JOURNAL OF THE MEDICAL ASSOCTATION OF THAILAND最新文献

{"title":"Anesthetic Management of Intraoperative Aneurysm Rupture: A Narrative Review","authors":"","doi":"10.35755/jmedassocthai.2023.09.13887","DOIUrl":"https://doi.org/10.35755/jmedassocthai.2023.09.13887","url":null,"abstract":"Intraoperative aneurysm rupture (IOAR) is a serious and potentially life-threatening complication that can occur during intracranial aneurysm surgery. Understanding the perioperative risk factor contributing to IOAR may help prevention and better handle if it occurs. The anesthesiologist should be familiar with the management of IOAR to facilitate bleeding control and improve perioperative outcome. There is controversy surrounding the management of IOAR. The main goal of management includes promptly securing for control of bleeding as well as maintaining adequate cerebral perfusion and providing neuroprotection. The purpose of the present article was to review the anesthetic management during IOAR. The authors focused on the hemodynamic and intracranial pressure control for optimizing cerebral perfusion, neuroprotection during temporary arterial occlusion, monitoring of cerebral ischemia, and recent techniques for controlling bleeding. Keywords: Intraoperative aneurysm rupture; Anesthetic management; Intracranial aneurysm; Surgical clipping","PeriodicalId":484667,"journal":{"name":"JOURNAL OF THE MEDICAL ASSOCTATION OF THAILAND","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135484930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors Associated with Cesarean Operations of Gestational Diabetic Mellitus and Diabetes Complications","authors":"","doi":"10.35755/jmedassocthai.2023.09.13757","DOIUrl":"https://doi.org/10.35755/jmedassocthai.2023.09.13757","url":null,"abstract":"Objective: To identify risk factors of cesarean delivery in pregnant women with diabetes mellitus and complications caused by gestational diabetes. Materials and Methods: A retrospective cohort study was conducted at the Department of Obstetrics and Gynecology, Phatthalung Hospital. The participants consisted of pregnant women who labored at Phatthalung Hospital between 2017 and 2021. The inclusion criteria comprised women who labored from 28 to 42 weeks and had complete medical records. Patients having previous cesarean sections, cesarean section on maternal demand, and twin pregnancy were excluded. The study group was diabetic mellitus pregnant women, while non-diabetic pregnant women was generated by random numbers at ratio of 1:1 as control group. The data collected were demographic data, age, body mass index (BMI), number of gestations, parity, abortion, type of diabetic mellitus, underlying disease, route of delivery, indications for cesarean delivery, and maternal and neonatal outcomes. Results: Two thousand twelve pregnant women consisted of 1,006 pregnancies with diabetes and 1,006 non-diabetic pregnancies. Pregnant women with diabetes significantly increased the risk of cesarean section 1.42 time (95% CI 1.19 to 1.70, p<0.001). The greatest indication for cesarean section of both groups was cephalopelvic disproportion, but failure for induction of labor and macrosomia were found in the study group more than in the control group. Logistic regression analysis, adjusted for age group, number of gestations, and BMI, showed that pregnancy-induced hypertension and newborn weight of 4,000 g or more were risk factors for cesarean section among diabetic pregnancies. The maternal complications of the study group were preeclampsia, indicated preterm labor, and premature rupture of membranes. The common fetal complications were macrosomia and birth asphyxia. Conclusion: Risk factors of cesarean section among pregnant women with diabetes included preeclampsia and newborn weight of 4,000 g or more. Gestational diabetes increased significantly the maternal and fetal complications. Keywords: Gestational diabetic mellitus; Cesarean section; Complications","PeriodicalId":484667,"journal":{"name":"JOURNAL OF THE MEDICAL ASSOCTATION OF THAILAND","volume":"42 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135484932","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Different Kinematic Values of Lower Extremities during Gait between Individuals with Chronic Non-Specific Low Back Pain and Healthy Persons","authors":"","doi":"10.35755/jmedassocthai.2023.09.13863","DOIUrl":"https://doi.org/10.35755/jmedassocthai.2023.09.13863","url":null,"abstract":"Objective: The primary purpose of the present