Journal of the Medical Association of Thailand = Chotmaihet thangphaet
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Review Case Reports
Spinal cord compression and bilateral sensory neural hearing loss: an unusual manifestation of neurocysticercosis.
Neurocysticercosis is the most common parasitic infestation involving the central nervous system in tropical countries. Common presentations are seizure, meningitis and increased intracranial pressure. The authors report a case of a 52-year-old woman with racemose neurocysticercosis in the subarachnoid space at the cistern of the brain through the lumbar cistern. ⋯ The histopathologic examination confirmed cysticercosis. After treatment by albendazole and surgical removal, she still developed recurrent spinal compression at a higher level and obstructive hydrocephalus. Finally, she died from status epilepticus and septic shock.
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Aloe vera has been used as a popular herbal medicine since ancient times for many conditions including burns. Much evidence has reported the efficacy of topical Aloe vera gel in the treatment of thermal burns through its different pharmacological actions. This review article consists of pathophysiology of the thermal burns, the botany and chemical constituents of Aloe vera, and therapeutic properties of Aloe vera on thermal burns. The mechanisms that may underlie its action include: anti-inflammation, antimicrobials, wound healing promotion, and biological/immunological modulation.
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A retrospective study was performed on 38 patients (23 males and 15 females) in whom the intubating laryngeal mask airway (ILMA) was used for airway management at Srinagarind and Siriraj Hospital in 2003. The patients 'age and weight ranged between 12 and 75 years and 40 and 94 kg, respectively. Difficult tracheal intubation was suspected before starting general anesthesia in 17 patients, whereas it was found difficult after induction of general anesthesia in 21. ⋯ In the four patients with failed tracheal intubation through the ILMA, three were successfully intubated with conventional laryngoscopy and one with gum elastic bougie. There were no serious complications following the use of the ILMA in these patients. The ILMA proved a safe, very useful and easy to use device with a high success rate for difficult airway management.
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Pain in normal labour can be relieved using many non-pharmacological methods including:- Techniques that reduce painful stimuli: Assuming various upright positions to ease the pain, encourage labour progress and increase the diameter of the pelvis. Techniques that activate peripheral sensory receptors: Of the various techniques used, intradermal injection of sterile water (ISW) results in over 50% of pain relief compared to 18% in the 'dry needling' group, Dahl V., Aarmes T. One RCT concluded that ISW is more effective than TENS for relieving low back pain in labour. Two trials, Erkkola et al and Bundsen et al found that mothers using TENS received good to moderate pain relief 48%: 37% and 31%: 55%. There were no ill effects produced in the newborn infant. The use of essential oils, lavender, frankincense and rose for relief of anxiety and fear were favourably reported by E. Burn et al. Also for the effectiveness rating of pain by parity and labour onset more women recorded a positive or equivocal score than a negative one. The use of Active Birth embraces many methods of non-pharmacological pain relief including using a humane approach and providing continuous emotional support by a companion or caregiver throughout labour. Two Bangkok hospitals, using Active Birth, showed a marked reduction in the use of pharmacological pain relief. ⋯ Pharmacological methods to help alleviate the pain of labour should only be used as a last resort.
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Pre-eclampsia, formerly called pregnancy-induced hypertension, refers to the new onset of hypertension (SBP > or = 140 mmHg or DBP > or = 90 mmHg) and proteinuria (> or = 0.3 g protein in a 24-hour urine specimen or 1+ on dipstick) after 20 weeks of gestation in a previously normotensive women. It is a life-threatening, multi-organ involvement disease and remains the leading cause of maternal death. Its clinical manifestations are the result of generalized vasospasm, activation of the coagulation system, and changes in several humoral and autoregulatory systems related to volume and blood pressure control. ⋯ To date, no screening test has been proved to be reliable and cost-effective. The prevention of pre-eclampsia with antioxidant therapy (vitamin C, E) has shown promise, but large, randomized trials are needed. Although controversy exists, calcium supplementation has shown no benefit in large trials, and most evidence suggests little or no benefit for low-dose aspirin as prevention in women in the low-risk category.