Journal of the Medical Association of Thailand = Chotmaihet thangphaet
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Randomized Controlled Trial Comparative Study
Randomized controlled trial of high dose bolus versus continuous intravenous infusion pantoprazole as an adjunct therapy to therapeutic endoscopy in massive bleeding peptic ulcer.
After therapeutic endoscopy is performed in high-risk patients with peptic ulcer bleeding, rebleeding occurs in about 25 to 30%. High dose intravenous proton pump inhibitors (PPI) have been recommended for the use in high-risk patients to prevent rebleeding following successful therapeutic endoscopy. ⋯ In the present study, both PPI drug administration methods showed an equally effective for massive peptic ulcer bleeding. Further studies with a larger sample size are recommended.
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Hyponatremia (serum sodium < 135 mEq/L) is the most common electrolyte abnormality in hospital and has impact on patient morbidity and mortality. The accuracy of volume status assessment is a major problem for the treatment planning especially to discriminate mild hypovolemic from euvolemic patients. ⋯ Plasma NT-pro-BNP levels provide objective information with respection to volume status in hyponatremia patients and can be used in clinical diagnosis of hypovolemic vs. euvolemic hyponatremic hyponatremia.
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Identify the various factors that predict a Focused Assessment with Sonography for Trauma (FAST) positive result and a subsequent therapeutic laparotomy. ⋯ Patients with blunt abdominal injuries who present with decreased oxygen saturation and an abnormal abdominal examination have a high probability of FAST-positive result. Patients with the time of injury of less than one hour before reaching the emergency room, and a FAST-positive are important predictors of the need for therapeutic laparotomy.
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Colorectal cancer is the third most common cancer worldwide. There were only a few reports of disease outcomes in Thai. Therefore, the authors retrospectively reviewed the clinical characteristics and disease outcome of patients with curable colorectal cancer treated at Siriraj Hospital, the largest tertiary-care hospital in Thailand. ⋯ Approximately two-thirds (68%) of patients with colorectal cancer at Siriraj hospital presented with a potentially curable stage. Multi-modality treatments with surgery, adjuvant chemotherapy and radiation resulted in comparable survival as in Western countries. Independent risk factors for worse survival in this cohort were stage III disease and male gender.
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Gabapentin has an antipruritus effect, which its efficacy in reducing pruritus induced by intrathecal morphine has not been well documented. The purpose of the present study was to know if a single smaller dose of gabapentin could decrease the intrathecal morphine-induced pruritus. ⋯ Preoperative gabapentin 600 mg did not significantly reduce the postoperative intrathecal morphine-induced pruritus.