Journal of the Medical Association of Thailand

Permanent URI for this collection

https://imsear.searo.who.int/handle/123456789/30517

Browse

Recent Submissions

Now showing 1 - 20 of 7787
  • No Thumbnail Available
    Item
  • No Thumbnail Available
    Item
    Antitriiodothyronine antibody in patient with Hashimoto's thyroiditis.
    (1997-03-01) Plengvidhya, N; Sunthornthepvarakul, T; Vannasaeng, S
    We described a 44-year-old female patient with a history of goiter for 2 months. Physical examination revealed a diffusely enlarged thyroid gland weighing 40 g firm to hard in consistency. She was clinically euthyroid and had neither ophthalmopathy nor dermopathy. Serum thyroid hormone levels revealed total T4 (RIA) of 4.8 micrograms/dL (normal, 4-11 micrograms/dL), total T3 (RIA) of above 600 ng/dL (70-175 ng/dL), and TSH (IRMA) of 54 mU/L (0.3-6 mU/L). Antithyroglobulin and antiperoxidase antibody titers were 1:5,120 and 1:409,260, respectively. Because of the discrepancy between the patient's clinical status and laboratory values, assay for thyroid hormone autoantibodies (THAA) was done and subsequently demonstrated antitriiodothyronine antibody with percentage of precipitation by polyethylene of 98.4 per cent (normal range, 3.06 +/- 8.58%). In conclusion, THAA should be suspected in patients whose clinical status is incoherent with the thyroid function test.
  • No Thumbnail Available
    Item
    Mansonella infecting man in Thailand.
    (1988-10-01) Sucharit, S
  • No Thumbnail Available
    Item
    The incidence of hepatitis B surface antigen in liver tissues of liver diseases in Thailand.
    (1982-05-01) Panyathanya, R; Thakerngpol, K; Chinda, K; Stitnimankarn, T
  • No Thumbnail Available
    Item
    Differentiation of dementia with Lewy bodies, Alzheimer's disease and vascular dementia by cardiac 131I-meta-iodobenzylguanidine (MIBG) uptake (preliminary report).
    (2004-10-25) Jindahra, Panitha; Vejjajiva, Athasit; Witoonpanich, Rawiphan; Sirisriro, Rojana; Sritara, Chanika; Pulkes, Teeratorn
    OBJECTIVE: Differentiation of dementia with Lewy bodies (DLB), vascular dementia (VAD), and Alzheimer's disease (AD) is difficult in clinical practice. Several new techniques have been used for differentiation of various types of dementia. Among these techniques 123I-meta-iodobenzylguanidine (MIBG) uptake was reported to have benefit in distinguishing DLB from AD. The authors study the role of MIBG as a tool for differentiation of DLB, AD and VAD. METHOD: Patients with dementia were recruited to the study by DSMIIIR criteria. Diagnosis of each dementia type was made by standard clinical criteria. Brain imagings and 131I-MIBG uptake were performed in all the studied patients. RESULTS: Five DLB, 3 AD and 3 VAD patients were clinically diagnosed. The heart/mediastinum (H/M) ratio in 4 out of 5 in DLB was significantly lower than H/M ratio in patients with AD and VAD. AD patients had the highest uptake of MIBG MIBG uptake of VAD patients was in the range between AD and DLB but the values were close to the AD group. CONCLUSIONS: 131I-MIBG is helpful in differentiating DLB from AD.
  • No Thumbnail Available
    Item
  • No Thumbnail Available
    Item
    Recombinant interferon-alpha 2b and megestrol acetate in patients with advanced renal cell carcinoma.
    (2000-02-11) Voravud, N; Sriuranpong, V; Lertsaguansinchai, P
    Fifteen patients with histologically proven metastatic or unresectable renal cell carcinoma were enrolled for a phase II trial of Interferon-alpha 2b (> or = 6 x 10(6) U/m2) plus megestrol acetate (160 mg/day). A response rate of 14.3 per cent was achieved in this study. We observed weight gain (median 3.2 kilogram; range 1.1 to 6.9) in 5 patients, and stable weight in 5 of the 14 patients who completed the protocol. Weight gain occurred regardless of extent of metastasis or response to interferon. Our data suggest a possible role for megestrol acetate in alleviating anorexia and weight loss in patients with renal cell carcinoma undergoing interferon treatment. Further clinical trials are clearly warranted.
  • No Thumbnail Available
    Item
    Light chain disease with hypergammaglobulinemia.
    (1984-05-01) Harisdangkul, V; Srichaikul, T
  • No Thumbnail Available
    Item
    Hospitalized infant morbidity in the Prospective Cohort Study of Thai Children Project.
    (2008-06-14) Sornsrivichai, Vorasith; Chongsuvivatwong, Virasakdi; Mo-suwan, Ladda; Intusoma, Utcharee
