Journal of the Medical Association of Thailand = Chotmaihet thangphaet
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Pitfalls in the respiratory care and mechanical ventilation for patients continue to prevail in intensive care unit (ICU) or in some hospital wards in Thailand. There are two reasons that explain this phenomenon. Firstly, there are no professional respiratory therapists in Thailand. ⋯ Academic institutes have to provide training courses in respiratory therapy and grant appropriate levels of diplomas or certificates in respiratory therapy. Did actics and clinical skills required for respiratory care have to be sufficiently integrated into the curricula for medical students as well as nursing students. Physicians and nurses need to master their skills and acquired appropriate knowledge in respiratory care and mechanical ventilation until we can assure the necessary number of registered or certified respiratory therapists here in Thailand to help avoid such pitfalls.
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Randomized Controlled Trial
Effect of intravenous fentanyl given prior to the end of surgery on emergence agitation in pediatric patients.
Evaluate the effect of intravenous fentanyl on the incidence and severity of EA. ⋯ Administration of intravenous fentanyl 1 microg/kg 15 minutes prior the end of surgery decreased the incidence of EA and reduced pain without delaying emergence and without any increase in postoperative complications.
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Acute (open abdomen) and late (ventral hernia) abdominal wall defects are difficult surgical problems requiring appropriate management for acceptable results. Several methods of abdominal wall reconstruction in these patients have been introduced with varying outcomes. Components separation method (CSM) is an autologous tissue repair that has been employed for such situations with satisfaction by many investigators. The authors have adopted this method of abdominal wall repair or reconstruction and used it in our patients with difficult abdominal wall problems since May 2005. The aim of the present study was to examine results of treatment of patients with large abdominal wall defects by CSM at our institution. A brief demonstration of surgical techniques and discussion of the related issues were also made. ⋯ CSM is a good alternative for management of difficult abdominal wall problems, especially in situations that employment of prosthetic mesh may be inappropriate. Its advantages are avoidance of prosthetic mesh and low risk of infection in potentially infected environment. It is versatile in various abdominal wall problems even in large abdominal wall defects. CSM is recommended when associated enteric fistula, ileostomy, colostomy closure, or other potentially infected procedures are simultaneously performed.
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Randomized Controlled Trial
A prospective placebo-controlled study on the efficacy of onion extract in silicone derivative gel for the prevention of hypertrophic scar and keloid in median sternotomy wound in pediatric patients.
New topical treatments studied in adults have been published to be potentially effective in the treatment of hypertrophic scar and keloids. There is still no study in Thai children. ⋯ Onion extract in silicone derivative gel can significantly decreased the incidence of hypertrophic scar from median sternotomy wound in pediatric patients. Keloid did not show statistically significant differences in both groups.
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Randomized Controlled Trial Comparative Study
Comparison the incidence of emergence agitation between sevoflurane and desflurane after pediatric ambulatory urologic surgery.
To compare the incidence and severity of emergence agitation, recovery profile, and adverse events between desflurane and sevoflurane anesthesia in unpremedicated pediatric ambulatory urologic surgery patients. ⋯ The occurrence of EA and adverse events between sevoflurane and desflurane were not different, except that the overall of intraoperative respiratory events was higher in desflurane group.