Beating heart as an alternative for closure of secundum atrial septal defect.

We repaired secundum atrial septal defect in 135 consecutive patients from February 2003 to December 2010. There were 98 females and 37 males, with a mean age of 22.92 ± 17.46 years (range, 3-55 years). To prevent myocardial dysfunction and systemic embolism caused by the conventional technique, the operation was performed with a beating heart under cardiopulmonary bypass in 63 cases, and compared the data retrospectively with cases treated under aortic crossclamping, to determine the safety of the beating-heart technique and to evaluate risk factors for embolism in stroke patients. Patient age and size of defect were similar in both groups. There was no death and no residual shunt in either group. The mean cardiopulmonary bypass time was 36.84 ± 9.8 min in the beating-heart group and 43.13 ± 16.7 min in the crossclamp group. The ejection fraction and the incidence of postoperative arrhythmia were similar in both groups. There were no differences in blood products transfused, intensive care unit stay, hospital stay, or perioperative morbidity. In our experience, the results of the beating-heart technique were not different from the conventional technique.

Unrecognized congenital heart disease among Thai children.

OBJECTIVE: To report on the prevalence of unrecognized congenital heart disease (CHD) among elementary school children (231 schools, 6 cities in Tak province). MATERIAL AND METHOD: Between January, 2006 and December 2006, 38,055 children were examined by trained nurses and health officers to ausculate the precordium. Those with abnormal heart sounds were re-evaluated by pediatric cardiologists. RESULTS: Of the 278 subjects with abnormal heart sounds, 43 had proven heart disease, 40 showed CHD (1.05 per 1,000) and three had rheumatic valvular diseases. CONCLUSION: Understanding the case rate helped approximate the number of children who are currently undetected but have heart problems or may develop heart problems in the future. Every diseased person will receive treatment.

Bioequivalence of generic lamotrigine 100-mg tablets in healthy Thai male volunteers: a randomized, single-dose, two-period, two-sequence crossover study.

BACKGROUND: Lamotrigine is an antiepileptic drug which has been used in the treatment of epilepsy and bipolar disorder. A search of the literature did not find previously published bioequivalence and pharmacokinetic evaluations of lamotrigine in healthy Thai male volunteers. OBJECTIVE: The aim of this study was to compare the pharmacokinetic parameters between 2 brands of lamotrigine in healthy Thai male volunteers. METHODS: A randomized, single-dose, 2-period, 2-sequence, crossover study design with a 2-week washout period was conducted in healthy Thai males. Subjects were randomized to receive either the test or reference formulation in the first period. All subjects were required to be nonsmokers and without a history of alcohol or drug abuse. Plasma samples were collected over a 120-hour period after 100-mg lamotrigine administration in each period. A validated high-performance liquid chromatography ultraviolet method was used to analyze lamotrigine concentration in plasma. Pharmacokinetic parameters were determined using a noncompartmental method. Bioequivalence between the test and reference products, as defined by the US Food and Drug Administration (FDA), is determined when the ratio for the 90% CIs of the difference in the means of the log-transformed AUC(0-t), AUC(0-infinity), and C(max) of the 2 products are within 0.80 and 1.25. Adverse events were determined by measuring vital signs after dosing. Subjects were also asked if they suffered from undesirable effects such as nausea, vomiting, dizziness, and headache. RESULTS: This bioequivalence study was performed in 24 healthy Thai males (mean [SD] age, 20.5 [1.3] years; range, 19-24 years; weight, 62.5 [7.4] kg; height, 172.8 [6.9] cm; body mass index, 20.9 [2.0] kg/m(2)). The mean (SD) C(max) and T(max) of the test formulation of lamotrigine were 1.7 (0.3) microg/mL and 1.2 (0.9) hours, respectively. The mean (SD) C(max) and T(max) of the reference formulation of lamotrigine were 1.7 (0.3) microg/mL and 1.4 (1.0) hours, respectively. The mean (SD) AUC(0-t) was 67.1 (13.2) microg/mL x h(-1) for the test product and 66.4 (14.6) microg/mL x h(-1) for the reference product. The mean (SD) AUC(0-infinity) was 74.9 (18.3) microg/mL x h(-1) for the test product and 74.3 (20.5) microg/mL x h(-1) for the reference product. The mean (SD) t((1/2)) values were 35.0 (7.6) hours for the test product and 34.7 (7.6) hours for the reference product. The mean test/reference ratios for AUC(0-t), AUC(0-infinity), and Cmax were 1.01, 1.01, and 1.05, respectively. The parametric 90% CIs for AUC(0-t), AUC(0-infinity), and Cmax were 0.98 to 1.05, 0.98 to 1.06, and 0.98 to 1.13, respectively. Following administration, dizziness or headache was reported in 2 subjects in the test group and 1 subject in the reference group. CONCLUSION: The results of this study suggest that the test product was bioequivalent to the reference product in these healthy Thai male subjects, based on the US FDA's regulatory definition.

Paraplegia after thoracotomy for division and suture Patent Ductus Arteriosus (PDA).

A Thai women, aged 22 years old, came to hospital with Patent Ductus Arteriosis (PDA). Left thoracotomy, with division and suturing PDA, was performed. The second day after operation, she developed paraplegia below umbilical level. The CT-scan detected an extradural hematoma in the spinal cavity from T3-T6. To remove the blood clot, the T spine laminectomy was performed. 6 months after the laminectomy, the patient was able to perform her regular exercise.