Pub Date : 2023-07-14DOI: 10.35755/jmedassocthai.2023.07.13862
Background: Cardiopulmonary bypass (CPB) activates inflammatory and fibrinolytic pathways, potentially disrupting hemostasis. Transfusion of non-red cell blood product is a conventional method of restoring hemostasis and treating coagulopathy and thrombocytopenia, the two common adverse outcomes of CPB. Objective: To determine the incidence and outcomes of postoperative thrombocytopenia and coagulopathy in adult Thai cardiac surgery patients with CPB receiving non-red cell blood product transfusions. Materials and Methods: The present study included patients aged 18 years and older that underwent cardiac surgery with CPB at Siriraj Hospital between January 2017 and June 2018. Enrolled patients were divided into four groups, no non-red cell blood products in Group 1, platelets (PLT) only in Group 2, fresh frozen plasma (FFP) and/or cryoprecipitate (cryo) in Group 3, and PLT, FFP and/or cryo in Group 4. Patients, clinical status and histories, intraoperative outcomes, and perioperative outcomes were collected and assessed for all groups. Postoperative thrombocytopenia was defined by PLT counts less than 100,000 cells/mm³. Coagulopathy was defined by prothrombin time (PT) or activated partial thromboplastin time (aPTT) greater than 1.5 of its institutional reference values. Non-red cell blood product transfusions for cardiac patients were determined by their attending physician. Results: Of the 360 patients included, 61.7% were male, with a mean (±SD) age of 65.3±11.7 years, and BMI of 24.1±4.0 kg/m². Most patients were classified as ASA-PS class 3 (71.9%), had elective surgeries (96.4%), history of antiplatelet use (65.8%), and coronary artery bypass graft (CABG) surgical procedure (56.9%). Postoperative thrombocytopenia was significantly more prevalent in Group 1 at 11.6%, followed by Group 3 at 9.5%, Group 4 at 3.7%, and Group 2 at 0% (p=0.010). Post-operative coagulopathy was more prevalent in Group 3 at 4.8%, followed by Group 2 at 4.1%, Group 1 at 3.9%, and Group 4 at 0.7%. Group 4 had a significantly greater incidence of anticoagulant use at 17.8% (p=0.007) and significantly longer CPB durations compared to the other groups at 146.6±74.7 minutes (p<0.01). Conclusion: The researchers’ study confirmed that preoperative antithrombotic use prior to cardiac surgical procedures and longer CPB duration influences physicians’ decision to transfuse. The present study recommended prohibiting prophylactic administration of FFP and PLT as well as implementing restrictive non-red cell blood product transfusion strategies. Keywords: Thrombocytopenia; Coagulopathy; Non-red Cell Blood Product Transfusion; Cardiopulmonary Bypass; Cardiac Surgery
{"title":"Postoperative Thrombocytopenia and Coagulopathy in Cardiac Surgery with Cardiopulmonary Bypass: Incidence and Outcomes after Non-Red Cell Blood Product Transfusion","authors":"","doi":"10.35755/jmedassocthai.2023.07.13862","DOIUrl":"https://doi.org/10.35755/jmedassocthai.2023.07.13862","url":null,"abstract":"Background: Cardiopulmonary bypass (CPB) activates inflammatory and fibrinolytic pathways, potentially disrupting hemostasis. Transfusion of non-red cell blood product is a conventional method of restoring hemostasis and treating coagulopathy and thrombocytopenia, the two common adverse outcomes of CPB.\u0000\u0000Objective: To determine the incidence and outcomes of postoperative thrombocytopenia and coagulopathy in adult Thai cardiac surgery patients with CPB receiving non-red cell blood product transfusions.\u0000\u0000Materials and Methods: The present study included patients aged 18 years and older that underwent cardiac surgery with CPB at Siriraj Hospital between January 2017 and June 2018. Enrolled patients were divided into four groups, no non-red cell blood products in Group 1, platelets (PLT) only in Group 2, fresh frozen plasma (FFP) and/or cryoprecipitate (cryo) in Group 3, and PLT, FFP and/or cryo in Group 4. Patients, clinical status and histories, intraoperative outcomes, and perioperative outcomes were collected and assessed for all groups. Postoperative thrombocytopenia was defined by PLT counts less than 100,000 cells/mm³. Coagulopathy was defined by prothrombin time (PT) or activated partial thromboplastin time (aPTT) greater than 1.5 of its institutional reference values. Non-red cell blood product transfusions for cardiac patients were determined by their attending physician.\u0000\u0000Results: Of the 360 patients included, 61.7% were male, with a mean (±SD) age of 65.3±11.7 years, and BMI of 24.1±4.0 kg/m². Most patients were classified as ASA-PS class 3 (71.9%), had elective surgeries (96.4%), history of antiplatelet use (65.8%), and coronary artery bypass graft (CABG) surgical procedure (56.9%). Postoperative thrombocytopenia was significantly more prevalent in Group 1 at 11.6%, followed by Group 3 at 9.5%, Group 4 at 3.7%, and Group 2 at 0% (p=0.010). Post-operative coagulopathy was more prevalent in Group 3 at 4.8%, followed by Group 2 at 4.1%, Group 1 at 3.9%, and Group 4 at 0.7%. Group 4 had a significantly greater incidence of anticoagulant use at 17.8% (p=0.007) and significantly longer CPB durations compared to the other groups at 146.6±74.7 minutes (p<0.01).\u0000\u0000Conclusion: The researchers’ study confirmed that preoperative antithrombotic use prior to cardiac surgical procedures and longer CPB duration influences physicians’ decision to transfuse. The present study recommended prohibiting prophylactic administration of FFP and PLT as well as implementing restrictive non-red cell blood product transfusion strategies.\u0000\u0000Keywords: Thrombocytopenia; Coagulopathy; Non-red Cell Blood Product Transfusion; Cardiopulmonary Bypass; Cardiac Surgery","PeriodicalId":17486,"journal":{"name":"Journal of the Medical Association of Thailand = Chotmaihet thangphaet","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74860950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-14DOI: 10.35755/jmedassocthai.2023.07.13866
