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No abstract available.
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Objective : To describe our preliminary experiences with cordocentesis at Srinagarind HospitalDesing : A describtive studySetting : Srinagarind HospitalPatients : A total of 10 cases of cordocentesis performed from July 1991 to June 1992Measurements : Cordocentesis (Percutaneous umbilical blood sampling under sonographic guidance) for prenatal diagnosis was performed at 18 to 38 weeks of gestation on an outpatient basis without medication. The most common indication was rapid karyotyping in late pregnancy for fetuses at risk of chromosomal abnormalities.Results : Pure fetal blood was obtained 9 of 10 cases. The complications of the procedures were minimal. The most common complications were bleeding at puncture site and transient bradycardia. The laboratory results were reliable.Conclusion : This method would be useful in prenatal diagnosis and therapy of patients in the northestern region of Thailand especially the fetus at risk of severe thalassemic diseases.
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The objective of this project was to study the attitude and general knowledge of Medical students at Khon Kaen University (KKU), Thailand concerning cigarrette smoking. The study examines the relationship between knowledge, attitude to smoking and smoking habits. Certain socio-economic factors known to infulence smoking behaviour were controlled in this study. The population used in this research was the medical students studying in the first and fifth years in the faculty of Medicine, Khon Kaen University, Thailand during the academic year 1987-1988. A total number of 145 responses were returned out of possible 192. The questionnaires were analysed and the chisquared test was used to test the hypothesis. The study shows that most medical students are nonsmokers with less females smoking than males. A relationship was found between knowledge of the effects of smoking and year of study. Fifth year students have greater knowledge than the first years. A relationship was also found between attitude and year of study; the first year medical students had a better attitude than the fifth years. In addition, it was discovered that some specific combinations of attitude and opinion have a relationship with smoking habits (non-smokers, daily and occasionally smokers) at a significance level of P
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There were 423 consecutive pregnant women underwent intrapartum fetal heart rate monitoring at Srinagarind Hospital from January 1985 to December 1986 . Of these 423 tests during the study period 421 (99.5%) were available for study. There was no stillbirth in this series. The incidence of birth asphyxia was 9.1% while the perinatal death rate was 12 per 1000 livebirths. The accuracy of the test in predicing birth asphyxia was 87.4%. Those subjects with positive results had relative risks of 5.3 and 2.6 in developing birth asphyxia and perinatla death respectively. The results of intrapartum fetal heart rate monitoring at Srinagarind Hospital is valid. It can be used to select pregnant women at higher risk in developing fetal distress and birth asphyxia so that special care and appropriate intervention can be taken.
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Two cases of FIGO stage IV , inoperable squamous cell carcinoma of the vulva were given primarily with two courses of chemotherapy. The tumor masses in both cases turned to be operable and radical vulvectomy with groin and pelvic nodes and lymph nodes were free of tumor in the first case while the other one had bilateral lymph nodes involved by the tumor and so radio therapy was given. Both patients were in good health and free of disease at the time of last follow-up
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There were 43 malignant GTD patients who were admitted to Srinagarind Hospital from March 1983 to October 1987. The incidence of the disease was 1 :329 patients (62.8%) had pathological diagnosis of choriocarcinoma and of invasive mole in 22 cases (51.2%) and 5 cases (11.6%) respectively. 28 patients (65.1%) had metastatic disease. The majority of patients had chemotherapy alone. The remission rates of the patients in non-metastatic, low-risk metastatic and high-risk metastatic were 100 , 50 and 36.8% respectively.There were 16 deaths (37.2%) . Only 6 patients (20.7%) visited for follow up examination program completely. The major problems found in this study were the high mortality rate of the patients, the problem of urinary hCG level analysis and the large proportion of patients not attending the follow up program after treatment.
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Background : Thalassemia is a hereditary anemia which is an important health problem of Thailand. About 30-40% of population are carriers while 1% of them are diseases. There were 1,000 thalassemia patients who received medical care at the out patient department of Srinagarind hospital per year. Screening pregnant women for thalassemia carriers or diseases and hemoglobinopathy is one method in controlling thalassemia.Objective : 1. To study the acceptance of screening for thalassemia in first trimester pregnant women. 2. To study the relation of demograpfic factors, history of preterm labor, family history of thalassemia, with screening acceptance and husbands’s acceptance of screenings and analytical.Design : Descriptive studySetting : Obstetric and Gynecology out patient department, Srinagarind Hospital.Subjects : The 299 first trimester pregnant women who had a first prenatal visit between 29 january and 31 July 1996 were chosen for the study.Measurements : Data was collected by questionnaires after the study group had received the information about thalassemia from brochures. The percentage, mean values and Chi-square or Fisher exact test were used for data analysis.Results : The first trimester pregnant women who accepted screening were 295 cases (98.7%). There were no factures that significantly affected acceptance. Of the 155 positive screening pregnant women, 124(80%) had their partner tested. The family income was the factor that affected partners’ acceptance.Conclusions : These results indicate that the acceptance of screening for thalassemia in the first trimester pregnant women including the acceptane of testing their partners when positive screening was high. This could be one of the effective methods in the thalassemia prevention program.
