Journal of the Medical Association of Thailand = Chotmaihet thangphaet
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To document the natural history of brachial plexus birth palsy in relation to the recovery of elbow flexion and shoulder flexion in the first six months of life; to assess the outcome after microsurgery of the brachial plexus in patients who had no recovery of bicep function at six months. ⋯ Most babies with traction injuries of the brachial plexus at birth have an excellent prognosis if the recovery has started within three months. Microsurgical reconstruction was effective in improving function in the small subgroup of patients with no evidence of recovery of bicep function within the first six months of life.
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Randomized Controlled Trial
Effects of vitamin E on chronic hepatitis C genotype 3: a randomized, double-blind, placebo-controlled study.
Hepatitis C virus (HCV) infection is associated with chronic inflammation and oxidative damage, with hepatic steatosis being common in genotype 3 cases. Vitamin E, a potent antioxidant protective against oxidative stress-induced liver damage in vitro and in vivo, has beneficial effects on alanine aminotransferase (ALT) and histological outcomes in patients with non-alcoholic steatohepatitis. ⋯ Vitamin E treatment decreased serum ALT levels in patients with HCV genotype 3. Because of its good safety profile, vitamin E may be a worthwhile supportive therapy for patients with HCV particularly for those who were unable to achieve viral eradication by standard therapy.
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Observational Study
Incidence of major adverse cardiac event in low risk chest pain patients in emergency department of Rajavithi Hospital.
Acute myocardial infarction is a major problem of public healthcare in Thailand. In the emergency room, patients who present chest pain are at low risk for myocardial infarction and short term risk of adverse cardiac events. In the present study, the incidence of major adverse cardiac events among low risk chest pain patients who presented at the emergency room of Rajavithi Hospital was investigated to improve treatment in the future. ⋯ Incidence of a major adverse cardiac event within 30 days among low risk chest pain patients was low. No significant difference was observed between each group of TIMI score 0-2 for major adverse cardiac event and no significant risk factor was found for major adverse cardiac events in low risk chest pain patients.
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Acute kidney injury (AKI) is a common complication in patients undergoing open cardiac surgery. Urinary neutrophil gelatinase-associated lipocalin (UNGAL) is an early marker of AKI, however its predictive value in adult patients undergoing open cardiac surgery has never been investigated in Thailand. ⋯ UNGAL level may be a useful marker for predicting AKI in Thai adult patients undergoing open cardiac surgery. Lower ejection fraction and longer CPB time were two major risk factors for AKI development.
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Clinical Trial
Predictors for low disease activity and remission in rheumatoid arthritis patients treated with biological DMARDs.
Optimal outcome of treatment in rheumatoid arthritis (RA) is early clinical remission to delay joint damage. Therefore, severe RA patients with inadequate response to conventional disease modifying anti-rheumatic drugs (cDMARDs) need highpotency drug as biological DM4RDs (bDMARDs). In general, one-third of RA patient could not get into disease remission with cDMARDs, and half ofthem are still suffering from severe arthritis. However, high cost of this agent is the major barrier for patient engagement, and it is affordable to only 5-10% of patients. We need a good strategy to distribute bDMARDs to patients, especially in limited resource situation. ⋯ Chance to control rheumatoid arthritis in the level of remission or low disease activity is predicted by time of bDAMRDs exposure. This result is mainly influenced by dose ofmethotrexate and number of cDMARDs.