Molar pregnancy--associated ectopic decidua: report of a case and review of the literature.

Ectopic or extrauterine decidual transformation is regularly associated with pregnancy. This phenomenon has been observed most often in the ovary and cervix. Sporadic reports have documented decidua formation of peritoneal surfaces, lymph nodes and other organs in pelvic and abdominal cavity. Molar pregnancy-associated ectopic decidua has never been documented. We report the case of ectopic decidua at posterior surface of uterus, near the cul de sac, in a 45-year-old woman with molar pregnancy. The article review reveals that it is the first report of molar pregnancy-associated ectopic decidua.

The study of discriminant values of dyspeptic symptoms for identifying the etiology of dyspepsia.

This prospective study aims to determine whether specific symptoms or group of symptoms could positively discriminate the etiology of patients who present with dyspepsia. Two hundred and eight patients were studied and 111, 55, 35 patients were classified as non-ulcer dyspepsia, peptic ulcer disease and hepatobiliary disease, respectively. All patients completed a structured history questionnaire by personal interview and completed investigation with complete blood count, stool examination, liver function test, HBsAg, HBsAb, ultrasonography of the abdomen and endoscopy. Variable of interest and variables of statistical significance by univariate analysis were put into discriminant function of logistic model for discrimination. The results suggest that anorexia and no periodicity of epigastric pain significantly discriminated non-ulcer dyspepsia from peptic ulcer disease and hepatobiliary disease, pain occurring before a meal or when the patient was hungry and nocturnal epigastric pain significantly discriminated peptic ulcer disease from hepatobiliary disease.

Human pythiosis in Srinagarind Hospital: one year's experience.

We have reported four cases of human pythiosis arteritis from Srinagarind Hospital, Khon Kaen, Thailand. This unusual human infection occurring perhaps exclusively in thalassemia and hemoglobinopathy patients, should be noted by physicians, who work in areas with a high incidence of hemoglobinopathy, and for patients who present with unexplained arterial insufficiency. As our reported cases occurred within only one year, this condition may be more common than originally suspected and found more frequently if actively searched for.

Rhinocerebral mucormycosis: a report of eleven cases.

Rhinocerebral mucormycosis (RCM) is a rare, fulminant fungal infection that usually occurs in diabetic or immunocompromised patients. The mortality rate has been reduced recently with the advent of amphotericin B combined with aggressive surgery. Eleven RCM patients have been treated over the past five years at Srinagarind Hospital. Eight had underlying diabetes, five had renal failure and three of them had both. In eight patients, the diagnosis was established by KOH preparation before histological confirmation. Only two cases revealed positive cultures for Rhizopus spp and Cunninghamella spp. All patients underwent surgical treatments (extensive debridement, 8 cases; sphenoidectomy, 7 cases; ethmoidectomy 8 cases; maxillectomy 5 cases and orbital exenteration, 6 cases). Amphotericin B was administered to all patients as soon as the diagnosis of RCM was made. Only three patients survived. Early diagnosis and cooperation among ophthalmologist, otolaryngologist and physician are the most important factors for the survival of patients with mucormycosis.

Comparative in vitro sensitivity to metronidazole of Trichomonas vaginalis with isolates and clones.

Isolates of Trichomonas vaginalis from a group of Thai women in Khon Kaen, Thailand were studies for their in vitro sensitivity to metronidazole. Forty-five isolates of T. vaginalis and further 226 laboratory clones of these isolates were examined for drug sensitivity under anaerobic conditions using the CPLM (Cysteine-Peptone-Liver infusion Maltose) medium. The in vitro sensitivity of T. vaginalis to metronidazole, recorded as MLC values revealed highly variable sensitivity profiles Greater than 90% of the trichomonads studies were susceptible to relatively low concentrations of metronidazole in the range of 1-10 micrograms/ml. The remaining fraction of trichomonads, appeared to be less sensitive and required higher concentration of drug to attain the MLCs. The highest recorded MLC was 60 micrograms/ml. The geometric mean MLC of the 45 isolates was 7.99 micrograms/ml while that of The influence of the individual clones of subpopulations of T. vaginalis on the observed sensitivity of the isolate was also examined. A positive linear relationship was observed between the MLC of the isolated and the MLC of the least sensitive clone of the same isolate (p less than 0.05). This suggests that the most resistant clone present within an isolate of T. vaginalis plays an important role in determining the overall drug sensitivity of the isolate.