Siriraj Medical Journal

33-38

Authors: Kunyarat Chuamor, B.N., Jiraporn Thongdonjuy, B.N.

Objective: To compare the additional use of gum chewing with standard post-operative care in management of post-operative bowel ileus in Thai gynecological patients undergoing abdominal surgery. Methods: A total of 128 patients were recruited in this study. Eligible patients were randomly assigned to one of two groups; group A received standard post-operative care and group B received gum chewing with standard post-operative care. Each patient was asked to complete a questionnaire on demographic data. Data about diagnosis, operation, anesthetic method, blood loss, analgesic drugs, and anti atulants were obtained from operative notes, anesthetic notes, and medical records. Results: The rst passage of blenching and atus was noted post-operatively at hours 14.7 and 16.1 in group B, and 19.2 and 19.9 in group A, respectively. Patients in group B had signi cantly higher number of blenching, atus, and bowel sound than those in group A in every time point assessment, except the number of atus in post-operative day 3 which was not signi cantly different. Patients in group A had signi cantly higher abdominal distention score than those in group B in every time point assessment. Increased waist circumference was signi cantly higher in group A than group B in post-operative days 2 and 3. Patients in group A had signi cantly more severity of ileus than those in group B in post-operative days 1-3. Patients in group B had higher satisfaction and overall satisfaction score than those in group A. Conclusion: Gum chewing provides a simple method for early recovery from post-operative ileus. Patients can tolerate gum chewing as early as the rst operative day. It is a physiological method for stimulating bowel motility. Gum chewing should be added as an adjunctive treatment in post-operative care in gynecologic surgery.

42-44

Authors: Mehmet H. Koseoglu, M.D., Serap Cuhadar, M.D., Aysenur Atay, M.D., Yavuz Yigit, M.D., Yasemin Akcay, M.D., Eser Sozmen, M.D.

Objective: Aspirin is generally used in the prevention of thrombotic occlusive events such as coronary heart disease and stroke. Underlying mechanism of action is that aspirin inhibits platelets by irreversibly inactivating cyclooxygenase-1, thereby blocking the generation of thromboxane A2 which is a potent vasoconstrictor and platelet agonist. Aspirin may also help to decrease the progression of atherosclerosis by its antioxidant effect in addition to its inhibiting effect on the coagulation sys- tem. The aim of this study was to examine the antioxidant effect of low-dose aspirin supplementation in a short term period. Methods: Ten healthy volunteers were enrolled in the study. Low-dose aspirin (300 mg. daily for 10 days) was given orally to subjects. Serum specimens were taken after 12-14 hr fasting as baseline and at 4th hr and 10th day of the oral aspirin supplementation. Serum total antioxidant activity (AOA), ferritin, iron, total cholesterol, LDL cholesterol, HDL cholesterol and triglycerides were measured. Results: Serum AOA at 4th hr were found signi cantly higher in comparison to baseline levels (p=0.006), but no signi cant difference was determined on the 10th day. There were no signi cant differences among baseline, 4th hr and 10th day values for the remaining parameters. Conclusion: Our results suggest that low-dose aspirin supplementation rapidly increases total antioxidant activity. Aspirin may play a role in improving the general antioxidative potency of the body.

49-52

Authors: Jirapong Leeyaphan, M.D., Patama Sutha, M.D., Unchana Thawaornwan, M.Sc., Tippawan Muennoo, B.Sc.

Atypical mycobacteria are an extremely rare cause of vertebral infection. Review of the English literature by use of MEDLINE from 1955 to 2012 revealed less than 50 cases of vertebral osteomyelitis due to atypical mycobacteria. Three of these cases were due to Mycobacterium abscessus. Infection of the musculoskeletal system with atypical mycobacterium usually involves tenosynovitis and occurs from either percutaneous inoculation or hematogenous spreading. The clinical course is indolent, slowly progressive, and destructive. Most cases were immunocompetent hosts. This presented case de- monstrated vertebral osteomyelitis due to M. abscessus in an HIV-negative patient without history of any underlying diseases or trauma before having this infection. There are no consensus guidelines for the treatment of these infections. Treatment of these infections is dif cult and requires a prolonged course of combination antimicrobial agents. Antimycobacterial treatments for infection due to M. abscessus are based on case series, in vitro susceptibility testing and the clinical experience of experts in patients with pulmonary diseases. Surgery is generally indicated with extensive cutaneous diseases, abscess formation or where drug therapy is dif cult.