Srinagarind Medical Journal

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https://imsear.searo.who.int/handle/123456789/133194

SMJ Policy is to encourage distribution of scientific information in medical and health sciences. It publishes seven types of article; medical innovation, original article, case report, review article, conference, symposium and letter to editor.

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How to Cope with Massive Obstetric Hemorrhage During Cesarean Section?
(Faculty of Medicine, Khon Kaen University, 2009-12-22) Waraporn Chau-In
In the majority of mothers who are delivering the babies; it is able to anticipate and plan to manage the primary obstetric hemorrhage by considering the risk factors before delivery. All of which we can enhance our careful observations of the mother preoperatively. The successful prevention and control of primary hemorrhage after delivery depend on the corporation of multidisciplinary experts. The delivery must be performed by an active management of the third stage of labor. It must be made sure that there is no retained placenta. This is done along with the re-evaluation of the applications of both uterotonic and non-surgical haemostatics. The appropriate management for the primary obstetric hemorrhage by massive blood transfusion and the possible coagulopathy of the mother are complicated matter that is directly dependent upon the clinical decision. Such decision must be made carefully after the examination of each patient. The obstetric anesthesiologists’ part is to be the organizer for different departments concerned beginning from the delivery-room, operating room, blood bank, and laboratories to the supporting personnel.
The Effectiveness of Spinal Morphine plus Intravenous Patient-Controlled Analgesia on Postoperative Pain Controlled at Srinagarind Hospital
(Faculty of Medicine, Khon Kaen University, 2009-12-22) Malinee Wongswadiwat; Janjira Kuanratikul; Somboon Thienthong; Sasiwimol Ponjanyakul; Panaratana Ratanasuwan Yimyaem; Wimonrat Sriraj
Background and Objectives: Effective pain control can minimize post operative complications especially for pulmonary complications. Previous reports showed pain management using combined spinal morphine (spinal MO) plus patient-controlled analgesia (IV PCA) was more effective than either intravenous or PCA alone. This technique had been conducted in our institute since 2004 but its effect on postoperative pain control was not reported. Aim is study the effect of spinal morphine plus IV PCA on postoperative pain control. Methods: The author conducted this descriptive study at Srinagarind Hospital, Faculty of Medicine, Khon Kaen University, by retrospectively reviewing all medical record of surgical patients who received spinal morphine plus PCA for postoperative analgesia between January 2005 and December 2006. Data extracted were age, gender, types of operation, dosage of spinal morphine, pain scores (both at rest and during movement) on the first post operative day, adverse effects, and patient’s satisfaction. Effect of the pain control were classified as; effective (pain score 0-4) and ineffective (pain score 5-10)Results: Two hundred and sixty two records were analyzed. There were 63% female with a mean age of 49.6+10.5 years. Most of patients (69%) underwent abdominal surgery (excluded cesarean section and kidney surgery). Median dosage of spinal morphine was 0.3 mg depending on types of surgery. There were 62% of cases received effective analgesia at rest whereas 35.4% received while movement. No respiratory depression was reported but 1.5% of patients experienced severe nausea and vomiting. However, 92% of patients were satisfied with the treatment received.Conclusion: Spinal morphine plus PCA is effective for pain control in the first postoperative day only for at rest, but not during movement. Keywords: postoperative pain, spinal morphine, patient-controlled analgesia
Comparison study of Teaching and Learning Process Assessment of Basic Science for Educational Media Technology
(Faculty of Medicine, Khon Kaen University, 2009-12-22) Chongchareon Metta
Background and Objective: Basic science for educational media technology is important basic course for the students in order to study another subjects. Due to improving the course and in line with the medical education quality assurance, therefore, this study was out. We compared teaching and learning process assessmentof basic science for educational media technology in the first year medical illustration and audio visual technology students between the year 2007 and 2008. This study aims to compare the point of view of the first year medical illustration and audio visual technology Students in 2007 and 2008 regarding the teaching and learning process of the basic science for educational media technology course.Methods: Prospective descriptive study in farget group 20 and 21 questionnaires were self-administered by the first year medical illustration and audio visual technology students in the year 2007 and 2008. Material and methods: Self administered questionnaire using Likert scale (1-5 score) and quality control by expert content validity consultation and reliability testing (alpha 0.92) were employed. The Microsoft Excels 2003, Epi info ver 6 for data double entry and SPSS for descriptive