VOLUME

At  Bangkok  Hospital,  we  believe  in  Service  from  the  Heart.  It  is  thus  appropriate  that  our  3rd edition  continues  to  see  a  distinctive  and  varied  contribution  from  our  Cardiac  Unit. We  are pleased to finally see in print Dr. Gumpanart’s account of how he and his capable team saved a patient’s life with the first emergent primary coronary angioplasty performed in Thailand. Dr. Pradub appraises  evidence-based  management  of Acute  decompensated  heart  failure.  Dr.  Rattanapan’s  case study shows how conservative treatment over a longer period can be used to deal with a large thrombus where standard surgical intervention was inadequate to restore coronary perfusion. Dr. Lertlak details using MRI images to study regional wall motion of the left ventricle, to develop additional quantitative tool, with which to detect impaired myocardial regional wall motion. Dr. Poomiporn describes a rare case of Kawasaki Disease Shock Syndrome in a young child, which if untreated could lead to ischemic heart disease, myocardial infarction or sudden death.

Another  rare  presentation  is  the  case  study  of  the  patient  with  headache  onset  after  laughter,  as
related by Dr. Kiratikorn; MR imaging of the cervical spine detected a Chiari I malformation, the most likely  secondary  cause  associated  with  this  peculiar  condition. We  continue  to  see  strength  from  our imaging team’s close co-operation with our oncologists, using nuclear medicine for increase sensitivity and  specificity  in  diagnosing  breast  cancer,  using  3D  software  reconstructions  with  CT  studies  to improve surgery prospects in liver tumor and detection of small throat cancer by Diffusion-weighted MRI pulse sequence. Gastric cancer is still a major killer throughout the world because it is so often diag- nosed at a late stage, so it is exciting to see patient prognosis improving after using adjuvant therapy with Trastuzumab being effective at reducing tumors that do not have HER2 gene amplification.

On the theme of fighting sepsis, Dr. Paithoon explains how the BMC drastically reduced catheter related  blood  stream  infections  and  Dr.  Panpit  gives  clear  and  up  to  date  guidelines  on  how  to  treat urinary  tract  infections.  Dr.  Att  enthuses  over  the  new  hydrosurgery  tools  available  to  debride wounds difficult to access with traditional methods. Our Spine unit describes how they are improving their  accuracy  of  measuring  surgical  outcomes  by  incorporating  Oswestry  Disability  Index  question- naires and the EuroQol-5D questionnaires into the pre and post operative treatment process.

We are also pleased to welcome guest authors from outside the BDMS group to this volume. Professor Douglas Kieper from the Department of Physics at the Hampton University gives further perspective on molecular breast imaging. Professor Van de Werf from Leuven University Hospital gives a cogent and useful review of Lytic therapy to treat acute myocardial infarction; after all, there are still few hospitals worldwide who provide a well staffed primary 24/7 PCI unit. Dr. Phornthip, a senior nurse researcher from Lerdsin Hospital illustrates how the concept of cognitive behavioral change is being practically enlisted into preventive public health programs to tackle the growing obesity problem in Thailand.

Finally, we’d like to announce the establishment of the Bangkok Health Research Center, which will offer up to date health information to medical professionals and the general public.

We hope our readers will enjoy and be stimulated by the diversity of this month’s offerings. Happy Valentines to you all!


                                                                                                                        Chirotchana Suchato, MD
                                                                                                                                        Editor in Chief
                                                                                                                            Rergchai Varatorn, MD
                                                                                                                                               Co-Editor