    BACKGROUND: Infant morbidity causes a substantial resource burden, however, its magnitude and pattern in developing countries is still unknown. MATERIAL AND METHOD: The authors prospectively followed a cohort of 2,739 children over a one-year period in three rural areas of Thailand to detect the hospitalized infant morbidity. RESULTS: The incidence of morbidity was 454.9/1,000 live births. The top five morbidities were perinatal conditions, respiratory diseases, pneumonia, infectious diarrhea, and disorders related to short gestation/ low birth weight, and had an incidence of 88.7, 35.4, 34.3, 30.3, and 23.0 diagnoses/1,000 live births, respectively. They accounted for 1,973 days (76.6%) of hospital stay Of all morbidities, 34.8% occurred in the early neonatal period and 3.1% occurred in the late neonatal period. CONCLUSION: The present study confirmed that perinatal conditions in the early neonatal period and pneumonia and diarrhea in the post neonatal period are still an important health problem. Further attempts for prevention and control will be needed.
  • No Thumbnail Available
    Item
  • No Thumbnail Available
    Item
    Superior orbital fissure syndrome as a presenting symptom in hepatocellular carcinoma.
    (1991-12-01) Phanthumchinda, K; Hemachuda, T
    A patient with superior orbital fissure syndrome caused by metastatic hepatocellular carcinoma is reported. She had painful ophthalmoplegia and decreased sensation along the first branch of the trigeminal nerve. Histological confirmation was done by biopsy of sternal metastases. The awareness of various neurological presentations apart from hepatic failure in this malignancy is emphasized.
  • No Thumbnail Available
    Item
    Immunization in Thailand, 1970.
    (1971-02-01) Siripoonya, P
  • No Thumbnail Available
    Item
  • No Thumbnail Available
    Item
    Moral education in medical schools.
    (2006-11-09) Iramaneerat, Cherdsak
    The present report summarizes challenges in teaching medical ethics, defines its goals, describes theoretical frameworks for moral education, and reviews strategies for teaching medical ethics to serve as guidelines in developing medical ethics instruction. Medical teachers should clarify the instructional goals in cognitive, attitudinal, and behavioral domains. The cognitive developmental and behavior-analytic theories called for ethical instruction using a series of discussions based on real-life ethical dilemmas while pointing out all the basic rules related to medical practice. Ethical courses for medical students should be student-centered, problem-based, and integrative. Ethical instruction should be systematically taught to every student, but additional elective courses could also be used. Moral education for residents should be more focused to issues specific to their specialties. Medical researchers need both formal ethical training and informal teaching, and role modeling. Finally, experienced staff could use small group discussions of shared ethical problems to maintain their ethical knowledge and skills.
  • No Thumbnail Available
    Item
    Susceptibility to current antimicrobial agents of Bacteroides fragilis.
    (1989-05-01) Dhamabutra, N; Sripayak, B; Chongthalung, A; Vichivanives, P
    Agar dilution technique susceptibility test of isolated Bacteroides fragilis from the normal healthy women's and infected gynecological patients' cervical areas were studied with current antimicrobial agents. Among the N H W group, imipenem had the lowest MIC90 while cefoxitin had the highest value. Metronidazole, chloramphenicol, imipenem and piperacillin had differentiated-lower values of MIC90 and MIC90 than the others. In the I G P group, imipenem also had the lowest value of MIC90 while benzylpenicillin had the highest value. The different values of MIC90 and MIC50 less than "1" were seen in metronidazole, chloramphenicol and imipenem. The significant role of MIC90 and MIC50 was discussed in this article. Although the isolated strains had beta-lactamase enzymes, the antimicrobials resistances were not correlated with the specific enzymes. Also in this article, the significant role of anaerobic component in mixed infection was also discussed.
  • No Thumbnail Available
    Item
    Screening of cirrhosis in Thailand for schistosomiasis by rectal biopsy.
    (1975-11-01) Sriratanaban, A; Israsena, S; Taveesin, P; Wilairatana, S; Jimakorn, P
  • No Thumbnail Available
    Item
    Nosocomial infections in Maharaj Nakhon Chiang Mai Hospital 1987.
    (1989-07-01) Srisupan, V; Senaratana, W; Pichiansathien, W; Tongsawas, T
    All 5,543 patients discharged from 24 wards of Maharaj Nakhon Chiang Mai hospital from April 8 to July 7, 1987 were studied. It was found that 29.2 per cent of patients had community infections, 6.3 per cent (348) of the patients developed nosocomial infections, the infection rate was 9.3 per cent (514 episodes). The highest infection rate was found among ICU, followed by private, surgical, medical, pediatrics, and Ob-Gyn nursing services. Females were more affected than males. The most common infections were urinary and respiratory; followed by bacteremia, surgical wound infections, infections of skin, and gastrointestinal tract. E. coli, Pseudomonas aeruginosa and Klebsiella species were the major causative micro-organisms. The commonly used antibiotics were penicillins and aminoglycosides. Patients who had a nosocomial infection had to stay in hospital for an average of 17 days longer than patients who did not. The mortality rate of patients who had a nosocomial infection was 3.8 times that of patients who did not.