The nasoalveolar region is an uncommon area of all rhabdomyosarcoma (RMS) cases. RMS has a bimodal distribution in children, occurring in those aged two to four years and 12 to 16 years. The authors presented an unusual case of alveolar RMS that presented at a young age, in an uncommon region, with an atypical presentation, and imaging findings mimicking organized hematoma and complicated nasoalveolar cyst. Confounding as a result of the presence of trauma can delay diagnosis and treatment. Keywords: Nasoalveolar; Rhabdomyosarcoma; Hematoma
{"title":"Nasoalveolar Rhabdomyosarcoma Presenting as Traumatic Nasal Injury: A Rare Case Report Mimicking Organized Hematoma","authors":"","doi":"10.35755/jmedassocthai.2023.07.13866","DOIUrl":"https://doi.org/10.35755/jmedassocthai.2023.07.13866","url":null,"abstract":"The nasoalveolar region is an uncommon area of all rhabdomyosarcoma (RMS) cases. RMS has a bimodal distribution in children, occurring in those aged two to four years and 12 to 16 years. The authors presented an unusual case of alveolar RMS that presented at a young age, in an uncommon region, with an atypical presentation, and imaging findings mimicking organized hematoma and complicated nasoalveolar cyst. Confounding as a result of the presence of trauma can delay diagnosis and treatment.\u0000\u0000Keywords: Nasoalveolar; Rhabdomyosarcoma; Hematoma","PeriodicalId":17486,"journal":{"name":"Journal of the Medical Association of Thailand = Chotmaihet thangphaet","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91196858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-14DOI: 10.35755/jmedassocthai.2023.07.13864
Background: Psoriasis is a chronic non-infectious inflammatory skin disease caused by genetic and environmental predispositions. There is a Thai herbal remedy for psoriasis recorded in Wat Pho’s marble inscriptions, consisting of Dictyophora indusiate Fisch, Psilocybe cubensis (Earle) Sing, and sesame oil. Objective: To compare the efficacy and safety of a Thai herbal remedy as an alternative treatment to the standard treatment of 0.1% triamcinolone lotion in patients with mild chronic plaque psoriasis. Materials and Methods: A randomized, split-body controlled design was conducted in 30 mild chronic plaque-type psoriasis patients with symmetrically distributed psoriasis rashes. Each patient was randomized to apply a Thai herbal remedy on a rash on one side of the body and 0.1% triamcinolone lotion on the other side, using the same dosage of twice daily for eight weeks. Efficacy was assessed at week 1, 2, 4, and 8 by the Targeted Area Score (TAS). The Self-Assessment Score (SAS) at week 8 was compared to the baseline. Safety was assessed through the interviews at each visit. Product satisfaction was evaluated by the visual analog scale (VAS). Results: The TAS and SAS for erythema, desquamation, and induration decreased in both treatment groups, with no significant difference. However, product satisfaction in color (p=0.012), odor (p=0.013), and absorption (p=0.003) were significantly higher in the 0.1% triamcinolone lotion group. Conclusion: The present study showed that the Thai herbal remedy was safe and efficacious in treating chronic plaque-type psoriasis, therefore, can be used as an alternative treatment. Keywords: Thai herbal remedy; Psoriasis; Dictyophora indusiate Fisch; Psilocybe cubensis (Earle) Sing; Sesame oil
{"title":"Efficacy of a Thai Herbal Remedy in Patients with Mild Chronic Plaque Psoriasis: An Observer-Blinded Randomized, Standard Treatment-Controlled Trial","authors":"","doi":"10.35755/jmedassocthai.2023.07.13864","DOIUrl":"https://doi.org/10.35755/jmedassocthai.2023.07.13864","url":null,"abstract":"Background: Psoriasis is a chronic non-infectious inflammatory skin disease caused by genetic and environmental predispositions. There is a Thai herbal remedy for psoriasis recorded in Wat Pho’s marble inscriptions, consisting of Dictyophora indusiate Fisch, Psilocybe cubensis (Earle) Sing, and sesame oil.\u0000\u0000Objective: To compare the efficacy and safety of a Thai herbal remedy as an alternative treatment to the standard treatment of 0.1% triamcinolone lotion in patients with mild chronic plaque psoriasis.\u0000\u0000Materials and Methods: A randomized, split-body controlled design was conducted in 30 mild chronic plaque-type psoriasis patients with symmetrically distributed psoriasis rashes. Each patient was randomized to apply a Thai herbal remedy on a rash on one side of the body and 0.1% triamcinolone lotion on the other side, using the same dosage of twice daily for eight weeks. Efficacy was assessed at week 1, 2, 4, and 8 by the Targeted Area Score (TAS). The Self-Assessment Score (SAS) at week 8 was compared to the baseline. Safety was assessed through the interviews at each visit. Product satisfaction was evaluated by the visual analog scale (VAS).\u0000\u0000Results: The TAS and SAS for erythema, desquamation, and induration decreased in both treatment groups, with no significant difference. However, product satisfaction in color (p=0.012), odor (p=0.013), and absorption (p=0.003) were significantly higher in the 0.1% triamcinolone lotion group.\u0000\u0000Conclusion: The present study showed that the Thai herbal remedy was safe and efficacious in treating chronic plaque-type psoriasis, therefore, can be used as an alternative treatment.\u0000\u0000Keywords: Thai herbal remedy; Psoriasis; Dictyophora indusiate Fisch; Psilocybe cubensis (Earle) Sing; Sesame oil","PeriodicalId":17486,"journal":{"name":"Journal of the Medical Association of Thailand = Chotmaihet thangphaet","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80506101","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-14DOI: 10.35755/jmedassocthai.2023.07.13780
