April22-24,2006 at Matra Island Chumporn ,Thailand

more pixs http://www.thaidphoto.com/forums/showthread.php?t=29245&page=1&pp=15

The article that I want to depict today is about the result of using herb in men to study about prostate health.Eventhough herb is very useful in a wide range of health,it is no effect to prostate gland.

The study showed that the pateint who had enlarge prostate gland but they were not anything different from the other patients who did not use herb. From http://news.bbc.co.uk/1/hi/health/4906364.stm

What is prostate enlargement? “The prostate is a male reproductive gland that produces the fluid that carries sperm during ejaculation. It surrounds the urethra, the tube through which urine passes out of the body.

An enlarged prostate means the gland has grown bigger. Prostate enlargement happens to almost all men as they get older. As the gland grows, it can press on the urethra and cause urination and bladder problems.

An enlarged prostate is often called benign prostatic hyperplasia (BPH) or benign prostatic hypertrophy. It is not cancer, and it does not raise your risk for prostate cancer.”

More information…. http://www.nlm.nih.gov/medlineplus/ency/article/000381.htm

BACKGROUND An 18-year-old woman presents to the emergency department (ED) after experiencing syncope while backpacking 2 days ago. The patient states that she had been hiking with her friends up a steep hill, and the next thing that she remembered was waking up, lying on the trail. The event was not witnessed, and the patient does not recall any antecedent chest pain, shortness of breath, palpitations, or dizziness. She denies biting her tongue or having incontinence at the time of the event, but she remembers briefly feeling dazed. After a period of rest, she was able to finish the hike without further problems, but she comes into the office to get checked out just to be safe. She denies any past medical problems but does report experiencing a similar syncopal episode a few years ago again while she had been exerting herself. She has no recent history of illness or fever and does not report any subsequent chest pains, shortness of breath, or palpitations. She also denies recent dieting or use of any over-the-counter or illicit drugs.

On examination, the patient has a normal temperature with a heart rate of 65 bpm and a blood pressure of 110/73 mm Hg. She is a well-appearing young woman in no acute distress. Findings on her head and neck examination are unremarkable. She has normal S1 and S2 heart sounds without any appreciated rubs, murmurs, or gallops. She has no jugular venous distention, and her lungs are clear bilaterally. Her abdomen is soft, without masses. She has no peripheral edema, and findings on neurologic examination are normal. Results of her laboratory work-up, including a complete blood count, chemistry panel, pregnancy test, and toxicology screen are normal. Her chest radiograph was likewise normal.

An ECG is obtained (see Image). What is the diagnosis?
Hint The patient recalls that her younger brother has had similar episodes of syncope over the past few years.

Authors: Malkeet Gupta, MS, MD, Department of Emergency Medicine, UCLA/Olive View-UCLA Emergency Medicine Residency Program, Los Angeles, Calif

การศึกษาวิจัยนี้พบว่า การใช้ยาปฏิชีวนะ พวกกลุ่ม Bactrim ร่วมกับการนอนกางมุ้งที่เคลือบสารป้องกันยุง จะช่วยลดความเสี่ยงในการเป็นโรคมาลาเรียได้ถึง 95 %

Combinding a mosquito net with insecticide and antibiotic can protect Malaria in HIV patient up to 95 percent.This is the new research from the Uganda Virus Research Institute in Entebbe. The study found that the antibiotic co-trimoxazole and bed nets are each effective in contesting malaria in HIV patients but it maybe increase their impact also.

From the study shown that Co-trimoxazole, which is a general treatment for patients infected with HIV, reduced the incidence of malaria in the patients by 76 percent. When combined with anti-AIDS drugs it hit 92 percent and cut cases by up to 95 percent when the bed nets were included.

for more information.

Report http://www.nidcd.nih.gov/news/releases/02/102102.asp http://www.malaria.org/

After 40 days in Paska festival ,today is the big day for christian people.I mean Easter day ,A Christian feast commemorating the Resurrection of Jesus,comes again in this year and I cannot refuse to talk about this day. Easter day is the day that all Christian people will cerebrate with the rising form dead of Jesus.So they will use the egg be sumbol for this cerebration because it is mean a new life.

Sonkran Festival is one of the most famous festival in Thailand that I want to talk about today.In this festival, people will come out to join together with throwing water to each other.Therefore,we can see crowded people on every street.It is also known as the “Water Festival” as people belive that water will wash away bad luck.

The festival starts on April 13 to 15 in every year. In fact, “Songkran” is a Thai word that means “move” or “change place” because we belive that it is the day when the sun changes its position in the zodiac.So It is Thai traditional new year too. In this cerebration,people will be get up early in the morning to offer food for monks.In the afternoon,they will perform a bathing rite for Buddha images and the monks,and then the celebrants both young and old, joyfull splash water on each other.

วันนี้ มีเด็กหญิง 5 ปี ถูกหามส่งโรงพยาบาลเนื่องจากถูกงูเห่ากัด พร้อมซากงูลำตัวเล็กขนาดเท่ากับนิ้วมือของเรา เด็กรู้สึกตัวดี มีรอยเขี้ยวงูดำๆที่นิ้วชี้มือขวา บวมไปถึงโคนนิ้ว วันนี้จึงอยากจะมาทบทวนเรื่องการพยาบาลผู้ป่วยที่โดนงูกัดกันสักนิดนะคะ

