[Profile of a nurse. Ms. Tokie Karasu, clinical instructor at the Akita Red Cross Hospital].
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Canine rabies remains a public health problem in Thailand and other developing countries. This study of animal bites at the Animal Bite Clinic at the Queen Saovabha Memorial Institute revealed that: (1) The majority of patients were bitten by dogs and the time of the attack was mostly during the day. (2) School-aged children are at the highest risk for animal bites. (3) The most common site of injury are the legs and foot (64.2%), with the second most common site being the hands and fingers (21.2%). (4) Only 48 per cent of patients received rabies vaccine 1-2 days after being exposed. There was considerable delay before the rest received treatment. Solving Thailand' s rabies problem depends on control of canine rabies and educational campaigns. Public education must be an integral part of efforts to decrease the incidence of animal bites and assurance that they are managed properly.
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BACKGROUND: Electroconvulsive therapy (ECT) is the effective treatment in psychiatric patients. However, the controversies about the risk and benefit limit the use of this procedure. Some efficacies of ECT may be interesting to use in hospitalized patients such as rapid onset, risk reduction but it may increase the length of stay (LOS) in previous study. OBJECTIVES: To study the use of ECT in hospitalized psychiatric patients in the aspect of indication , diagnosis and the length of stay. MATERIAL AND METHOD: From August to September 2004, all 51 cases of psychiatric inpatient medical records were studied. The top five of diagnosis were schizophrenia (49%), bipolar disorder (23.5%), acute psychosis (7.8%), depressive disorder (5.9%) and dementia (5.9%). ECT was performed in 22 cases (43.1%). RESULTS: The average length of stay was 21.5 +/- 14.5 days. The mean LOS of the ECT group 25.9 +/- 15.8 days was not quite longer compared with 17.8 +/- 12.7 days of the Non ECT group comparison between the ECT group (64%) and the non ECT group (36%) of schizophrenia, the LOS of each group was 27.3 +/- 16.7 and 16.9 +/- 8.8 days which was also not significant. LOS of ECT of the bipolar group (20%) and the non ECT bipolar group (80%) was 10.5 +/- 4.9 and 23.0 +/- 18.3 days which was not statistically significant (p = 0.39). There were 3 major indications for ECT such as a severe violence case, suicidal case, refractory case with the mean LOS of 19.9 +/- 10.9, 17.5 +/- 12.8, 43.3 +/- 21.2 and 31.7 +/- 8.3 days subsequently. The patients who had the refractory indication had a longer length of stay than other indications. CONCLUSION: Overall average length of stay was not longer in the ECT group. The ECT group had a longer length of stay than the non ECT group in the refractory treatment case only. ECT can be used in a psychiatric ward with the efficacy of its indication without prolonged length of stay.
OBJECTIVE: To explore the relationship between running away from home with doing poorly at school, the use of alcohol and drugs, family structure, etc. MATERIAL AND METHODS: Analysis of data collected among adolescents who sought help at the RCH, the period 1996-2000 was compared to a prior report on RCH guests for the period 1985-1995. Admission records of the RCH were used for collecting data for subsequent analysis and the guests were grouped into runaways, throwaways and homeless adolescents. Runaways came off the street or left home on their own accord. Throwaways had been asked to leave home. The homeless had nowhere to stay, did not live with parents/guardians, presented following alcohol/drug treatment or were escorted by the police. RESULTS: Compared with the operation of RCH during 1985-1995, there was about 32% increase of registered visits, mostly runaway boys and throwaways of both sexes. Fewer adolescents were homeless than in 1985-1995. About one third of runaways/throwaways and more than 70% of homeless were neither working nor at school when presenting at the RCH. Use of tobacco, alcohol/ drugs was common among guests. The most frequent reasons for the homeless seeking assistance was alcohol/ drug abuse but for runaways/throwaways having nowhere to stay and conflicts within their family. Runaway/throwaway boys were more likely than girls to be school dropouts, abuse alcohol/drugs and be out of work. Frequent visitors were worse off than first time visitors. CONCLUSIONS: The plight of homeless adolescents seemed more serious than that of runaways and throwaways. The RCH aims to keep adolescents off the streets and to prevent runaways or throwaways to become homeless who are more likely to be out of work, commit crimes and abuse alcohol/drugs. The increase of visits by adolescents registered as runaways or throwaways to the RCH, and the decrease of visits by those registered as homeless might suggest that frequency of severe relational problems between parents and their child is on the increase in Icelandic homes.
Our new environment can afford one PC (personal computer) for every two students in the course of PC classes as well as for research. It has been clarified that the students acquired greater information literacy through this new environment and PC classes.
Central venous catheters can be of major benefit to children in whom prolonged intravenous access is required. For their everyday use, however, the known associated morbidity needs to be at an acceptably low level. Experience with 44 central venous catheters in 31 children (3318 catheter days over a 40-month period) is reported. The complication rate of catheter sepsis (0.3/100 catheter days), thrombosis (1 catheter), and technical problems (17, of which 6 required removal) justified catheter usage. Provided catheters are correctly inserted and the patients meticulously nursed, these catheters offer major advantages to infants and children requiring long-term intravenous access, particularly for parenteral nutrition.
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