The relation of vesicoureteral reflux and renal scarring in childhood urinary tract infection.

OBJECTIVE: Assess the relation of age and sex in vesico ureteral reflux (VUR) and renal scarring and the relation of VUR and renal scarring in childhood urinary tract infection. MATERIAL AND METHOD: A descriptive study of one hundred and twenty-six children who received renal cortical scintigraphy from 1st Jan 2000 to 31st Dec 2004 in the Department of Radiology, Faculty of Medicine Siriraj Hospital, was conducted. Ninety-three (50 males, 43 females) patients were diagnosed with urinary tract infections (UTIs) but only ninety-one of them had renal cortical scintigraphic results available. The male to female ratio was 1.16:1. The mean age of the patients was 4.33 years (SD +/- 4.17, range 7 days-16 years). During the 1st year of life the male to female ratio is 2.6:1. Fever, dysuria, and poor feeding were the most presenting signs and symptoms. Eighty-five (45 males, 40 females) patients received Voiding Cysto Urethro Gram (VCUG). RESULT: The authors did not find the correlation between the age groups and sex with VCUG results on right and left side, respectively (p = 0.856, p = 0.145, p = 0.77, p = 0.75). Ninety-one (49 males, 42 females) patients received DMSA renal scintigraphy. Fifty-two patients (57.1%) had abnormal DMSA renal scan results. However; the authors did not find the correlation between age groups and sex with DMSA renal scan results on the right and left kidneys, respectively. (p = 0.202, p = 0.416, p = 0.511, p = 0.791). The authors compared times of UTIs with and DMSA renal scintigraphy in each side of the kidney. Even though the authors did find the correlation between episodes of UTIs and abnormal DMSA on the left kidneys (p = 0.017), it was not found on the right kidneys (p = 0.081). There were 80 patients who received both VCUG and DMSA renal scintigraphy. The authors found the correlation between severity of VUR and abnormal DMSA results on right and left kidneys (p = 0.001, p = 0.01). CONCLUSION: The authors recommend that all children who have repeated UTI and/or VUR, irrespective of age and sex, should receive DMSA renal scintigraphy to detect renal scarring and follow up future complications.

Management pattern and hospital charge of repairing cleft palate at Siriraj Hospital.

Management pattern and hospital charge for repairing cleft palate at Siriraj Hospital during 1996-1999 were studied retrospectively. From the examination of 100 patient records, four cases were excluded since no surgical correction was performed during hospitalization. Fifty-nine percent were female and the average age was 5.54 years old. Fever and otitis media were associated with two and three cases respectively. Other underlying diseases included hypothyroidism, patent ductus arteriosus and ventricular septal defect were found one in each case. The cleft palate was successfully repaired in all cases. Surgical correction was done in 84 percent of cases within the first five days of hospitalization. The average length of stay was 5.89 + 2.85 days and ranged from 2-20 days. The hospital charge for cleft palate repair was 7,031.22 + 1,365.33 Baht per case. This study illustrate that a small variation is practiced in the management of a reasonably straight forward condition and better preparation of the patients before hospitalization could reduce the hospital stay or avoid unnecessary hospitalization.

Applicability of the Thai nasality test.

The aim of this study was to investigate the applicability of a speech stimuli, the Thai Nasality Test, to identify the presence of hypernasality and hyponasality speech. The Thai Nasality Test was evaluated by a comparison study between the perceptual assessment rated by the investigators and the acoustic assessment by using a Nasometer. The study was conducted to 69 normal speakers, 36 dysarthric speakers, and 32 clients with cleft palate. The perceptual assessment was preceded acoustic assessment. Each subject was asked to read or repeat the Thai Nasality Test. Results indicate the reliability and validity of the Thai Nasality Test by a) a positive correlation between perceptual assessment and the instrumental assessment, b) a significant correlation between age and the Tuk Tuk passage and significant correlations between gender and the Manee as well as the Sai Yok water fall passages of the normal group, and c) the discriminating power between disordered speech from normal speech. This study indicated the Thai Nasality Test as a perfect speech stimuli to elicit speech sample for acoustic assessment, particularly the TukTuk and the Sai Yok water fall passages in assessing for hypernasality problems. While an applicability of nasal sentences the Manee to detect the hyponasality could not be confirmed definitely because there was no significant difference among studied groups.

Characters of a dean of the autonomous University.

Opinion about the appropriate characters of a dean of the autonomous university, regarding the academic level, administrative ability and method of selection was elicited in a survey among selected academic staff of Mahidol University during June 15-30, 1998. A questionnaire was designed and distributed to all administrators (n=302) of the University and to a random sample of 471 from 2,360 academic staff who did not have administrative position. A total response rate of 46.1 percent was achieved. Sixty-two percent of the responders were administrators and 80 percent of them were older than 40 years of age. Our study revealed that no sexual preference for a dean in 93.6 percent. The dean should be at least 40 years old (61%) but the one who retired, were not suitable (54%). Seventy-seven percent agreed that the dean’s profession should be the same kind as of officials of that faculty and a talent outsider is still unacceptable (58%). Previous experience in university administrative ability before being chosen. Sixty-five percent preferred to have equal ability in administration and academic achievement though 31 percent preferred the former to the latter. Academic level of associate preferable or higher with master degree or higher of relevant profession to the Faculty is preferred in 63 and 85 percents respectively. Publication in a peer reviewed international journal is required in 59 percent with emphasis on citation in international journal in 47 percents. Election by faculty staff is preferable to selection by a search committee and the selected candidate must be accepted by more than 50 percent of the faculty staff. All members of the search committee should have good reputation and accountability. The opinion about the academic level of the dean by administrators who had academic level of lecturer and assistant professor was different from other groups. The former voted the academic rank of the dean to be any ranks from lecturer while the latter preferred associate professor and professor to other lower ranks.