Journal of the Medical Association of Thailand = Chotmaihet thangphaet
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Multicenter Study
Anesthesia-related complications of caesarean delivery in Thailand: 16,697 cases from the Thai Anaesthesia Incidents Study.
Maternal complications related to anesthesia are low in comparison with the results from obstetric factors in developing countries. The purposes of the present study were to determine the incidence of maternal mortality related to anesthesia, to analyze the causes and to suggest measures to improve anesthetic safety for the parturients. ⋯ The authors found that inexperience, inadequate knowledge, inadequate care, and patient conditions were the major contributory factors. Most of them were preventable and correctable. Additional training and quality assurance can improve and prevent these serious adverse events.
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Streptococcus pneumoniae is a rarely recognized cause of neonatal sepsis. We report invasive pneumococcal infection in three neonates. ⋯ There was no identifiable risk factor. Maternal colonization should be further studied.
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Case Reports
Late manifestation of congenital cystic adenomatoid malformation with lung abscess: a case report.
Congenital cystic adenomatoid malformation (CCAM) is a rare congenital cystic abnormality of the lung. Most of cases are usually diagnosed and managed in the newborn period even though some are asymptomatic and present in childhood or adult. The authors report a 7-year-old girl who presented with chronic cough, hemoptysis and clubbing of fingers. ⋯ She continued to be healthy at a follow-up visit about 8 months postoperatively but chest radiograph showed soft tissue density at right upper lung field. Chest CT findings were compatible with recurrent CCAM. A follow-up chest radiograph at 13 months postoperatively showed significant reduction in size of the lesion.
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To determine the position of the lumbar vertebrae in relation to the intercrestal line and variation in distance between the midpoint of the L(4/5) interspinous space and the intercrestal line in varying patients age groups of Thai people. ⋯ The intercrestal line crosses the posterior part of the lumbar vertebral column between the upper half of L4 spinous process level and lower half of L5 spinous process level, most often at the lower half of L4 spinous process level (37.41%) and at the L(4/5) interspinous space level (27.78%). This line crosses the anterior part of the lumbar vertebral column between the upper half of L4 body level and lower half of L5 body level, most often at the upper half of L5 body level (38.15%) and at the L(4/5) intervertebral space level (32.22%). The level of the intercrestal line tends to be high in elderly patients, neutral position and the intercrestal line by palpation tends to be identified at the higher level.
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Baby EAR circuit is a new modified enclosed afferent reservoir anesthetic breathing system invented to use in pediatric patients. By following His Majesty the King of Thailand's self-sufficiency philosophy, the circuit is simplymade of low-cost and easy-to-find materials in the operating room. ⋯ Baby EAR circuit can be made economically and used safelyfor general anesthesia with spontaneous breathing in pediatric patients who weighed 5-20 kg at optimal fresh gas flow rate of > or = 2.5 LPM