Objective: To compare the American Thyroid Association (ATA) classification system of 2015 with the American College of Radiology (ACR) Thyroid Imaging Reporting and Data System (TI-RADS) of 2017 to determine the superior system to predict cancer risk in thyroid nodules. Materials and Methods: The present study was a retrospective study that included patients with thyroid nodule(s) referred to the department of radiology for fine-needle aspiration (FNA) between February 2019 and March 2021. The authors assessed the ability of either system to predict malignancy based on FNA cytology results. Sensitivity, specificity, negative predictive values (NPV), and positive predictive values (PPV) were calculated. Results: One hundred sixty-five nodules were reviewed based on the ATA guideline of 2015 and ACR-TI-RADS of 2017. The sensitivity, specificity, PPV, and NPV of the ATA guidelines were 95.45%, 65.04%, 29.58%, and 98.94%, respectively, while that of the ACR-TI-RADS were 95.45%, 62.24%, 28%, and 98.89%, respectively. Conclusion: The ATA guidelines of 2015 and the ACR-TI-RADS of 2017 have comparable sensitivity and NPV for thyroid carcinoma diagnosis with moderate specificity for both systems. These results confirm a high probability of both systems rejecting malignancy. Keywords: Thyroid; FNA; ATA guideline; ACR-TI-RADs
{"title":"Diagnostic Accuracy of Thyroid Cancer Using the American Thyroid Association Guidelines and American College of Radiology-Thyroid Imaging Reporting and Data System","authors":"","doi":"10.35755/jmedassocthai.2023.07.13780","DOIUrl":"https://doi.org/10.35755/jmedassocthai.2023.07.13780","url":null,"abstract":"Objective: To compare the American Thyroid Association (ATA) classification system of 2015 with the American College of Radiology (ACR) Thyroid Imaging Reporting and Data System (TI-RADS) of 2017 to determine the superior system to predict cancer risk in thyroid nodules.\u0000\u0000Materials and Methods: The present study was a retrospective study that included patients with thyroid nodule(s) referred to the department of radiology for fine-needle aspiration (FNA) between February 2019 and March 2021. The authors assessed the ability of either system to predict malignancy based on FNA cytology results. Sensitivity, specificity, negative predictive values (NPV), and positive predictive values (PPV) were calculated.\u0000\u0000Results: One hundred sixty-five nodules were reviewed based on the ATA guideline of 2015 and ACR-TI-RADS of 2017. The sensitivity, specificity, PPV, and NPV of the ATA guidelines were 95.45%, 65.04%, 29.58%, and 98.94%, respectively, while that of the ACR-TI-RADS were 95.45%, 62.24%, 28%, and 98.89%, respectively.\u0000\u0000Conclusion: The ATA guidelines of 2015 and the ACR-TI-RADS of 2017 have comparable sensitivity and NPV for thyroid carcinoma diagnosis with moderate specificity for both systems. These results confirm a high probability of both systems rejecting malignancy.\u0000\u0000Keywords: Thyroid; FNA; ATA guideline; ACR-TI-RADs","PeriodicalId":17486,"journal":{"name":"Journal of the Medical Association of Thailand = Chotmaihet thangphaet","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77195695","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-14DOI: 10.35755/jmedassocthai.2023.07.13765
Background: Secondary pulmonary infection (SPI) is a severe complication in patients with COVID-19. Objective: To investigate the risk factors, mortality rates, and complications associated with SPI in hypoxemic COVID-19 pneumonia patients. Materials and Methods: A retrospective cohort study was conducted at Saraburi Hospital, analyzing medical records of 512 hospitalized COVID-19 patients. The Fine-Gray model identified risk factors for SPI. Results: SPI was diagnosed in 25.4% of hypoxemic COVID-19 pneumonia patients. SPI patients (mean age of 65.9±15.1 years) had higher inflammation biomarkers, increased in-hospital mortality (IHM), and more complications than non-SPI patients. The primary pathogens causing IHM were gram-negative bacteria in 59.23%. Risk factors for SPI included age of 65 years or older (sHR 1.52; 95% CI 1.03 to 2.25; p=0.032), obesity (sHR 1.52; 95% CI 1.04 to 2.23; p=0.028), invasive mechanical ventilation (sHR 2.87; 95% CI 1.64 to 5.02; p<0.001), lactate dehydrogenase (LDH) level of 520 U/L or more (sHR 2.37; 95% CI 1.69 to 3.33; p=0.027), and catheter-related bloodstream infection (sHR 2.74; 95% CI 1.71 to 4.40; p<0.001). SPI patients had an IHM rate of 74.62%. Multivariable analysis showed higher IHM in SPI patients (aOR 5.29; 95% CI 2.70 to 10.36) compared to non-SPI patients. Conclusion: SPI is a common and harmful complication in hypoxemic COVID-19 pneumonia. Older age, obesity, invasive mechanical ventilation, elevated LDH levels, and catheter-related bloodstream infection are significant risk factors for SPI. Early detection and prevention strategies are crucial to mitigate the short-term consequences of SPI in COVID-19 patients. Keywords: COVID-19; Secondary pulmonary infection; Mortality; Risk factors
