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Objective: To evaluate effectiveness and safety of Khampitak Uterine Forceps in Modified Laparoscopically assisted Vaginal Hysterectomy (M- LAVH) Design: One case of 12 week - size leiomyoma was operated by M-LAVH Setting: Srinagarind Hospital, Faculty of Medicine, Khon Kaen University.Results : The uterine size was 13 x 10 x7 cm3. The total operative time was 210 minutes. The forceps procedure time (applying, sawing and uterine removing) was 35 minutes. Average blood loss was 130 cc. The patient was discharged in 5 days. Febrile morbidity was detected in the 2nd day after surgery.Conclusion: Using Khampitak Uterine Forceps in M-LAVH is a safe and effective method for treatment the patient with large leiomyoma. Khampitak Uterine Forceps in M-LAVH is expected to benefit the gynecologist to increase the success of LAVH in large uterus.
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Background: The number of people diagnosed with diabetes trends to dramatically increase over time. Diabetes is recognized as a serious global health problem often resulting in substantial morbidity and mortality. Diabetes and its complications can be prevented or delayed through lifestyle alterations. Early diagnosis and identifying high risk people are beneficial in diabetes control.Objective: To study the prevalence of diabetes and impaired glucose tolerance in volunteers residing in rural and urban area of Khon Kaen Province and to follow-up diabetes and impaired glucose tolerance volunteers one year after the previous survey.Methods: The volunteers were interviewed and checked for general health status. After fasting overnight, the fasting plasma glucose and glucose tolerance test were conducted by taking 75 grams of glucose orally. Blood samples were analyzed for plasma glucose.Study design: Descriptive studySetting: Taang Kwang village, Wang Noi district; Noon Chai village, Khon Kaen township and Srinagarind hospital. Samples: One hundred and three volunteers in Taang Kwang, Wang-Noi district, Khon Kaen and 211 volunteers in Noon Chai village, Khon Kaen township, Khon KaenResults: In comparison of the prevalence of diabetes diagnosed by fasting plasma glucose, the urban and rural volunteers had 17.2% and 10% of diabetes respectively. The prevalence of diabetes was higher to 36% for urban and 19% for rural volunteers when diagnosed by oral glucose tolerance test. In the 1 year follow-up survey of rural volunteers showed that volunteers with diabetes changed their behaviour to increase exercise and diet control more than normal volunteers.Conclusion: The prevalence of diabetes was higher in urban volunteer group than in rural volunteer group. The prevalence was 2 times higher when diagnosed by glucose tolerance test both in urban and rural volunteers. In rural volunteer group, the prevalence of diabetes increased with the increasing age range while the prevalence of urban volunteer group was related to abdominal fat. The volunteers with high plasma glucose changed their lifestyle in favour of preventing long term complication and increased well-being.Keywords: diabetes of diabetes; urban and rural volunteer; lifestyle
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Background: Laparoscopically asisted vaginal hysterectomy (LAVH) has continued to gain popularly. However, one of the limitations is a huge leiomyoma. Modified LAVH, using uterine screw and forceps, was designed and introduced by our research team for solving this problem. Study objective: To evaluate the effectiveness and safety of modified laparoscopically assisted vaginal hysterectomy (M- LAVH), using uterine screw and forceps.Design: Descriptive study.Setting: Srinagarind Hospital, Faculty of Medicine, Khon Kaen University.Patients: Patients scheduled for hysterectomy for a benign condition, in whom a vaginal hysterectomy was not possible and no moderate to severe adhesion.Interventions: Modified laparoscopically assisted vaginal hysterectomy (M- LAVH), using uterine screw and forceps.Results: Ten patients were recruited in this study. Huge leiomyoma ( \> 12 week-size ) was diagnosed in 8 patients. The others were recurrent uterine bleeding, caused by submucous leiomyoma, and recurrent dysfunctional uterine bleeding. The operative procedures were M- LAVH in 6 patients, additionally with unilateral salpingooophorectomy in 3 patients and bilateral salpingo-oophorectomy in 1 patient. The mean operative time was 194 minutes (S.D. = 54, 95% CI: 155.4, 232.6). The mean duration of forceps applied throughout the procedure was 27 minutes (S.D. = 9.2, 95% CI: 20.4, 33.6). The median weight of uterus, including cervix, was 315 gm (range 270-750 gm). Two patients developed post operative complications. One, whose the suture material of uterine artery had spontaneously slipped in 12 hours after surgery, was repeated laparoscopic electrocoagulation for homeostasis. Another developed pelvic inflammatory disease at the third week after operation. Almost all patients were discharged from the hospital on the third day after operation (range 2- 5 days). Conclusions: M-LAVH, using uterine screw and forceps, is a safe and effective method for treatment the patient who indicated hysterectomy, especially due to largeleiomyoma. Therefore we would like to distribute this new procedure to the gynecological laparoscopists for further study and further evaluate for improving the success of LAVH.Keywords: Uterine forceps, LAVH, Laparoscopic hysterectomy