ABSTRACT
OBJECTIVE: To examine the profile and treatment pattern of patients with neuropathic pain attending Siriraj Pain Clinic. MATERIAL AND METHOD: A 2-year retrospective study of the prevalence of neuropathic pain, characteristics of the patients and the use of medical treatment. Records of all the patients that attended Siriraj Pain Clinic from September 1, 2002 until September 30, 2004 were reviewed. RESULTS: One thousand three hundred and thirty patients' records were reviewed. Five hundred and three patients were diagnosed as having neuropathic pain. The prevalence of neuropathic pain at Siriraj Pain Clinic during the survey period was 37.8%. The average age of neuropathic pain patients was 54 years. The most common type of neuropathic pain was peripheral type, nerve compression in particular. The most common concomitant illness was malignant tumor. The majority of patients (71.8%) had one pain location and the most common site was the lower extremity. The main descriptions of neuropathic pain were radiating, electric shock-like, burning, numbing and shooting. Oral medication was the most common method (79%) of pain-relief treatment. Almost all of the patients (93%) had received more than one type of oral medication. The most commonly used medicine was TCA (77.1%), followed by gabapentin (35%), carbamazepine (34%) and tramadol (24.3%). Most of the pain-relief medicines prescribed at this clinic were under the recommended doses for the treatment of neuropathic pain. CONCLUSION: Characteristics and treatment patterns of neuropathic pain at Siriraj Pain Clinic are similar to those seen in other pain clinics elsewhere in the world. The high prevalence of neuropathic pain in the clinic indicates that this type of pain syndrome is increasingly critical to our clinical practice. More educational programs on neuropathic pain and management are needed for Thai healthcare professionals.
Subject(s)
Neuralgia/diagnosis , Neuralgia/therapy , Pain Clinics , Adolescent , Adult , Aged , Aged, 80 and over , Female , Health Surveys , Humans , Male , Middle Aged , Neuralgia/epidemiology , Pain Measurement , Retrospective Studies , Thailand/epidemiologyABSTRACT
The causes and consequences of a Co-60 radiation accident in Samutprakarn Province, Thailand, were scrutinized to learn lessons aimed at preventing future radiation accidents. "Orphan sources" may end up in scrapyards. An out-of-use Co-60 medical teletherapy source, left unattended in a disused parking area belonging to a Medical Dealer, was stolen and sold to a scrap dealer in Samutprakarn Province at the end of January 2000. Because of its valuable appearance, a number of workers in the scrap trade who were not aware of radiation hazards managed to dismantle all parts. The Co-60 source was removed and left unshielded among pieces of scrap metal in the yard of the scrap shop. Some workers immediately became sick. Eighteen days later when they went to a local hospital their symptoms were recognized as radiation sickness and the incident was reported to the Office of Atomic Energy for Peace (OAEP) in Thailand. The unshielded source, with an estimated activity of 15.7 TBq (425 Ci), was retrieved soon after by an emergency team and placed in safe storage at the OAEP premises. Ten victims developed radiation sickness symptoms, of which three died soon after the accident. The accident alarmed the public, and has raised national concerns. The accident is similar in some ways to the 1987 radiation accident at Goiania, Brazil, involving a Cs-137 radiotherapy source. If not properly disposed of orphan radiation sources can lead to serious injury or even death. The accident highlights the need for security of spent high activity sources and the importance of regulatory controls.
Subject(s)
Cobalt Radioisotopes/adverse effects , Radiation Injuries/etiology , Radioactive Hazard Release/legislation & jurisprudence , Radioactive Waste/adverse effects , Radioactive Waste/legislation & jurisprudence , Decontamination/methods , Environmental Exposure , Humans , Radiation Injuries/prevention & control , Radioactive Hazard Release/prevention & control , Radioactive Waste/prevention & control , Radioisotope Teletherapy/instrumentation , Security Measures/legislation & jurisprudence , Thailand , Waste Management/legislation & jurisprudence , Waste Management/methods , Waste Management/standardsABSTRACT
By injection of eosin dye with latex into 45 cadaveric fingers we were able to demonstrate: (1) a distinct digital pulp arch formed by the ulnar and radial digital arteries over the mid-point of the terminal phalanx in 93% of digits; (2) variations in size of the proper digital arteries to each digit; (3) numerous branches from the pulp arch to the tip of each digit and (4) a constant pattern of dorsal veins over the terminal segment in 89% of digits.