  • No Thumbnail Available
    Item
    Serum and urinary uric acid levels in healthy subjects and in patients with urolithiasis.
    (1991-08-01) Sila-On, A; Pavaro, U; Nuchpramool, W
    Serum uric acid and 24-hour urine uric acid levels were determined in 47 patients with urolithiasis and in 177 healthy volunteers. The normal volunteers had serum and urinary uric acid levels of 6.0-6.4 mg/dl, 619.4-683.7 mg/day for males and 4.6-4.8 mg/dl, 531.5-589.6 mg/day for females. Uric acid levels in both serum and urine were higher in male volunteers than in female volunteers (p less than 0.05), whereas, among patients the ranges of serum and urinary uric acid levels were not significantly different between males and females (p greater than 0.05). However, the normal distribution of the determined small experimental data, was statistically different and is obviously reliable. Patients with urolithiasis showed significantly higher levels of serum uric acid (8.0 +/- 0.3 mg/dl) than healthy volunteers (5.5 +/- 0.1 mg/dl) (p less than 0.05), but showed no difference in urinary uric acid levels compared with healthy volunteers (p greater than 0.05). The highest number of urolithiasis in both male and female patients fell within the same age range of 41-50 years. The 24-hour urine pH of healthy volunteers showed a range of 5.1-7.0 while the patients with urolithiasis had a pH range of 4.6-7.0. It was also found that 33 per cent of patients had urine pH less than 5.0.
  • No Thumbnail Available
    Item
    Serum cardiac troponin T in unstable angina pectoris patients.
    (2000-11-24) Leowattana, W; Mahanonda, N; Bhuripanyo, K; Pokum, S; Kiartivich, S
    Cardiac troponin T (cTnT) is a regulatory contractile protein not normally found in blood. Its detection in the circulation has been shown to be a sensitive and specific marker for myocardial cell damage. In this study, we used a second-generation enzyme immunoassay for cTnT to determine whether its presence in the serum of patients with unstable angina was a prognostic indicator. Thirty patients with unstable angina pectoris (UAP) and 30 patients with Q-wave acute myocardial infarction (AMI) were screened for serum CK-MB activity and cTnT at 6, 12, 24 and 48 hours after the onset of chest pain, All of the mean concentrations of CK-MB activity determined in UAP patients were less than the upper limit of normal (25 U/L). Meanwhile, the mean concentration of cTnT at 6, 12, 24 and 48 hours after onset of chest pain were higher than the cutoff values (0.1 microg/L), We found that one third of UAP patients had serum cTnT at the time of admission more than 0.1 microg/L and that these groups of patients were associated with a high risk for cardiac events. Our results suggested that patients with elevated serum cTnT could be considered as high-risk patients for developing myocardial infarction, Patients with normal cTnT levels and a low or intermediate clinical risk could be stabilized and further stratified noninvasively.
  • No Thumbnail Available
    Item
    Scrub typhus: chest radiographic and clinical findings in 130 Thai patients.
    (2006-05-08) Charoensak, A; Chawalparit, O; Suttinont, C; Niwattayakul, K; Losuwanaluk, K; Silpasakorn, S; Suputtamongkol, Y
    OBJECTIVE: To describe chest radiographic findings and their clinical correlation in patients with scrub typhus diagnosed in Thailand and to determine abnormalities that assist in the diagnosis of scrub typhus. MATERIAL AND METHOD: Between July 2001 and December 2002, 130 patients with scrub typhus admitted to three hospitals in the northeastern Thailand were studied. Data of clinical presentations and chest radiographic findings, reviewed by two radiologists who were unaware of the final diagnosis, were analyzed. RESULTS: There were 33 women, 97 men; age range, 11-92 years; median age, 45 years old. Pulmonary symptoms occurred in 61.5% of the patients and eschar was found in 33.1%. Hepatic dysfunction occurred in 58.5% and cardiovascular dysfunction in 33%. Pulmonary involvement was the major presentation in 41.5%. Acute respiratory distress syndrome developed in 7 patients. Overall 5 patients died. The initial radiography showed abnormalities in 64.6% of the patients. Common radiographic abnormalities included bilateral reticular opacities (48.5%), cardiomegaly (28.5%), congestive heart failure (18.5%), air space nodules (13.1%), and pleural effusion (10.8%). Significant association between chest radiographic abnormalities and hepatic and cardiovascular dysfunction were documented. CONCLUSION: Chest radiography should be included in the initial evaluation of patients with suspected scrub typhus. Bilateral reticular infiltration, with or without cardiomegaly or congestive heart failure, was the most frequent radiographic finding of scrub typhus.