背景:继发性肺部感染(SPI)是COVID-19患者的严重并发症。目的:探讨低氧血症COVID-19肺炎患者SPI相关危险因素、死亡率及并发症。材料与方法:在萨拉布里医院进行回顾性队列研究，分析512例住院COVID-19患者的医疗记录。Fine-Gray模型确定了SPI的危险因素。结果:新冠肺炎低氧血症患者SPI阳性率为25.4%。SPI患者(平均年龄65.9±15.1岁)比非SPI患者有更高的炎症生物标志物、更高的住院死亡率(IHM)和更多的并发症。引起IHM的主要病原菌为革兰氏阴性菌，占59.23%。SPI的危险因素包括65岁及以上(sHR 1.52;95% CI 1.03 ~ 2.25;p=0.032)，肥胖(sHR 1.52;95% CI 1.04 ~ 2.23;p=0.028)，有创机械通气(sHR 2.87;95% CI 1.64 ~ 5.02;p<0.001)，乳酸脱氢酶(LDH)水平520 U/L及以上(sHR 2.37;95% CI 1.69 ~ 3.33;p=0.027)，导管相关血流感染(sHR 2.74;95% CI 1.71 - 4.40;p < 0.001)。SPI患者的IHM率为74.62%。多变量分析显示SPI患者IHM较高(aOR 5.29;95% CI 2.70 - 10.36)与非spi患者相比。结论:SPI是COVID-19低氧性肺炎常见且有害的并发症。老年、肥胖、有创机械通气、LDH水平升高和导管相关血流感染是SPI的重要危险因素。早期发现和预防策略对于减轻COVID-19患者SPI的短期后果至关重要。关键词:COVID-19;继发性肺部感染;死亡率;风险因素
{"title":"Predictive Factors and Impact of Secondary Pulmonary Infection on Mortality in Patients with Hypoxemic COVID-19 Pneumonia: A Retrospective Cohort Study","authors":"","doi":"10.35755/jmedassocthai.2023.07.13765","DOIUrl":"https://doi.org/10.35755/jmedassocthai.2023.07.13765","url":null,"abstract":"Background: Secondary pulmonary infection (SPI) is a severe complication in patients with COVID-19.\u0000\u0000Objective: To investigate the risk factors, mortality rates, and complications associated with SPI in hypoxemic COVID-19 pneumonia patients.\u0000\u0000Materials and Methods: A retrospective cohort study was conducted at Saraburi Hospital, analyzing medical records of 512 hospitalized COVID-19 patients. The Fine-Gray model identified risk factors for SPI.\u0000\u0000Results: SPI was diagnosed in 25.4% of hypoxemic COVID-19 pneumonia patients. SPI patients (mean age of 65.9±15.1 years) had higher inflammation biomarkers, increased in-hospital mortality (IHM), and more complications than non-SPI patients. The primary pathogens causing IHM were gram-negative bacteria in 59.23%. Risk factors for SPI included age of 65 years or older (sHR 1.52; 95% CI 1.03 to 2.25; p=0.032), obesity (sHR 1.52; 95% CI 1.04 to 2.23; p=0.028), invasive mechanical ventilation (sHR 2.87; 95% CI 1.64 to 5.02; p<0.001), lactate dehydrogenase (LDH) level of 520 U/L or more (sHR 2.37; 95% CI 1.69 to 3.33; p=0.027), and catheter-related bloodstream infection (sHR 2.74; 95% CI 1.71 to 4.40; p<0.001). SPI patients had an IHM rate of 74.62%. Multivariable analysis showed higher IHM in SPI patients (aOR 5.29; 95% CI 2.70 to 10.36) compared to non-SPI patients.\u0000\u0000Conclusion: SPI is a common and harmful complication in hypoxemic COVID-19 pneumonia. Older age, obesity, invasive mechanical ventilation, elevated LDH levels, and catheter-related bloodstream infection are significant risk factors for SPI. Early detection and prevention strategies are crucial to mitigate the short-term consequences of SPI in COVID-19 patients.\u0000\u0000Keywords: COVID-19; Secondary pulmonary infection; Mortality; Risk factors","PeriodicalId":17486,"journal":{"name":"Journal of the Medical Association of Thailand = Chotmaihet thangphaet","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73041356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-14DOI: 10.35755/jmedassocthai.2023.07.13869
Background: Snoring is an important symptom that is associated with obstructive sleep apnea and increases the risk of adverse pregnancy outcomes. In Thailand, the prevalence of snoring during pregnancy is uncertain. Determining the prevalence and characteristics may reduce the prevalence of snoring and improve pregnancy outcomes. Objective: The primary outcome was to determine the prevalence of snoring in Thai pregnant women in the third trimester, including pregnancy and chronic onset. The secondary outcome was to investigate the associations between pregnancy outcome and habitual snorer or those identified as high risk by the Thai Berlin Questionnaire. Materials and Methods: Three hundred eighty-two singleton pregnant women aged at least 18 years and at least 33 weeks of gestational age were recruited from the antenatal care clinic at Vajira Hospital, Navamindradhiraj University, between November 2021 and September 2022 and filled out the Thai Berlin Questionnaire. The 382 pregnant women were identified the presence of snoring or high risk of OSA in the previous month. Medical records, including demographic information and pregnancy outcomes, were collected, and analyzed. Results: The prevalence of snoring was 31.4% in the third trimester of pregnancy of which 27% were pregnancy onset snoring and 4.4% were chronic onset snoring. Habitual snoring was significantly different from non-snoring in regard to the requirement for positive-pressure ventilation in newborns (aOR 6.67, 95% CI 1.2 to 35.54). The high risk group had significantly more pregnancy induced hypertension than the low risk group (aOR 5.96, 95% CI 2.15 to 16.5), gestational hypertension (aOR 13.6, 95% CI 2.1 to 86.8), preeclampsia (aOR 4.07, 95% CI 1.09 to 15.2), severe preeclampsia (aOR 4.9, 95% CI 1.15 to 20.93), preterm birth (aOR 6.21, 95% CI 1.58 to 24.42), and low birth weight of newborn (aOR 6.09, 95% CI 2.5 to 14.87). Conclusion: The prevalence of snoring among Thai pregnant women was comparable to previous Western studies. Screening pregnant women at risk of the symptom may provide an early chance to lower the prevalence of snoring and adverse pregnancy outcomes. Keywords: Snoring; Snoring in pregnancy; Pregnancy outcomes
