Thailand

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A 10-year review of maternal mortality in Chon Buri Hospital, Thailand.
(1993-06-01) Pinchun, P; Chullapram, T
1. The overall maternal mortality rate (MMR) in Chon Buri Hospital in the 10-yr period from 1982-1991 was 51.1/100,000 livebirths. 2. The top causes of death were abortion related complications, pregnancy induced hypertension, puerperal infection and postpartum hemorrhage. 3. What we have done is to improve the quantity and quality of obstetric and medical care, solve the problem of vital statistics reports in our hospital, contact doctor in nearby hospitals in referral and interhospital OB-GYN conferences to meet and discuss both knowledge and management problems. 4. What we still faced in the last 4-yr were deaths from abortion related complications, puerperal sepsis and postpartum hemorrhage. Most of the deaths were preventable. 5. So what we have to target to lessen the MMR is to improve the obstetric and medical care, improve the quality of medical personnel in our area in KAP aspect (knowledge, attitude, practice) especially in the field of family planning to prevent unwanted pregnancies, proper prevention and management of postpartum hemorrhage, and prevention and treatment of puerperal and postabortal infection.
10-year Survival Rate of Laryngeal Cancer Patients in Maharat Nakhon Ratchsima Hospital
(Buddhachinaraj Medical Journal, 2007-02-04) Phairuch Changprayad
PROBLEM/BACKGROUND: Laryngeal cancer is a common malignancy of the head and neck. Favorable prognosis and long-term survival rate is better than other head and neck cancers. OBJECTIVE: To study 5-year and 10-year survival rate of laryngeal cancer patients. RESEARCH DESIGN: A prospective cohort study. SETTING: Department of Otorhinolaryngology, Maharat Nakhon Ratchsima Hospital. MATERIALS and METHOD: Fifteen-year prospective data gathered from medical records of laryngeal cancer patients during January 1992 to December 2006 were analyzed. Data analysis used Kaplan-Meier survival analysis and Cox-regression analysis with significant level at 0.05. RESULTS: Among 248 patients with histologically proven laryngeal cancer (228 males, 20 females) with age range 30-87 (mean 63.49 years); there were supraglottic 38.3%, glottic 25.4%, subglottic 3.2% and transglottic 33.1%. The overall 5-year and 10-year survival rates were 26.1% (95% confidence interval=20.37-32.20) and 19.3% (95% confidence interval=13.93-25.40) respectively. The overall 10-year survival rate by site was 10.9% for supraglottic, 24.0% for glottic, 0% for subglottic and 27.3% for transglottic. The overall 10-year survival rate for stage I through IV was 47.2%, 36.3% 15.2% and 11.5% respectively. CONCLUSIONS: Significant prognostic factors for laryngeal cancer patients are T-stage, N-stage and M-stage. Early diagnosis and treatment are the keys for better survival rates.
A 12-case series of Penicillium marneffei pneumonia.
(2006-04-16) Deesomchok, Athavudh; Tanprawate, Surat
BACKGROUND: Penicillium marneffei, an endemic fungus in Southeast Asia and southern China, is the cause of opportunistic infection in HIV-infected patients who may present with symptoms and signs of the lungs, and abnormal chest radiographs. However, only a few cases of pulmonary infection from this organism have been reported. OBJECTIVE: To study the clinical manifestations of patients with Penicillium marneffei pneumonia diagnosed by sputum or bronchoalveolar lavage (BAL) fluid culture MATERIAL AND METHOD: Retrospective descriptive study of patients who were diagnosed with Penicillium marneffei pneumonia at Maharaj Nakorn Chiang Mai Hospital from September 1999 to July 2004. RESULTS: Twelve patients (eight males, four females) were included with mean age of 36.1 years. Nine cases were HIV-infected. Their presenting symptoms included fever, cough, dyspnea and weight loss. Skin lesions, hepatomegaly and lymphadenopathy were extrapulmonary signs. Chest radiographs revealed diffuse reticulonodular, diffuse reticular, localized alveolar, localized reticular infiltration, and cavitary lesion. The diagnosis was made by cultures from the sputum in five cases and BAL fluid in the others. Co-infections with Streptococcus pneumoniae, Klebsiella pneumoniae, Mycobacterium tuberculosis, Cryptococcus neoformans, and Strongyloides stercoralis were found. Most of them were treated by intravenous amphotericin B followed by oral itraconazole, or oral itraconazole. CONCLUSION: Penicillium marneffei pneumonia has non-specific clinical manifestations, it cannot be excluded from other infections and may have co-infections. Physicians should include this infection in their differential diagnosis especially in immunocompromised patients.