and independent sample t-test statistics were used in this study.Results: The answers of all questionnaires in 2007 and 2008 were thoroughly compared. The study samples ranked the teaching and learning process evaluation of this course at the high level of all aspects. There were; (1) content, (2) course management, (3) lecturers, (4) learners, (5) measurement and evaluation and (6) instructional media and facilitating materials. The best mean score is in the instructional media and facilitating materials category (4.0, SD 0.25) in 2007 and measurement and evaluation category (4.10,SD 0.32) in 2008. There were statistically significant difference between the teaching and learning process mean score in course management category and all category (p \< 0.05)Conclusions: The first year medical illustration and audio visual technology students in 2007 and 2008 had judged at high score in all parts of teaching and learning process assessment of the Basic Science for Educational Media Technology Course and there was statistically difference mean score in all aspects.Keywords: Assessment, Basic Science for Educational Media Technology, Medical Illustration and Audio Visual Technology Students, Ranking Scale of 5
Predictive Statistical Model for the Risk of Cholangiocarcinoma in Northeast Thailand
(Faculty of Medicine, Khon Kaen University, 2009-12-22) Supot Kamsa-ard; Supannee Sriamporn Promthet; Paiboon Sithithaworn; Patravoot Vatanasapt; Narong KhuntiKao; Noppadol Pimchan; Siriporn Kamsa-ard; Surapon Wiangnon
Background and Objective: Cholangiocarcinoma (CHCA) is the most common cancer in Thai people especially in the Northeast of Thailand. Primary prevention is very important for CHCA control. This study attempted to find the exposures associate with CHCA in order to develop a predictive statistical model for CHCA in people in Northeast Thailand.Methods: This study was carried out in 2007 as a nested case-control study within the Khon Kaen cohort study at Cancer Unit, Khon Kaen University. The cohort recruitment was performed during 1990 to 2001. There were 108 CHCA cases occurred in the cohort and individual matched control was randomly selected for each case (1:1), matched by age, sex and date of recruitment to the cohort.Results: For the predictive model, was: logit (CHCA) = 0.69 X Opisthorchis Viverrini, OV (egg in stool finding) with the precision of 56.48% (95%CI:= 51.25-61.71), sensitivity 54.02% (95%CI: = 46.32 - 61.59), specificity 66.67% (95%CI: = 50.45 - 80.43), positive predictive value 87.04% (95%CI:=79.21-92.73) and negative predictive value 25.93% (95%CI:=17.97-5.25).Conclusion: The results of this study suggested that OV infestation has high association with CHCA. To reduce the incidence of CHCA, liver fluke control is priority work for health policy.Keywords: Cholangiocarcinoma, Risk factors for cholangiocarcinoma, Predictive model for cholangiocarcinoma
Inhaled Anesthetic Delivery System Problems during General Anesthesia at Srinagarind Hospital, Khon Kaen University
(Faculty of Medicine, Khon Kaen University, 2009-12-22) Akkharawat Sinkueakunkit; Panaratana Ratanasuwan Yimyaem; Tippawan Muknumporn; Pumpuang Sarapanish; Penwisa Naewthong
Background and Objective: During general anesthesia, inhaled anesthetic delivery system problems may contribute to anesthetic morbidity and mortality. The magnitude and pattern of these problems had not been established at Srinagarind Hospital. The objectives of this study are to identify the incidence and severity of common problems of inhaled anesthetic delivery system and find strategies for prevention.Methods: Prospective, descriptive study at Srinagarind Hospital, Faculty of Medicine, Khon Kaen University. All patients received general anesthesia in the year 2005. Details of anesthetic management in all patients were recorded on the anesthetic charts on a routine basis. When inhaled anesthetic delivery system problems had occurred, the anesthesia provider responsible for the cases wrote a short description of the event on the anesthetic charts and reported to the authors to record more details in the incidence form for further analysis about the incidence and severity.Results: There were 8,904 consecutive general anesthetic patients in 2005. Sixteen inhaled anesthetic delivery system problems were recorded (0.18 %). One-third of problems involved the anesthetic ventilators. Human error was a contributing factor in a half of the cases. No patient suffered any lasting morbidity. Conclusions: The incidence of inhaled anesthetic delivery system problems was very low and not severe during the study period. This was probably due to the improvement in routines for preoperative equipment checks, regular equipment calibration and good monitoring system in our hospital. However, there is still a potential for serious problems and strategies to prevent human error should be implemented. In addition, an improved check between cases should be encouraged to reduce the occurrence of the problems. Keywords: anesthesia, complications, inhaled anesthetic delivery system
Statistics of Patients with Cleft Lip and Cleft Palate in Srinagarind Hospital, 1984-2007
(Faculty of Medicine, Khon Kaen University, 2009-12-22) Orathai Lekbunyasin; Suteera Pradubwong; Vasana Chantachum; Supitcha Udomtanasup; Bowornsilp Chowchuen
