Childhood asthma: Cases admitted to Siriraj Hospital in 1992.

A retrospective study of 132 childhood asthmatic patients admitted to the department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University from January to December 1992 was carried out. There were 87 male patients and 45 females, the male to female ratio thus being 1.93:1. The mean age of patients was 61.8 months but 60 percent of the patients were under 5 years of age. The rate of admission was highest in the rainy season and most of the patients had asthmatic attacks within 24 hours before admission. The most common precipitating factor was upper respiratory tract infection. On admission, all of the patients had dyspnea and prolonged expiration with wheezing. Eighty eight point eight percent of them had mild asthmatic attacks (Wood’s asthma score 4-6), 1.6% had severe asthmatic attacks (score 7-8) and 9.6% had mild asthmatic (score 0-3) Eosinophilia was found in 8.1% of the cases. Almost all of the patients received oxygen therapy, intravenous fluid and nebulized salbutamol. Seventy four point two percent received intravenous aminophylline and 31.1% received corticosteroid. Two patients developed respiratory failure and were referred to the respiratory care unit. All of the patients recovered from their asthmatic attacks and were discharged the mean duration of admission being 4.9 days.

Delayed type hypersensitivity skin testing to tetanus toxoid in Thai children.

Delayed type hypersensitivity skin testing to tetanus toxoid was performed in 498 healthy Thai children. The subjects were 230 males and 268 females. The ages at testing were 2, 4, 6, 9, 15, 18 and 48 months and the number of subjects were 98, 94, 82, 77, 43, 70 and 34, respectively. The study was performed by intradermal injection of 0.1 ml. of tetanus toxoid (20 Lf/ml) 0.1 ml at the volar surface of left forearm. An indurations of 5 mm. or greater at 72 hours was considered a positive result. The positive result in each group was 7.14, 30.85, 76.82, 98.7, 90.7, 97.14 and 94.12 percent respectively. The mean induration size in each group was 2.16, 3.74, 6.46, 9.79, 10.42, 9.07 and 9.76 mm., respectively. The results of the study showed no difference between the sexes. Positive skin tests to tetanus toxoid were correlated to the number of previous DPT immunizations. No significant adverse reaction was found. These results indicate that tetanus toxoid skin testing is safe and yields highly positive results in children who have been immunized with tetanus toxoid. It should be used as an antigen for delayed type hypersensitivity skin testing as PPD, mumps, monilia, trichophyton and streptokinase-streptodornase.

Aeroallergens in Nakornnayok Hospital.

An all year survey of atmospheric pollens and molds was made in Nakornnayok Province, Thailand by Durham’s standard gravity method from 1st September 1988 to 31st August 1988. Most aeroallergens found were mold spores, with Cladaosporium (Hormodendrum) on top of the first, and Alternaria, Curvularia, Helminthosporium, Leptosporium, Rust, Tetraploa, Ascospore, Smut, Fusarium, Stemphylium were found to be less common in that order. Grass pollens were found 11 percent of total pollen count. Pine pollens were found in winter and weed pollens were found very low count. Unidenfiable pollens were found in high count with the peak between October to March.

Bioavailability of elixir theophylline (siriraj formula) in Thai asthmatic children.

The bioavailability of Elixir Theophylline (Siriraj Hospital Formula) and Table Aminophylline (The Government Pharmaceutical Association) was compared with Elixir Quibron in Thai asthmatic children. The mean rate of absorption and the extent of drug absorption were not significantly different for local made drugs, compared with that of an imported one. With regards to the mean maximum serum levels (Cmax) and time to maximum serum level (Tmax) values, there were also no significant differences between two local preparations and an innovative one. Thus, the results suggest that the local made theophylline drugs possess the same efficacy as the imported drug.

Childhood asthma on South Thailand: A prospective study of 100 cases.

One hundred Thai asthmatic children aged below 15 years were under prospectice study. Fifty-seven percent of the patients were from Songkhla province and fourty three percent from nearby provinces in the south of Thailand. Males were more affected than females, male and female ratio being 3 : 2. Fifty-six percent of patients developed first attacks within the first 2 years of life. Attacks during night time were common and seasonal attacks usually occurred during the rainy season. Respiratory infections were the most common precipitants of attacks. Other precipitating factors were weather change, exertion, inhalants, emotion and irritants. Sixty-one percent of patients had associated allergic diseases and 81 percent had family history of allergic diseases. Sixteen percent of the patients were growth retarded. Absolute oeosinophil of less than 500 cells/mm3 was found in 36 percent of patients. Chest roentgenography at the first visit was found to be abnormal in 42 percent of patients. Ninety-three percent of the cases had positive skin tests. The important antigens were house dust and mite. Our findings are similar to previous studied with minor variations.