12-week clinical effects of erythropoietin espogen in end stage renal patients undergoing hemodialysis.
(2007-04-10) Thitiarchakul, Supachai; Tasanarong, Adis
BACKGROUND: Anemia is one of most common complications in end stage renal disease (ESRD) patients. Erythropoietin has been recommended for treatment of anemia in these patients. OBJECTIVES: To evaluate the clinical efficacy, safety and usefulness of newly imported erythropoietin, called Espogen, usage in ESRD undergoing hemodialysis. MATERIAL AND METHOD: An open, non-comparative, prospective study of administered Espogen was conducted in 30 ESRD patients undergoing hemodialysis for a 12 week period. Eligible criteria included hemoglobin of less than 8 g%, hematocrit of less than 25% for at least three consecutive months with a serum ferritin of more than 100 ng%. Initial dose of drug was 150 units/kg/week subcutaneously, two or three times a week and dosage was adjusted to maintain the Hb at 10-12g%. RESULTS: In 28 patients, hemoglobin and hematocrit were increased significantly from 7.1 +/- 1.14 g/dl and 22.1 +/- 3.24% at baseline to 10.1 +/- 1.49 g/dl and 31.7 +/- 4.01% at the end of the study period respectively (p < 0.05). Mean weekly of Espogen dosage was 8390 +/- 2452.7 IU/week, which was 152.1 IU/kg/week. Some patients could reduce the dose at week 10. Reticulocyte increased significantly from 0.69 +/- 0.58% at baseline to highest value, 1.41 +/- 0.74 at 2 week and 1.30 +/- 0.66 at the end of the present study. Serum vitamin B12, serum folate, and red blood cell folate were not significantly changed. However serum ferritin decreased significantly from 840.6 +/- 948.95 to 582.7 +/- 990.70 ng/ml (p < 0.05). General condition including SF-36 score and tiredness were improved. There were no significant adverse events except mean arterial blood pressure of pre dialysis value which was statistically significant increased at the end of the present study (from 101.0 +/- 17.65 at week 0 and 110.4 +/- 16.8 mmHg at week 12, p = 0.0223). CONCLUSION: This clinical study showed that Espogen has proven effective and safe for treatment of anemia in hemodialysis patients. No serious adverse events occurred during the study period.
123iodine.
(1988-07) Chaudakashetrin, P; Pleehachinda, R; Pusuwan, Pawana; Na Songkla, S; Chanachai, R; Intrasupht, S
131 -I-fibrinogen metabolism and fibrinolytic activity in Plasmodium falciparum malaria.
(1971-12-01) Areekul, S; Kanakakorn, K; Kasemsuth, R; Boonyananta, C; Matrakul, D
131-I-MAA scintiscanning of the lungs. An analysis of results from 313 performances.
(1970-12-01) Bovornkitti, S; Suwanik, R; Satyavanich, S
131I treated hypothyroidism and thyroid antibody levels.
(1979-02-01) Vejjajiva, S; Poshyachinda, M; Yenbutra, D
14-day quadruple therapy with ranitidine bismuth citrate after Helicobacter pylori treatment failure in Thailand.
(2006-09-28) Thong-Ngam, Duangporn; Mahachai, Varocha
BACKGROUND: A quadruple therapy with a proton pump inhibitor, bismuth, metronidazole and tetracycline is recommended as a second line therapy after Helicobacter pylori treatment failure. OBJECTIVE: To evaluate the efficacy of 14-day ranitidine bismuth citrate (RBC) base quadruple therapy after H. pylori treatment failure in Thai patients. METHOD AND MATERIAL: Between June 2003-May 2005, thirty-four patients who were H. pylori positive after first line (Omeprazole, Amoxicillin, Clarithromycin or Metronidazole) treatment failure received 14-day quadruple therapy with RBC (400 mg bid), Rabeprazole (20 mg bid), Metronidazole (500 mg tid) and Tetracycline (500 mg qid). Four weeks after completion of treatment, eradication was confirmed with 14C-urea breath test. RESULTS: There were 18 males (52.9%) and 16 females (47.1%) with a mean age of 47.3 +/- 14.6 years. Four patients dropped out due to side effects. Per-protocol eradication rate was 86.7% and the intention-to-treat eradication rate was 76.5%. Adverse effects were found in 38.2% with a bitter taste, nausea, and dizziness. The mean age in the treatment failure group was younger than that in the successful group (35.3 +/- 13.9 vs 51.1 +/- 13.9 years, p = 0.046, 95%CI, 0.3-31.5%). The abdominal symptoms were improved after eradication (82.4%). CONCLUSION: The 14-day quadruple therapy with ranitidine bismuth citrate is effective and well tolerated for the patients who failed with the Helicobacterpylori treatment. The patients with older age may receive a more favorable outcome of the treatment.
