Journal of the Medical Association of Thailand = Chotmaihet thangphaet
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Laparoscopic radical cystectomy is now widely performed in cases of muscle-invasive bladder cancer. The present study experience with laparoscopic radical cystectomy using an ileal neobladder in which urethra-neobladder anastomosis was successfully performed intracorporeally ⋯ Laparoscopic radical cystectomy of ileal neobladders using intracorporeal urethra-neobladder anastomosis is technically feasible. This technique takes advantage of laparoscopic surgery, good visualization, additional stitches, and more secure anastomosis.
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Presently, in Siriraj Hospital, intrathecal morphine is routinely used in spinal anesthesia for postoperative pain control in more than 600 cases per month with doses lower than 0.3 mg. However, the incidence of side effects is high. This retrospective data review was performed to identify incidence and risk factors of postoperative nausea, vomiting, and pruritus. ⋯ The intrathecal morphine is effective in postoperative pain control. However it induces high incidence of nausea, vomiting, and pruritus. Prevention of side effects and alternatives to intrathecal morphine need further research.
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Low density lipoprotein cholesterol (LDL) levels were significantly lower in diabetic patients with homozygous hemoglobin E (HbEE) measured by a homogeneous assay. ⋯ The direct homogeneous method showed a higher LDL concentration than the Friedewald formula indicated in diabetes and diabetes with HbE disorders. The percentage of higher LDL levels by direct method than Friedewald formula significantly increased along the subgroups of higher TG levels. The dissociation occurred at TG levels of 100 mg/dL and higher Systematic biases between both methods were found in all groups but the proportional difference between both methods was only observed in diabetes without HbE disorders.
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Comparative Study
Comparison of maternal factors and neonatal outcomes between elective cesarean section and spontaneous vaginal delivery.
The rising rate of cesarean section has been of concern worldwide. Maternalfactors and neonatal outcomes of cesarean section and vaginal delivery remain unclear ⋯ The neonates of ECS mother had a greater weight and a higher risk for pulmonary problems. The neonates of SVD mother have a higher risk for MSAF cord accident, and meconium aspiration. It reflected the need for prolong process of labor and delivery prevention.
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Randomized Controlled Trial Comparative Study
A comparison of dexmedetomidine and propofol in Patients undergoing electrophysiology study.
Dexmedetomidine provides profound levels of sedation without affecting cardiovascular and respiratory stability based on its pharmacological profile. It may be a valuable sedative for procedures with minimal to mild pain. Electrophysiology study (EP study) is a mildly painful procedure that requires conscious sedation. The authors hypothesized that dexmedetomidine would cause lower respiratory and cardiovascular depression than propofol during equal sedation level in an electrophysiology study. ⋯ The present study demonstrated that comparable sedation could be achieved by a combination of pethidine with either dexmedetomidine or propofol during EP study. Dexmedetomidine group provided more hemodynamic and respiratory stability than propofol group.