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This clinical study is to compare the use of coaxial circle circuit with CO2 absorber and coaxial D circuit without CO2 absorber in 20 patients of physical status ASA class I and II. The mean age, body weight, and hemoglobin concentration are 40 ± 9.94 years old, 56.77 ± 7.33 kgs., 11.76 ± 1.22 gms/dl respectively. Fresh gas flow (FGF) and arterial blood gas was taken after stabilizing period of 15 – 30 minutes. Coxial D circuit without CO2 absorber was used secondly and arterial blood gas was taken in the same manner. The pH, PaCO2, PaO2 values were compared by paired T-test statistical analysis. It is concluded that at 6 lpm. Of FGF and minute ventilation, there is statistically significant difference (P
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The recent epidemic of Cholera Strain Vibrio cholera 0139 were occurred in India and Bengal Surveillance for Vibrio cholera 0139 in Srinagarind Hospital has been done from 11th March 1994 to 5th August, 1994. One hundred and five patients were infected by this organism. There were three outbreaks of Vibrio cholera 0139 in Srinagarind Hospital. In the first outbreak from 11-13th March 1994 there were 18 cases of infected patients in the second one in 8-13 June 1994 there were 36 cases and the last one was the 28th July to 5th August, 11 cases were found in only one case of breast feeding was the infant reported to be infected with this organism. Most of the cases occurred in Amphur Muang, Khonkaen, percentage with a ratio of man : woman, 2:1, and average age was 41 years old (4 days-82 years). The susceptibility of the organism to Tetracycline, Gentamicin, Nalidixic acid, Neomycin, Ampicillin was good, but there was moderate sensitivity to Chloramphenicol, no response to colistin and Cotrimoxazole Many control programs were done in these outbreaks such as hygeine education, surveillance for infection and the personnel who were carriers and cooked food. The source of organism in Khon Kaen University was detected in rectal swab C/S of 253 personnel but only 7 cases infection were found and 318 specimens of swab C/S of used water food and vegatables were taken, and 4 specimens were positive for this organism. The implementations for controling of this outbreak were the rapidly indentify and treat, mass media for the communication, including, personal hygiene the used of chlorination etc. the case.
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Celiac plexus block was done in 49 patients by simple blind technique, without the aid of flouroscopic X-ray. The percentage of satisfactory result was 89.8% without serious complication. The procedure and caution were discussed in detail.
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The comparative study of the modified To \& Fro circuit and the Mapleson D circuit blood gas technique was chosen as a method of comparison due to its simplicity and no injury to vessel. Using constant FGF, Fi02 and minute ventilation, it was found that the modified To \& Fro circuit showed lower pC02 than the Mapleson D circuit significantly.
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Background: Out-Patient department is the first place where patients and relatives met hospital team. There are many steps for hospital service delivery. Hospital consumers satisfaction is an important measure of service quality in health care organizations. Therefore, a hospital consumers satisfaction on Out-Patient department was studied.Objective: To assess the peri9od of time consumed for receiving services; to assess the level of satisfaction of hospital consumers in each step of Out-Patient department service: and general opinion related to out-patient activates.Design : A descriptive research.Setting : Out-Patient department, Srinagarind Hospital Faculty of Medicine, Khon Kaen UniversitySubjects: 803 patients and relatives were selected by purposive sampling. The subjects were new and former cases. The were not limited by sex and age.Measurement : Interviewed questionnaires with reliability 0.85 were used. The data were collected by interviewing the subjects in front of Pharmacy unit which is the last step of hospital service.Results: The mean (+SD) age of participants was 40.8+13.8 years. The most of 19.9~ and 15.1% were checked and treated in medical and general practitioner checked –up room respectively. Average time consumed in mal waiting time more than 5 hours. Average time consumed for the whole process was 2 hours and 51 minutes with the longest waiting time more than 8 hours (2 cases). The study also found that the dentist check-up room was longest waiting time with 1 hour 45 minites. The time to wait in medicine check-up room and at general practitioner check-up room was 1 hour 42 minites, and 1 hour 32 minites, respectively. The