背景:打鼾是与阻塞性睡眠呼吸暂停有关的重要症状，并增加不良妊娠结局的风险。在泰国，怀孕期间打鼾的流行程度尚不确定。确定打鼾的患病率和特征可以减少打鼾的患病率，改善妊娠结局。目的:主要结局是确定泰国孕妇在妊娠晚期(包括妊娠和慢性发作)打鼾的患病率。次要结果是调查妊娠结局与习惯性打鼾者或泰国柏林问卷确定的高风险者之间的关系。材料与方法:在2021年11月至2022年9月期间，从Navamindradhiraj大学Vajira医院的产前保健诊所招募了382名年龄至少为18岁，孕龄至少为33周的单胎孕妇，并填写了泰国柏林问卷。382名孕妇在前一个月被确定有打鼾或阻塞性睡眠呼吸暂停的高风险。收集并分析了包括人口统计信息和妊娠结局在内的医疗记录。结果:妊娠晚期打鼾发生率为31.4%，其中妊娠性打鼾占27%，慢性打鼾占4.4%。在新生儿正压通气需求方面，习惯性打鼾组与非打鼾组差异有统计学意义(aOR为6.67,95% CI为1.2 ~ 35.54)。高危组妊高征发生率明显高于低危组(aOR 5.96, 95% CI 2.15 ~ 16.5)、妊娠期高血压发生率(aOR 13.6, 95% CI 2.1 ~ 86.8)、先兆子痫发生率(aOR 4.07, 95% CI 1.09 ~ 15.2)、重度先兆子痫发生率(aOR 4.07, 95% CI 1.15 ~ 20.93)、早产发生率(aOR 6.21, 95% CI 1.58 ~ 24.42)、新生儿低出生体重发生率(aOR 6.09, 95% CI 2.5 ~ 14.87)。结论:泰国孕妇打鼾的患病率与之前的西方研究相当。筛查有症状风险的孕妇可能提供早期机会，降低打鼾的患病率和不良妊娠结局。关键词:打鼾;怀孕时打鼾;妊娠结局
{"title":"Prevalence of Snoring in Pregnancy and Its Maternal-Fetal Outcomes at Vajira Hospital","authors":"","doi":"10.35755/jmedassocthai.2023.07.13869","DOIUrl":"https://doi.org/10.35755/jmedassocthai.2023.07.13869","url":null,"abstract":"Background: Snoring is an important symptom that is associated with obstructive sleep apnea and increases the risk of adverse pregnancy outcomes. In Thailand, the prevalence of snoring during pregnancy is uncertain. Determining the prevalence and characteristics may reduce the prevalence of snoring and improve pregnancy outcomes.\u0000\u0000Objective: The primary outcome was to determine the prevalence of snoring in Thai pregnant women in the third trimester, including pregnancy and chronic onset. The secondary outcome was to investigate the associations between pregnancy outcome and habitual snorer or those identified as high risk by the Thai Berlin Questionnaire.\u0000\u0000Materials and Methods: Three hundred eighty-two singleton pregnant women aged at least 18 years and at least 33 weeks of gestational age were recruited from the antenatal care clinic at Vajira Hospital, Navamindradhiraj University, between November 2021 and September 2022 and filled out the Thai Berlin Questionnaire. The 382 pregnant women were identified the presence of snoring or high risk of OSA in the previous month. Medical records, including demographic information and pregnancy outcomes, were collected, and analyzed.\u0000\u0000Results: The prevalence of snoring was 31.4% in the third trimester of pregnancy of which 27% were pregnancy onset snoring and 4.4% were chronic onset snoring. Habitual snoring was significantly different from non-snoring in regard to the requirement for positive-pressure ventilation in newborns (aOR 6.67, 95% CI 1.2 to 35.54). The high risk group had significantly more pregnancy induced hypertension than the low risk group (aOR 5.96, 95% CI 2.15 to 16.5), gestational hypertension (aOR 13.6, 95% CI 2.1 to 86.8), preeclampsia (aOR 4.07, 95% CI 1.09 to 15.2), severe preeclampsia (aOR 4.9, 95% CI 1.15 to 20.93), preterm birth (aOR 6.21, 95% CI 1.58 to 24.42), and low birth weight of newborn (aOR 6.09, 95% CI 2.5 to 14.87).\u0000\u0000Conclusion: The prevalence of snoring among Thai pregnant women was comparable to previous Western studies. Screening pregnant women at risk of the symptom may provide an early chance to lower the prevalence of snoring and adverse pregnancy outcomes.\u0000\u0000Keywords: Snoring; Snoring in pregnancy; Pregnancy outcomes","PeriodicalId":17486,"journal":{"name":"Journal of the Medical Association of Thailand = Chotmaihet thangphaet","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75426169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-06-15DOI: 10.35755/jmedassocthai.2023.06.13860
Background: Given the ongoing impact of the COVID-19 pandemic, self-risk assessment tools are crucial for individuals, particularly the working-age group, to evaluate their infection risk. There is a lack of such tools as of early 2021. Objective: To develop and evaluate the effectiveness of the self-assessment test application named Thai Save Thai (TST) for determining individuals’ risk level of COVID-19 infection before entering premises. Materials and Methods: The present research consisted of two phases between April 2021 and July 2022. In the first phase, factory workers from all regions of the country were recruited using population allocation sampling. TST was used for self-assessment three times within two-week period to determine risk levels. The second phase evaluated the sensitivity, specificity and predictive value of TST among 320 subjects underwent reverse transcription polymerase chain reaction (RT-PCR) testing. Results: TST showed varying percentages for each risk level: normal, 44.4%, 38.8%, 29.2%; low, 54.3%, 60.8%, 70.5%; high, 0.2%, 0.02%, 0.1%; very high, 1.1%, 0.36%, 0.21%; and infection results, 0.02%, 0%, 0.05%. TST indicated a sensitivity of 95.7% (95% CI 87.3 to 104.0), a specificity of 75.0% (95% CI 63.2 to 86.8) for detecting infection. Sensitivity for very high-risk level was 85.7% (95% CI 59.8 to 111.6) with 63.9% specificity (95% CI 51.9 to 76.0). The high-risk level had a sensitivity of 75% (95% CI 32.6 to 117) with specificity of 28.1% (95% CI 20.6 to 35.5), while the low-risk level had sensitivity of 90% (95% CI 71.4 to 109.0) with specificity of 27.1% (95% CI 19.8 to 34.3). The negative predictive value (NPV) were the same value as 97.5% at all results. Conclusion: TST application is a self-risk screening tool that effectively discriminates between different risk levels and provides sensitivity for detecting infection with NPV for all assessment results. This application can enable individuals to assess their risk level of COVID-19 infection before entering any premises. Keywords: Self-risk assessment; COVID-19; Infection; Verify of entry; Working-age
