No abstract available.
Emergencies* ; Emergency Service, Hospital* ; Hospitals, General* ; Humans

Purpose: The purpose of this study is to find out the meaning of self-care experiences of family members of mentally ill patients and describe its essential structure. Methods: The Giorgi's phenomenological research methodology was used. Six families participated in this study. In-depth individual interviews were used to collect data from October to December in 2021. Results: Five clusters of themes were identified. They were “Selfless life”, “Life on shaky grounds”, “Attempts to escape from the suffering”, “Moving forward on self-care path”, and “Happiness blooming in being together”. Conclusion The findings suggest that mental health care professionals should provide educational programs to enable families of patients with mental illness to recognize the necessity for self-care and discover ways to take care of themselves. In addition, it is necessary to develop policies to expand patient management services at mental health welfare centers so that families of patients with mental illness can secure time for self-care.

Purpose: The purpose of this study was to examine the suffering experienced by the primary caregiver of people with mental disabilities in community dwellings to explain the fundamental structure thereof. Methods: The Giorgi’s phenomenological research methodology was used. Three male subjects and five female subjects participated in this study. The data were collected September-December, 2019 through in-depth individual interviews, and analysis based on the Giorgi’s method. Results: Four clusters of themes were identified. They are: “Mental disability came as a burden of pain”, “Painful time from caring due to being mentally recoiled and being hurtful”, “My life is broken by illness”, and “Hope discovered in the midst of pain”. Conclusion The findings provide deeper understanding and insight into the suffering experienced by primary caregivers for people with mental disabilities in community dwellings. A comprehensive program encompassing psychological and social aspects must be developed to facilitate resolving the problem of the suffering experienced by the primary caregiver for people with mental disabilities.

Heterotopic pregnancy occurs when there are coexisiting intrauterine and ectopic pregnances. It occure, more often, due to assisted reproductive technology such as IVF-ET, GIFT and increased pelvic inflammatory diseases. We present a case of heterotopic pregnancy confirmed by surgical removal of ruptured left ovarian pregnancy and sonographic finding of the intrauterine pregnancy following natural conception.
Female ; Fertilization ; Pelvic Inflammatory Disease ; Pregnancy ; Pregnancy, Ectopic ; Pregnancy, Heterotopic* ; Reproductive Techniques, Assisted ; Ultrasonography

BACKGROUND: Mannitol is widely used in neurosurgical patients and may induce an increase in serum potassium concentration according to doses and administration rates with unknown mechanism. The treatment of hyperkalemia is aimed at eliminating the causes and includes calcium, sodium bicarbonate, glucose with insulin, loop diuretics and hyperventilation. This study was undertaken to observe the effects of hyperventilation on the serum potassium concentration following infusion of mannitol (2.0 gm/kg). METHODS: We studied 30 patients who were operated brain aneurysm clipping surgery and were divided into 3 groups (n=10). In control group, mild hypocapnia was maintained (PaCO2, 32 2 mmHg) before and after mannitol infusion. In group I, moderate hypocapnia was maintained (PaCO2, 27 2 mmHg) before and after mannitol infusion. In group II, mild hypocapnia (PaCO2, 32 2 mmHg) was maintained before 30 minutes of mannitol infusion and moderate hypocapnia (PaCO2, 27 2 mHg) after mannitol infusion. We started infusion of 20% mannitol with a dosage of 2.0 gm/kg, 15~20 min after cranium was opened. RESULTS: The changes of serum potassium were as follows (Mean SD mEq/l) (just before and 15min, 30min, 60min after mannitol infusion): 3.79 0.48, 4.66 0.60, 4.44 0.48, 4.13 0.40 (Control group), 3.62 0.18, 3.63 0.42, 4.14 0.51, 3.95 0.33 (Group I), 3.76 0.20, 3.91 0.15, 4.11 0.30, 4.04 0.23 (Group II). After 15 minutes of mannitol infusion, the serum potassium levels of group I and II were lower than that of control group (p<0.05) and there was no significant difference between group I and II. CONCLUSIONS: These results suggest that hyperventilation may blunt the increase in serum potassium concentration following rapid infusion of high dose mannitol.
Calcium ; Glucose ; Humans ; Hyperkalemia ; Hyperventilation* ; Hypocapnia ; Insulin ; Intracranial Aneurysm ; Mannitol* ; Potassium* ; Skull ; Sodium Bicarbonate ; Sodium Potassium Chloride Symporter Inhibitors

There are few methods to control heavy intra-operative bleeding during cesarean delivery of placenta previa. Transient occlusion of uterine arteries (TOUA) during operation has previously been reported as a quick and safe method to control intra-operative uterine bleeding. We reported 2 cases of cesarean delivery with complete placenta previa in which TOUA was performed to safely reduce intra-operative complication, especially heavy intra-operative bleeding. In the 2 cases, cesarean deliveries were safe and without any complications under the TOUA method. TOUA can be a good method to control heavy intra-operative bleeding during cesarean delivery of complete placenta previa with risk of heavy bleeding.
Hemorrhage* ; Placenta Previa* ; Placenta* ; Uterine Artery* ; Uterine Hemorrhage

