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Fifty clinical isolates of Burkholderia(Pseudomonal) pseudomallei were tested by broth microdilution technique for susceptibility to OPC-17116 , a new 5-methyl substituted quinolone. The minimul inhibitory concentration (MIC) range was 1-8 µg/ml. The MIC 50 and MIC 90 were 2.6 µg/ml and 0.4 µg/ml, respectively.
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Two cases of massive upper gastrointestinal haemorrhage that had short histories and were unresponsive to conservative treatment are presented. Both cases underwent emergency operations to stop bleeding and were found to be non epithelial gastric tumours. The surgical pathology and surgical decisions are discussed in this report
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The authors reported a 16 year-old Thai girl who presented with upper gastrointestinal bleeding, high fever and left upper quadrant abdominal pain. The preoperative diagnosis of isolated splenic vein thrombosis was confirmed by percutaneous sphenoportography. Splenectomy was performed. She has not bled during her 1 year period of follow-up. Criteria of diagnosis and pathophysiology of this condition will be discussed in details.
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Background: Out-Patient department is the first place where patients and relatives met hospital team. There are many steps for hospital service delivery. Hospital consumers satisfaction is an important measure of service quality in health care organizations. Therefore, a hospital consumers satisfaction on Out-Patient department was studied.Objective: To assess the peri9od of time consumed for receiving services; to assess the level of satisfaction of hospital consumers in each step of Out-Patient department service: and general opinion related to out-patient activates.Design : A descriptive research.Setting : Out-Patient department, Srinagarind Hospital Faculty of Medicine, Khon Kaen UniversitySubjects: 803 patients and relatives were selected by purposive sampling. The subjects were new and former cases. The were not limited by sex and age.Measurement : Interviewed questionnaires with reliability 0.85 were used. The data were collected by interviewing the subjects in front of Pharmacy unit which is the last step of hospital service.Results: The mean (+SD) age of participants was 40.8+13.8 years. The most of 19.9~ and 15.1% were checked and treated in medical and general practitioner checked –up room respectively. Average time consumed in mal waiting time more than 5 hours. Average time consumed for the whole process was 2 hours and 51 minutes with the longest waiting time more than 8 hours (2 cases). The study also found that the dentist check-up room was longest waiting time with 1 hour 45 minites. The time to wait in medicine check-up room and at general practitioner check-up room was 1 hour 42 minites, and 1 hour 32 minites, respectively. The result show that the hospital consumers were moderate by satisfied with the services. The highly satisfied service was in Public Relations. The least satisfied service was cashier room. However, some hospital consumers were less satisfied to all steps of out-patient education and counselling related to their illness.Conclusion : Hospital administrator should plan to improve and implement Out-Patient manpower development program to orientated the hospital employees to the various aspects of health service. It is necessary to provide one-point service and to provide a computer system to cooperate among the clinical departments. Furthermore, it is highly recommended that the standard of care and tow-way communication should be more clearly brought into use in each step as a measure of the ongoing.Keywords: Satisfaction, Out-Patient Services, Srinagarind Hospital
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Objective: To study the rate of appointment postponing in Department of Surgery.Design : Retrospective, descriptive study.Setting : Surgical OPD, Srinagarind hospital, Faculty of Medicine, Khon Kaen University.Subjects : All patients who have appointment with Department of Surgery during January 1, 1996 and December 31, 1996.Data collection: Review from the appointment book, database of Srinagarind hospital, and cards of medical record.Measurement: Descriptive statistics, including number, percentages, and means.Results: The appointment postponing occurred in 1,295 cases out of 2,402 patients (53.91%). These were divied in to 5 groups according to numbers of postponing: one time 1,064 cases (44.30%) , two times 175 cases (7.29%), three time 47 cases (1.96%), four time 6 cases (0.25%), and five times 3 cases (0.12%). The highest incidence of posponing occurred in the 3rd trimester (28.03%), while the lowest incidence occurred in the 1st trimester (22.24%). Postponin incidence mostly occurred in cardiovascular \& thoracic surgery 62.07% (288/464), while the postpoing incidence was lowest in pediatric surgery 32.58% (130/399). The causes of appointment postponing were 1) surgeons only 613 cases (47.34%), 2) patients only 563 cases (43.47%), and 3) both surgeons and patients 119 cases (9.19%). The division of which the surgeon was the major cause of postponing was neuro surgery (81.82%), in contrast with general surgery 2 (34.21%).Conclusions: The incidence of appointment postponig in Department of Surgery is 53.91% in 1996. Causes of postponment is similar from surgeon and patients. Neurosurgery has the highest incidence of postpoing from surgeon, while general surgery 2 has the lowest incidence. The highest incidence of postponing is in the 3rd trimester.Keywords : (1) Appointment postponing (2) Outpatient (3) Surgery
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Objective: 1. To audit the management of surgical patients by computer system. 2. To collect the problems of data analysis for auditing the management of surgical patientsDesign: Retrospective, descriptive study.Setting: Department of surgical, Faculty of Medicine, Khon Kaen UniversitySubject: All in-patients of Department of Surgical within 1998.Data collection: Review from computer database.Measurement: Descriptive statistics.Result: Important factor, which can be retrieved from computer database, include age, sex, diagnosis, operation, result, hospital stay, and mortality rate. A total of 6,821 patients was admitted in Department of Surgery during January and December 1998. The male: female ratio was 0.98:1 (3,375:3,446). The mean age of male and female patients was 43.17 and 43.76 years, respectively. The average hospital stay was 9.53 days. There were 1,224 patients (17.94%) who had complications and 6,048 patients (88.67%) had good discharge status. The average hospital mortality was 1.92%Conclusions: Computerized audit of surgical patients can be done much faster than manual audit. The result is highly accurate but may have some mistakes. Misunderstanding, inappropriate coding, unclear wording and input error cause mistakes in the computerized patient records. Some important factors for auditing are not collected in the computer system.Keyword: (1) Computer (2) Audit (3)Surgical patients
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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.