Browsing by Author "Vinai Tantiyasawasdikul"
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Item Computerized Audit for Surgical Patients(Faculty of Medicine, Khon Kaen University, 2010-04-10) Potchavit Aphinives; Vajarabhongsa Bhudhisawasdi; Chaiwit Thanapaisal; Sompop Pratanee; Bowornsilp Chowchuen; Vinai TantiyasawasdikulObjective: 1. To audit the management of surgical patients by computer system. 2. To collect the problems of data analysis for auditing the management of surgical patientsDesign: Retrospective, descriptive study.Setting: Department of surgical, Faculty of Medicine, Khon Kaen UniversitySubject: All in-patients of Department of Surgical within 1998.Data collection: Review from computer database.Measurement: Descriptive statistics.Result: Important factor, which can be retrieved from computer database, include age, sex, diagnosis, operation, result, hospital stay, and mortality rate. A total of 6,821 patients was admitted in Department of Surgery during January and December 1998. The male: female ratio was 0.98:1 (3,375:3,446). The mean age of male and female patients was 43.17 and 43.76 years, respectively. The average hospital stay was 9.53 days. There were 1,224 patients (17.94%) who had complications and 6,048 patients (88.67%) had good discharge status. The average hospital mortality was 1.92%Conclusions: Computerized audit of surgical patients can be done much faster than manual audit. The result is highly accurate but may have some mistakes. Misunderstanding, inappropriate coding, unclear wording and input error cause mistakes in the computerized patient records. Some important factors for auditing are not collected in the computer system.Keyword: (1) Computer (2) Audit (3)Surgical patientsItem 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 ThugkanopasBachground : 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.Item Result of the poor - grade student file rotation in KKU Medical School in nineteen ninety.(Faculty of Medicine, Khon Kaen University, 2010-05-22) Amorn Premgamone; Surapol Veerasire; Theerawat Whantog; Chulapant Oungjanil; Sompong Srisaenpang; Weerayut Daenseekaew; Chanchai Pantongviriyakul; Vinai Tantiyasawasdikul; Fackchit KunuratA file for each student who had a poor study result in 1989 was created. The file contained the student’s background data related information. There was a tatal of 75 files. Half of theem were randomly selected to be he study group and the rest were the control group. The files of the study group were distributed to the study group and the rest were the control group. The files of the A set of quedtionnaires for the staff was went to the department as son as the students left the department. Students’ opinions were collected by questionnaires at the beginning and the end of the academic year. The numbers of re – examinations of each student in 1989 and 1990 were collected and served as indicator for the sudent’s study achievements. This randomized control study revealed that there was no significant difference in staff attitudes to both groups. The students in both group had no difference in the number of re – examination. The opinions of both groups as a result of the response to 32 questions, are not statistically different. The major problem in this study was the low response rate. Only one – hied of he staff used the circulated file, and 61.5% of them responded to the questionnaires. No negative effect was found in this study . Most of the staff who replied to questions supported the continuation of the file rotation. To improve the effectiveness, we suggest that the file should be sent to the staff who are really interested in student’s problems.