result show that the hospital consumers were moderate by satisfied with the services. The highly satisfied service was in Public Relations. The least satisfied service was cashier room. However, some hospital consumers were less satisfied to all steps of out-patient education and counselling related to their illness.Conclusion : Hospital administrator should plan to improve and implement Out-Patient manpower development program to orientated the hospital employees to the various aspects of health service. It is necessary to provide one-point service and to provide a computer system to cooperate among the clinical departments. Furthermore, it is highly recommended that the standard of care and tow-way communication should be more clearly brought into use in each step as a measure of the ongoing.Keywords: Satisfaction, Out-Patient Services, Srinagarind Hospital
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Background : Punctuality and responsibility are disirable virtues to incalcate in Thai medical students beginning from the fundamental level for both the students themselves and the families and the society at large.Objective : To make the students realize the basic virtue of punctuality. They practise to possess the qualities of punctuality and responsibility. Both qualities must be fulfilled at the self-entities before they could be applied to the larger scale of family and society.Method : The 5th year students in Anesthesiology rotation block of 3 weeks were divided into 2 groups, the first group was taught the integrated contents, virtues and professional ethics. The method of leaching is by way of active discussions on the content. This is to concentrate the student on student on what they are practicing to learn the technique of handling the model and the patient. The students were taught to meditate after discussion and before the actual practice and evaluation took place. The second group was taught the same technique without a discussion and meditation to serve as control group.Result : The experiment group was impressed and interested in the integrated teching approach. They judged the method as being relevant to the time and situation. Ninety seven point two percent of them were punctually coming to classes. The control group of students was 83.3 percent punctual. The Video record of the practical classes illustrated that the experimental group was gental and careful in handling the models whereas the opposite is true with the control group.Conclusion : It could be said is inferred that the integrated method of teaching is rather successful as expected. We, therefore, suggest the adoption of the method to further develop the learning teaching technique.
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Background: Generally, an uncuffed endotracheal tube is used for general anesthesia in pediatric patients; thus, an inappropriate tube size intubation can lead to complications. In clinical practice, tube size selection can be done using a formula then adjusting for each patient. An appropriate tube size should allow a leak at airwaypressures (leak pressure) between 20-40 cmH2O, but leak pressure is not routinely monitored.Objective: To study the incidence of inappropriate tube size used in pediatric patients receiving general anesthesia by using leak pressure test.Design: Prospective, descriptive study. Setting: Operating room, Srinagarind Hospital Subject: Pediatric patients between 0 and 8 years of age undergoing general anesthesia with uncuffed endotracheal tube.Methods: After anesthesia was induced and the patient was intubated, leaked pressure was measured. Leak pressure between 20 and 40 cmH2O was considered appropriate. We recorded each patient’s characteristics, number of attempts to intubate, leak pressure, duration of intubation, and respiratory complication. The results were analyzed using descriptive statistics and were presented as means, percentages and 95% confidence intervals (95% CI).Results: We enrolled 98 patients averaging 2.3 + 2.2 years of age (67 males and 31 females). Patients with inappropriate leak pressure numbered 39 (39.80%), of which 24.49% (95% CI: 17,33) were in the group where leak pressure was \> 40 cmH2O and 15.31% (95% CI: 10,23) in the group where leaked pressure was \< 20 cmH2O. The most frequent complication was hoarseness 27.55% (95% CI: 20,37). No patients had any serious respiratory complications.Conclusion: Pediatric patients between 0 and 8 years of age, undergoing general anesthesia with an uncuffed endotracheal tube had a 39.80% incidence of inappropriate endotracheal size used. Hoarseness was the most common complication (27.55%). Tube size selection should be done carefully and include leak pressure test.Keywords: Uncuffed endotracheal tube; Leak pressure; General anesthesia; Pediatric patients