study was to compare the differences in lower extremity kinematic parameters in individuals who have chronic non-specific low back pain (CNLBP) with healthy control subjects (CTRL) during subphase of the stance phase. The secondary purpose was to compare the average walking speed of individuals who had CNLBP with CTRL during stance phase. Materials and Methods: The present study was conducted with 26 patients, 13 of 26 were participants with CNLBP and the other 13 were CTRL. To study the subject’s walking characteristics, 3D motion analysis was applied. Each subject was attached to 47 retroreflective markers and asked to walk barefoot on a 10-meter walkway at the preferred walking speed. The independent t-test and Mann Whitney U-test were used to compare joint excursions of each subphase of the stance phase and the average walking speed between two groups. Results: The CNLBP group had significantly lower forefoot motion in the sagittal plane during the initial contact phase than CTRL group, (p=0.017). They exhibited significantly lower hip motion in the sagittal plane (p=0.043), and lower knee motion in the transverse plane (p=0.007) during the forefoot contact phase as well. The CNLBP group exhibited significantly increased rearfoot motion in the frontal plane (p=0.002) during the foot flat phase. Moreover, the CNLBP group had significantly lower hip motion in the sagittal plane during the push-off phase (p=0.033). Conclusion: Individuals with CNLBP might modify their walking characteristics of the lower extremities and walk slower when compared with healthy persons to accommodate the pain they were dealing with. Keywords: Lower Extremity; Kinematics; Chronic Non-specific Low Back Pain; Gait; Gait Speed","PeriodicalId":484667,"journal":{"name":"JOURNAL OF THE MEDICAL ASSOCTATION OF THAILAND","volume":"356 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135485083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Breastfeeding Practices among Postpartum Women with and without a History of Gestational Diabetes Mellitus: A Prospective Study","authors":"","doi":"10.35755/jmedassocthai.2023.09.13884","DOIUrl":"https://doi.org/10.35755/jmedassocthai.2023.09.13884","url":null,"abstract":"Objective: To compare breastfeeding (BF) practices, particularly exclusive BF (EBF), among women with and without a history of gestational diabetes mellitus (GDM) during the first six postpartum months and assess the impact of EBF on offspring weight from birth to six months postpartum. Materials and Methods: The present study was a prospective study that included 244 women, with 123 with a history of GDM (GDM group) and 121 without a history of GDM (non-GDM group). All participants were first interviewed on the discharge date and then via telephone at 1, 2, 3, 4, 5, and 6 months postpartum. BF practices were classified as EBF, partial BF (PBF), or no BF. Data on infant weight at six months were evaluated. Results: Upon hospital discharge, women mostly practiced PBF with 53.6% PBF versus 30.1% EBF in the GDM group and 48.8% PBF versus 38.0% EBF in the non-GDM group. However, EBF was more commonly practiced than PBF, during the first six months postpartum. The 6-month EBF rates for the GDM and non-GDM groups were 28.4% and 17.4%, respectively (p=0.039). In a multivariate analysis, only the intended EBF period was a factor that significantly impacted 6-month EBF rates (adjusted odds ratio 3.49 and 95% confidence interval 1.48 to 8.22). EBF for six months resulted in reduced weight gain during the first six months of life among offspring of women in both groups. Conclusion: The GDM group practiced EBF for six months postpartum more frequently than the non-GDM group. However, a history of GDM was not an independent predictor of EBF success over six months. EBF demonstrated lower offspring weight gain from birth to six months postpartum for women with and without a history of GDM. These findings may be used to design targeted educational programs for informed postpartum BF practices. Keywords: Breastfeeding practices; Breastmilk; Exclusive breastfeeding; Gestational diabetes mellitus; Infant weight gain; Postpartum","PeriodicalId":484667,"journal":{"name":"JOURNAL OF THE MEDICAL ASSOCTATION OF THAILAND","volume":"208 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135484929","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Efficacy of Double-Dose Mometasone Furoate Nasal Spray in Postoperative Management of Nasal Polyps: A Randomized Controlled