Menopausal Symptoms among Women Attending of the Menopausal Clinic at Srinagarind Hospital

Blackground : Menopause is the period of life after complete cessation of ovarian function. In this period, many physiologic changes occur as process of aging. Studying about menopausal symptoms in woman attending at  the Menopausal Clinic provides basic information and will be useful in developing appropriate medical and health  care services.Objective : To study menopausal symptoms among women attend at the Menopausal Clinic Srinagarind  Hospital.Design : Descriptive studySetting : Menopausal Clinic, Srinagarind Hospital. Faculty of Medicine  Khon Kaen University.Method ; One thousand and two hundred twenty-one records of menopausal women both natural and surgical menopause, attending the menopausal clinic at Srinagarind hospital during January 1997 to December 2006 were reviewed. Natural menopause was divided into 2 subgroups, peri-menopausal group and post-menopausal group. The results were expressed  as mean value + standard deviation (SD). Chi-Square test were used for statistical comparison. The level of statistical significance was chosen as p\< 0.05. Results  : Mean age of the subjects were 51.53 + 6.05 years, 52.82% were post- menopausal group. Mean age of natural menopause was 48.76 + 4.33 years. The three most menopausal symptoms were forgetfulness (90.90%), muscle/joint pains (87.05%) and tiredness (83.12%). Hot flushes was significant higher in surgical menopausal women (70.7%) than natural menopausal groups. Those in natural menopause, moody and decreasing sexual desire were more  presented in peri-menopausal women (87.6% and 75.5 % repectively) while vaginal dryness were mostly presented in post- menopausal  group (62.8 % ).Conclusion :The three most common menopausal symptoms were forgetfulness, muscle/joint pains and tiredness. Hot flushes was significant higher in surgical menopausal women than those in natural  menopause. Moody and decreasing sexual desire were more presented in peri-menopausal women  while vaginal dryness were mostly presented in post- menopausal  group. Key word  : Menopausal symptoms, hot flush, sexual desire, vaginal dryness. 

Adolescent counselling service

 A project on health education and heallh services regarding human reproduction and contraception among adolescents was carried out in 1987-1988.  It was conducted by the family Planning Unit of the Department of Obstetrics and Gynecology, Faculty of Medicine, Khon Kaen University, with the support of the United Nations Population Fund.  The project design was a longitudinal, prospective study.  A total of 5,651 students (2,875 male and 2,776 female) from three vocational schools in Khon Kaen were recruited as the target population, ranging in age from 15 to 26 years.  For the health services, special adolescent clinics were set up in schools, in Khon Kaen City and in Srinagarind (University) Hospital.  A total of 761 students (13.5%) in the project used the services.  Seventy-five percent of the students who came to the clinics came for counselling on sex-related health matters and 25% for general health.  Males came twice as often as females.  Forty-one percent of the students requested birth control, 16.1% came for sexually-transmitted disease treatment and 9% came for counselling on unwanted pregnancies.  Fewer students living with their families (parents) came for health counselling than those living independently.

The Normal Fetal Biparietal Diameter Against Week of Gestation in Normal Pregnant Women at Srinagarind Hospital

\ The fetal biparietal diameters (BPD) between 12th and 40th weeks were measured by two ultrasonologists, using a Hitachi model 50 A, at Srinagarind Hospital during October 1987-March 1990.\  The measurements that were confirmed gestational age by paediatricians after births were 565 occasions in 409 newborns.\  The gestational ages were based on the history of the last menstrual period and the correlated fundal height.\  No medical, surgical or obstetrical complication was found during these pregnancies.\  The mean increase in the BPD between the 12th and 28th weeks, the 29th and 35th weeks, the 36th and 39th weeks were 3.16  0.9, 1.95  1.2 and 0.61  0.6 mm./mk. respectively.\  The growth of BPD in this study followd the curves similar to those in Western countries in the third trimester.\  The growth of BPD in this study compared with in country study was similar to Chula\’s study but it was more than Health Promotion Center 4\’s study.\ 

KAP Study About Sex, Reproduction and contraception in The Teenagers : Case study in Khon Kaen Vocational Students.

 This study examines the khowledge, atitude and practice (KAP) of sexual activity and family planning among vocational students in Khon Kaen.  The study process consists of 4 part : 1) collection of KAP information using self reporting pretested questionnaire, 1) verification of practice information using anthropological procedure, 3) health education about family psychology, sex education, family planning, unwanted pregnancy and induced abortion and sexually transmitted diseases, and 4) family planning service.  The response to the same three questionnaire during one year period was completed in 44.82% of the students (502/1120).  The detail of the study results will be presented.  The other conclusion which can be drawn from this study is that the sexual practice information can be collected more reliably by the combination of sociological and anthropological methods. 

AIDS Prevention Strategies in a High-Risk Population

 Although Acquired Immune Deficiency Syndrome is not yet epidemic in Thailand , there is evidence that AIDS is spreading to Asia. Because the disease is most likely to first establish itself among high risk group it is important to develop educational programs to promote accurate knowledge of AIDS and preventive health behavior.This study will test three education strategies among high a risk group to develop cost-effective AIDS-prevention education. The study will be of benefit to others who are interested in AIDS education strategies.

Use of Ultrasound in Obstetrics and Gynecology

 Ultrasound has been used in diagnostic and therapeutic medicine for 30 years.  Its improvement results in much progress in Obstetrics and Gynecology.  Ultrasound can demonstrate pelvic organ, fetus and fetal movement so anatomy and physiology can be studied at the same time.  Until now, no side effect to the fetus or female genital organ can be found.

