Health Science Clinical Research

General Consideration for Non-operating Room Anesthesia

2023-10-26T20:25:47+07:00

Non-operating room anaesthesia (NORA) is an anaesthetic procedure, taken place in remote locations in the hospital, outside traditional operating room. In past several years, the growing field of NORA was suited for several procedures and places, for example, interventional and nuclear radiology, cardiac catheterization, Gastrointestinal endoscopy, Interventional neuroradiology procedure and dental clinic. The challenges of NORA are unfamiliarity to environments and settings, post-anaesthetic complications management difficulty, dealing with patient comorbidity, as well as other setting and staff limitations, which directly affected to patient risk and outcome. According to limitations, the NORA principle is needed to enhance patient safety in several aspects, for example, preoperative evaluation, machine and equipment preparation, patient monitoring, post-operative and discharge planning, as well as emergency complications management.^1-3

Keywords: Non-operating room anesthesia, Preoperative assessment, Comorbidity, complications

Study of WBC and MCV of Blood Donors Effect to the Quality of Leukocyte Poor Packed Red Cells at Phuket Regional Blood Centre

2023-12-06T11:49:19+07:00

Objective: This research aim to study WBC and MCV from Complete Blood Count (CBC) in blood donors effect to the quality of leukocyte content in leukocyte poor packed red cells (LPRC) at Phuket Regional Blood Centre

Methods: Random the blood donation (2 men 2 women) amount 4 units/day with K₂EDTA blood was collected for CBC testing by automated hematology analyzer. Divide LPRC separated by Kawasumi KL-521 automated separators and find out high leukocyte content in LPRC (> 1.2 x 10⁹cells/unit) from blood donors between January to December 2018 amount 1,448/30,977 units (4.67%)

Results: The results showed that the amount of LPRC with high leukocyte content 332/1,448 units (22.93%) in case of high WBC from whole blood (parameter WBC > 8,000 cells/µL) 200 units (60.25%) low MCV (parameter MCV < 80 fL) 121 units (36.45%) and WB mixed with high leukocyte content and low MCV 63 units (18.98%). Conclusion: high WBC and low MCV of blood donors effect to the quality of LPRC (p < 0.05). Therefore, donor screening from the first step is very important. Then, the preparation of LPRC should be considered testing with automated hematology analyzer with criteria WBC < 8,000 cells/µL and MCV > 80 fL before blood donation as confirmed by this study

The Association of Asthma or Reactive Airway Disease in early childhood (2-6 years) with low birth weight

2024-01-01T17:10:16+07:00

Abstract

Objective: To study association of asthma or reactive airway disease in early childhood (2-6 years) with low birth weight.

Methods: Studying of 258 infants in Uttaradit hospital from January 1^st, 2015 – December 31^st, 2015. Collecting data from ICD-10 (Z380-P071) medical records divided into 2 groups that were 129 low birth weight infants and 129 normal birth weight infants to assess the combined association of early childhood asthma, reactive airway disease and low birth weight. All data were analyzed by descriptive and analytic study

Results: Low birth weight infants were not significant in asthma or reactive airway disease between age 2 and 6 years old (relative risk 6.08, 95%CI 0.61-60.63, p=0.124)

Conclusion: Association of asthma or reactive airway disease in early childhood (2-6 years) with low birth weight were not significant compared with normal birth weight.

The Prevalence of Pathogen and Clinical Outcomes of Infective Endocarditis in Uttaradit Hospital

2023-10-26T20:14:20+07:00

Background: Infective endocarditis (IE) is a severe cardiac infection that affects individuals with multiple cardiac valve conditions. In Thailand, the overall in-hospital mortality rate is high, and people in Uttaradit province are at risk of exposure to Streptococcus Suis due to certain behaviors and occupations. However, data on the prevalence of pathogens and clinical outcomes, especially Streptococcus Suis, at Uttaradit hospital are limited.

Methods: This retrospective cohort study collected data from left-sided, native-valve endocarditis patients who underwent echocardiography at Uttaradit Hospital between January 2017 and December 2022. Patients were stratified by the organism, and the primary outcome was in-hospital death. The secondary outcome was death at 6 months of follow-up.

Results: Of the 69 patients with IE included in the study, Streptococcus Suis was the most prevalent pathogen 17 patients (24.6%). In-hospital mortality and any death at 6 months were 24.6% and 33.3%, respectively. The Streptococcus Suis group had a numerically higher in-hospital mortality than the non-Streptococcus Suis group (29.4% vs. 23.1%), but the difference was not significant (HR=1.35, CI 0.48-3.84, p=0.569). At 6 months, all-cause mortality in both groups was 47.1% and 28.8%, respectively (HR=1.64, CI 0.74-4.10, p=0.207). The study found that in univariate analysis, T2DM, Euroscore II, and alteration of consciousness were all associated with 6-month mortality in IE patients. However, in multivariate analysis, only alteration of consciousness remained a significant predictor of mortality, with a hazard ratio of 4.96, 95% CI 1.88-13.08, and p=0.001.

Conclusion: The overall in-hospital mortality and 6-month mortality rate of IE at Uttaradit hospital were high. Streptococcus Suis was prevalent, but not significantly associated with higher mortality compared to other organisms.

Keywords: Infective endocarditis, Uttaradit, mortality, Streptococcus suis