Background and Objective: Srinagarind Hospital is a tertiary hospital with high potential for medical care of patients with cleft lip and cleft palate so we need to study about statistic and trend of the types of the patients who receive the medical care which depends on the age and illness in order to prepare to be a center of medical care, to have excellent researches in the Northeast and the nearest regions, to plan for giving the medical care and to have complete service which will benefit for patients with cleft lip and cleft palate. This study aim to determine statistics and trend of admitted patients with cleft lip and cleft palate in Srinagarind Hospital regarding types of the disease, distribution, frequency and age of the operated patients.Methods: A retrospective descriptive study was done. All admitted patients with cleft lip and cleft palate in Srinagarind Hospital, Faculty of Medicine, Khon Kaen University during 1984-2007 were included. Results: The study result is found that the most patients is male patients with cleft lip and cleft palate were 56%. There were 32% cleft lip patients, 22% cleft palate patients and 46% cleft lip with cleft palate patients from 1,950 in patient cases that came 3,342 visits, the patient can came to received the treatment many time. The majority of the patients live in Khon kaen, Mahasarakham, and Kalasin were 55%, 25% and 17% respectively. During 1984-1992, the patients to received cheiloplasty treatment age 3-4 months were 14%, to received palatoplasty treatment age 9-12 months were 29%, and during 1993-2001, the patients to received cheiloplasty treatment age 3-4 months were 32%, to received palatoplasty treatment age 9-12 months were 52% and the patients received correction of cleft lip and cleft palate age 4-5 years were 15%. The trend of patients has been increasing by patient’s age; because of the mutidisciplinary team has developed a medical care tendency and work together to the concrete. In 2002, the referral system was developed and the treatment by multidisciplinary team and treatment protocol has absolutely and efficiency. Therefore, a patient to received cheiloplasty treatment aged 3-4 months were increasing 57%, to received palatoplasty treatment aged 9-12 months were 63%, and the patients received correction of cleft lip and cleft palate aged 4-5 year were 11%. Conclusion: The study result is found that cleft lip with cleft palate patients has come to received medical treatment by patient’s age increasing as follows Nation Health Security system plan. However, some patients received medical treatment late, such as to send a patient late, an intervening disease, to be in need a knowledge for the authorities, and the many patients to wait for treatment. This reason might be effect to patients who received the treatment late.Keywords: Cleft lip and cleft palate
Factors Related to Treatment of Patients with Cleft lip or Cleft Palate in Srinagarind and Khon Kaen Hospital
(Faculty of Medicine, Khon Kaen University, 2009-12-22) Suteera Pradubwong; Siriporn Mongkonthawornchai; Pimwara Akaratiensin
Background and Objective: The holistic care of treatment by multidisciplinary is a necessesity for care giver to provide good care to some patients with cleft lip and cleftpalate for sending to the hospital and follow them up. The factor of the care givers are, age, gender, education, marital status, income, member of family, relationship, knowledge and awareness of source of help, timing for taking them to the hospital are so important for the success rate of treatment. The objective of this study was to survey the factors.Methods: Descriptive study of 242 care givers of patients with cleft lip /cleft palate by questionnaires were done and data were analyzed using frequencies, percent, medium, Pearson’s product moment correlation coefficient.Results: The response rate of the questionnaires was 57%. The mean average age a gender was of the important care giver was 33 years which 85% were female. Most respondents had only grade school education (43%). Marital status was predominantly married (90 %) and income was under 5,000 Baht/month (51 %). Family size was between 5 and 8 persons (52%) and included extended family (69%). The mean knowledge score was 3.6 and the perception of sources of help was 3.3. Patients had cheiloplasty at the age of 3-4 months (61%) and palatoplasty at the age of 9-18 months (72%). The age of care giver was found to associate with period of treatment (p=0.006). Conclusion: The caregiver is so important in that one must look after the patient for a long time after surgeries. The age factor of caregiver in 33 years to make good decision, who could learn and take care to the best quality and well being of them.Keywords: Cleft lip and palate, Care giver, knowledge, perception source to help
Routine Preoperative Screening
(Faculty of Medicine, Khon Kaen University, 2009-12-22) Banchong Udomthavornsuk; Pisake Lumbiganon
Preoperative laboratory testing in preparing the patient for surgery should be indicated by the medical history of the patient, type and extent of the planned surgical procedure. Routine screening without indication has very little value in patient care, is not cost effective, and may cause disadvantage to the patient. Hence routine screening is inappropriate and should not be practiced.
