Clinico-epidemiology of hepatitis C viral infection in northeastern Thailand.

Hepatitis C virus (HCV) is responsible for a large number of cases of chronic liver disease worldwide. A study of clinico-epidemiology of HCV infection was conducted in 214 patients who were seropositive for antibody to HCV (anti-HCV) in Srinagarind Hospital, Khon Kaen University, northeastern Thailand, during August 1997 to December 1998. There were 199 males, 15 females and their mean age was 34.96 +/- 9.75 years with a range from 16 to 72 years. The clinical features of acute hepatitis, chronic hepatitis, liver cirrhosis, hepatocellular carcinoma (HCC) and asymptomatic HCV infection were 2, 115, 15, 2 and 80 cases. Risk factors for HCV acquisition were intravenous drug use (IVDU), tattooing and blood transfusion in 46.7, 32.2 and 18.8% of cases, respectively. 23.36% had a history of multiple risk factors while 28.9% had no history of risk factor exposure.

Clinico-epidemiology of hepatitis B viral infection in Northeastern Thailand.

Hepatitis B viral (HBV) infection is a common disease world wide. A study of clinico-epidemiology of HBV infection was conducted in 381 patients who seropositive for hepatitis B surface antigen (HBsAg) in Srinagarind Hospital, Khon Kaen University, Northeastern Thailand, during August 1997 to December 1998. 293 males, 88 females and their mean age was 30.96 +/- 12.78 years with a range from 15 to 77 years. The clinical features of acute hepatitis, chronic hepatitis, liver cirrhosis, hepatocellular carcinoma (HCC) and asymptomatic carrier were 2.36, 34.12, 4.99, 1.05 and 57.48% of cases. Possible routes for HBV transmission were family history of hepatitis, tattooing, intravenous drug addict and blood transfusion in 20.3, 11.3, 8.2 and 6.9% of cases, respectively. Signs of chronic liver disease were common in liver cirrhosis and HCC. Acute fulminating hepatitis was not found in this study.

Comparison of adult somatic and excretory-secretory antigens in enzyme-linked immunosorbent assay for serodiagnosis of human infection with Fasciola gigantica.

Adult somatic antigen extract of Fasciola gigantica was compared with excretory-secretory (ES) antigen in an enzyme-linked immunosorbent assay (ELISA) for serodiagnosis of human fascioliasis gigantica. The absorbance values in ELISA using the adult somatic antigen were not significantly different from the values obtaining using ES antigen (p > 0.05). The diagnostic sensitivity, specificity and positive and negative predictive values of the test using adult somatic extract as antigen were 100%, 98%, 70% and 100%, respectively. On the other hand, these values of the test using adult ES antigen were 100%, 99.3%, 87.5% and 100%, respectively. It appears that both somatic and ES antigens are effective antigens for use in the serodiagnosis of human fascioliasis gigantica.

Intestinal capillariasis: a cause of chronic diarrhea and hypoalbuminemia.

Seventeen cases of intestinal capillariasis in Srinagarind Hospital, Khon Kaen University, Thailand were reviewed. The mean age was 40.41 years with a range from 21 to 69 years. Most cases had intermittent or continuous voluminous watery diarrhea for one month to three years with hypoalbuminemia. Borborygmi, vague abdominal pain, weight loss and pedal edema were significant associated symptoms. Fecal examination was the most useful for diagnosis by finding the Capillaria philippinensis ova in all cases. Mebendazole 400 mg per day for 20 to 28 days is the treatment of choice. Usually, relapse and death are unusual, inadequate treatment is a major factor.

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.