ABSTRACT
Abstract Risk Factors associated with Inguinal Hernia in Adult Male: A Case-control Study Anan Manomaipiboon MD, MSc (Clinical Epidemiology)* Sawit Ampornareekul MD** Vasin Chotivanich MD* Nataphon Santrakul MD* * Department of Surgery, BMA Medical College and Vajira Hospital ** Department of Surgery, Phrapinklao Hospital Objective: To determine the association between heavy object lifting and occurrence of inguinal hernia in adult male and to identify the other risk factors of inguinal hernia in adult male Study design: A case-control study. Subjects: Two hundred and nineteen patients in two tertiary care hospitals - BMA Medical College and Vajira Hospital and Phrapinklao Hospital were enrolled in this study during June 2002 to March 2003, 73 patients as cases and 146 patients as controls. Cases were defined as newly diagnosed inguinal hernia in adult male with the duration of symptoms less than one year. The corrected diagnoses were confirmed from operative report. Previously surgical repairs of inguinal hernia were excluded. Controls were male in-patients during the same periods as cases. Controls were approximately age-matched within five years interval to cases. In-patients with urological, colo-rectal and cardio-thoracic diseases were not recruited as controls. Methods: Both cases and controls were asked to answer the same questions on their demographic background, past history of heavy object lifting, smoking, urinary outflow tract obstruction, constipation, chronic cough. Their height and estimated body weights before occurrence of the diseases and previous appendectomy via right lower abdominal incision were recorded. Results: In univariate and multivariate analysis, no association between all exposure variables and inguinal hernia were found. The adjusted odds ratio for inguinal hernia in relation to past history of heavy object lifting was 1.1 (95% CI, 0.6-2.2). The adjusted odds ratio in relation to smoking, increased intra-abdominal pressure, previous appendectomy and obesity were 1.0 (95% CI, 0.6-1.9), 1.1 (95% CI, 0.6-1.9), 1.3 (95% CI, 0.4-3.7) and 0.7 (95% CI, 0.3-1.3) respectivel Conclusion: This study did not suggest an inverse effect between past history of heavy object lifting, smoking, urinary outflow tract obstruction, constipation, chronic cough, previous appendectomy and inguinal hernia. Vajira Med J 2007 ; 51 : 179 - 187
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Abstract A Comparative Study between Compressible Brassiere and Conventional Pressure Dressing for Seroma Prevention after Mastectomy in Breast Cancer Suphakan Techapongsatorn MD, FICS Wisit Kasetsermviriya MD Satit Srimantayamas MD Vasin Chotivanich MD Anan Manomaipiboon MD, MSc, FICS Department of Surgery, BMA Medical College and Vajira Hospital Objective: To evaluate the effectiveness between compressible brassiere without axillary compression and conventional pressure dressing for seroma prevention after mastectomy in breast cancer. Study design: Prospective, randomized controlled trial. Subjects: A total of 56 female patients with breast cancer managed by modified radical mastectomy in BMA Medical College and Vajira Hospital during December 2004 to October 2005 were enrolled. They were divided into two groups. First, conventional dressing was applied in 29 patients as control group. Second, compressible brassiere without axillary compression was applied in 27 patients as study group. Methods: All subjects were randomly assigned into two groups after surgical wound closing. Surgeons and the patients never knew the dressing techniques until finishing the operation. Patients' characteristics, clinical data, intra-operative data and outcomes were collected and analysed. Main outcome measures: Occurrence of seroma, amount of drainage serum, length of hospital stay after operation and other post-operative wound complications. Results: Patients' characteristics, clinical data and intra-operative data were not different significantly between two groups. Amount of drainage serum, length of hospital stay and occurrence of seroma in control group and study group were 725.0 ± 511.6 ml vs 774.3 ± 535.6, 9.3 ± 5.4 days vs 11.1 ± 4.9 days and 4/29 vs 6/27 patients (p-value \> 0.05). These final outcomes were not different significantly too. Conclusion: Pressure dressing with compressible brassiere without axillary compression after modified radical mastectomy in breast cancer could not reduce seroma, drainage serum and length of hospital stay. Vajira Med J 2007 ; 51 : 87 - 94
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Abstract Quality of Life in Breast Cancer Patients Suphakan Techapongsatorn MD, FICS* Supada Techapongsatorn MD** Wisit Kasetsermviriya MD* Satit Srimantayamas MD* Vasin Chotivanich MD* *Department of Surgery, BMA Medical College and Vajira Hospital **Department of Preventive Medicine, BMA Medical College and Vajira Hospital Objectives: To study the quality of life in patients with stage 1-3 breast cancer and affecting factors in BMA Medical College and Vajira Hospital. Study design: Descriptive study. Subjects: One hundred and five patients with stage 1-3 breast cancer attending breast cancer clinic, BMA Medical College and Vajira Hospital during December 2004 to November 2005 were enrolled. Methods: Quality of life was assessed by using self-administered questionnaire (WHOQOL- BREF, Thai version). The socioeconomic and status of treatment were collected and analyzed. Main outcome measures: Quality of life score and affecting factors. Results: The mean quality of life score were 87.8 ± 8.6 with classified to medium level. The incomes and educational status affected with the quality of life score significantly (p-value \< 0.05). Conclusion: The quality of life in breast cancer patient stage 1-3 was in medium level. Incomes and educational status were the affecting factors to the quality of life. Vajira Med J 2007 ; 51 : 33 - 40