Browsing by Author "Pensri Kosuwon"

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    Biliary atresia : The example cases in surgical treatment
    (Faculty of Medicine, Khon Kaen University, 2010-04-03) Monthon Mekanantawat; Suchart Aremitra; Sumitr Sutra; Pensri Kosuwon
     We reported 2 example cases of biliary atresia. Both of them had clinical cholestasis jaundice in late neonatal period, and passed clinical evaluation process. We found that intraoperative cholangiography reveal pathology clearly before the definite surgery-hepatic portoenterostomy or Kasai’s operation-which performed at 58 days and 108 days of age respectively. The first case recovered completely within age of 7 months. And the second case had biliary cirrhosis. The pathology was too far for surgery to treat her disease.
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    Kawasaki disease with gallbladder hydrops Report of a Case
    (Faculty of Medicine, Khon Kaen University, 2010-05-28) Pop Kosalaraksa; Pagakrong Lumbiganon; Pensri Kosuwon; Arnkisa Chaikitpinyo
     A 4 ½ -year-old boy Presented w9ith high fever and right cervical lymphadenitis for five days.  One day before admission, he still had fever and developed abdominal pain.  During admission, abdominal pain progressed, jaundice and gallbladder hydrops were detected.  He was treated with antimicrobial agents without clinical improvement.  Kawasaki disease was diagnosed one week after admission.  The patient was treated with aspirin and intravenous immunoglobulin (IVIG).  Fever defervesed within 24 hours with improvement in general conditions, jaundice and abdominal pain.  Peripheral and perianal desquamation developed in the third week of illness.  This patient recovered without complication. 
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    Neonatal Cholestasis : Biliary Atresia, the Possible Solution
    (Faculty of Medicine, Khon Kaen University, 2010-04-03) Pensri Kosuwon; Suchart Aremitra; Sumitr Sutra; Vinai Tantiyasawasdikul; Monthon Mekanantawat; Araya Thugkanopas
    Bachground : Neonatal cholestasis is defined clinically abs the accumulation in the blood conjugated bilirubin higher than 2 mg/dl or a fraction greater than 20 % of an elevated total bilirubin level. The clinical features of any form of cholestasis are similar, including jaundice, dark yellow urine and pale stools. The correct diagnosis of biliary atresia and neonatal hepatitis is important because the clinical course of these two diseases are different. In biliary atresia if Kasai operation would not be performed within 2 months of age, the child will end up with biliary cirrhosis and die at average age of one and a haff year.Objective :\  To assess the problem of diagnosis and result of treatment in order to improve management guildline for neonatal cholestasis.Study design : Retrospective descriptive study. The medical records of patients with neonatal cholestasis during Jury 1997 to July 2000 were used in this study.Results : There 33 cases of patients, 20 males, 13 females with average age was 82.69  34.39 days. A Conbination of blood test for congenital infection, imaging by ultrasound, DISIDA scan, exploratory laparotomy with intraoperative cholangiography (IOC) and histological study aided in establishing the diagnosis and differentiating biliary atresis from other causes of neonatal cholestasis. There were 13 cases of biliary atresia, 5 cases were neonatal hepatitis and 15 cases were cholestasis with non specific causes. The mean age was 78.07,57.0,97.73 days in group of libiary atresia, neonatal hepatitis, and cholestasis group respectively, The most reliable investigation was exploratory laparotomy and IOC. Kasai operation was done in only 8 cases. Only 2 had good result and liver transplantation was required in one of these. The others had cirrhosis. There were 3 cases in the neonatal hepatitis group and 7 cases in cholestasis group had results.Conclusions : The early definite diagnosis of neonatal cholestasis is the most important especially biliary atresia which the early operative treatment is crucial. There for, the parents are given advise that jaundice with pale stools after age of 2 \– 3 weeks should be regarded as abnormal. The first wellbaby examination should be happens at 4 weeks of age. The appropriate investigations should be performed for detection of biliary atresia which surgical procedure can safe their lives.Key words : neonatal cholestasis, biliary atresia, neonatal hepatitis.
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    The True Cost of Recycle Syringe Compared with Disposable Syringe at Srinagarind Hospital
    (Faculty of Medicine, Khon Kaen University, 2010-05-13) Weerachai Kosuwon; Pensri Kosuwon
     A comparative study of the true cost of recycled syringe and disposable syringe at Srinagarind hospital in 1987.  The labour cost, present value of the capital cost and overhead cost of the central supply service department were taken into account.  The result presented that the usage rates of all recycled syringes were 698, 484 per year.  The total cost of recycled syringe was 566,632 bahts per year whereas that of disposable syringe was 1,808,850 bahts per year.  There are two factors which might change the total cost of the recycled syringe such as the rates of broken-defective syringe and the labour cost.  However the sensitivity analysis shows that the result is not sensitive to change by those factors.  At the present time the use of recycled syringe is more economically than that of disposable syringe.