Journal of the Medical Association of Thailand = Chotmaihet thangphaet
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Meta Analysis Comparative Study
Proton pump inhibitors for the prevention of stress-related mucosal disease in critically-ill patients: a meta-analysis.
Despite the scanty data, proton pump inhibitors (PPI) are widely used for stress-related mucosal disease (SRMD) prophylaxis. There were few studies using PPI for SRMD prophylaxis but the results were conflicting, most probably due to inadequate sample size. The present meta-analysis aimed to determine the efficacy of PPI, as compared to histamine-2 receptor antagonists (H2RA) in the prevention of SRMD in critically-ill patients. ⋯ The use of PPI for SRMD prophylaxis was associated with a significantly lower rate of clinically important bleeding than H2RA with similar rates of nosocomial pneumonia.
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Randomized Controlled Trial Comparative Study
Lower uterine segment compression for management of early postpartum hemorrhage after vaginal delivery at Charoenkrung Pracharak Hospital.
1. To evaluate the efficacy of lower uterine compression method in treatment of postpartum hemorrhage (PPH). 2. To compare the amount of blood loss in PPH between the lower uterine compression method and the conventional treatment. ⋯ The lower uterine compression method is a very effective procedure for treating PPH. It is simple to use, safe and no cost. This technique is an innovative scheme in the obstetrics field. The more efficient treatment of PPH would have a positive impact on the outcome of many patients who have postpartum hemorrhage, leading to the reduction in morbidity or even save the lives of patients.
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Randomized Controlled Trial
Effects of dual blockade of renin-angiotensin system in type 2 diabetes mellitus patients with diabetic nephropathy.
Angiotensin-converting enzyme (ACE) inhibitors or angiotensin II receptor blockers (ARB) have been shown to delay the progression to proteinuria and kidney failure in hypertensive type 2 diabetic patients with diabetic nephropathy. Further synergistic effect may be obtained by combined therapy with both ARB and ACE inhibitors. ⋯ Adding maximal recommended dose of ARB with maximal recommended dose of ACE inhibitors in type 2 diabetic patients can reduce proteinuria more than ACE inhibitors alone. This treatment is safe and well tolerated.
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Multiple lines of evidence have indicated that the dose of hemodialysis (HD) affects patient outcome. According to K-DOQI, daily spKt/V > 1.2 predicts the morbidity and mortality among thrice-weekly HD. However in developing countries, about three-fourths of end stage renal disease patients undergo twice-weekly HD. No data studied the outcome and nutritional status between twice- and thrice-weekly HD patients. ⋯ HD patients with delivered weekly Kt/V > 3.6, nutritional status of patients undergoing twice-weekly HD are not different from that of thrice-weekly HD patients. Higher energy intake in twice-weekly HD patients might be the explanation.
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Baby EAR circuit is a new modified enclosed afferent reservoir anesthetic breathing system for pediatric patients. By following His Majesty the King of Thailand's self-sufficiency philosophy, the circuit is simple and made of low-cost and easy-to-find materials found in the operating room. This present study was to investigate clinical use of the circuit and to find the optimal fresh gas flow in clinical setting. ⋯ Baby EAR circuit can be made economically and used safely for general anesthesia with control ventilation in pediatric patients weighing 5 to 20 kg at optimal fresh gas flow of 3 LPM.