Simple and accurate formula to estimate umbilical arterial catheter length of high placement.

OBJECTIVE: The present study aimed to derive the new simple, reliable, and accurate formula based on a body measurement parameter and not on reference graphs, to determine umbilical arterial catheter length of high placement, between the sixth to tenth thoracic vertebral (T6-T10) levels. Accuracy among a variety offormulas was also examined. MATERIAL AND METHOD: A prospective recruitment of 40 babies who had an umbilical arterial catheter placed in the NICU, Thammasat University Hospital was studied Insertional length for high placement was measured. The body measurement parameters were measured twice on each patient to indicate their reliability properties. Three individual umbilical arterial lengths, from umbilical ring to anatomical points of T6, T8, and T10 levels accordingly, were estimated by verifying the catheter tip against those anatomical points on chest and abdominal radiograph. Correlation coefficient (r) between each parameter and the umbilical arterial length to the T8 level was calculated. RESULTS: Suprasternal notch to superior iliac spine length (SSSL) was the selected parameter to derive a new formula because of high reliability coefficient of 0.964, high correlation to the umbilical arterial length to the T8 level (r = 0.906), and its simplicity to measure. The accuracy of the 'SSSL' to position the catheter tip at T6-T10 was 90%. CONCLUSION: The SSSL is simple and accurate for predetermination of the umbilical arterial catheter length to position the catheter tip at T6-T10. It can be an alternative formula, especially where birth weight and total body length are not available.

Survival and outcome of very low birth weight infants born in a university hospital with level II NICU.

OBJECTIVES: Determine the survivals, neonatal outcomes to hospital discharge, and perinatal risks of death among VLBW infants born in the Thammasat University Hospital. MATERIAL AND METHOD: This was a retrospective longitudinal study. Data were colleted from medical charts of all neonates with a gestational age of more than 25 weeks and birth weight of less than 1500 grams, who were born in Thammasat University Hospital for a 3-year period between July 1st, 2003 and June 30th, 2006. Antenatal history, perinatal data, and neonatal outcome until hospital discharge were extracted and analyzed. RESULTS: Seventy-eight neonates with a birth weight between 600-1485 grams were analyzed. Survival rate of very-low-birth-weight (VLBW) infants and extremely-low-birth-weight (ELBW) infants were 81% and 52% respectively. Respiratory distress syndrome (RDS) was the major cause of death. Major morbidity was found in 35% of survived infants to hospital discharge. Unfavorable outcome was documented in infants with a birth weight < 750 grams. Perinatal risks of mortality among VLBW infants included no use of antenatal steroids (p = 0.015), gestational age of <28 weeks (p = 0.012), ELBW (p < 0.001), congenital abnormalities (p = 0.002), Apgar score at 5 minute <5 (p = 0.019), needed endotracheal intubation in the delivery room (p < 0.001), and first temperature at NICU < 35.0 degrees C (p = 0.023). CONCLUSION: Overall survival and outcome among very-low-birth-weight infants born in Thammasat University Hospital is acceptable. The mortality and morbidity in extremely-low-birth-weight infants remained high. A continuing audit of these measures should be encouraged.

Inappropriate weight management among Thai women consuming anorectics prescribed by private clinics in Bangkok.

This cross-sectional survey was conducted by a 2-stage sampling design. A total of 250 women, aged > or = 18 years, were recruited from 10 randomly chosen private clinics located around Bangkok with a license for possession and utilization of anorectic drugs, the psychotropic substances in category II. Body mass index was calculated at the time of survey. The prevalence of obesity, based on the proposed classification by body mass index in Asian adults, among the participants was 23.2% (95% CI: 18.0%-28.4%). Only 79 (31.6%) and 72 (28.8%) reported having low-calorie diets and increasing physical activities, respectively, both of which were recommended as the main part of comprehensive weight control. Cosmetic purpose was the main reason given by most participants (84.0%) to enter current weight-control treatments. Interestingly, most of the non-obese individuals (82.8%) misperceived themselves as being obese. These findings suggested that the inappropriate use of anorectic drugs among Thai women was a significant public health concern. Misperception of bodyweight status may contribute to the misuse of such anorectic drugs. The result would alarm the Food and Drug Administration, Ministry of Public Health to evaluate and revise the measures of the anorectic drug disposal. Further qualitative methods are recommended to investigate for body-image misconception, weight-control behavior among various populations.

Aeroallergen sensitivity among Thai children with allergic respiratory diseases: a hospital-based study.

One hundred and twenty patients, aged 3-15 years, attending the Allergy Clinic, Thammasat University Hospital, with allergic rhinitis, asthma or both conditions were studied. Standardized skin prick tests were performed with 15 common aeroallergens. The subjects were 85 boys and 35 girls with the mean age of 8.1 years (SD = 3.4 years). There were 63 cases (53%), 22 cases (18%) and 35 cases (29%) diagnosed with allergic rhinitis only, asthma only and both conditions, respectively. The prevalence of asthma among the allergic rhinitis patients was 36 percent whereas the prevalence of allergic rhinitis among the asthmatic patients was 61 percent. The sensitization patterns for major aeroallergens among the three groups were similar with the most common sensitized allergens as D. pteronyssinus, followed by D. farinae, American cockroach, Kopok and German cockroach, respectively. Among the atopic patients, a greater number of allergen reactivity was significantly associated with the increased risk of having their coexistence of allergic rhinitis and asthma (p = 0.0046; score test for trend of odds ratio).