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Background : Prevalence of births with neural tube defect varies geographically. There is no information about this issue in Srinagarind HospitalObjective : To determine trends in birth prevalence of neural tube defects at Srinagarind Hospital during 19881996 and clinical characteristics of affected pregnancies.Design : A retrospective descriptive study.Setting : Department of Obstetrics and Gynecology, Faculty of medicine, Srinagarind Hospital, Khon Kaen University.Subjects : All 44 births affected by neural tube defects from 45,350 total in 1988-1996.Main outcome measures : birth prevalence of individual and all nural tube defects.Results : Among 44 cases of neural tube defects, there were 38 cases of anencephaly, 4 cases of cephalocele and 2 cases of spina bifida. Birth prevalence of neural tube defects was 0.97/1,000 total births with no upward or down ward trend. Birth prevalence of anencephaly, cephalocele and spina bifida were 0.84, 0.09 and 0.04/1,000 total births respectively. Mean gestatinal age at delivery was 38 weeks and 22.7% of all neural tube defects were undiagnosed prenatally.Conclusion : Birth prevalence of neural tube defects at Srinagarind hospital remained relatively stable. To enhance the fall in birth prevalence, the prenatal screening program for neural tube defects such as routine second trimester ultrasonographic screening should be established in the future.Key words : neural tube defects, birth prevalence
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Background : Laparoscopically surgery has become more and more popular during recent years. Srinagarind hospital has been offering laparoscopic hysterectomy since February 1996.Objective : To study patient profiles in the initial 10 cases of laparoscopically assisted vaginal hysterectomy (LAVH) at Srinagarind HospitalStudy design : A retrospective descriptive studySetting : Department of Obstetrics and Gynecology, Faculty of Medicine, Srinagarind Hospital, Khon Kaen UniversitySubjects : 10 cases with LAVH between February 1996 and July 1996Main outcome measures : Operating times, techniques for LAVH, 8 cases were myoma uteri, 2 cases were recurrent DUB. The average operating time was 2 hours 27 minutes DUB. The average operating time was 2 hours 27 minutes per case. One case had torn dome of urinary bladder during surgery, repaired by laparoscopic suturing.Conclustion : LAVH is a new technique for gynecologic surgery. It needs gynecologists with more training and requires further study to determine the effectiveness of the procedureKey words : LAVH
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Background : The prenatal diagnosis of duodenal obstruction enables clinicians to plan proper obstetric management and early postnatal surgical correction.Objective: To present an case report.Results: We report the case of a 38-year-old woman obstetric ultrasound examination at 31 weeks’ gestation because of the large size of her uterus. The examination revealed a single live fetus left whose size was consistent with 31 weeks’ gestation. The fetus had polyhydramnios and the double-bubble sit in its abdomen. Cordocentesis was performed. Chromosomal examination of the fetal blood revealed trisomy 21. Preterm delivery occurred at 34 weeks’ gestation and a baby girl weighing 2,460 grams was delivered vaginally. Surgical correction of the duodenal obstruction was carried out. The cause of the obstruction was an annular pancreas. The baby died on the fifth postoperative day because of sepsis.Conclusion: Ultrasound was show to be a useful diagnostic toll for the prenatal diagnosis of duodenal obstruction. It enabled further management to be properly planed.
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Background : Incidence of births with cleft lip and palate varies geographically. There is no information about this issue at Srinagarind Hospital.Objective : To determine trends in birth incidence of cleft lip and palate at Srinagarind Hospital during 1900-1999 and clinical characteristics of affected pregnancies.Design : A retrospective descriptive study.Setting : Department of Obstetrics and Gynecology, Faculty of Medicine, Srinagarind Hospital, Khon Kaen University.Subjects: All 56 births affected by cleft lip and palate from 51,386 live births during 1900-1999.Main outcome Measures: Birth incidence of cleft lip and palate.Results : Among 50 cases of cleft lip and palate, there were 28 cases of cleft lip with cleft palate, 20 cases of isolated cleft lip and 8 case of isolated cleft palate. Birth incidence of cleft lip and palate was 1.1/1,000 live births with no upward and downward trend. Birth incidence of cleft lip with cleft palate, isolated cleft lip and isolated cleft palate were 0.5,0.4,0.2/1,000 live births respectively. Associated malformations were 17.95% and only 1.8% could be prenatally diagnosed.Conclusion: Birth incidence of cleft lip and palate at Srinagarind Hospital remained relatively stable. The increase of effectiveness in prenatal diagnosis of cleft lip and palate by ultrasound would be useful in counseling, prenatal care and preparation for neonatal care of these congenital anomalies.Key words : Cleft lip and palate, birth incidence.