BACKGROUND: The present investigation was undertaken to evaluate the neuroprotective effect of etomidate against kainic acid (KA) induced neurotoxicity in rats by using the immunoreactivity of heat shock protein-70 (HSP-70) and the acid-fuchsin stain. METHODS: Administration of etomidate (20 mg/kg, I.P.) was performed in sequence; first being just one hour after a KA (10 mg/kg, I.P.) injection, then three more times at one hour intervals. Neuronal damages in the hippocampus were evaluated by using the acid-fuchsin stain to detect cell death and HSP-70 induction as an index of cell injury at 24 h after the administration of KA. RESULTS: HSP-70 induction and acid fuchsin positive neurons were increased in the CA1 and CA3 regions of the hippocampus after a KA injection but significantly decreased by an injection of etomidate (P < 0.01). CONCLUSIONS: These results suggest that the etomidate has a potential effect on the protection of neurons against KA-induced neurotoxicity.
Animals ; Cell Death ; Etomidate* ; Hippocampus* ; Hot Temperature ; Kainic Acid ; Neurons ; Neuroprotective Agents ; Rats* ; Rosaniline Dyes ; Shock

The brachial plexus block is a valuable method of providing anesthesia for the surgery of forearm and hand. Common technique for brachial plexus block include axillary, supraclaviculer, and interscalene approaches. The supraclavicular brachial plexus block offers adventages, ie, high success rate, rapid onset of action and relatively complete block over axillary and interscalene approach, but may be associated with pneumothorax. We marked the P point which was placed on the upper margin of clavicle that crossed the first rib on the chest PA film and marked on the skin of the patient and inserted 23G scalp needle at that point to the first rib. We performed this modified technique of supraclavicular brachial plexus block using chest PA film in 20 patients and there was no incidence of pneumothorax after this block but general anesthesia was sdministered in one case because of incomplete block. We recommend that this modified technique guided by chest PA film for supraclavicular block is simple, reliable and may reduce the incidence of pneumothorax and to increase the success rate in difficult case such as patient with extremely obesity.
Anesthesia ; Anesthesia, General ; Brachial Plexus* ; Clavicle ; Forearm ; Hand ; Humans ; Incidence ; Needles ; Obesity ; Pneumothorax ; Ribs ; Scalp ; Skin ; Thorax*

The spontaneous rupture of splenic artery aneurysm during pregnancy is a rare but catastrophic event. Two thirds of all ruptures happen during the third trimester. Clinical presentation is often non-specific, with good hemodynamic compensation, followed by a rapid deterioration. Active management and operation are the most important procedures for diagnosis and therapy of the bleeding. Abdominal delivery will help to establish diagnosis and should be performed immediately. We report a case of a patient at 38 weeks of gestation suffering epigastric pain and fetal distress. At emergency cesarean delivery, an aneurysmal rupture of the splenic artery was found to be the reason for the hemoperitoneum. Spleen, aneurysm and the tail of the pancreas were removed. In spite of fatal hemorrhage, the patient survived but her fetus was dead. With a review of the literature on this topic, diagnostic aspects and treatment options are discussed.
Aneurysm* ; Cesarean Section ; Compensation and Redress ; Diagnosis ; Emergencies ; Female ; Fetal Distress ; Fetus ; Hemodynamics ; Hemoperitoneum ; Hemorrhage ; Humans ; Pancreas ; Pregnancy ; Pregnancy Trimester, Third* ; Rupture ; Rupture, Spontaneous* ; Spleen ; Splenic Artery*

PURPOSE: To report a case of periorbital infantile capillary hemangioma treated with propranolol. CASE SUMMARY: A 6-month-old girl visited our clinic for a mass on the right upper eyelid, which had been present since birth. A dome-shaped, red-purple colored mass occupying almost the entire right upper eyelid was observed, and overlying branch-shaped telangiectases were also detected. The visual axis of the right eye was partially obscured, due to the ptotic eyelid, and her ability to fix and follow was poor in the right eye. The patient was diagnosed with infantile capillary hemagioma. Because amblyopia in her right eye was suspected, treatment with propranolol was initiated. After 2.5 months of propranolol treatment, the hemangioma decreased in size and volume dramatically, changed from red-purple to light red color, and softened. The ptosis of the right upper eyelid improved, as well as the ability of the right eye to fix and follow. No significant adverse effects (e.g. hypotension, bradycardia, hypoglycemia, bronchospasm, or elevated liver enzymes) were observed, except transient QTc prolongation during cotreatment with ibuprofen, due to an upper respiratory infection. CONCLUSIONS: Propranolol should be considered as a treatment option for periorbital infantile capillary hemangioma. Further clinical studies are required to establish the optimal guidelines and long-term outcome.
Amblyopia ; Axis, Cervical Vertebra ; Bradycardia ; Bronchial Spasm ; Capillaries ; Eye ; Eyelids ; Hemangioma ; Hemangioma, Capillary ; Humans ; Hypoglycemia ; Hypotension ; Ibuprofen ; Infant ; Light ; Liver ; Parturition ; Propranolol ; Telangiectasis