Validity of the Multidimensional Ethics Scale for a Sample of Thai Physicians.

Research in ethical decision-making has received considerable attention in the realm of the business community in the last three decades due in part to numerous high profile scandals (e.g., Enron). The medical community has been less engaged in this line of investigation as the primary scholar focus has been in biomedical as opposed to social science/humanities. However, recently researchers and their methods have been attracted to the medical field. The purpose of this paper is to explore whether an ethical decision-making measure prominent in the business literature can be applied to the medical contexts.

Psychiatric consultation at Srinagarind Hospital: a report on 271 cases.

The author reviewed psychiatric consultations at a teaching general hospital over a two year period. Two hundred and seventy-one patients or 0.6 per cent of all admission were referred for psychiatric consultation. The referral rate from the medical and surgical departments were higher than that of other departments. The most common psychiatric diagnosis by psychiatric consultants was delirium, followed by adjustment disorder and mood disorders. The delirious patients were significantly older than the other groups. The delirious state was commonly caused by infectious diseases, diseases of the nervous system and sense organs and disorders of fluid, electrolyte and acid-base balance. Most of the patients who had two or more active medical problems would have greater incidence of delirium. The delirious patients tended significantly to have behavior that disturbed the therapeutic environment. Among the functional psychiatric disorder patients, 22.4 per cent manifested suicide attempts as the principal reason for admission to non-psychiatric wards. The study revealed that the consultee could give the proper psychiatric diagnosis in only 18.3 per cent of the delirious group, 21.2 per cent in other organic mental disorder group and 24.6 per cent in functional psychiatric disorder group. Most of the consultees described only the psychiatric symptoms of the referred patients and did not specify the psychiatric diagnosis. The most frequently stated reason for psychiatric consultation was for proper evaluation and management.

Marital problems: an analysis of the causes among 115 clinical couples.

Among 115 couples seeking counselling for marital problems from Jan 1, 1987-Dec 31, 1989, 86.1 per cent of the consultations were initiated by the wives. Striking characteristics were as follows: 51.3 per cent of the couples had husbands who were either younger or more than three years older than their wives. A total of 62.6 per cent had dated less than bands with lower educational attainment or educational attainment more than three years higher than their wives. Sixty-two drop six had dated less than 1 year; 46.1 per cent married because of parental suggestions or had unreal expectations about marriage; 40.9 per cent did not get both partners' parents to agree to their marriage; 46.1 per cent had premarital sexual relationships, 26.1 per cent did not register for a marriage license; 26.1 per cent did not hold a wedding celebration. A history of divorce among both partners' first degree relatives was lacking in only 41.7 per cent of the couples. The three most frequent marital problems were extramarital sexual activity, lack of intimacy and not loving the partner. The wives had a marginally significant trend to face the problems arising from their partners' extramarital sexual relationships more often than the husbands. The problem of not loving the partner was found significantly more frequently during the first five years of marriage.

Delusion of parasitosis: a report of ten cases at Srinagarind Hospital.

Ten patients with delusion of parasitosis who attended the psychiatric service at Srinagarind Hospital from August 1st 1981 to May 31st 1988 were analysed and discussed. Males and females were equally affected. Their ages were between early adulthood and late adulthood. Most of them were or had been married and were economically independent. Their symptoms appeared chronic and they tended to refuse psychiatric treatment. The dermatologist and general practitioner from whom the patients are most likely to seek treatment are reasonable to treat these patients. Haloperidol, a widely available neuroleptic, seems to relieve the symptom, enabling the patient to live comfortably.

Pre-exposure vaccination with purified chick embryo cell rabies vaccines in children.

Children who have close contact with rabid dogs, with a history of neither being bitten nor scratched nor licked on broken skin or on mucous membranes were given purified chick embryo rabies vaccine as pre-exposure prophylaxis. Thirteen children received 0.5 ml of the vaccine, while 12 children received 1 ml of the vaccine intramuscularly on days 0, 7 and 28. The rabies antibody level was measured by a standard mouse neutralization test. Before vaccination, all vaccinees had no detectable level of antibody to rabies. On day 14, all children had antibody levels higher than 0.5 IU/ml; the titer peaked from day 28 to day 56 and then was lower on day 90. Children of the 1 ml group had antibody levels higher than the 0.5 ml group, but there was no statistically significant difference. No serious reaction occurred. At 2-3 years of follow up, all children were doing well.

Severe lithium toxicity treated by hemodialysis: a case report.

A 51-year-old manic woman who developed acute severe lithium intoxication with neurotoxicity and nephrotoxicity during rapid abatement of manic episode was reported. The underlying causes of the serious toxicity were reviewed. Awareness and early detection of the toxic symptoms are emphasized in order to avoid permanent toxic sequelae. It is suggested that hemodialysis is the treatment of choice and should not be delayed, especially in severe toxic states and a daily 10 hours hemodialysis is needed to prevent the rebound effect as lithium in intracellular fluid equilibrates with extracellular fluid.

Psychiatric illnesses among khon kaen university medical students.

This is a study of incidence rate of psychiatric illnesses among Khon Kaen University Medical Students. We found that, during the four years of observation from June 1, 1981 – May 31, 1985, the incidence rate of all kinds of psychiatric illnesses was 17.9/1000/year. The ratio of male to female cases was 2 : 1 and the mean age of the cases was 21.5 years. Most of the cases were first diagnosed when the students were in their third year. Neurotic disorders were the most common psychiatric disorder with incidence rate 11.9/1000/year. The incidence of schizophrenic disorder among medical students was only 1.6/1000/year. Hopefully, the data presented here will be useful in planning of preventive psychiatry in medical educational institutions, and encourage others to make more relevant specific studies.