Knowledge, Understanding of Drug Allergy and Drug Allergy Card Carrying Behavior of Drug Allergic Patients in Srinagarind Hospital
(Faculty of Medicine, Khon Kaen University, 2009-12-22) Nataporn Chaipichit; Narumol Jarernsiripornkul; Pansu Chumworathayi
Background and Objective: The recurrence of drug allergy was classified as preventable drug related problem might result in life-threatening allergic symptoms. The difference in drug allergy knowledge and understanding might lead to an awareness of drug allergy and drug allergy card carried by patients. The aim of the study was to assess the knowledge, understanding of drug allergy and drug allergy card carrying behavior of patients with drug allergy in Srinagarind Hospital.Methods: A 3-month cross-sectional descriptive study was conducted. Self-administered questionnaires was distributed by post to drug allergic patients from pharmacy database and patients who were diagnosed with anaphylaxis, maculopapular rash, erythema multiforme, Stevens- Johnson syndrome and toxic epidermal necrolysis.Results: A total of 288 questionnaires were evaluated. There were 137 patients (47.9%) had moderate knowledge level (mean+S.D.=3.19+1.03; total score of five).Moreover, 38.8% of the patients were unable to address the name of allergic drug and 85.7% of them answered the importance of drug allergy card incorrectly. The management of drug allergy was answered correctly in 86.4% of the patients. The majority of patients (76.1%) always carried their drug allergy cards and about 73.3% of the patient always showed their drug allergy card at health care services. Furthermore, 40.3% of the patients had received their drugs from non- healthcare professionals. Conclusion: Most of the patients knew the management of drug allergy. However, one-third of patients failed to recall the name of allergic drug and neglected to carry drug allergy card all the time. The continuing patient education might improve drug allergy knowledge and drug allergy card carrying behavior.Keywords: knowledge, understanding, behavior, drug allergy, drug allergy card
Thai-elderly; Mahasarakham Province Context
(Faculty of Medicine, Khon Kaen University, 2009-12-22) Somporn Pothinam; Phit Saensak; Jongkol Poonsawat; Wirat Pansila; Chanisa Pansila; Chanuttha Ploylearmsang; Siritree Suttajit; Teabpaluck Sirithanawuttichai; Natchaporn Pichinarong
Background and Objectives: At present, elderly Thais rapidly grow both in number and longevity of life which effect Thai population structure, dependent ratio, and health services system. Mahasarakham province, no doubt has been confronted these problems. The Mahasarakham elderly studies review the relevance to understanding the elderly in Mahasarakham context including the exploration of research gaps and strategy in regards to health improving among the elderly. To review Mahasarakham elderly studies we divided into 6 parts; (1) general information, (2) elderly and their family, (3) the elderly potential, (4) quality of life, satisfaction and factors related, (5) the elderly happiness and (6) the elderly social welfare.Methods: Cross-sectional descriptive study by reviewing all of Mahasarakham elderly studies in 2007 in Faculty of Medicine, Mahasarakham University. Total studies were 6 parts which all of these are cross-sectional study. Results: Most of the elderly are female, widow, completed primary school, had low income since the childhood by government standard. Most of the elders perceived their health status as moderate level and more than half of the elders had chronic diseases. However, there were 70.9% of all elderly samples who were family leaders and their family role was moderate level. This study found the elderly were highly respected in cultural Thai level, especially in the areas of Thai culture, Thai and E-san tradition and handicrafts. This study also found the elderly perceived their quality of life and life satisfaction as in good level, factors related were community participation, family relationship, health status, self esteem. The same as happiness level, the elderly perceived happiness level as high level; factors related were self esteem, education level, community club member, community participation and number of family member. Besides, the elderly perceived their social welfare in part of government living allowance and health insurance as high as well. This study also found urban elderly