14th Ottawa Conference Hyatt Regency Miami, Florida, USA
(Buddhachinaraj Medical Journal, 2011-03-10) Dansawang, Sa-ang; Buddhachinaraj Phitsanulok Hospital
no abstract
16th Japanese Pathology for Carcinogenesis Meeting (Hatsugan-Byori Kenkyukai).
(2001-01-30) Fukushima,
17β-Hydroxysteroid dehydrogenase activity in uterine cervix of normal subjects and carcinoma patients.
(1998-05) Kalpravidh, Ruchaneekorn W; Niyomporn, Bunrueang
The ability of the human normal uterine cervix and cervical carcinoma to interconvert estradiol-17β and estrone is due to the activity of 17β-hydroxysteroid dehydrogenase (17β-HSD). Human cervical 800 x g supernatant fractions were analyzed by incubating with 3H-estradiol (20 nM) and NAD (0.25 ตmol) in 50 mM Tris buffer at pH 8.0. The incubation was terminated by adding 1 ml of 100% methanol and the supernatants were evaporated in air. The dry residues were resuspended in methanol, and aliquots were chromatographed in silica gel thin layer plates in benzene : ethanol (9 : 1, V : V). The 17β-HSD activity was determined from the amount of estrone formed and expressed as nanomoles of estrone formed/mg protein X h. The 17β-HSD activity was higher in normal cervix than in cervical carcinoma. Estradiol-17β added to incabation mixture caused a slight increase in enzyme activity only in cervical carcinoma while it had no effect in normal tissues. Progesterone administration increased 17β-HSD activity in some cases of normal and carcinoma cervix. These results suggest that changes in enzyme concentrations may play a physiologic role in the regulation of tissue levels of estradiol-17β.
180 doses in 26 weeks vs 56 doses in 24 weeks of chemotherapy in pulmonary tuberculosis: a preliminary report.
(1988-05-01) Jittinandana, A; Kecharanandana, P; Payanandana, W; Daramas, M
The 18F-FDG PET scan in oncology
(Songklanagarind Medical Journal, 2010-01-15) T Thientunyakit
A rapidly emerging clinical application of Positron Emission Tomography (PET) is the detection and staging of cancer. The glucose analogue tracer 2-[fluorine-18]fluoro-2-deoxy-D-glucose (18F-FDG) has been used successfully for assessing primary tumours and metastases, to indicate prognosis, planning and for monitoring of tumour therapy as well as the early detection of recurrent tumour growth. This review summarises the uptake mechanism of 18F-FDG in benign and malignant lesions, its relation to histopathology, and the potential of PET in oncology practice.
The 1973 epidemic of dengue haemorrhagic fever in Malaysia: (a preliminary report).
(1974-09-01) Lim, T W; Wallace, H G; Rudnick, A; Cheong, W H; Knudsen, A B; Chew, V
The 1982 dengue epidemic in Malaysia: epidemiological, serological and virological aspects.
(1984-03-01) Fang, R; Lo, E; Lim, T W
In 1982, Malaysia experienced the worst dengue/dengue haemorrhagic fever outbreak in its history. All states in Peninsular and East Malaysia were similarly affected. There was a total of 3,005 cases with 35 deaths, with the majority of cases occurring between the months of July to October. There was a total of 1,001 laboratory confirmed cases. Most of the cases were in patients over the age of 15 years. The Chinese population was mainly affected, although a much higher proportion of Malays was noted in comparison to previous years. The main serotypes involved were dengue-1 and dengue-3. No dengue-4 serotype were isolated.
The 1990-1991 outbreak of melioidosis in the Northern Territory of Australia: clinical aspects.
(1993-09-01) Currie, B; Howard, D; Nguyen, V T; Withnall, K; Merianos, A
From November 1990 to June 1991, 33 cases of acute melioidosis were diagnosed in tropical Northern Territory, Australia during an exceptionally wet monsoon. Eighteen (55%) were alcoholic, 16 (48%) diabetic and only 4 (12%, all survivors) had no risk factors. Twenty-seven (82%) were considered recent infection, with an incubation period of 3-21 days (mean 14) documented in eight cases with presumed cutaneous inoculation. Fourteen patients presented with pneumonia (4 septicemic) and of 11 others with septicemia 4 had genitourinary foci. Three of 4 with splenic abscesses required splenectomy. Three had only skin/soft tissue infection. One patient with brainstem encephalitis needed prolonged ventilation. Overall mortality was 36% (12 cases, including three relapses), despite therapy with ceftazidime and intensive care facilities. Pseudomonas pseudomallei is the commonest diagnosed cause of fatal bacteremic pneumonia at Royal Darwin Hospital and emphasis is placed on early appropriate antibiotic therapy and compliance with maintenance therapy for at least three months.
