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Background : Routine urine culture for all pregnant women is recommended as the screening test for asymptomatic bacteriuria (ABU). The is not readily available in many parts of the world including Thailand. Identification of the pregnant women at higher risk for ABU and performing urine culture to detect ABU may be the appropriate alternative management.Objective : To asses risk factors for asymptomatic bacteriuria (ABU) in pregnant women.Design: A cross-sectional study.Setting : A tertiary care (university) hospital in Thailand.Subjects : 774 pregnant women who attended their first antenatal care at Srinagarind hospital, Khon Kaen University were recruited for the study, Clean-catched mid stream urine were obtained from every subject for culture.Main outcome measures : Information regarding sociodemographic characteristics, obstetric history, history of previous urinary tract infection, the status of the present pregnancy and the result of urine culture were recorded. Risk factors for ABU were initially evaluated by univariate analysis. We used multiple logistic regression analysis for controlling confounding effect.Results : The prevalence of ABU in pregnant women was 11.2%. After univariate and multiple logistic regression analysis, anemia and low education were found to be significant risk factors for ABU in pregnant women. Anemic pregnant women had a 2.5 fold risk of having ABU compared with the non-anemic pregnant women. Low educated pregnant women had a 1.7 fold risk of ABU compared with educated subjects. Age, occupation, monthly income, gravidity, gestational age, previous history of urinary tract infection were not statistically associated with ABU.Conclustions : Selective urine culture for anemic or low educated pregnant women may be considered in situation in which routine urine culture for pregnant women is not feasible. A sensitive but inexpensive routine screening test is required to detect ABU in pregnant women.
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OBJECTIVE : 1To study knowledge and attitude towards thalassemia in reproductive women who have the disease or are carriers. 2. To assess factors affecting knowledge. 3. To study knowledge and attitude towards prenatal diagnosis in these women.STUDY DESIGN : A descriptive study.SETTING : University Hospital.SUBJECTS : 150 reproductive women with thalassemic disease or who are carriers. They were either mothers of thalassemic children or were found to have thalassemic disease found to be carrier in the antenatal clinic.MAIN OUTCOME MEASURES : knowledge was evaluated by a pretested questionnaire co7ntaining 16 questions. Women were classified as having adequate knowledge in thalassemia if they answered at least 10 questions correctly. Attitude was assessed also by a pretested questionnaire containing 14 questions. Factors associated with knowledge were assessed by univariate analysis using Chi-square statistics. Multiple logistic regression analysis was used as a control for potential confounding effects.RESULTS : Sixty women (40.0%) were defined as having adequate knowledge. Concerning attitude, the 150 women had a good attitude towards thalassemia. Factors affecting knowledge significantly (p
ABSTRACT
Pelvic examination in antenatal care has been neglected by some obstetricians because lack of concern. The aim of this study was to determine the abnormalities detected care. A total number of 400 pregnant women during their first visit to antenatal care clinic of srinagarind hospital were examined by speculum examination, bimanual palpation, Papanicolaou smear for cervical cytology and wet smear of vaginal discharge Abnormal findings were detected in 42.2 percent. These included 20.5 percent of fungal infection, 14.5 percent of non specific inflammation, 1.0 percent of Trichomonas virginities, 0.8 percent of fungal and Trichomonas virginities, 0.3 percent of HSV and fungal and fungal infection. These was also 0.6 percent of ovarian tumor, 0.8 percent of uterine size uncorrelated with gestational age, 0.8 percent of cervical polyp. Abnormal cervical cytology were detected in 3.4 percent, 0.8 percent of patients in class 2, 2.3 percent in class 3 and 0.3 percent in class 4. From result of this study, We concluded that routine pelvic examination and cervical cytology can detect substantial pathologic conditions in effectively treated. Pelvic examination should there fore bge performed as a routine procedure in first antenatal care visit.
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Comparative study of VCE and cervical scraping Pap smears of the uterine cervices was done in 470 OPD cases in Srinagarind Hospital from October 1987 to January 1990. The cervical scraping Pap smear had low sensitivity in detecting endocervical cells and atypical cells when compared with the VCE technique (34.7% and 23.3% respectively), but had high sensitivity in detecting dysplastic cells (72.7%). However, in the VCE slides the cervical scraping parts © were the most sensitive parts to detect dysplastic cells.
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The main purpose of rubella immunization is the eradication of congenital rubella syndrome. The majority of medical personnels are female in reproductive age. Those personnels with negative rubella antibody are at risk of developing rubella infection during pregnancy. It is not known whether screening for rubella antibody first and vaccinate only those with negative antibody is more cost benefit than routine vaccination without screening. 137 volunteer female medical personnels have had their blood drawn for rubella antibody before vaccination with attenuated live virus strain wistar RA 27/3, human diploid cells. All direct and indirect costs are calculated in order to analyes the cost-benefit of each program. The results indicated that the prevalence of positive rubella antibody was 67%. About 17 of the vaccinees, with and without antibody against rubella experienced side-effects, most of them were mild. From the perspective of hospital administrator, routine rubella vaccination without screening has more cost-benefit than screening before vaccinating only those who are susceptible.
