Asian J Surg
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Critically ill patients are at high risk for developing venous thromboembolism. The objective of this study was to determine the prevalence of, and risk factors for, lower extremity deep vein thrombosis (DVT) among critically ill surgical patients in Thailand. ⋯ The prevalence of DVT in critically ill patients in a Thai surgical ICU was approximately 10.5%. Further research is needed to evaluate the risks and benefits of venous thromboprophylaxis in Thai patients.
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Case Reports
Use of continuous venovenous haemodialysis to reverse acute hypothermia after multiple trauma.
Hypothermia is an independent risk factor for mortality in trauma patients. We describe the use of continuous venovenous haemodialysis (CVVHD) as a rewarming method in a hypothermic, multiply injured patient. CVVHD achieved rapid rewarming and holds advantages over established rewarming methods in the trauma setting.
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Surgical sphincterotomy reduces anal tone and sphincter spasm and promotes ulcer healing. Because the surgery is associated with the side effect of faecal incontinence, pharmacological agents to treat chronic anal fissure have been explored recently. ⋯ Diltiazem ointment achieved healing of chronic anal fissure comparable to 0.2% GTN ointment but was associated with fewer side effects. Other drugs that have been tried are lidocaine, the alpha-adrenergic antagonist indoramin, and the potassium channel opener minoxidil.
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Randomized Controlled Trial Comparative Study
Ondansetron versus metoclopramide in prophylaxis of nausea and vomiting for laparoscopic cholecystectomy: a prospective double-blind randomized study.
Patients who undergo laparoscopic cholecystectomy may be at risk of experiencing postoperative nausea and vomiting. This prospective, randomized, double-blind study compared the prophylactic use of metoclopramide and ondansetron for the treatment of postoperative nausea and vomiting in patients who underwent elective laparoscopic cholecystectomy. ⋯ Ondansetron 4 mg given intravenously at the end of surgery is effective for preventing vomiting after laparoscopic cholecystectomy.
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Case Reports
Transcatheter arterial embolization of spontaneous rectus sheath haematoma in a Chinese woman.
Spontaneous extraperitoneal haemorrhage is a rare but well-described complication of anticoagulation therapy. We report a case of spontaneous rectus sheath haematoma in a 69-year-old Chinese woman who had received low-molecular-weight heparin for pulmonary embolism. ⋯ Arterial embolization with Gelfoam was performed and succeeded in stopping the bleeding. Transcatheter arterial embolization can be an effective and safe modality to localize and treat the bleeder in spontaneous extraperitoneal haematoma for high-risk patients.