Journal of the Medical Association of Thailand = Chotmaihet thangphaet
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The purpose of the present study was to determine the quality of analgesia of continuous thoracic paravertebral nerve block after thoracic surgery by inserting a catheter under direct vision and assessing complications related to the analgesia technique. ⋯ The use of continuous thoracic paravertebral blockade under direct vision technique offered satisfactory pain control and less complications. It could be considered as an alternative when thoracic epidural block is difficult to access.
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Delirium, an acute decline in attention and cognition, is found to be a common life-threatening clinical syndrome among hospitalized older patients. However, there has been no study to date regarding prevalence and incidence of delirium in Thai older patients. ⋯ In conclusion, the prevalence of delirium among older patients admitted to general medical wards in the present study were alarmingly high. Meanwhile, the incidence of delirium was comparable to other studies. Obviously, it requires serious attention from physicians, nurses and hospital administrators. These findings may reflect the importance of delirium detection for proper management. To lower morbidity and mortality in older patients, effective preventive strategies of delirium should be implemented promptly during hospital admission.
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Endobronchial ultrasound guided transbronchial needle aspiration (EBUS TBNA) is performed by using special bronchoscope which has an ultrasound probe at its tip that could demonstrate lymph node outside the airway and allow for real time observation of transbronchial needle aspiration. The sensitivity and specificity of EBUS TBNA are high in many studies. However because of the high expense and special training required, the impact of this method on clinical practice guidelines (CPG) needs to be further evaluated. ⋯ EBUS TBNA has impact on CPG for assessment of mediastinal node in lung cancer and mediastinal lymphadenopathy patients.
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To evaluate the diagnostic performance of apparent diffusion coefficient (ADC) value in discriminating benign from malignant vertebral compression fracture. ⋯ The ADC promises to be an effective implement for characterization of vertebral body compression fracture in differentiating benign and malignant compression fractures.
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Randomized Controlled Trial
A randomized, prospective, double-blind study of the efficacy of dexpanthenol nasal spray on the postoperative treatment of patients with chronic rhinosinusitis after endoscopic sinus surgery.
To assess the efficacy of dexpanthenol nasal spray compared with normal saline spray in the postoperative treatment of patients with chronic rhinosinusitis (CRS) who underwent endoscopic sinus surgery (ESS). ⋯ The majority of the postoperative symptom scores and all of the endoscopic scores of the dexpanthenol group were not statistically different from those of the normal saline group. However, dexpanthenol nasal spray has superior efficacy compared with normal saline nasal spray on improvement of mucociliary clearance and nasal discharge in the postoperative care of CRS patients after ESS.