背景:鉴于2019冠状病毒病大流行的持续影响，自我风险评估工具对于个人，特别是工作年龄群体，评估其感染风险至关重要。到2021年初，还缺乏这样的工具。目的:开发并评价泰铢自评测试应用程序(TST)在个人进入场所前确定COVID-19感染风险水平的有效性。材料与方法:本研究分为2021年4月至2022年7月两个阶段。在第一阶段，采用人口分配抽样方法从全国所有地区招募工厂工人。TST在两周内进行三次自我评估，以确定风险水平。第二阶段对320名接受逆转录聚合酶链反应(RT-PCR)检测的受试者进行TST的敏感性、特异性和预测值评估。结果:TST在不同危险水平中所占比例不同:正常、44.4%、38.8%、29.2%;低，54.3%，60.8%，70.5%;高，0.2%，0.02%，0.1%;非常高，1.1%，0.36%，0.21%;感染结果分别为0.02%、0%、0.05%。TST检测感染的敏感性为95.7% (95% CI 87.3 ~ 104.0)，特异性为75.0% (95% CI 63.2 ~ 86.8)。高危水平的敏感性为85.7% (95% CI 59.8 ~ 111.6)，特异性为63.9% (95% CI 51.9 ~ 76.0)。高危水平的敏感性为75% (95% CI 32.6 ~ 117)，特异性为28.1% (95% CI 20.6 ~ 35.5)，低危水平的敏感性为90% (95% CI 71.4 ~ 109.0)，特异性为27.1% (95% CI 19.8 ~ 34.3)。阴性预测值(NPV)均为97.5%。结论:TST应用是一种自我风险筛查工具，可有效区分不同风险水平，并对所有评估结果提供检测NPV感染的敏感性。该应用程序可以使个人在进入任何场所之前评估其感染COVID-19的风险水平。关键词:自我风险评估;COVID-19;感染;入境证明;工作年龄
{"title":"Effectiveness of COVID-19 Self-Risk Assessment Tool for Infection Prevention among Working-Age Population","authors":"","doi":"10.35755/jmedassocthai.2023.06.13860","DOIUrl":"https://doi.org/10.35755/jmedassocthai.2023.06.13860","url":null,"abstract":"Background: Given the ongoing impact of the COVID-19 pandemic, self-risk assessment tools are crucial for individuals, particularly the working-age group, to evaluate their infection risk. There is a lack of such tools as of early 2021.\u0000\u0000Objective: To develop and evaluate the effectiveness of the self-assessment test application named Thai Save Thai (TST) for determining individuals’ risk level of COVID-19 infection before entering premises.\u0000\u0000Materials and Methods: The present research consisted of two phases between April 2021 and July 2022. In the first phase, factory workers from all regions of the country were recruited using population allocation sampling. TST was used for self-assessment three times within two-week period to determine risk levels. The second phase evaluated the sensitivity, specificity and predictive value of TST among 320 subjects underwent reverse transcription polymerase chain reaction (RT-PCR) testing.\u0000\u0000Results: TST showed varying percentages for each risk level: normal, 44.4%, 38.8%, 29.2%; low, 54.3%, 60.8%, 70.5%; high, 0.2%, 0.02%, 0.1%; very high, 1.1%, 0.36%, 0.21%; and infection results, 0.02%, 0%, 0.05%. TST indicated a sensitivity of 95.7% (95% CI 87.3 to 104.0), a specificity of 75.0% (95% CI 63.2 to 86.8) for detecting infection. Sensitivity for very high-risk level was 85.7% (95% CI 59.8 to 111.6) with 63.9% specificity (95% CI 51.9 to 76.0). The high-risk level had a sensitivity of 75% (95% CI 32.6 to 117) with specificity of 28.1% (95% CI 20.6 to 35.5), while the low-risk level had sensitivity of 90% (95% CI 71.4 to 109.0) with specificity of 27.1% (95% CI 19.8 to 34.3). The negative predictive value (NPV) were the same value as 97.5% at all results.\u0000\u0000Conclusion: TST application is a self-risk screening tool that effectively discriminates between different risk levels and provides sensitivity for detecting infection with NPV for all assessment results. This application can enable individuals to assess their risk level of COVID-19 infection before entering any premises.\u0000\u0000Keywords: Self-risk assessment; COVID-19; Infection; Verify of entry; Working-age","PeriodicalId":17486,"journal":{"name":"Journal of the Medical Association of Thailand = Chotmaihet thangphaet","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91009966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-06-15DOI: 10.35755/jmedassocthai.2023.06.13854
Na
Objective: To study image findings in covid pediatric patients, both in the first diagnosis images and follow-up images to see disease progression over time. Materials and Methods: The present research was conducted in all pediatric patients aged 0 to 18 years diagnosed as Covid-19 infection and admitted at Phramongkutklao Hospital during the study period. Image findings were retrospectively reviewed by an experienced pediatric radiologist and Brixia score was given. The maximum severity score and timing to reach this score were calculated and recorded in all patients. Results: During the study period, 428 films were collected from 170 patients. Most patients were male with a mean age of 9.89 years. Most common presenting symptom was fever. One-fourth of the studied patients had underlying illnesses. Most patients were symptomatic patients with 156 out of 170 (91.8%). The first X-ray showed abnormalities in 64.7% of symptomatic group and 42.9% in asymptomatic group. Common lobes of lungs involved were middle and lower lobes, which was slightly right-side predominate. Mean Brixia score was 2.79 (0 to 12) and 2.97 (0 to 14) in asymptomatic and symptomatic patients, respectively, which was not statistically significant. Time to reach maximum severity score was phase 1 (0 to 4 days) for symptomatic patients and phase 2 (5 to 8 days) for asymptomatic ones. For patients with normal first X-ray, abnormalities could be detected on later films, mostly in phase 1 and 2. Conclusion: Screening X-ray at the first diagnosis had high rates of abnormality detection regardless of symptom. For patients with normal first X-ray, abnormalities could be detected on later films, mostly in phase 1 and 2. Therefore, even with the fear of unnecessary exposure to radiation in children, X-ray should be performed at the first diagnosis regardless of symptom. Appropriate timing to follow-up X-ray was phase 2, at day 5 to 8 of disease. Keywords: Covid 19 X-ray; Covid in children; X-ray of pediatric covid