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Objective: To compare severity of pain and determine side effects from digital examination between using Aloe vera gel and K-Y gel as a lubricant.Material and Method: This study included 400 patients who required per vaginal examination from February 1,1999 to June 30, 1999. Aloe vera gel was used as a lubricant in 200 patients and K-Y gel was used in other 200 patients. Visual analogue scale was used to assess the level of pain during digital examination. Mailing questionnaire was used to evaluate side effects during the first week after examination.Results: There were no significant differences in the level of pain and side effects between using Aloe vera gel and K-Y gel.Conclusion: The level of pain and side effects were not significantly different between using Aloe vera gel and K-Y gel. Therefore, Aloe vera gel should be promoted to be an alternative lubricant for digital examination due to its lower cost.Key words: K-Y gel, Aloe vera gel, lubricant, per vaginal examination
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Background : Partial trisomy 14 is an excess long arm of chromosome 14. It is a rare chrmomosomal aberration but it is associated with several fetal abnormalities. Moreover, it is frequently noted as a cause of havitual abortion. Prenatal diagnosis of this abnormality, therefore, is necessary for proper genetic counseling and patient management.Objective : To report a case with partial trisomy 14. Results : We reported a case, 37 years old, with a past history of 3 consecutive abortions. This 4th pregnant was prenatal diagnosis by amniocentesis at 19 weeks of gestation. Giemsa banding and husband were genetic counseled and decide to terminate. The phenotypic change of fetus at autopsy was a narrow and small chin. Other organs were grossly unremarkable.Conclusion : Prenatal detection of fetal chromosomal of fetal chromosome abnormality is useful for obstetrician and gynecologist to genetic counsel and manage patient appropriately.
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abstract in pdf file
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Objective : To evaluate the prevalence of congenital anomalies at Srinagarind Hospital. Design : Descriptive study by prospective data collection.Setting : Srinagarind Hospital, Khon Kaen University.Subjective : All mothers and their anomalous infants who were born at Srinagarind Hospital between 1st April 1997 and 31st March 1998 . Intervention : Data collection of the anomalous infants and their mothers. Main outcome measures : Prevalence of congenital anomalies .Results : This study revealed a 2.2 percent prevalence of congenital anomalies at Srinagarind Hospital during the study period (120 cases out of 5,420 total births). Among anomalous newborn cases, the male to female ratio was 1.7:1. Seventy eight percent of the anomalous infants were considered malformation . Syndrome, sequence, dysplasia, deformation , association and disruption were found to be 11.7, 5.8, 1.7, 0.8, 0.8 and 0.8 percent respectively. Major and minor congenital anomalies were found to be 64.2 and 35.8 percent respectively. Common major congenital anomalies were the abnormalities of gastrointestinal system, cardiovascular system , chromosomal abnormality , musculoskeletal system and central nervous system respectively. Conclusion : Prevalence of congenital anomalies was not uncommon. To avoid congenital anomalies or provide proper obstetrical management , prenatal diagnosis should be offered in all pregnant women especially in high-risk groups.
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Background : Anemia is the most common hematological disorder in pregnant woman. Early diagnosis and cause identificaion of anemia could be useful for correction and treatment of this condition and subsequently reduction of maternal and neonatal complications.Objective : To assess the prevalence of anemia and risk factors in pregnant women having their first antenatal cares at Srinagarind Hospital. Design : A descriptive and analytical study.Setting : Department of Obstetrics and Gynaecology, Faculty of Medicine, Srinagarind Hospital, Khon Kaen University.Subjects : The total of 464 pregnant women who had their first antenatal care at Srinagarind Hospital form November 1, 1995 to March 31, 1996. Main outcome measures : Hemoglobin level less than 11 g/dl in all gestational age.Results : The prevalence of anemia in pregnant women is 23.49% if the criteria was Hb
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Objective: To determine the prevalence of chlamydial infection in the lower genital tract, patient demographics and reproductive health, among infertile women being treated at Srinagarind Hospital, Khon Kaen University, Thailand.Design: Descriptive studySetting: Infertility Clinic, Department of Obstetrics and Gynecology, Srinagarind Hospital, Khon Kaen University, Thailand.Subjects: Infertile women attending the Clinic between June 2000 and June 2001.Methods: Screening for Chlamydial trachomatis was initiated at Srinagarind Hospital's Infertility Clinic in June 2000. Specimens were taken by endocervical swabs at the first visit from 70 consecutive patients for PCR and GENPROBE testing. Demographic and reproductive health data were recorded.Outcome measurement: The prevalence of chlamydial infection in the lower genital tract in infertile women being treated at the Hospital.Results: The overall chlamydial infection rate was 1.43% (0.04-7.70 95% CI). The average of studied women was 29.6 years. The proportion of primary and secondary infertility was 81.4 and 18.6 %, respectively. The average length of infertility was 4.6 years. Only 28.6% of the consecutive women had previously used contraception of which 85% was a combined contraceptive tablets.Conclusion: The prevalence of chlamydial infection in the lower genital tract of infertile women at Srinagarind Hospital was 1.43%. Keywords: Chlamydial infection; Infertile women