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anagement.

Our study further substantiates the recent global trend of conservative approach towards managing patients with acute necrotizing pancreatitis as reflected in the recent available literature. Therefore surgeons of the developing world need to evolve and adapt to these new measures for better outcomes in patient management.

Unstable pelvic fracture may emerge to major bleeding complication. Angioembolization is one of method to stop the bleeding effectively. This case series aims to analyze whether the bleeding of unstable pelvic fracture is managed by angioembolization to achieve the better functional outcome.

Three cases of haemodynamically unstable pelvic fracture were studied retrospectively and prospectively. A staged approach using damage control orthopaedic surgery was performed. Initial resuscitation began from fluid resuscitation, pelvic wrapping using binder. All patients followed with pelvic external fixation, while 2 patients immediately replaced binder to C-Clamp, and 1 patient with anterior frame. Angioembolization was done to all patients. All patients required definitive internal fixation, while only 2 patients reach the definitive surgery. Finally, we measured the functional outcome of all patients using Hannover Pelvic score, Majeed pelvic score, and Iowa Pelvic score.

We review some literatures regarding pelvic angioembolization. The previous study suggested to resuscitate patients when the hemodynamic is unstable, the angioembolization procedure is still preferred. selleck inhibitor The indication and successful definition of this procedure is still unclear, yet it shows decrease of mortality rate of pelvic injury if this procedure starts ahead a schedule.

Angioembolization as a part of damaged control orthopaedic has been shown a favorable result in managing unstable pelvic injury.

Angioembolization as a part of damaged control orthopaedic has been shown a favorable result in managing unstable pelvic injury.

The success of the micro-surgery procedure for the treatment of postganglionic brachial plexus injury was influenced by several factors, including the surgical timing and also the viability of the proximal stump. This study evaluates the evidence of apoptosis in the brachial plexus proximal stump and its correlation with the surgical timing.

Proximal stump biopsy of postganglionic brachial plexus injury patients were obtained during nerve procedure surgery. The samples were grouped based on the surgical timing, before six months post-trauma (early group) and after six months post-trauma (late group). The apoptosis of motorneurons was evaluated by immunohistochemistry expression of Caspase-3, TNF-α, Caspase-8, and Caspase-9.

Immunohistochemistry findings showed higher expression of Caspase-3 in the late group compared to the early group, as well as the expression of Caspase-8 and Caspase-9 (p<0,05), and with a positive correlation between Caspase-8 and Caspase-9 to Caspase-3. Meanwhile, TNF-α expression was higher in the early group than the late group (p<0,05) and with no correlation between TNF-α to Caspase-3.

Apoptosis of proximal stump motorneuron plexus brachialis on more than six months post-trauma is higher than on less than six months post-trauma.

Apoptosis of proximal stump motorneuron plexus brachialis on more than six months post-trauma is higher than on less than six months post-trauma.

A dry mouth or xerostomia is one of the most common long-term complications following radiotherapy for head and neck cancer and has a negative impact on quality of life in cancer survivors. Transcutaneous electrical nerve stimulation (TENS) is a novel approach to improving saliva flow in these patients.

To perform a systematic review of studies evaluating TENS in the treatment of radiotherapy induced xerostomia in head and neck cancer patients.

A comprehensive electronic search was performed in PubMed/MEDLINE, the Cochrane Library, and Google Scholar databases for appropriate published studies. The last search was conducted in January 2020. Two review authors assessed all studies identified by the search strategy and carried out data extraction.

Five studies were included in the systematic review which analysed a total of 280 patients with head and neck cancer. Methodological quality and outcomes were evaluated in every study included. The outcome measure was either subjectively assessed or objectivelspecific parameters used in the included studies, further evidence is needed in order to establish optimal settings and parameters of TENS for treatment of xerostomia.

ISPD recommends culture-negative peritonitis in each peritoneal dialysis (PD) center should less than 15%. The hospital in Thailand, however faced a significantly high rate of culture negative peritonitis, even using blood culture bottles technique. This study evaluates the performance of three different culture methods in detecting organisms in PD related peritonitis

A prospective cohort diagnostic study was performed in PD patients diagnosed with PD related peritonitis in Surin Hospital from October 2018 to June 2020. The Diagnosis of peritonitis was followed ISPD guidelines. PDF sample from each patient was processed by three different blood culture bottle-based techniques, including i) 50ml PDF centrifugation, and ii) 10ml PDF centrifugation before inoculated into blood culture bottles, and iii) inoculation into blood culture bottles without centrifugation. The sensitivities and isolated organisms were compared among the individual methods.

Of 126 PD patients with clinical peritonitis, PD related peritonitis was diagnosed in 87 patients with 105 PDF analysis. PDF culture showed gram-positive organisms 34%, gram-negative organisms 41%, fungal 5.71%, and culture-negative result in 22.86%. The direct blood culture method was positive in 59.05%, while centrifugation before inoculated into blood culture bottles, has a higher percentage of positive results, 60.95% and 64.76% from 10ml to 50ml PDF volume; respectively. The sensitivity was 84% and 76.5% for 50ml PDF centrifugation and blood culture without centrifugation.

Large volume PDF centrifugation before inoculating into blood culture bottles may improve the positive culture rate in PD related peritonitis.

Large volume PDF centrifugation before inoculating into blood culture bottles may improve the positive culture rate in PD related peritonitis.