{"title":"Chest Radiograph Findings Monitoring with Time Course of COVID-19 Pediatrics Patients","authors":"Na","doi":"10.35755/jmedassocthai.2023.06.13854","DOIUrl":"https://doi.org/10.35755/jmedassocthai.2023.06.13854","url":null,"abstract":"Objective: To study image findings in covid pediatric patients, both in the first diagnosis images and follow-up images to see disease progression over time.\u0000\u0000Materials and Methods: The present research was conducted in all pediatric patients aged 0 to 18 years diagnosed as Covid-19 infection and admitted at Phramongkutklao Hospital during the study period. Image findings were retrospectively reviewed by an experienced pediatric radiologist and Brixia score was given. The maximum severity score and timing to reach this score were calculated and recorded in all patients.\u0000\u0000Results: During the study period, 428 films were collected from 170 patients. Most patients were male with a mean age of 9.89 years. Most common presenting symptom was fever. One-fourth of the studied patients had underlying illnesses. Most patients were symptomatic patients with 156 out of 170 (91.8%). The first X-ray showed abnormalities in 64.7% of symptomatic group and 42.9% in asymptomatic group. Common lobes of lungs involved were middle and lower lobes, which was slightly right-side predominate. Mean Brixia score was 2.79 (0 to 12) and 2.97 (0 to 14) in asymptomatic and symptomatic patients, respectively, which was not statistically significant. Time to reach maximum severity score was phase 1 (0 to 4 days) for symptomatic patients and phase 2 (5 to 8 days) for asymptomatic ones. For patients with normal first X-ray, abnormalities could be detected on later films, mostly in phase 1 and 2.\u0000\u0000Conclusion: Screening X-ray at the first diagnosis had high rates of abnormality detection regardless of symptom. For patients with normal first X-ray, abnormalities could be detected on later films, mostly in phase 1 and 2. Therefore, even with the fear of unnecessary exposure to radiation in children, X-ray should be performed at the first diagnosis regardless of symptom. Appropriate timing to follow-up X-ray was phase 2, at day 5 to 8 of disease.\u0000\u0000Keywords: Covid 19 X-ray; Covid in children; X-ray of pediatric covid","PeriodicalId":17486,"journal":{"name":"Journal of the Medical Association of Thailand = Chotmaihet thangphaet","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84747842","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-06-15DOI: 10.35755/jmedassocthai.2023.06.13858
Background: Pulmonary arterial hypertension (PAH) is associated with high mortality and frequent complications in end stage renal disease patients. Epidemiological data for this disorder across the spectrum of end stage renal disease in Thai patients is limited. Objective: To compare the prevalence and risk factors of PAH in hemodialysis and peritoneal dialysis in end stage renal disease among the Thai patients. Materials and Methods: The authors retrospectively studied in patients with end stage renal disease at Pranangklao Hospital between January 2016 and December 2021. Results: A total of 201 patients were enrolled. The average age of patients was 55.57±16.22 years (47.3% male). Most patients had hypertension. Most patients had been prescribed folic acid. The number of patients with mean pulmonary artery pressure >20 mmHg was 81 (77.1%) in the hemodialysis group and 52 (54.2%) in the peritoneal dialysis group (p<0.001). PAH in hemodialysis was higher than peritoneal dialysis (OR 2.86, 95% CI 1.56 to 5.24, p<0.001). The following were factors associated with PAH: history of coronary artery disease (OR 2.77, 95% CI 1.29 to 5.94, p<0.009), history of beta-blocker use (OR 2.09, 95% CI 1.15 to 3.79, p<0.015), left ventricular ejection fraction by Simpson’s method (OR 0.95, 95% CI 0.92 to 0.98, p<0.001). The variable associated with PAH (peritoneal dialysis group) in multivariate logistic regression was Hemodialysis (adjusted OR 3.16, 95% CI 1.66 to 6.03, p<0.001). Conclusion: End stage renal disease in Thai patients undergoing hemodialysis carry a three-fold risk of pulmonary hypertension than peritoneal dialysis patients. Keywords: Pulmonary hypertension; Hemodialysis; Peritoneal dialysis
背景:肺动脉高压(PAH)与终末期肾病患者的高死亡率和频繁并发症相关。这种疾病在泰国终末期肾病患者中的流行病学数据是有限的。目的:比较泰国终末期肾病患者血液透析和腹膜透析中PAH的患病率及危险因素。材料和方法:作者回顾性研究了2016年1月至2021年12月在Pranangklao医院就诊的终末期肾病患者。结果:共纳入201例患者。患者平均年龄55.57±16.22岁，男性占47.3%。大多数患者有高血压。大多数患者都服用了叶酸。血液透析组平均肺动脉压> 20mmhg的患者为81例(77.1%)，腹膜透析组为52例(54.2%)(p<0.001)。血液透析组PAH高于腹膜透析组(OR 2.86, 95% CI 1.56 ~ 5.24, p<0.001)。以下是与PAH相关的因素:冠状动脉疾病史(OR 2.77, 95% CI 1.29 ~ 5.94, p<0.009)， β受体阻滞剂使用史(OR 2.09, 95% CI 1.15 ~ 3.79, p<0.015)，辛普森法左心室射血分数(OR 0.95, 95% CI 0.92 ~ 0.98, p<0.001)。在多因素logistic回归中，与PAH(腹膜透析组)相关的变量是血液透析(校正OR 3.16, 95% CI 1.66 ~ 6.03, p<0.001)。结论:终末期肾病患者接受血液透析的肺动脉高压风险是腹膜透析患者的三倍。关键词:肺动脉高压;血液透析;腹膜透析
