Incidence of childhood type 1 (insulin dependent) diabetes mellitus in northeastern Thailand.

The incidence of type 1 (insulin dependent) diabetes mellitus in children under 15 years from northeastern Thailand was reported. Data of new cases from 1991 to 1995 were collected retrospectively by a mail survey from 257 government hospitals in the northeastern part of Thailand. The incidence rate of type 1 (insulin dependent) diabetes mellitus was 0.3/100,000 (95% confidence interval [CI] = 0.24-0.38). The incidence rate in girls was 2 fold that of boys. More than half of the cases were diagnosed between the ages of 10 and 14. These data indicated that incidence of childhood type 1 diabetes mellitus in Thailand is one of the lowest in the world.

Doctors' statistical literacy: a survey at Srinagarind Hospital, Khon Kaen University.

Medical doctors need to keep abreast of new developments in medicine. This is often done by reading medical journals and carrying out research activities that require an understanding of statistical methods. This study was designed to assess the knowledge of statistics among doctors in Thailand. A pretested, self-administered questionnaire with nine multiple-choice questions on basic statistical issues was used. In a survey of university hospital staff, there were 365 doctors, including 156 specialists, 152 residents and 57 final year medical students (externs). The overall response rate was 40.0 per cent. The overall median number of correct answers was 4.0 (95% CI 3.0, 4.0). Specialists had a significantly higher median score, 4.0 than residents, and externs, 3.0's, (p = 0.02). Respondents who had previously attended statistical workshops had a significantly higher median score (5.0) than those who had not (3.0) (p < 0.01). These results indicate that doctors in our hospital have insufficient knowledge of the basic statistical concepts that are commonly used in medical journals. Continuing education in statistics for doctors during residency and post doctoral training must be given serious consideration.

Abnormal glucose tolerance and blood pressure in Khon Kaen.

To quantify the association of abnormal glucose tolerance with hypertension, a population based study was carried out in subjects aged 30-65 years with oral glucose tolerance and blood pressure measurement compared with clinic based known diabetics. In males, subjects with diabetes (newly diagnosed and clinic based) had increased systolic and diastolic blood pressure with clinical significance compared to normal. The diastolic blood pressure in diabetic males was higher than normal but was not different from IGT. In females, the differences were observed between normal vs IGT, and diabetes. The differences were independent of age and obesity. The prevalence of hypertension also increased in diabetic patients, especially for systolic hypertension.

Osseous adenocarcinoma of unknown primary site: study of survival and prognostic factors.

A prospective study of 149 patients suffering from adenocarcinoma of unknown primary site (ACUPS) of bone was carried out. The tumors are classified as 63 extraspinal, 67 spinal and 19 mixed involvement. Upon meticulous physical examination, Virchow's node was detected in 15 cases, rectal shelf in 11 cases and hepatomegaly in 44 cases. Blood chemistry showed elevation of alkaline phosphatase (> 3 sigma units) in 98 cases and chest roentgenogram showed pulmonary lesions in 23 cases. Treatment was surgery and radiotherapy in 64 and two cases respectively. In all of these patients histological findings of the biopsy or resection specimen had confirmed the diagnosis of adenocarcinoma. Among 124 evaluable patients, overall survival was analysed using Kaplan-Meier life table analysis. Survival rates at one, two and four months after diagnosis were 80.7, 60.5 and 25 per cent with a mean and median survival times of 90 and 77 days respectively. Statistical analysis was also performed to ascertain the prognostic importance of the following variables: age, gender, Virchow's node, rectal shelf, hepatomegaly, serum alkaline phosphatase, pulmonary lesion, and multiplicity and site of the osseous lesions. The presence of pulmonary lesion or hepatomegaly significantly produced unfavorable impact on the duration of survival (p = 0.0004 and 0.0150, respectively) while other remaining factors had not.

The impact of routine preoperative chest X-ray in Srinagarind Hospital, Khon Kaen.

We conducted a prospective study of 1,013 consecutive patients who were scheduled for elective surgery in Srinagarind Hospital to determine the prevalence of abnormal chest X-rays and the change in management. Chest X-ray abnormalities were detected in 19.4 per cent (181/933) and lead to management change in 3.6 per cent (34/933). Fifty out of 933 had tuberculosis like lesions and 59 had cardiomegaly. By using Mantel-Haenzel chi-square and logistic regression, age greater than or equal to 45 years old was the most important predictors of the abnormalities found. Other predictors were cough and productive sputum. There was no statistical difference of the intraoperative and postoperative complications among the patients aged less than 45 years who had normal and abnormal chest X-rays. A preoperative chest X-ray may be useful as a routine evaluation only in those aged greater than or equal to 45 years.