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Background and Objective: Primary hyperparathyroidism is now being diagnosed with increasing frequency. Simultaneously there has been an apparent change in the presentation of the disease and indication for surgery. The aim of this study was to examine the clinical presentation and pathology of parathyroid glands for primary hyperparathyroidism.Methods : This retrospective descriptive study was carried out over 14 years, from 1994 to 2008, at Srinagarind Hospital, Faculty of Medicine, KhonKaen University. Information on the clinical presentation, parathyroid hormone level, serum calcium level and pathological report of parathyroid glands was obtained from retrospective parathyroid surgical database.Results: Out of 40 patients diagnosed with primary hyperparathyroidism at Srinagarind Hospital, there were 27 female, mean age 47.22(13 – 73) years and 13 male patients. Bone fracture was the most common clinical presentation found in 19 patients, the second was renal calculi found in 11 patients, one patient was presented with bone fracture and renal calculi and 8 patients were presenteded with non-specific symptoms. Pathological reports were adenoma in 39 glands of 39 patients and hyperplasia 4 glands in one patient. Mean serum parathyroid hormone level 481.69 pg/ml (79 - 1361.7 pg/ml)and mean serum calcium level was 12.66 md/dl (9.5-16.5 mg/dl)calcium was 12.66 mg/dl (9.5 – 16.5 mg/dl) and levelConclusion: This study shows that severe bone disease with fractures are the most common presentation of primary hyperparathyroidism. The second is renal calculi. The most common pathological report was adenoma.Keywords: Primary hyperparathyroidism; clinical spectrum, pathology
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During January 1992 through November 1995, 45 patients who sustained colonic injuries were retrospectively analyzed. Thirty-eight were men and 7 were women, their mean age was 29 years. Blunt abdominal injury from traffic accident was the most common cause. The indication to perform laparotomy was based on physical findings more than diagnostic peritoneal lavage or other investigation. Right side colon was the most common location of injury and multiple colonic injuries was found in One –third of cases. Ninty-one percent of patients had associated intra or extra – abdominal injuries. Primary repair, include simple repair and resection with primary anastomosis, was carried out in most cases. Colostomy was performed in 5 cases. Pneumonia and wound infection were common complications.
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The abdominal cocoon is a rare cause of intestinal onstruction in young and adolescent girls. It characterized by encasement of the small intestine in fibrous tissue. The diagnosis is often made at laparotomy for acute or chronic intestinal obstruction. The treatment of choice is sinple excision of the fibrous tissue. This condition was first described by Foo et al in 1978, and until September 1993 only 25 cases have been reported in English literature. This paper reports a case who was admitted and operated recently at the Srinagarind hospital , Faculty of Medicine, Khon Kaen University.
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Objective : To study the outcome of inpatient trauma cases of Accident and Emergency Unit, Department of Surgery, Faculty of Medicine, Khonkaen university compared with the result of Khon Kaen Hospital and standard outcome. Method : We retrospectively studied trauma patients who was admitted in Accident and Emergency Unit, Department of Surgery, Faculty of Medicine, Khon Kaen university between 1 January 1997 to 31 December 1997. TRISS score has been calculated to define the survival probability (Ps) of all 291 patients and stratified into 3 groups. We compared the actual death of each group to the outcome study of Khon Kaen Hospital (n=2492). We also used Z-statistic to compared the actual survivors and expected survivors from TRISS norms.Result : The actual death of Non-preventable death group, Potentially preventable death group and Preventable death group were 41.67%, 45.45% and 6.39% respectively. The outcome study of Khon Kaen Hospital in each group were 87.6%, 67.7% and 2.8% respectively. The Z-score was – 0.02306 (P = 0.008 – 0.01)Conclusion : In Non-preventable death group (Ps 0.00-0.25), the outcome of treatment was better than the outcome study of Khon Kaen Hospital In Potentially preventable death group (Ps 0.25-0.50), no statistically difference between the 2 studies In preventable death group (Ps 0.50-1.00), the outcome study of Khon Kaen Hospital was better than outcome of Accident and Emergency Unit The Z-score -0.02306 indicated no statistically difference between number of actual survivors and expected survivors from TRISS norms.