{"title":"Comparison of Pulmonary Arterial Hypertension and Risk Factors in End Stage Renal Disease Patients with Peritoneal Dialysis and Hemodialysis","authors":"","doi":"10.35755/jmedassocthai.2023.06.13858","DOIUrl":"https://doi.org/10.35755/jmedassocthai.2023.06.13858","url":null,"abstract":"Background: Pulmonary arterial hypertension (PAH) is associated with high mortality and frequent complications in end stage renal disease patients. Epidemiological data for this disorder across the spectrum of end stage renal disease in Thai patients is limited.\u0000\u0000Objective: To compare the prevalence and risk factors of PAH in hemodialysis and peritoneal dialysis in end stage renal disease among the Thai patients.\u0000\u0000Materials and Methods: The authors retrospectively studied in patients with end stage renal disease at Pranangklao Hospital between January 2016 and December 2021.\u0000\u0000Results: A total of 201 patients were enrolled. The average age of patients was 55.57±16.22 years (47.3% male). Most patients had hypertension. Most patients had been prescribed folic acid. The number of patients with mean pulmonary artery pressure >20 mmHg was 81 (77.1%) in the hemodialysis group and 52 (54.2%) in the peritoneal dialysis group (p<0.001). PAH in hemodialysis was higher than peritoneal dialysis (OR 2.86, 95% CI 1.56 to 5.24, p<0.001). The following were factors associated with PAH: history of coronary artery disease (OR 2.77, 95% CI 1.29 to 5.94, p<0.009), history of beta-blocker use (OR 2.09, 95% CI 1.15 to 3.79, p<0.015), left ventricular ejection fraction by Simpson’s method (OR 0.95, 95% CI 0.92 to 0.98, p<0.001). The variable associated with PAH (peritoneal dialysis group) in multivariate logistic regression was Hemodialysis (adjusted OR 3.16, 95% CI 1.66 to 6.03, p<0.001).\u0000\u0000Conclusion: End stage renal disease in Thai patients undergoing hemodialysis carry a three-fold risk of pulmonary hypertension than peritoneal dialysis patients.\u0000\u0000Keywords: Pulmonary hypertension; Hemodialysis; Peritoneal dialysis","PeriodicalId":17486,"journal":{"name":"Journal of the Medical Association of Thailand = Chotmaihet thangphaet","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83168141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-06-15DOI: 10.35755/jmedassocthai.2023.06.13861
Objective: To determine the outcomes of patients undergone parotidectomy with or without facial nerve monitoring. Materials and Methods: The present study was a retrospective study that included 35 patients underwent superficial parotidectomy with pathologic findings of benign parotid tumor. The patients were divided into two groups. Intraoperative facial nerve monitoring was performed in 15 patients and did not monitor in 20 patients. Data were compared between the surgical groups with intraoperative facial nerve monitoring and the groups without intraoperative facial nerve monitoring using the chi-square test and independent t-test. Results: Patients who underwent parotidectomy between January 1, 2020 and December 31, 2022, whose pathologic findings were benign, a total of 35 cases were divided into 15 patients underwent surgery with intraoperative facial nerve monitoring and 20 patients underwent surgery without intraoperative facial nerve monitoring. There was no statistical difference in operation time and saliva leakage. However, there was a statistical difference in intraoperative blood loss, postoperative facial nerve weakness rate, and postoperative earlobe numbness. Conclusion: The most common complication of parotidectomy is paralysis of the facial nerve. The present study showed that intraoperative facial nerve monitoring can reduce facial nerve paralysis, blood loss during surgery and postoperative earlobe numbness. Keywords: Intraoperative facial nerve monitoring; Parotidectomy; Parotid tumor
{"title":"The Outcomes of Superficial Parotidectomy with Intraoperative Facial Nerve Monitoring: Experience in Sawanpracharak Hospital 2020 to 2022","authors":"","doi":"10.35755/jmedassocthai.2023.06.13861","DOIUrl":"https://doi.org/10.35755/jmedassocthai.2023.06.13861","url":null,"abstract":"Objective: To determine the outcomes of patients undergone parotidectomy with or without facial nerve monitoring.\u0000\u0000Materials and Methods: The present study was a retrospective study that included 35 patients underwent superficial parotidectomy with pathologic findings of benign parotid tumor. The patients were divided into two groups. Intraoperative facial nerve monitoring was performed in 15 patients and did not monitor in 20 patients. Data were compared between the surgical groups with intraoperative facial nerve monitoring and the groups without intraoperative facial nerve monitoring using the chi-square test and independent t-test.\u0000\u0000Results: Patients who underwent parotidectomy between January 1, 2020 and December 31, 2022, whose pathologic findings were benign, a total of 35 cases were divided into 15 patients underwent surgery with intraoperative facial nerve monitoring and 20 patients underwent surgery without intraoperative facial nerve monitoring. There was no statistical difference in operation time and saliva leakage. However, there was a statistical difference in intraoperative blood loss, postoperative facial nerve weakness rate, and postoperative earlobe numbness.\u0000\u0000Conclusion: The most common complication of parotidectomy is paralysis of the facial nerve. The present study showed that intraoperative facial nerve monitoring can reduce facial nerve paralysis, blood loss during surgery and postoperative earlobe numbness.\u0000\u0000Keywords: Intraoperative facial nerve monitoring; Parotidectomy; Parotid tumor","PeriodicalId":17486,"journal":{"name":"Journal of the Medical Association of Thailand = Chotmaihet thangphaet","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77119238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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