โดยทั่วไปเราจำแนกพิษของงูได้เป็น 4 ประเภทดังนี้

1. พิษต่อระบบประสาท [Neurotoxin]ได้แก่พิษของงูเห่า งูจงอาง งูสามเหลี่ยม ผู้ที่ได้รับพิษจะทำให้เกิดอัมพาตของกล้ามเนื้อ ลืมตาไม่ได้ กลืนลำบาก และที่สำคัญคือทำให้หยุดหายใจเสียชีวิตได้ 2.พิษต่อโลหิต [Hemotoxin ] ได้แก่พิษของงูแมวเซา งูกะปะ งูเขียวหางไหม้ ทำให้มีเลือดออกตามที่ต่างๆ ตามผิวหนัง เหงือก อาเจียนเป็นเลือด ปัสสาวะเป็นเลือด 3.พิษต่อกล้ามเนื้อ [Myotoxin] ได้แกพิษงูทะเล ทำอันตรายต่อกล้ามเนื้อ ปวดกล้ามเนื้อมาก ปัสสาวะสีดำเนื่องจากกล้ามเนื้อถูกทำลายเกิด myoglobinuria

2. พิษต่อกล้ามเนื้อหัวใจ [Cardiotoxin] ได้แก่พิษงูเห่า งูจงอาง

   ในกรณีเด็กรายนี้โดนงูเห่ากัด เป็นงูที่ผลิต Neurotoxin การช่วยการหายใจเป็นหัวใจสำคัญของ การรักษา ผู้ป่วยทุกรายควรได้รับการติดตามอาการกล้ามเนื้ออ่อนแรงอย่างใกล้ชิดและตรวจ peak flow เป็นระยะๆ ทุก 1 ชั่วโมง เพื่อเตรียมพร้อมการใส่ endotracheal tube และการใช้เครื่องช่วยหายใจเป็นเวลา 12-24 ชั่วโมง ข้อบ่งชี้ในการใส่ท่อช่วยหายใจ 1. ผู้ป่วยที่เริ่มอาการกลืนลำบากต้องได้รับการใส่ endotracheal tube เพื่อป้องกัน aspiration 2. ผู้ป่วยที่มี ptosis (palpebral fissure <0.5 ซม.) 3. peak flow <200 ลิตร/นาที 4. มีอาการกล้ามเนื้อการหายใจอ่อนแรง (respiratory muscle fatigue) อันได้แก่ respira-tory paradox, respiratory alternans, apnea ต้องได้รับการช่วยหายใจโดยใช่เครื่องช่วยหายใจในกรณีที่ไม่มีเครื่องช่วยหายใจให้ใช้ ambu mask with bag และส่งต่อ

Poisonous snake bites are medical emergencies, and they can be deadly if not treated quickly. Children are at higher risk for death or serious complications because of their smaller body size. However, the right anti-venom can save a victim’s life. Getting the victim to an emergency room as quickly as possible is the top priority, as many snakebites if properly treated will not have serious effects.

First Aid 1. Keep the person calm, reassuring them that bites can be effectively treated in an emergency room. Restrict movement, and keep the affected area below heart level to reduce the flow of venom. 2. If you have a pump suction device (such as that made by Sawyer), follow the manufacturer’s directions. 3. Remove any rings or constricting items because the affected area may swell. Create a loose splint to help restrict movement of the area. 4. If the area of the bite begins to swell and change color, the snake was probably poisonous. 5. Monitor the person’s vital signs — temperature, pulse, rate of breathing, and blood pressure if possible. If there are signs of shock (such as paleness), lay the victim flat, raise the feet about a foot, and cover the victim with a blanket. 6. Get medical help immediately. 7. Bring in the dead snake only if this can be done without risk of further injury. Do not waste time hunting for the snake, and do not risk another bite if it is not easy to kill the snake. Be careful of the head when transporting it — a dead snake can bite from reflex for up to an hour. Do Not DO NOT allow the victim to become over-exerted. If necessary, carry the victim to safety. DO NOT apply a tourniquet. DO NOT apply cold compresses to a snake bite. DO NOT cut into a snake bite with a knife or razor. DO NOT try to suction the venom by mouth. DO NOT give the victim stimulants or pain medications unless instructed to do so by a doctor. DO NOT give the victim anything by mouth. DO NOT raise the site of the bite above the level of the victim’s heart.

( From http://www.nlm.nih.gov/medlineplus/ency/article/000031.htm )

more…about sankebites http://www.emedicine.com/med/topic2143.htm http://www.nurse.nu.ac.th/cai/firstaid0291.html http://www.thaiall.com/data/primary.htm#gud http://thailabonline.com/snakebite.htm

Reference Hemodynamic Measurement Terminology

CHF http://www.seattleavir.com/patientcare.html http://www.seattleavir.com/patientcare.html

To investigate pain in babies is very difficult becuase it is authentically know that the pain was going to their brain. This study is shown how to know that the babies get pain.

This research study from premature babies by observing when a premature babies respond to their pain.Premature babies pain leads to a surge of blood and oxygen in the sensory area of the babies ’s brains.

More…. http://news.bbc.co.uk/2/hi/health/4875196.stm http://www.susheewa.com/blog/?p=262

Nowadays I rarely heard about mump problems in Thailand because mostly children in Thailand have to take mump vaccine since they was 9 month.Mumps is caused by a virus that usually spreads through saliva and can infect many parts of the body, especially the parotid salivary glands. Therefore, cases of mumps will be started with fever,swelling and pain in the parotid gland.If it is solved this infection,it can be breakout to brain,and lead to meaningitis later. According to this news from CNN,and I think it will be recalled our care giver to concern about this problem,and can stop this problem before it breakout to another person by taking good of care and following vaccine.

More information & References http://www.medpagetoday.com/InfectiousDisease/PublicHealth/tb/2979 Mumps http://www.nlm.nih.gov/medlineplus/mumps.html http://www.nfid.org/factsheets/mumpsadult.html http://www.medinfo.co.uk/conditions/mumps.html