male preponderance and high prevalence of patients younger than 15 years were noted in this study. Blunt ocular trauma was the most common type of eye injury (88.59%), with penetrating injury (7.38%) and missile (4.03%) being the next in order of decreasing frequency. ⋯ Complications from secondary glaucoma accounted for 24.16 per cent, whereas, corneal blood staining and rebleeding were 10.07 and 6.71 per cent respectively. Shorter duration of injury, good initial visual acuity and absence of complications were responsible for favorable visual prognosis. However, age, grade of the initial hyphema and surgical intervention were not demonstrated to have any influence on the eventual visual outcome.
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The intramuscular injection of benzathine penicillin G 2.4 million units weekly for 3 consecutive weeks to syphilitic pregnant women was again confirmed to be clinically effective for prevention of their neonates from congenital syphilis and well accepted as treatment for syphilis in pregnancy. It was administered to 184 cases, or 93.5 per cent, of 197 syphilitic gravidas. It was found that pregnancy outcomes in terms of abortion, stillbirth, prematurity, full term delivery, neonatal birth weight, macroscopic examination of the placenta and general physical examination of the neonate were clinically useful as a parameter to evaluate the effectiveness of the therapy for the infant. Clinical symptoms and signs in the mother, serological tests for syphilis in the gravida and cord blood of the newborn, and placental weight were not useful in the evaluation of adequacy of treatment of our study group.