Cost analysis of hematopoietic stem cell transplantation in adult patients with acute myeloid leukemia at King Chulalongkorn Memorial Hospital.

The purpose of the study was to analyze the first-year cost ofhematopoietic stem cell transplantation (HSCT) program for the treatment of adult patients with acute myeloid leukemia (AML) at King Chulalongkorn Memorial Hospital (KCMH). The present retrospective study was carried out on 67 AML patients treated with bone marrow transplantation (BMT) or peripheral blood stem cell transplantation (PBSCT) at KCMH during the period of 1994 to 2005. The actual total one-year cost from the provider perspective were determined by the reviewing medical records for medical care costs (MCCs) and by adjusting data from the reports of annual cost analysis of KCMH for routine services costs (RSCs). All costs were converted to 2006 values using the Thai consumer price indices. It was found that the full cost of allogeneic HSCT (allo-HSCT) and autologous HSCT (auto-HSCT) in the first year of the program was $22,592.85 and $24,171.25 per case respectively. Cost-effective appraisal, comparing with chemotherapy, need to be studied further.

Indomethacin for recurrent cutaneous necrotizing eosinophilic vasculitis.

Recurrent cutaneous necrotizing eosinophilic vasculitis (RCNEV) is a rare disease characterized by clinical features of pruritic purpuric papules and angioedema. Skin biopsies revealed the eosinophil-predominate necrotizing vasculitis affecting small dermal vessels. Systemic corticosteroid is a very effective treatment. There are many side effects associated with systemic corticosteroid therapy. The authors report a case of RCNEVsuccessfully treated with indomethacin. To the authors'knowledge, there has been no reported case of RCNEV treated with indomethacin.

Drug eruptions at five institutes in Bangkok.

The study was performed in five hospitals in Bangkok for a period of one year. All in- and outpatients who developed drug eruption from January to December 2001 were enrolled into the study. Physical examinations and complete history-taking were performed by one of the authors. A skin biopsy was done to confirm the diagnosis in every suspected case. Oral challenge test was performed to obtain a definite diagnosis only in some patients with informed consent. Among 212 patients, the most common causative drugs were antimicrobial agents with cephalosporin group in the highest rank. Maculopapular rash was the most common type of drug eruption followed by urticaria and photosensitivity reaction. It was concluded that antimicrobial agents were the predominant causative agents and maculopapular eruption was the most frequent clinical manifestation. New kinds of antimicrobial agents, anti-inflammatory drugs and lipid lowering agents could cause various patterns of drug eruption.

Comparative study of the efficacy of topical corticosteroid: five locally made and one brand name creams.

The aim of this study was to evaluate the efficacy of 5 locally made clobetasol propionate creams compared with a brand name product. The study was divided into 3 parts 1) pharmacological study, 2) vasoconstriction test, and 3) double blind clinical trial. The results showed that the pharmacological properties of the locally made products were not different from the brand name product. Product C and D could diffuse through cellulose acetate membrane 3 fold more than the brand name product. Product D and E caused less vasoconstriction than the brand name product. This double blind study showed that all locally made products could improve psoriasis to the same extent as the brand name product, but there was more recurrence of psoriasis while using all the locally made products. It was concluded that locally made products were as effective as the brand name product in the treatment of psoriasis evaluated over a 2 week peroid, but more recurrence was observed with locally made products.