perceived the social welfare level better than rural elderly. Most of the elderly needs social welfare in aspects of financial and health support.Conclusion: Even through more than half of Mahasarakham elderly have chronic diseases, this study found the elderly potentially perceived their quality of life, life satisfaction, and happiness as in high level and important factors related such as community participation were satisfactory. The elderly perceived well of social welfare in respects to government living allowance and health insurance. Improving the elderly health is needed to explore as well as educate the elderly in the area of social welfare especially among rural elderly.Keywords: Thai-elderly, quality of life
Cleidohyoid Muscle in Human: A Case Report
(Faculty of Medicine, Khon Kaen University, 2009-12-22) Kowit Chaisiwamongkol; Kittisak Sripanidkulchai; Porntip Boonruangsri; Yanyong Toomsan; Somsuda Teepsawang; Lawan Songserm
Background and Objective: The surgical approaches of the neck region are very frequent. The examples are thyroidectomy, tracheotomy, and removal masses including lymph nodes. Therefore, the surgeons have to be aware of anatomical variations in the neck including the unseen and unreported ones. The present study was to report the cleidohyoid muscle in Thai cadavers as a first case in the Northeast Thailand.Methods: Re-dissection surveys had been performed on the embalmed, legally donated cadavers to Department of Anatomy, Faculty of Medicine, Khon Kaen University from 1974 to 2008.Results: The cleidohyoid muscle was observed in one male out off 939 cadavers. This muscle is present in birds and disappears somewhere along the course of evolution. The muscle helps in the process of feeding. It connects the pectoral girdle, specifically the clavicle, to the tongue skeleton especially the hyoid bone, so that the swallowing of food is possible. The incidence of this variation is very rare. It is 0.01% in this study. The developmental history and the surgical aspect of the muscle were presented. Conclusion: The occurrence of the cleidohyoid muscle in the densely packed region as in the neck requires an extremely careful procedure of the surgeons.Keywords: Gross anatomy variation, cleidohyoid muscle, mechanism of feeding, developmental history, evolution
Natural History of the Common cold with Respect to Daycare Attendance at a University Hospital In Khon Kaen, Thailand
(Faculty of Medicine, Khon Kaen University, 2009-12-22) Kasama Bhudhisawasdi; Thitiporn Leelasethe; Jamaree Teeratakulpisarn
Background and Objective: Srinagarind Hospital set up a pre-school day-care center to support working parents in the campus. However, some parents personally complained of frequent respiratory illnesses among their children attending day-care. This study was conducted to determine the incidence and natural history of common cold among children attending Srinagarind Hospital Daycare Center, Khon Kaen University.Methods: This was a one-year cohort comprising 90 children (with parental consent) assessed between August 2003 and October 2004. All of the respiratory symptoms and interventions of each child were recorded daily by day-care workers and parents on the weekends. The investigators checked for missing data every 2 weeks.Results: The enrolled children, between 8 and 53 months of age (mean±SD; 31±0.9 months), suffered an average 12 colds per person-year. The majority (77%) had more than 8 episodes per year. The mean duration of each episode was 5 days (SD=5.4). Complications included sinusitis (12%) and otitis media (0.1%). The number of children with common colds peaked during the cold season (between November and February). The rate of inappropriate antibiotic therapy was 6%. ‘Being under 2 years of age’ was the primary risk factor for getting frequent colds (more than 8 per year; Odds ratio, 95% confidence interval; 12, 1.53-95.6).Conclusions: This study demonstrates an increased frequency of upper respiratory tract infections among children attending a day-care center. Simple common colds are usually self-limiting and usually last not more than one week. The most common complication was sinusitis. Children attending day-care before their second birthday are at significant risk of getting frequent colds.Keywords: common cold, day-care attendance, natural history
CME Examination: How to Cope with Massive Obstetric Hemorrhage During Cesarean Section?