Trial","authors":"","doi":"10.35755/jmedassocthai.2023.09.13885","DOIUrl":"https://doi.org/10.35755/jmedassocthai.2023.09.13885","url":null,"abstract":"Background: Nasal polyps are benign growths of nasal mucosa associated with inflammation and topical nasal corticosteroids are the medical treatment of choice. Surgical removal is indicated for patients not responding adequately to medical treatment. There is little evidence on the efficacy of double-dose mometasone furoate nasal spray and conventional dose to prevent the recurrence of nasal polyps and decrease nasal symptom score following endoscopic sinus surgery. Objective: To compare the efficacy of double-dose mometasone furoate and conventional dose to prevent the recurrence of postoperative nasal polyps. Materials and Methods: The present study was a randomized controlled trial. Thirty patients who met the inclusion criteria were randomly divided into two groups, 15 patients in each group. Group I patients were given mometasone furoate two sprays in each nostril twice a day (400 μg) and Group II received mometasone furoate two sprays in each nostril once a day (200 μg) as a conventional dose for six months. Grading of nasal polyps and nasal symptom score were recorded before and after treatment at the first, second, fourth, twelfth and twenty-four weeks. Results: After six months of the endoscopic sinus surgery, Meltzer clinical scoring system of nasal polyps showed an average score of 0.67±0.72 in the conventional dose, which was significantly reduced to 0.07±0.26 (p<0.01) in the double dose of mometasone furoate. The average nasal symptom score in the conventional dose was 0.70±0.70, which was not significantly decreased to 0.30±0.50 (p=0.25) in the double dose. There were no side effects in both groups. Conclusion: Double-dose of mometasone furoate nasal spray might be recommended for preventing the recurrence of nasal polyps and decreasing nasal symptom score following surgery. Keywords: Nasal polyps; Intranasal corticosteroid; Endoscopic sinus surgery; Mometasone furoate; Recurrent nasal polyps; Nasal spray; Nasal symptom score; Randomized controlled trial; Postoperative management","PeriodicalId":484667,"journal":{"name":"JOURNAL OF THE MEDICAL ASSOCTATION OF THAILAND","volume":"24 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135484937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effect of Zingiber cassumunar (Phlai Capsule) on Bronchial Hyperresponsiveness in Asthmatic Patients: A Randomized Controlled Trial","authors":"","doi":"10.35755/jmedassocthai.2023.01.13744","DOIUrl":"https://doi.org/10.35755/jmedassocthai.2023.01.13744","url":null,"abstract":"Background: Bronchial hyperresponsiveness (BHR) is a key feature of asthma. Compound D, an active compound in Phlai, can bind cysteinyl leukotrienes receptors that play a role for asthma treatment. Objective: To determine the effect of Phlai capsules on BHR measured by the methacholine challenge test. Materials and Methods: A randomized, double-blind, placebo-controlled, crossover study was conducted in adult asthmatic patients with partly controlled symptoms. Each patient received four weeks of treatment with either Phlai or placebo separated by a 2-week washout period. The main outcome was provocative concentration of methacholine causing a 20% drop in FEV₁ (PC₂₀). Asthma control test (ACT) scores, and fractional exhaled nitric oxide (FeNO) levels were secondary end points. Results: Thirty patients were randomly allocated to either the Phlai or the placebo group. All patients had allergic rhinitis and received inhaled corticosteroid and long-acting beta2-agonist (ICS/LABA) or ICS alone. Four weeks after treatment, mean PC₂₀ in the Phlai group was higher than in the placebo group at 9.76±1.56 mg/mL versus 6.05±1.65 mg/mL (p=0.151). The improvement of ACT scores in the Phlai group was significantly higher than in the placebo group. FeNO levels decreased after treatment in the Phlai group. All patients tolerated the treatment well and had no side effects. Conclusion: In adult asthmatic patients with partly controlled symptoms, concomitant treatment with Phlai capsules tended to decrease BHR and significantly improve symptom scores. Keywords: Asthma; Asthma control test; Bronchial hyperresponsiveness; Zingiber cassumunar; Phlai","PeriodicalId":484667,"journal":{"name":"JOURNAL OF THE MEDICAL ASSOCTATION OF THAILAND","volume":"16 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135743995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}