Journal of the Medical Association of Thailand = Chotmaihet thangphaet
-
Urinary tract infection (UTI) is frequentlyfound in family physician clinics. The present study was designed to assess the reliability of a leukocyte esterase urine dipstick test in detecting UTI. ⋯ Pyuria can be used to detect UTI instead of urine culture due to its significant incidence. In the present study, the presence of pyuria had a higher specificity (60.9%) compared to the dipstick test (44.2%). However the significantly positive dipstick and pyuria results make the combined test more useful than the single test, and there is a statistically significant correlation between the dipstick test (leukocyte esterase) and the microscopic examination (p< 0. 001). Therefore, the dipstick test (leukocyte esterase) can be used as a diagnostic tool in detecting UTI cases.
-
Comparative Study
Neonatal morbidity and mortality for repeated cesarean section vs. normal vaginal delivery to uncomplicated term pregnancies at Srinagarind Hospital.
To evaluate the morbidities and mortality of neonates delivered by elective repeated cesarean section vs. normal vaginal delivery among women with uncomplicated term pregnancies. ⋯ Even among uncomplicated term pregnancies, cesarean section is associated with more neonatal respiratory morbidity and sepsis while those delivered by normal vaginal delivery tend to have a higher rate of birth trauma and hyperbilirubinemia. Clinicians should therefore be concerned about the route of delivery and the probability of negative neonatal outcomes.
-
To evaluate the efficiency and complications of catheter-directed thrombolysis (CDT) of acute limb ischemia (ALI) resulting from thromboembolic occlusion. ⋯ CDT is an effective armamentarium to salvage the ischemic limb resulting from acute embolism and acute thrombosis of native artery. However bleeding complication is a major problem of this treatment. Although CDT is usually applied for ALI patients with ischemic symptom onset less than 14 days, it also provides technical success for those with the symptom onset between the second and the sixth weeks.
-
To evaluate risk factors that influences the outcome of decompressive craniectomy (DC) in severe traumatic brain injury patients. ⋯ Younger age group patients and higher pre-operative GCS are two factors that influence the outcome of DC. Early decompressive craniectomy in patients with higher GCS may result in better functional outcomes.
-
Randomized Controlled Trial
Intraperitoneal sub-diaphragmatic instillation of bupivacaine plus morphine for reducing postoperative shoulder pain after gynecologic endoscopy.
Gynecologic endoscopic surgery is a minimally invasive surgical technique for treatment of various gynecologic diseases. When compared to conventional laparotomy, this procedure has advantages in many aspects such as reduced postoperative pain, short hospital stay, and decreased morbidity associated with laparotomy. However 15 to 30% of the patients experienced moderate or severe postoperative shoulder pain. Methods to minimize postoperative shoulder pain after gynecologic endoscopy are essential to maximize the quality of life of the patients. ⋯ Intraperitoneal instillation of bupivacaine plus morphine had no efficiency for reducing postoperative shoulder pain incidence after gynecologic endoscopy.