OVERVIEW ON AIDS

The worldwide epidemic of Acquired Immune Deficiency Syndrome ( AIDS ) is an international health problem. From the early to mid-1970s, when the global spread of Human Immunodeficiency Virus   ( HIV) appears to have started, untill the early 1980s, when HIV was first identified , the pandermic was silent. During the mid-1980s, the international health dimension of the HIV problem became abruptly evident. There is now wide spread realization that the implications of AIDS in terms of human suffering, costs for health services and social impact are devastating.As of June 1, 1987. 51,535 AIDS cases were officially reported in 113 countries to World Health Organization, WHO officials acknowledge that because of lack of reporting or poor reporting procedures-the actual number of AIDS cases is much higher. Globally, 5-10 million persons are currently infected and, conservatively estimating 10-30 % progression to AIDS within five years a half million to 3 million new cases will appear from this already infected mass. In the United state, there were 37,019 AIDS cases reported to the CDC as of June 15, 1987. An estimated 1.5 million people who are infected but show no symptoms.AIDS is a fatal disease that cannot now be curred. A person can look and feet healthy and still be able to spread the infection that causes AIDS.AIDS is not spread by casual contact but transmission is mainly spread by sexual intercourse, contaminated blood, and by contaminated hypodermic needles. Moreover, an infected woman can give AIDS to her child during pregnancy. A stable, faithful relationship with another uninfected person is safest. In any case, reducing the number of sexual partners reduces the chances of getting AIDS. For the sexually active, always using condom is good protection against AIDS.

Sefety and Immunogenicity of HIV-1 Immunogen in HIV Seropositive Subjects at Srinagarind Hospital : the first cohort study in Thailand.

Objectives : To assess the safety and immunogenicity of HIV-1 Immunogen in HIV seropositive subjects.Study Design : Randomized , double blind, adjuvant-controlled clinical trial.Setting : Srinagarind  Hospital. Khonkaen University.Methodology : The 40 weeks trial was conducted in 33 volunteers who were randomized to receive either HIV-1 Immunogen or IFA at a 2:1 ratio on Week 1, week 12, 24, and 36.Results: The primary end point for the trial was changes in CD4+ cell counts with secondary parameters of changes in CD8+ cell counts,  percentages of the CD4+  and CD8+, the ratio of CD4+ to CD8+, body weight, plasma HIV-1 RNA, HIV-1 DTH skin test and Western blot. As regards sefety, there was no serious adverse event in both treatment groups.  The result also showed that HIV-infected subjects who received HIV-1 Immunogen had significant higher increase in CD4+ cell counts.  This increased in CD4+ cell was associated with increased HIV specific immunogenicity on Western blots and enhanced HIV-1 DTH skin test.  Although there was no significant difference in the body weight, but increased in body weight was slightly higher for the HIV-1 Immunogen group compared to the IFA group. The plasma HIV-1 RNA remained stable for both treatment groups over the course of the trial.Conclusions : The results of this trial suggest that HIV-1 Immunogen is safe and significant increased in CD4+cell counts and HIV specific immunity compared to the adjuvant control group.  This preliminary study also suggests that this therapy may be important treatment alternative in countries where access to antiviral drugs is limited.Key words :   HIV-1 Immunogen , immunogenicity, body weight. 

Prevalence of Vitamin D Deficiency among Postmenopausal Women at Srinagarind Hospital, Khon Kaen Province, Thailand.

Background :Vitamin D is essential for bone strength and development. It enhances intestinal absorption of calcium and its apposition to bone. It also increases muscle strength. In vitamin D deficiency condition, blood calcium is depressed, parathyroid hormone production is stimulated resulting in secondary hyperparathyroidism which promotes bone turnover. Cortical bone is the primary site affected, particularly at the femoral neck.In previous studies, we documented an average calcidiol level of £  35 ng/ml as vitamin D deficiency. A very high (\> 60%) prevalence of vitamin D deficiency was found among urban elderly women in Khon Kaen, in contrast to less than 20% among their rural counterparts. Until now, only limited data has been available on the average level of calcidiol and prevalence of vitamin D deficiency among postmenopausal women in Thailand.ObjectivesPrimary: Ascertain the prevalence of vitamin D deficiency among postmenopausal womenSecondary: 1. Find out the average vitamin D (calcidiol) level in postmenopausal women                   2. Find out the correlation between calcidiol and PTH in the pooled data                 3. Find out the calcidiol level which indicates the level of vitamin D deficiency in the pooled dataDesign : Cross-sectional, descriptive studySetting : Postmenopausal Clinic, Srinagarind Hospital, Khon Kaen, ThailandOutcome measurement Serum calcidiol, PTH, and alkaline phosphataseResults: The pooled data set comprised 332 cases including 98 cases of postmenopausal women, 104 cases of previously cited urban elderly women, and 130 cases of rural elderly women. The mean (SD) calcidiol level among the postmenopausal women was 32.58 (8.93) ng/ml, and calcidiol and PTH had reverse relation with the correlation coefficient (r) = -0.265 (p-value \< 0.001). Calcidiol at £  35 ng/ml was associated with a significant increase in PTH, which indicated the level of vitamin D deficiency. The prevalence of vitamin D deficiency in postmenopausal women was 60.2 percent.Conclusion :The high prevalence of vitamin D deficiency with low average level of calcidiol among postmenopausal women suggests a risk for developing osteoporosis. Outdoor exercise with sunlight exposure, high vitamin D diet intake, or, if necessary, supplementation with vitamin D is advised.