The 1990-1991 outbreak of melioidosis in the Northern Territory of Australia: epidemiology and environmental studies.
(1993-09-01) Merianos, A; Patel, M; Lane, J M; Noonan, C N; Sharrock, D; Mock, P A; Currie, B
From November 1990 to June 1991 33 acute cases of melioidosis occurred in the Northern Territory, Australia; 25 cases were reported in the capital city, Darwin. We carried out an epidemiological investigation to exclude a common source outbreak, describe the risk factors for disease, and develop and institute appropriate control measures. We compared population based attack rates among various risk groups using logistic regression, and the demographic, medical and behavioral risk factors for melioidosis by a matched case-control study. Environmental Health Officers collected soil, surface water and cooling tower water specimens for Pseudomonas pseudomallei culture. The crude attack rate of melioidosis during the outbreak was 52 per 100,000. Age, gender, race, diabetes and alcohol abuse were independent risk factors for disease. The relative risk of disease in diabetic patients was 12.9 (95% CI 5.1-32.7; p < 0.001) and 6.7 in alcoholic patients (95% CI 2.9-15.2; p < 0.001). We found no significant difference between cases and controls in matched pair analysis for any of several exposure factors studied. We isolated Pseudomonas pseudomallei from 4% of soil samples and 9% of surface water samples. Our study confirms the importance of host factors in the development of melioidosis, and attempts to quantify the risk of disease during the Darwin epidemic. Pseudomonas pseudomallei is widespread in the soil of urban Darwin.
The 1993 epidemic of dengue fever in Mangalore, Karnataka state, India.
(1995-12-01) Padbidri, V S; Adhikari, P; Thakare, J P; Ilkal, M A; Joshi, G D; Pereira, P; Guttikar, S N; Walhekar, B D; Chowta, N; Hegde, B M
An epidemic of febrile illness with hemorrhagic manifestations occurred in certain parts of Mangalore city, Karnataka state, India, from the last week of July 1993. The epidemic reached its peak by mid-August and then started declining. Sporadic cases, however, continued to occur till early December. About 200 cases were reported covering all age groups and both sexes. The cases presented with pyrexia, myalgia, arthralgia and headache. Palatal petechiae, magenta colored tongue with central coating, maculopapular rash and facial flush were observed as classical signs. The tourniquet test was positive in 12% of the cases. Hemorrhage was observed in the form of epistaxis (2 cases), subconjunctival hemorrhage (2 cases) or purpura (3 cases). There were no deaths which were attributable to the epidemic. Five strains of dengue (DEN-2) virus were recovered from the acute-phase sera. Dengue virus-specific IgM type of antibodies were detected in 29/116 (25%) sera. Breeding of Aedes aegypti was observed in some of the areas where cases had occurred. No virus was isolated from any of the field-caught Ae. aegypti mosquitos.
The 1996 outbreak of dengue hemorrhagic fever in Delhi, India.
(1998-09-07) Anuradha, S; Singh, N P; Rizvi, S N; Agarwal, S K; Gur, R; Mathur, M D
A major outbreak of dengue hemorrhagic fever (DHF) affected more than 10,000 people in Delhi and neighboring areas in 1996. The outbreak started in September, peaked in October to November and lasted till early December. The clinical and laboratory data of 515 adult patients admitted to Lok Nayak Hospital, New Delhi were reviewed. Fever (100%), myalgias and malaise (96%), abdominal pain (10.2%) and vomiting (8.7%) were the prominent presenting features. Hemorrhagic manifestations were seen in all patients- a positive tourniquet test (21.2%), scattered petechial rash (23.07%), confluent rash (2.7%), epistaxis (38.4%), gum bleeds (28.06%) and hematemesis (22.86%) being the major bleeding manifestations. Hepatomegaly was observed in 96% of the patients. Laboratory investigations revealed thrombocytopenia, hemoconcentration and leukopenia. Serological confirmation with a microcapture ELISA technic was done in 143/515 patients. The mortality rate was 6.6% and, multiple bleeding manifestations, severe thrombocytopenia, hypoproteinemia and dengue shock syndrome (DSS) were associated with a higher mortality.

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