(Faculty of Medicine, Khon Kaen University, 2009-12-22) Waraporn Chau-In
Abstract not available
Diabetes and Hypertension Screening by Accredited Community Pharmacy in Khon Kaen under a Pilot Project with the National Health Security Scheme
(Faculty of Medicine, Khon Kaen University, 2009-12-22) Jeerisuda Khumsikiew; Wiwat Arkaravichien; Duangtip Hongsamoot; Pimolsri Sangkar
Background and Objective: Khon Kaen has implemented a pilot project to incorporate the accredited community pharmacy with Khon Kaen Hospital’s community medical units. These community pharmacies would provide screening and refer people with high risk to confirmed diagnosis and receive appropriate treatment. The objective of this study was to determine the outcome of diabetes and hypertension screening provided by Khon Kaen accredited community pharmacies.Methods: This cross-sectional descriptive study was conducted at 7 community pharmacies and 3 community medical units of Khon Kaen Hospital. People aged 35 years or more, were the residences responsible by the National Health Security Office (NHSO) area 7, Khon Kaen who received screening during 1 October 2008 - 31 March 2009 were included in the study. Data were collected from the NHSO risk assessment questionnaires version 2008 together with capillary blood glucose and blood pressure measurements. People with high blood glucose according to the criteria (fasting blood sugar \>110 mg/dL or postprandial blood sugar \>180 mg/dL or random blood sugar \>180 mg/dL) and/or high blood pressure according to the criteria (systolic blood pressure \>140 mmHg or diastolic blood pressure \>90 mmHg) would be referred to the doctorResults: A total of 928 individuals received the screening. There were 230 cases (24.8%) met the criteria for referring which 57 cases (6.3%) suspected diabetes, 145 cases (17.5%) suspected hypertension and 28 cases (3.5%) suspected diabetes with hypertension. However, from the positive screening, only 136 cases (59.2%) had been referred to see doctors. There were only 58 cases (42.7%) went to see doctors. From patients who met doctors, 21 cases (36.2%) did have abnormal values and treatment was started with life style modification, 23 cases (39.7%) received medication and 14 cases (24.2%) were found normal.Conclusions: This study showed the potential of Khon Kaen accredited community pharmacy in diabetes and hypertension screening. However, there were still some cases which met the referring criteria but were not referred and some false positive screening cases were found. The screening and/or patient referring process should be adjusted. Keywords: Community pharmacy, diabetes screening, hypertension screening
Cervical Cancer Screening of Health Personnel in Roi-et Hospital
(Faculty of Medicine, Khon Kaen University, 2009-12-26) Wanchai Atthakorn
Background: Cervical cancer is the most common cancer of Thai women. Over 3,000 Thai women died from this cancer. The death rate was 11.3-29.4 per 100,000 women. All women, age over 30 years old or had sexual intercourse should have cervical cancer screening once a year. Over 50% of cervical cancer patient never had cervical cancer screening. There is no study of cancer screening in health personnel in Thailand.Objective: To determine the rate of cervical cancer screening of health personnel in Roi-et Hospital and the reasons for obtaining and not obtaining cervical cancer screening.Methods: Descriptive study was conducted in female health personnel of Roi-et Hospital by using open- \& close end questionnaires. Ten female health personnel were randomly selected for in-depth interview. The data was analyzed by using descriptive and inferential statistics.Results: The women health personnel 542 subjects were included. Mean age was 34.2 years, range 18-70 years. Most of participant’s age ranged from 21 to 51 year old (94%). The rate of overall cervical cancer screening was 44.8%, nurses 44.2%, nurse’s aids 44.3%, clerk 47.9% and other professions 47.1% respectively. The two most important reasons for having cancer screening were their knowledge that early stage detected cancer can be cured, 54.3% and incorporation the cervical cancer screening in the annual health checkup program, 32.4%. The two most common reasons for not having cancer screening were shyness, 46.5%, busy and inconvenience, 43.2%. From in-depth interview, the participants suggested that cervical cancer screening should be conducted by female doctor, on holiday and the results must be kept confidentially.Conclusion: The prevalence of cervical cancer screening in health personnel’s at Roi-et Hospital was 44.8% No difference of prevalence between each profession. The prevalence rate of screening may be increased if the service adjusted properly according to their context.Keywords: Cervical cancer screening, Health personnel
Cephalosporins Induced Seizures
(Faculty of Medicine, Khon Kaen University, 2009-12-26) Tarinee Arkaravichien
Cephalosporin group is one of the widely used β lactam antibiotics as it has broad spectrum and relatively safe. Adverse reactions, however, are reported e.g. allergy, superinfection, and disulfiram like reaction. Anyway, cephalosporin can cause severe adverse reactions such as seizure if the drug is accumulated in the body especially in the central nervous system. Cephalosporin induced seizure may cause death in some cases. Understanding the risk factors and having a good practice guideline in using cephalosporin would promote the safe use of the drug.