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The prevalence of HBV markers among medical personnel at Srinagarind Hospital, Faculty of Medicine, Khon Kaen University, Northeast of Thailand, was studied by hemagglutination (HA) and ELISA techniques. The overall prevalence of HBV markers was 49.37%. The highest prevalence was found in medical doctors followed by laboratory personnel, nurses and the workers had the lowest prevalence. After control for the effect of age and sex by multiple logistic regression, the medical doctors and the laboratory personnel were found to have statistically significant higher risk of HBV infection. ELISA was statistically more sensitive than HA in detecting antiHBs (p
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There were 423 consecutive pregnant women underwent intrapartum fetal heart rate monitoring at Srinagarind Hospital from January 1985 to December 1986 . Of these 423 tests during the study period 421 (99.5%) were available for study. There was no stillbirth in this series. The incidence of birth asphyxia was 9.1% while the perinatal death rate was 12 per 1000 livebirths. The accuracy of the test in predicing birth asphyxia was 87.4%. Those subjects with positive results had relative risks of 5.3 and 2.6 in developing birth asphyxia and perinatla death respectively. The results of intrapartum fetal heart rate monitoring at Srinagarind Hospital is valid. It can be used to select pregnant women at higher risk in developing fetal distress and birth asphyxia so that special care and appropriate intervention can be taken.
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From July 1982 to June 1987, a total of 647 cervical cancer patients who had undergone cystoscopy for staging of the disease at Srinagarind hospital were available for the study. There were 21 patients (3.25%) found to have bladder mucosa involved by the cancer. Twenty patients were initially in stage III B and 1 patient was in stage IV B. The result of the cystoscopy changed the initial staging of the disease in only 3.09% of the patients. The urinalysis of the patients revealed 161 cases (24.88%) with abnormal amount of red blood cells in urine. One hundred and twelve patients with abnormal urinalysis were in stage III or more advanced disease. All of the patients who had bladder mucosa involved by the cancer had abnormal amount of red blood cells in urine. The authors suggest that cystoscopy for staging of cervical cancer be done only in patient with stage III or more advanced disease who has abnormal amount of red blood cells in urine. By this criterion, only one fifth of the cervical cancer patients would undergo cystoscopy for staging of the disease.
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The study was conducted to evaluate the validity of birth weight and mode of delivery data obtained from questionnaire. mail questionnaire was sent out to 345 mothers from Nong Rug district, Khon Kaen Province, who delivered their infants at Maternal and Child Health Center from Jauary 1, 1984 to December 31, 1984. The response rate was 72.17% (249/345). The in formation obtained from questionnaire was compared with the information from delivery record. The identiification of low birth weight (Less than 2,500 grams) by the questionnaire was less than 50%. The questionnaire had a good agreement with regard to mode of delivery with the exception of forceps extraction.
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Background : Endometriosis is a relatively relatively common gynecological condition. There was no report related to the prevalence and description in the northeast region of Thailand.Objective : 1.To assess the prevalence of endometriosis in inpatient unit of Obstetric – Gynecology department of Srinagarind hospital. 2. To assess the characteristics of endometriotic patients regarding clinical manifestations, results of investigations, modalities of treatment and results.Design : A descriptive study.Setting : Srinagarind hospital, Khon Kaen University. Subjects : 3,626 gynecologic patients who were admitted to Srinagarind hospital from January 1 , 1991 to December 31, 1992.Main Outcome Measures : The prudent indicators used in this study were the prevalence of endometriosis, ties and result of treatment.Results: The prevalence of endometriosis in Srinagarind hospital during the study period was 8.6% which consisted of 3.1% endometriosis externa, 3.1% adenomyosis , 0.8% combined and 1.6% with other diseases. In the adenomyosis group, this study revealed the mean age of 43.9 years. The most common presenting symptoms were abnormal vaginal bleeding (42.9%), chronic pelvic pain (33.9%) and dysmenorrheal (21.4%). Most of the patients were treated by hysterectome. The results of therapy were good, 99.1% of patients had no symptoms and normal pelvic examination. In the endometriosis externa group, this study revealed the mean age of 32.5 years, most of patients (54.4%) were nullipara. The most common presenting symptoms were infertility (46.5%) and dysmenorrheal (44.7%). Most of the pathology were found in ovaries (52.6%) . forty two percents of the patients were treated by surgery, in which 74.2% were conservative surgery. Other patients were treated by hormonat therapy and combined hormonal – surgical therapy in 30.7% and 15.8% respectively. Most of the patients (76.3%) were lost follow up.Conclusions : Endometriosis is a common disease in Gynecologic inpatient unit of Srinagarind hospital. The results of therapy especially in adenomyosis group was quite effective but there was a high rate of lost follow up in endometriosis externa group so the success rate of treatment could not be accurately evaluated.
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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.