The Development and Integration Nurture for Delayed Developmental Child
(Faculty of Medicine, Khon Kaen University, 2009-12-26) Napaporn Chotchuangnirun
Background: Caring of a delayed developmental child required knowledge and continuous developmental stimulation program. A child of parent who could not bring them to follow up might have lowered the ability to improve development by their potential. The development and integration nurture for the delayed developmental child was set for increase their development. Objective: To evaluate an outcome of the development and integration nurture for delayed developmental child.Methods: A retrospective analytical study of the development and integration nurture for the delayed developmental child in developmental stimulation clinic in Kalasin Hospital was carried out from January 1, 2006 to December 31, 2008. A study group was children who had been followed-up continuously and performed the development and integration nurture had been compared with a controlled group who had comparable in initial developmental status with a study group and had not followed-up continuously and had not performed the development and integration nurture .Results: The clinic had 429 children, 117 were continuously followed-up and performed development and integration nurture (study group). Another 117 (controlled group) were selected from the rest 312 children who did not continuously followed-up. Developmental improvement in the study group (29.52%) was 6.29% more than controlled group (23.23%) and had statistical significance (p-value =0.010).Conclusion: The development and integration nurture for a delayed developmental child could increase developmental status and should be used as a program for delayed developmental child.Keywords: delayed developmental child, integration nurture
Transcranial Magnetic Stimulation
(Faculty of Medicine, Khon Kaen University, 2009-12-26) Paradee Auvichayapat; Thawatchai Krisanaprakornkit
Transcranial magnetic stimulation is a non-invasive and painless stimulation of the human brain. There are three types of stimulation: single stimuli, pairs of stimuli separated by different intervals (to the same or to several brain areas), or trains of repetitive stimuli at various frequencies. Single stimuli give rise to motor evoked potentials that have clinical use and serve diagnostic and prognostic purposes. Repetitive transcranial magnetic stimulation can modify excitability of cerebral cortex. It has opened a new field of studying of the neural circuitry, and is developing into a therapeutic tool. This general review considers fundamental of transcranial magnetic stimulation, mode of stimulation and its application, mechanism of action, and their utility in clinical practice.
Comparison of Antigen Retrieval Techniques in Immunohistochemistry
(Faculty of Medicine, Khon Kaen University, 2009-12-26) Em-orn Phanomsri; Nisana Namwat; Sakda Waraasawapati; Roongpet Tangrassameeprasert; Supinda Koonmee
Objective: The study aimed to find the best antigen retrieval buffer and heat source for the immunohistochemical staining of various kinds of antibodies in our laboratory.Materials and methods: We designed the method to evaluate the efficacy of three different retrieval solutions including 10mM Tris-HCl + 1mM EDTA, pH 9, 0.05%citraconic anhydride solution pH 7.4 and 10 mM citrate buffer pH 6, and 3 heat source pretreatment methods (Microwave, pressure cooker and water bath treatment)to retrieve twenty-one immunoreactivity in formalin-fixed, paraffin-embedded sections.Results: We found that, modified retrieval solution, 10mM Tris-HCl + 1mM EDTA buffer, pH 9 is the most efficient for a large variety of antibodies and not depending on heat sources. On the other hand, 0.05% citraconic anhydride solution and 10mM citrate buffer are moderate and poor retrieval solutions, respectively. Moreover, these two solutions are heat source-dependent.Conclusion: These results demonstrate that 10mM Tris-HCl + 1mM EDTA, pH 9 and heat-pretreatment is useful for the immunohistochemistry of many antigens in aldehyde-fixed, paraffin-embedded tissues. Keywords: antigen retrieval, immunohistochemistry, citraconic anhydride, formaldehyde
Computer Aided Surgery
(Faculty of Medicine, Khon Kaen University, 2009-12-26) Kovit Khampitak
Abstract not available

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